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(DHS/DDD) 54 Kankakee 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14863.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14863.64 0 0 1000076593 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21751.7 0 0 0 0 0 0 0 0 0 0 0 0 0 21751.7 0 0 1000077582 1083982953 24 Speech Therapists DOGADKO AMY B 600624229 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 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 17052.95 17052.95 0 0 1000080634 1861529299 10 Physicians GUEVARA CARLOS J 402324098 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 9 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.35 0 875.52 0 0 0 0 0 0 955.87 0 0 1000081717 92 Waiver 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0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.03 0 0 0 0 0 0 1888.03 0 0 1001158433 1508173329 10 Physicians KMIECIK JOANNA 606071644 200 Cook 0 0 Family Practice 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 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 0 538.26 0 0 0 0 0 0 538.26 0 0 1001158502 1356772743 16 Nurse Practitioners UTOMI HELEN N 606123714 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.18 0 0 0 0 0 0 64.18 0 0 1001158591 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24780 0 0 0 0 0 0 0 0 0 0 0 0 0 24780 0 0 1001159022 1316233265 10 Physicians SANDHU MANPREET K 616151941 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 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1001163397 1902239809 56 School Based / Linked Health Clinics ORR ADOLESCENT HEALTH CENTER 606241063 200 Cook 0 0 0 7 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689.44 0 176.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 865.79 0 0 1001163684 1184057457 30 General Hospitals FRESENIUS MEDICAL CARE LAKEVIE 606132111 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18307.7 0 0 0 0 0 18307.7 0 0 1001163727 1588959548 10 Physicians NEVILLE PATRICK 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 10 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.47 0 6283.69 0 0 0 0 0 0 6404.16 0 0 1001163931 1134469364 16 Nurse Practitioners KUENSTLER MELISSA 624761202 32 Edwards 0 1 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 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paid under an ARS 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34575.93 0 0 0 0 0 34575.93 0 0 1001219129 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19999.1 0 0 0 0 0 0 0 0 0 0 0 0 0 19999.1 0 0 1001219180 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1001220108 1821387150 10 Physicians WILD BRIDGET M. 602011718 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2182.27 0 0 0 0 0 0 2182.27 0 0 1001220275 1376620112 10 Physicians KESAVAN ANIL 606123714 200 Cook 0 0 Pediatrics 0 0 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1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11185.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11185.31 0 0 1001592884 91 Waiver service provider--Adults (DHS/DDD) 35 Ford 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.6 0 0 1001593065 1154508570 10 Physicians DIHU JAMIL 600313358 57 Lake 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 826.99 0 0 0 0 0 0 826.99 0 0 1001593077 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22833.77 0 0 0 0 0 0 0 0 0 0 0 0 0 22833.77 0 0 1001593896 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 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0 0 0 11 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.09 0 3071.49 0 0 0 0 3204.58 0 0 1001596154 1235246109 65 Independent Diagnostic Testing Facility (IDTF) SONOGRAPHIC IMAGES INC 464021703 815 Indiana 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1572.8 0 0 0 0 0 0 0 0 1572.8 0 0 1001596584 1790031409 24 Speech Therapists ERICKSON KATIE M 609014544 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32286.06 32286.06 0 0 1001597052 1295022283 10 Physicians PUTMAN MARGARET 604532600 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2985.62 0 0 0 0 0 0 2985.62 0 0 1001597749 10 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0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 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 20217.94 0 0 0 0 0 0 0 0 0 0 0 0 0 20217.94 0 0 1001602439 1275730863 22 Physical Therapists FERGUSON ANNE 463221631 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39575.43 39575.43 0 0 1001602518 1255646857 40 Federally Qualified Health Centers ALIVIO MED CTR BERWYN 604022311 200 Cook 0 1 0 230 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 674 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 674 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49039.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49039.58 0 0 1001603123 1619026135 10 Physicians MAJCINA RYAN 627949639 91 Sangamon 0 0 Pediatrics 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 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 16104.75 0 0 0 0 0 0 16104.75 0 0 1001603252 1477986743 30 General Hospitals FRESENIUS MED ROLLING MEADOWS 600081375 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 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1974 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57800.67 0 0 0 0 0 57800.67 0 0 1001603742 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28377.52 0 0 0 0 0 0 0 0 0 0 0 0 0 28377.52 0 0 1001603822 1720306640 10 Physicians FOLMSBEE CASPIAN 606751611 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 4059.1 0 0 0 0 0 0 4065.4 0 0 1001604663 1093075590 11 Dentists DAVE ABDUL 604031881 107 Will 0 0 General Dentistry 0 0 59 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 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1001651821 1568538387 30 General Hospitals PRESENCE SAINT JOSEPH HOSPITAL 601234912 53 Kane DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 1 4 0 0 982 0 0 0 0 278 0 0 0 604 0 0 0 0 0 2 48 0 0 1499 0 0 0 0 307 0 0 0 1306 0 0 0 0 0 2 48 0 0 1499 0 0 0 0 1686 0 0 0 1350 0 0 0 0 0 76.08 9158.3 0 0 185070.91 0 0 0 0 735091.27 0 0 0 217779.88 0 0 0 0 0 1147176.44 0 0 1001651900 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 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 9551.98 0 0 0 0 0 0 0 0 0 0 0 0 0 9551.98 0 0 1001652903 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1001653086 10 Physicians 815 Indiana 0 0 Clinical Pathology 0 0 0 0 0 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 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(DHS/DRS) 91 Sangamon 0 0 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 0 667.96 0 0 0 0 0 0 0 0 0 0 0 0 0 667.96 0 0 1003177192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23843.56 0 0 0 0 0 0 0 0 0 0 0 0 0 23843.56 0 0 1003177323 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16687 0 0 0 0 0 0 0 0 0 0 0 0 0 16687 0 0 1003177335 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 78.09 0 0 1003179265 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 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facility (DHS) JACK MABLEY DEVELOPMENTAL CTR 610211258 60 Lee 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 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29952213.54 0 0 0 0 0 0 0 0 0 0 29952213.54 0 0 1003876819 1003077900 10 Physicians CHAUDHRY FARRUKH 999999999 30 DuPage 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 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 3749.93 0 0 0 0 0 0 3749.93 0 0 1003877023 1487674545 89 Physician Assistant Only(Encounter Only) ANDERSON KATHLEEN E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.1 0 0 0 0 0 0 92.1 0 0 1003877088 89 Physician Assistant Only(Encounter Only) 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 1003879156 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23187.47 0 0 0 0 0 0 0 0 0 0 0 0 0 23187.47 0 0 1003879252 1104216993 16 Nurse Practitioners SMITH TAMARA 604405125 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615.14 0 0 0 0 0 0 615.14 0 0 1003879308 1629266770 10 Physicians BLATNIK JEFFREY A 999999999 826 Missouri 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1245.75 0 0 0 0 0 0 1245.75 0 0 1003879371 1730565870 16 Nurse Practitioners WILLER SUSAN M 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1483.23 0 0 0 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0 0 0 0 2268.41 0 0 0 0 0 0 2268.41 0 0 1003880576 12 Optometrists 200 Cook 0 0 0 0 0 0 0 0 0 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 50.89 0 0 0 0 0 0 50.89 0 0 1003880719 1992910954 10 Physicians VALIKA AZIZ 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2081.39 0 0 0 0 0 0 2081.39 0 0 1003880862 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11623.49 0 0 0 0 0 0 0 0 0 0 0 0 0 11623.49 0 0 1003880875 1497020234 16 Nurse Practitioners HATHCOCK VIRGINIA 379321983 66 Marion 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 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 0 318.91 0 0 0 0 0 0 318.91 0 0 1003880990 10 Physicians 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2652.29 0 0 0 0 0 0 2652.29 0 0 1003881190 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13357.74 0 0 0 0 0 0 0 0 0 0 0 0 0 13357.74 0 0 1003881326 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48716.6 0 0 0 0 0 0 0 0 0 0 0 0 0 48716.6 0 0 1003881362 1366569345 10 Physicians REDDY SWATHY 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397.5 0 0 0 0 0 0 1397.5 0 0 1003881451 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14118.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14118.02 0 0 1003881483 1154705093 87 Psychologist(Encounter Only) BEIN LAURA A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 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 4264.24 0 0 0 0 0 0 4264.24 0 0 1003881584 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16660.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16660.35 0 0 1003881642 1710374988 16 Nurse Practitioners CHARO KIMBERLY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.2 0 0 0 0 0 0 70.2 0 0 1003881656 1790975837 10 Physicians LEVIN BENJAMIN R 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.13 0 2072.56 0 0 0 0 0 0 2286.69 0 0 1003881906 1396761441 89 Physician Assistant Only(Encounter Only) COLLINS RASHONDA 946081844 30 DuPage 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611.39 0 0 0 0 0 0 611.39 0 0 1003881953 1003864240 89 Physician Assistant Only(Encounter Only) WILLNER DEBORAH J 999999999 80 Peoria 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 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 0 230.33 0 0 0 0 0 0 230.33 0 0 1003882253 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11127.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11127.2 0 0 1003882400 1881947679 10 Physicians KHAN AMNA 999999999 200 Cook 0 1 Pediatrics 0 0 0 133 0 0 0 0 0 0 16 0 82 0 0 0 0 0 0 0 0 0 372 0 0 0 0 0 0 20 0 113 0 0 0 0 0 0 0 0 0 372 0 0 0 0 0 0 20 0 113 0 0 0 0 0 0 0 0 0 12992.66 0 0 0 0 0 0 258.44 0 6171.78 0 0 0 0 0 0 19422.88 0 0 1003882496 1679830293 10 Physicians SYED SAIRA 999999999 200 Cook 0 0 Pediatrics 0 0 0 25 0 0 0 0 0 0 9 0 23 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 14 0 40 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 14 0 40 0 0 0 0 0 0 0 0 0 2442.53 0 0 0 0 0 0 503.82 0 1673.03 0 0 0 0 0 0 4619.38 0 0 1003882686 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.99 0 0 0 0 0 0 25.99 0 0 1003882708 1841589843 10 Physicians SHOENER JALENE 999999999 200 Cook 0 0 Pediatrics 0 0 0 21 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 1843.93 0 0 0 0 0 0 0 0 7593.01 0 0 0 0 0 0 9436.94 0 0 1003882887 1720476914 16 Nurse Practitioners MILLER JOSEPH 629023988 47 Jackson 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.49 0 0 0 0 0 0 1074.49 0 0 1003882917 1427425248 75 Department of Alcohol and Substance Abuse Provider BRIDGEWAY INC. 999999999 102 Warren 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2366.39 0 0 2366.39 0 0 1003883047 1124315494 10 Physicians MORRIS STEPHANIE 999999999 91 Sangamon 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.24 0 0 0 0 0 0 209.24 0 0 1003883057 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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JESSICA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347.56 0 0 0 0 0 0 347.56 0 0 1003907273 1235118662 89 Physician Assistant Only(Encounter Only) LASHWAY KIMBERLY J 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.03 0 0 0 0 0 0 212.03 0 0 1003907279 1114318136 16 Nurse Practitioners STEWART LA''SHEAH M 999999999 200 Cook 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200.03 0 0 0 0 0 0 200.03 0 0 1003907339 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.21 0 0 0 0 0 0 0 0 8.21 0 0 1003907482 1518301399 10 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Physicians JEFFRIES JESSICA L 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.88 0 1392.92 0 0 0 0 0 0 1403.8 0 0 1003914695 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1003914772 1780930248 10 Physicians ANTONIOLLI MICHAEL 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.75 0 6437.41 0 0 0 0 0 0 6448.16 0 0 1003914777 1316343098 16 Nurse Practitioners HENRY JAMIE 606751611 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.96 0 0 0 0 0 0 26.96 0 0 1003914945 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278.4 0 0 1003915380 1720303381 10 Physicians BUCHCIC BARTOSZ A 601228942 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3915.25 0 0 0 0 0 0 3915.25 0 0 1003915561 16 Nurse Practitioners 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.32 0 0 0 0 0 0 0.32 0 0 1003915648 1942386529 86 Clinical Social Worker(Encounter Only) SWEET MICHELLE 999999999 19 Champaign 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628.46 0 0 0 0 0 0 628.46 0 0 1003916191 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10416 0 0 0 0 0 0 0 0 0 0 0 0 0 10416 0 0 1003916310 1417209933 10 Physicians RAVINDRAN SRIKANTH 606800618 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1735 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1735 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11660.09 0 0 0 0 0 0 11660.09 0 0 1003916343 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003916451 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22822.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22822.5 0 0 1003916675 1811201213 10 Physicians RAGHU PADMANABHAN 606123714 200 Cook 0 0 Internal Medicine 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 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 1081.48 0 0 0 0 0 0 1081.48 0 0 1003916745 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232.78 232.78 0 0 1003916765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20541.29 0 0 0 0 0 0 0 0 0 0 0 0 0 20541.29 0 0 1003916845 1376922302 11 Dentists CHOI JACOB 604112323 200 Cook 0 0 General Dentistry 0 0 269 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1347 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 1347 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 41256.39 0 0 0 0 0 0 0 0 0 0 0 4713.3 0 0 0 0 45969.69 0 0 1003917070 1609108018 88 Other behavior health professional ENGELMANN JILL 999999999 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2423.86 0 0 0 0 0 0 2423.86 0 0 1003917166 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6828.59 0 0 0 0 0 0 0 0 0 0 0 0 0 6828.59 0 0 1003917175 1205230844 48 Rural Health Clinics CARLE AT TUSCOLA 619532014 29 Douglas 0 1 0 239 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18143.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18143.34 0 0 1003917291 1801252531 36 Community mental health provider CENTERSTONE OF ILLINOIS 999999999 65 Madison 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 53.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154988.88 0 0 155042.76 0 0 1003917439 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6439 0 0 0 0 0 0 0 0 0 0 0 0 0 6439 0 0 1003917478 1528332632 10 Physicians NAAMAN SANDRA 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.03 0 0 0 0 0 0 113.03 0 0 1003917583 1295942670 10 Physicians VORA AVNI 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719.05 0 0 0 0 0 0 719.05 0 0 1003917667 1326330267 10 Physicians KARSEN ETHAN F. 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 895.03 0 0 0 0 0 0 895.03 0 0 1003917822 1437561040 89 Physician Assistant Only(Encounter Only) PATEL AMISHA 999999999 19 Champaign 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588.53 0 0 0 0 0 0 588.53 0 0 1003918033 1295118420 11 Dentists NAHHAS NOOR 999999999 200 Cook 0 0 General Dentistry 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14750.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14750.34 0 0 1003918344 89 Physician Assistant Only(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003918877 1982076444 28 Waiver service provider--Supportive living facility (HFS) GRAND REGENCY SOUTH SHORE 606493963 200 Cook 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561663.51 0 0 0 0 0 0 0 0 0 0 0 0 0 561663.51 0 0 1003918926 1962668590 89 Physician Assistant Only(Encounter Only) IRBY LAURA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925.7 0 0 0 0 0 0 925.7 0 0 1003919275 1619137346 10 Physicians GUPTA ARIKA 606116649 200 Cook 0 0 Pediatrics 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12735.16 0 0 0 0 0 0 12735.16 0 0 1003919306 1093820045 89 Physician Assistant Only(Encounter Only) KARG MICHAEL P 999999999 109 Winnebago 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 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 1994.06 0 0 0 0 0 0 1994.06 0 0 1003919383 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10544.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10544.6 0 0 1003919422 1396127890 10 Physicians PILYUYKO POLINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.6 0 2876.82 0 0 0 0 0 0 2889.42 0 0 1003919640 1700115789 10 Physicians KUNER ANTHONY 535625531 109 Winnebago 0 0 Radiology Diagnosis 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 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 1021.87 0 0 0 0 0 0 0 0 1021.87 0 0 1003920392 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 17331.72 0 0 0 0 0 0 0 0 0 0 0 0 0 17331.72 0 0 1003920441 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003920529 1659303063 87 Psychologist(Encounter Only) JEDD DEBRA 999999999 19 Champaign 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 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 1324.97 0 0 0 0 0 0 1324.97 0 0 1003921322 1306174008 10 Physicians POTTS MATHEW B. 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7824.8 0 0 0 0 0 0 7824.8 0 0 1003921401 1386055531 16 Nurse Practitioners COSTANTINI HOLLY BETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.82 0 0 0 0 0 0 114.82 0 0 1003921553 1801175823 10 Physicians SWARY JILLIAN 999999999 200 Cook 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 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 0 419.33 0 0 0 0 0 0 419.33 0 0 1003921631 1972615920 89 Physician Assistant Only(Encounter Only) BOWEN JEREMY S 628013655 66 Marion 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602.84 0 0 0 0 0 0 602.84 0 0 1003921649 10 Physicians 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.06 0 0 0 0 0 0 19.06 0 0 1003922037 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 124.04 0 0 0 0 0 0 124.04 0 0 1003922073 1003137522 10 Physicians AVERILL SARAH L 522421009 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 8 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.53 0 14.69 0 0 0 0 0 0 114.22 0 0 1003922426 1437299724 10 Physicians BOBO ANDRE 629011474 47 Jackson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 39 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102.04 0 9857.11 0 0 0 0 0 0 11959.15 0 0 1003922679 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16718.81 0 0 0 0 0 0 0 0 0 0 0 0 0 16718.81 0 0 1003923248 1942616594 16 Nurse Practitioners MAKINA MARGARET J 604631256 200 Cook 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 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 0 916.6 0 0 0 0 0 0 916.6 0 0 1003923753 1629268537 10 Physicians KOWALSKI ADAM 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.14 0 0 0 0 0 0 0 0 442.14 0 0 1003924082 1992068423 10 Physicians BHANDARI NIYATI P. 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376.02 0 0 0 0 0 0 376.02 0 0 1003924115 1558503318 10 Physicians MULUMBA SINDY 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 10 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.77 0 1976.78 0 0 0 0 0 0 2175.55 0 0 1003924121 1184092819 16 Nurse Practitioners LECRONE KRISTINA A 999999999 101 Wabash 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 1881.97 0 0 0 0 0 0 1986.93 0 0 1003924149 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629.3 0 0 0 0 0 0 0 0 0 0 0 0 0 629.3 0 0 1003924249 89 Physician Assistant Only(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.1 0 0 0 0 0 0 53.1 0 0 1003924374 1477690873 30 General Hospitals ST BERNARD HOSPITAL 606213114 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 3 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 884 0 0 0 0 0 0 0 0 0 0 4438.85 0 0 0 0 0 0 0 430689.05 0 0 0 0 0 0 0 0 0 435127.9 0 0 1003924380 1689057481 11 Dentists THEOBALD TIMOTHY 600642801 57 Lake 0 0 General Dentistry 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11897.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11897.39 0 0 1003924474 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3341.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3341.6 0 0 1003924487 1376953042 12 Optometrists ISGRIG JONATHAN R 999999999 100 Vermilion 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 0 119 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 1661.65 0 0 0 0 0 0 1661.65 0 0 1003924557 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1003924605 1740351543 10 Physicians RUNYAN STEPHANIE D 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 19 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 673.27 0 0 0 0 0 0 0 0 673.27 0 0 1003924682 1891123519 89 Physician Assistant Only(Encounter Only) WHETSTONE JARED 999999999 91 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JOLANTA 606313222 200 Cook 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 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 0 341.74 0 0 0 0 0 0 341.74 0 0 1003925990 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.19 0 0 0 0 0 0 310.19 0 0 1003926251 1710299946 10 Physicians MACRIE BRYAN D 999999999 91 Sangamon 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.54 0 146.66 0 0 0 0 0 0 157.2 0 0 1003926542 1902041924 89 Physician Assistant Only(Encounter Only) MCMAHON JEANNE A 999999999 200 Cook 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 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736.66 0 0 0 0 0 0 736.66 0 0 1003926552 1669706057 89 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0 0 0 0 0 1418.58 0 0 1003926843 1700925930 52 Certified local public health department KANKAKEE COUNTY HEALTH DEPT 999999999 54 Kankakee 0 0 0 191 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3060.46 0 3381.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6441.79 0 0 1003926848 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14650.87 0 0 0 0 0 0 0 0 0 0 0 0 0 14650.87 0 0 1003926865 24 Speech Therapists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 298.88 298.88 0 0 1003926884 1881057313 16 Nurse Practitioners FILL HEATHER 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4371.48 0 0 0 0 0 0 4371.48 0 0 1003929162 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23791.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23791.52 0 0 1003929192 1508221003 16 Nurse Practitioners MITCHELL SOFIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4150.83 0 0 0 0 0 0 4150.83 0 0 1003929343 1093172132 16 Nurse Practitioners LEEBERG KENNETH C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.48 0 0 0 0 0 0 231.48 0 0 1003929447 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 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Practitioners TRAN LORENA 605063814 53 Kane 0 0 0 0 0 3 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 1140.48 0 0 0 0 0 0 1236.93 0 0 1003931350 1477576114 87 Psychologist(Encounter Only) KRIPPNER KEVIN M 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.25 0 0 0 0 0 0 180.25 0 0 1003931357 10 Physicians 19 Champaign 0 0 Occupational Medicine 0 0 0 0 0 0 0 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 0 117.2 0 0 0 0 0 0 117.2 0 0 1003931383 1598911505 10 Physicians VERCILLO MICHAEL S 999999999 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281.06 0 0 0 0 0 0 281.06 0 0 1003931393 10 Physicians 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003931416 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32908.24 0 0 0 0 0 0 0 0 0 0 0 0 0 32908.24 0 0 1003931705 1467616193 10 Physicians JAHROMI BABAK S 999999999 53 Kane 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 8 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.35 0 7681.82 0 0 0 0 0 0 7703.17 0 0 1003931738 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 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 39747.11 0 0 0 0 0 0 0 0 0 0 0 0 0 39747.11 0 0 1003931792 1891168878 33 Nursing Facilities APERION 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0 0 0 0 0 0 0 665.65 0 0 0 0 0 0 665.65 0 0 1003934127 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26169.44 0 0 0 0 0 0 0 0 0 0 0 0 0 26169.44 0 0 1003934172 10 Physicians 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003934498 1114316288 30 General Hospitals CRYSTAL SPRINGS DIALYSIS 999999999 71 McHenry DIALYSIS Outpatient dialysis centers. 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18408.87 0 0 0 0 0 18408.87 0 0 1003934539 28 Waiver service provider--Supportive living facility (HFS) 104 Wayne 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 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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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4174.86 0 0 0 0 0 0 4174.86 0 0 1003936215 1528460383 11 Dentists HAFEEZ SABEEN 601602039 200 Cook 0 0 General Dentistry 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36732.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36732.56 0 0 1003936402 1134296916 10 Physicians AHMAD TABASSUM 999999999 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.36 0 64.41 0 0 0 0 0 0 84.77 0 0 1003936738 1841618998 16 Nurse Practitioners HYLAND DINARA 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 499.86 0 0 0 0 0 0 506.26 0 0 1003937117 10 Physicians 826 Missouri 0 0 0 0 0 0 0 0 0 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 52.71 0 0 0 0 0 0 52.71 0 0 1003937439 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003937503 1053783522 91 Waiver service provider--Adults (DHS/DDD) "AT HOME MISSION, NFP" 999999999 200 Cook 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 4742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 865657.24 0 0 0 0 0 0 0 0 0 0 0 0 0 865657.24 0 0 1003937544 1811246697 89 Physician Assistant Only(Encounter Only) HEGENER KATHRYN J. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 0 288.11 0 0 0 0 0 0 288.11 0 0 1003937680 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24847.71 0 0 0 0 0 0 0 0 0 0 0 0 0 24847.71 0 0 1003937740 91 Waiver service provider--Adults (DHS/DDD) 104 Wayne 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47705.28 0 0 0 0 0 0 0 0 0 0 0 0 0 47705.28 0 0 1003937924 1396852638 10 Physicians MCCAFFREY THOMAS J 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7543.44 0 0 0 0 0 0 7543.44 0 0 1003938003 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 547.87 0 0 0 0 0 0 547.87 0 0 1003938541 1649656430 91 Waiver service provider--Adults (DHS/DDD) SAZE COMMUNITY SERVICES INC 999999999 57 Lake 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596448.57 0 0 0 0 0 0 0 0 0 0 0 0 0 596448.57 0 0 1003938558 1124381769 10 Physicians RAVENNA PAUL A 606118709 200 Cook 0 0 Family Practice 0 0 0 20 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 1733.29 0 0 0 0 0 0 0 0 4863.2 0 0 0 0 0 0 6596.49 0 0 1003938606 1013268812 89 Physician Assistant Only(Encounter Only) LEESON SANDRA J. 999999999 200 Cook 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 0 371.9 0 0 0 0 0 0 371.9 0 0 1003938613 1982030649 16 Nurse Practitioners LEVIN RODION 600043023 200 Cook 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 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 0 841.77 0 0 0 0 0 0 841.77 0 0 1003938615 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 221.4 0 0 0 0 0 0 0 0 0 0 0 0 0 221.4 0 0 1003938621 1588893473 10 Physicians SHARMA ARJUN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 315 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6355.9 0 208.43 0 0 0 0 0 0 6564.33 0 0 1003938647 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12633.69 0 0 0 0 0 0 0 0 0 0 0 0 0 12633.69 0 0 1003938776 1801102058 10 Physicians GARCIA MARLON 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003938805 1376849109 10 Physicians HALL EMILY 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 89.1 0 0 0 0 0 0 0 0 5910.53 0 0 0 0 0 0 5999.63 0 0 1003938811 1699940932 10 Physicians RINGWALA SUKIT M. 999999999 200 Cook 0 0 Internal Medicine 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 0 110 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 0 768.88 0 0 0 0 0 0 768.88 0 0 1003938881 1619018991 89 Physician Assistant Only(Encounter Only) STILLWELL ERIN 999999999 53 Kane 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 0 234 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 1041.65 0 0 0 0 0 0 1041.65 0 0 1003939022 1316311269 89 Physician Assistant Only(Encounter Only) LONGMAN MELISSA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.67 0 0 0 0 0 0 195.67 0 0 1003939259 1245620855 16 Nurse Practitioners NICHOLAS OLGA 22417438 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314.07 0 0 0 0 0 0 314.07 0 0 1003939453 1710345335 16 Nurse Practitioners ARMES TRISTA K 999999999 21 Clark 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.7 0 0 0 0 0 0 135.7 0 0 1003939812 1023243334 10 Physicians OKON STANLEY 999999999 200 Cook 0 0 Psychiatry 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 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4351.71 0 0 0 0 0 0 4351.71 0 0 1003939906 1720309826 10 Physicians WALLIS BENJAMIN SCOTT 605638113 30 DuPage 0 0 Anesthesiology 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 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 2173.7 0 0 0 0 0 0 2173.7 0 0 1003939994 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.51 0 0 0 0 0 0 45.51 0 0 1003940026 1003960394 34 State-operated facility (DHS) WARREN G MURRAY DEV CENTER 999999999 66 Marion 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66461 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62979855.1 0 0 0 0 0 0 0 0 0 0 62979855.1 0 0 1003940101 1912395047 16 Nurse Practitioners MCGUIRE PATRICK 616151941 80 Peoria 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 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 0 739.25 0 0 0 0 0 0 739.25 0 0 1003940104 1245268127 10 Physicians BOND WILLIAM F. 999999999 80 Peoria 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 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 1146.45 0 0 0 0 0 0 1146.45 0 0 1003940134 1609950807 89 Physician Assistant Only(Encounter Only) PAJEAU NICHELLE 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 1630.13 0 0 0 0 0 0 1735.09 0 0 1003940301 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 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 1070.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1070.1 0 0 1003940518 1194024620 10 Physicians GO KEVIN 600475292 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3458.75 0 0 0 0 0 0 3458.75 0 0 1003940687 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.5 0 0 0 0 0 0 48.5 0 0 1003940709 1386909125 10 Physicians ANDREW EMILY K. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.97 0 0 0 0 0 0 193.97 0 0 1003940775 1013089697 16 Nurse Practitioners HOLLEY LINDA 999999999 107 Will 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 0 147 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 1383.41 0 0 0 0 0 0 1383.41 0 0 1003940787 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10767.16 0 0 0 0 0 0 0 0 0 0 0 0 0 10767.16 0 0 1003941012 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 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 97.68 0 0 0 0 0 0 0 0 0 0 0 0 0 97.68 0 0 1003941277 1154697027 10 Physicians GARGIULO RICHARD T 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 862.69 0 0 0 0 0 0 874.71 0 0 1003941523 1578950101 16 Nurse Practitioners CASWELL KAYLIE 627949639 91 Sangamon 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3019.98 0 0 0 0 0 0 3019.98 0 0 1003941685 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16960.72 0 0 0 0 0 0 0 0 0 0 0 0 0 16960.72 0 0 1003941871 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6961.07 0 0 0 0 0 0 0 0 0 0 0 0 0 6961.07 0 0 1003942042 1235524711 16 Nurse Practitioners RIVETTE MELISSA 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.63 0 0 0 0 0 0 78.63 0 0 1003942157 1427206689 10 Physicians QUINTEROS FRANCISCO 606576211 200 Cook 0 0 Surgery General 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 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10633.98 0 0 0 0 0 0 10633.98 0 0 1003942311 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24310.11 0 0 0 0 0 0 0 0 0 0 0 0 0 24310.11 0 0 1003942338 1871843946 10 Physicians GAGLIARDI GIUSEPPE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.54 0 1403.32 0 0 0 0 0 0 1443.86 0 0 1003942767 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17266.26 0 0 0 0 0 0 0 0 0 0 0 0 0 17266.26 0 0 1003943361 1922495050 16 Nurse Practitioners BISHOP MARGARET E 117474300 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 984.62 0 0 0 0 0 0 984.62 0 0 1003943514 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15038.08 0 0 0 0 0 0 0 0 0 0 0 0 0 15038.08 0 0 1003943613 1700269974 11 Dentists BALOCH WASAN 999999999 200 Cook 0 0 General Dentistry 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13813.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13813.76 0 0 1003943625 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 24830.94 0 0 0 0 0 0 0 0 0 0 0 0 0 24830.94 0 0 1003943647 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24613.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24613.2 0 0 1003943736 1437393816 10 Physicians KURZ JONATHAN 999999999 200 Cook 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 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 1239.08 0 0 0 0 0 0 1239.08 0 0 1003943743 87 Psychologist(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 0 0 0 0 0 0 0 0 0 1003943758 1104180173 10 Physicians PASTEUR NICHOLAS A 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500.13 0 0 0 0 0 0 500.13 0 0 1003943859 1891921029 10 Physicians BYRAM SUSANNA 601545716 200 Cook 0 0 Anesthesiology 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 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 1455.97 0 0 0 0 0 0 1455.97 0 0 1003944106 1417267832 16 Nurse Practitioners FINNEGAN HEATHER 616151941 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3107.21 0 0 0 0 0 0 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Surgical Treatment Centers METROEAST ENDOSCOPIC SURGERY C 999999999 96 St Clair 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 0 159 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 10628.84 0 0 0 0 0 10628.84 0 0 1003945074 1528324795 10 Physicians HORVATH EMILY M 616151941 80 Peoria 0 0 Internal Medicine 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 0 111 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 0 424.19 0 0 0 0 0 0 424.19 0 0 1003945146 1144680620 16 Nurse Practitioners JONES ROBSON EMILY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 823.35 0 0 0 0 0 0 823.35 0 0 1003945390 1740545763 10 Physicians GADBOIS STEPHANIE 999999999 63 Macon 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 10 0 23 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 18 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 18 0 30 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1081.68 0 0 0 0 0 0 1113.83 0 0 1003945427 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 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 5752.98 0 0 0 0 0 0 0 0 0 0 0 0 0 5752.98 0 0 1003945429 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945.25 0 0 0 0 0 0 945.25 0 0 1003945597 1194118687 22 Physical Therapists ALTGILBERS KELLY J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.86 1132.86 0 0 1003945696 1821493768 16 Nurse Practitioners REANEY NOREEN 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 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 35 0 0 0 0 0 0 0 0 0 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Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.6 0 8999.19 0 0 0 0 0 0 9051.79 0 0 1003947982 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5251.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5251.4 0 0 1003948495 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.81 0 0 0 0 0 0 137.81 0 0 1003948526 1467521146 30 General Hospitals SSM HEALTH ST JOSEPH HOSPITAL 999999999 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 25 0 0 0 0 21 0 0 0 16 0 0 0 0 0 0 0 0 0 28 0 0 0 0 25 0 0 0 31 0 0 0 0 0 0 0 0 0 28 0 0 0 0 381 0 0 0 31 0 0 0 0 0 0 0 0 0 3116.67 0 0 0 0 61298.99 0 0 0 761.7 0 0 0 0 0 65177.36 0 0 1003948822 1508108531 10 Physicians VERA DANER DENNYS 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9390.39 0 0 0 0 0 0 9390.39 0 0 1003948993 1275900656 16 Nurse Practitioners BOURGET CHRISTOPHER 999999999 23 Clinton 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 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 2340.64 0 0 0 0 0 0 2340.64 0 0 1003949275 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 92.52 0 0 0 0 0 0 92.52 0 0 1003949411 1144431925 10 Physicians MALIK MOHAMMAD 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 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T 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 6 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 34 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 34 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 93.56 0 3015.18 0 0 0 0 0 0 3115.14 0 0 1003963801 12 Optometrists 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003963874 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11696.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11696.3 0 0 1003964006 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1003964090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 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Dentists KIM ILSOON 617272914 28 De Witt 0 0 General Dentistry 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17862.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17862.99 0 0 1003965116 1528350865 10 Physicians AGUINALDO ELAINE TUASSON 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4606.07 0 0 0 0 0 0 4606.07 0 0 1003965130 1396069886 87 Psychologist(Encounter Only) ROSENBERG JANINE 606770001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1626.8 0 0 0 0 0 0 1626.8 0 0 1003965823 1699173013 61 Independent Laboratories AMERICAN MEDICAL LAB LTD 604551822 200 Cook 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 0 958 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958 0 0 0 0 0 0 0 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1003970526 1972975480 16 Nurse Practitioners ODIGIE JOAN 999999999 200 Cook 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1403.76 0 0 0 0 0 0 1403.76 0 0 1003970663 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.08 0 0 0 0 0 0 143.08 0 0 1003970991 92 Waiver service provider--Disability (DHS/DRS) 29 Douglas 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17232.1 0 0 0 0 0 0 0 0 0 0 0 0 0 17232.1 0 0 1003971005 1811971559 10 Physicians ALI NAHEED 49155500 200 Cook 0 0 Internal Medicine 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 0 110 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 0 426.98 0 0 0 0 0 0 426.98 0 0 1003971656 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1497116750 16 Nurse Practitioners HEISCHMIDT WHITNEY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2072.07 0 0 0 0 0 0 2072.07 0 0 1003976375 1497181697 40 Federally Qualified Health Centers LEGACY MEDICAL CARE INC 600051529 200 Cook 0 1 0 436 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498 0 780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498 0 780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135339.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135339.34 0 0 1003976435 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22898.82 0 0 0 0 0 0 0 0 0 0 0 0 0 22898.82 0 0 1003976743 1518266576 16 Nurse Practitioners RIECHES BETH 999999999 13 Boone 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.34 0 0 0 0 0 0 54.34 0 0 1003977334 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24717.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24717.81 0 0 1003977539 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32541.12 0 0 0 0 0 0 0 0 0 0 0 0 0 32541.12 0 0 1003977685 1962891739 10 Physicians BRUKSCH KATHERINE 604023429 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.99 0 150.48 0 0 0 0 0 0 204.47 0 0 1003978424 91 Waiver service provider--Adults (DHS/DDD) 27 Dekalb 0 0 0 0 0 0 0 1 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 23467.62 0 0 0 0 0 0 0 0 0 0 0 0 0 23467.62 0 0 1003978616 1659682524 10 Physicians BROOKS JUSTIN 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 961 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1534 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1534 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16980.31 0 101.92 0 0 0 0 0 0 17082.23 0 0 1003978814 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21761.13 0 0 0 0 0 0 0 0 0 0 0 0 0 21761.13 0 0 1003978990 1366565962 60 Pharmacies BUBBLEPACK PHARMACY INC 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147934.48 0 0 0 147934.48 0 0 1003979068 1275930414 16 Nurse Practitioners KIOUTAS ALLISON C 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.66 0 0 0 0 0 0 165.66 0 0 1003979143 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.05 0 0 0 0 0 0 0 0 100.05 0 0 1003979148 10 Physicians 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171.81 0 0 0 0 0 0 171.81 0 0 1003979267 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7930.53 0 0 0 0 0 0 0 0 0 0 0 0 0 7930.53 0 0 1003979698 1073745188 10 Physicians ARYA RAHUL 606751186 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 176 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.16 0 2026.3 0 0 0 0 0 0 3881.46 0 0 1003979947 1518115526 10 Physicians ARGENTO ANGELA C. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.35 0 1954.2 0 0 0 0 0 0 1984.55 0 0 1003980139 1487862652 10 Physicians POSLUSZNY JOSEPH 606910263 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7996.99 0 0 0 0 0 0 7996.99 0 0 1003980206 1548300395 10 Physicians HILGERS MARC P 606313222 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 7 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.28 0 1258.79 0 0 0 0 0 0 1343.07 0 0 1003980357 1689652455 10 Physicians DAMMANN GREGORY G 999999999 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 35 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.3 0 9766.21 0 0 0 0 0 0 9933.51 0 0 1003980429 1396037685 16 Nurse Practitioners GUILLAUME DIANA 999999999 200 Cook 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 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 0 356.09 0 0 0 0 0 0 356.09 0 0 1003980718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23034.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23034.55 0 0 1003980956 1346356524 89 Physician Assistant Only(Encounter Only) LISENBY CATHY 628013655 66 Marion 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1214.22 0 0 0 0 0 0 1214.22 0 0 1003981194 1538433438 10 Physicians RUTILI LAUREN K 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376.7 0 0 0 0 0 0 376.7 0 0 1003981416 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25974.9 0 0 0 0 0 0 0 0 0 0 0 0 0 25974.9 0 0 1003981690 1245618016 33 Nursing Facilities SYMPHONY OF LINCOLN PARK 606142129 200 Cook 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 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732228.7 0 0 0 0 0 0 0 1732228.7 0 0 1003981716 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003981817 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 0 0 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 0 668.64 0 0 0 0 0 0 0 0 0 0 0 0 0 668.64 0 0 1003981989 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1503.54 0 0 0 0 0 0 1503.54 0 0 1003981999 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751.25 0 0 0 0 0 0 751.25 0 0 1003982172 1538471099 10 Physicians HOPPING JACOB 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6103.04 0 0 0 0 0 0 6103.04 0 0 1003982483 1306207733 16 Nurse Practitioners BLASH TIA-MONIQUE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667.36 0 0 0 0 0 0 667.36 0 0 1003982493 1922328624 10 Physicians MURPHY DANIEL PATRICK 999999999 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365.3 0 0 0 0 0 0 365.3 0 0 1003982635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24973.61 0 0 0 0 0 0 0 0 0 0 0 0 0 24973.61 0 0 1003983556 1336172014 10 Physicians AL-AHDAB MOHAMAD 605152049 30 DuPage 0 0 Pediatrics 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3808.43 0 0 0 0 0 0 3808.43 0 0 1003983592 1982093837 30 General Hospitals RIVERSIDE MEDICAL CENTER 999999999 54 Kankakee 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 52 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 1207.95 0 0 0 0 0 0 0 0 0 1207.95 0 0 1003983639 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003983783 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23979.12 0 0 0 0 0 0 0 0 0 0 0 0 0 23979.12 0 0 1003983801 1689092348 86 Clinical Social Worker(Encounter Only) MINSHALL MARCY 999999999 200 Cook 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1254.43 0 0 0 0 0 0 1254.43 0 0 1003983819 16 Nurse Practitioners 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1003983991 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.56 0 0 0 0 0 0 99.56 0 0 1003983995 1932179843 16 Nurse Practitioners BROWN MARY M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2114.87 0 0 0 0 0 0 2114.87 0 0 1003984062 1194076208 89 Physician Assistant Only(Encounter Only) COLEMAN JAMES 999999999 91 Sangamon 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7143.05 0 0 0 0 0 0 7143.05 0 0 1003984064 1538547591 16 Nurse Practitioners ELLIOTT TIFFANY M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 777.95 0 0 0 0 0 0 777.95 0 0 1003984471 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 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 8340.53 0 0 0 0 0 0 0 0 0 0 0 0 0 8340.53 0 0 1003984989 1649367467 10 Physicians PAIK HAN 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 857.38 0 0 0 0 0 0 857.38 0 0 1003985433 1427451525 16 Nurse Practitioners CAREY KATHRYN A. 606118709 200 Cook 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 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 0 106.28 0 0 0 0 0 0 106.28 0 0 1003985665 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 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1871678334 30 General Hospitals KINDRED HOSPITAL CHICAGO 999999999 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 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 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1826679.63 0 0 0 0 0 0 0 0 0 1826679.63 0 0 1003987115 91 Waiver service provider--Adults (DHS/DDD) 61 Livingston 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24559.92 0 0 0 0 0 0 0 0 0 0 0 0 0 24559.92 0 0 1003987331 1609242049 16 Nurse Practitioners KITTS-FARON ANGELA D 953586411 96 St Clair 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714.27 0 0 0 0 0 0 714.27 0 0 1003987388 10 Physicians 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 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 98.03 0 0 0 0 0 0 98.03 0 0 1003987474 1205157781 10 Physicians IMAM NEDA 339012699 200 Cook 0 0 Family Practice 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 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5464.44 0 0 0 0 0 0 5464.44 0 0 1003987594 1184081556 16 Nurse Practitioners ELDRED-SMITH DARCY L 999999999 50 Jersey 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 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 41.27 0 0 0 0 0 0 41.27 0 0 1003987600 1497948087 10 Physicians MONTENEGRO GRACE A 999999999 200 Cook 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157.66 0 0 0 0 0 0 1157.66 0 0 1003987633 1790033926 22 Physical Therapists SULTAN RANDI E 999999999 200 Cook 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 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 0 588.73 588.73 0 0 1003987736 1669880951 16 Nurse Practitioners SUNIL DHANYA 606313222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468.2 0 0 0 0 0 0 468.2 0 0 1003987761 1164827242 16 Nurse Practitioners MCALLISTER ALEXIS A 631600352 79 Ogle 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 1493.1 0 0 0 0 0 0 1499.5 0 0 1003987993 1154724912 16 Nurse Practitioners DAVIES ANNA 604611185 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.75 0 0 0 0 0 0 1156.75 0 0 1003988026 1326295957 87 Psychologist(Encounter Only) ROWLAND SHELLEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003988037 1184022352 16 Nurse Practitioners CLEMENTS KRISTOPHER P 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569.83 0 0 0 0 0 0 569.83 0 0 1003988368 1346631645 60 Pharmacies HEALING HEALTH PHARMACY INC 604292196 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117819.54 0 0 0 117819.54 0 0 1003988514 1437150471 89 Physician Assistant Only(Encounter Only) PARKS ANDREA B. 999999999 200 Cook 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 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 0 224.01 0 0 0 0 0 0 224.01 0 0 1003988561 22 Physical Therapists 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.81 246.81 0 0 1003988563 1891187423 16 Nurse Practitioners ABOGUNRIN OLUWAKEMI 606313222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 0 219.27 0 0 0 0 0 0 219.27 0 0 1003988591 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 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 64.9 0 0 0 0 0 0 64.9 0 0 1003988760 1134222425 89 Physician Assistant Only(Encounter Only) GRIESEMER REBECCA 606313222 200 Cook 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 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 0 513.12 0 0 0 0 0 0 513.12 0 0 1003988792 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 19063.88 0 0 0 0 0 0 0 0 0 0 0 0 0 19063.88 0 0 1003988854 1396715017 89 Physician Assistant Only(Encounter Only) OROZCO JENNIFER M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003988876 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14861.26 0 0 0 0 0 0 0 0 0 0 0 0 0 14861.26 0 0 1003989138 1477837235 86 Clinical Social Worker(Encounter Only) KOTTRA SUSAN 999999999 30 DuPage 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 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3507.43 0 0 0 0 0 0 3507.43 0 0 1003989265 24 Speech Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 99.15 99.15 0 0 1003989637 1295159846 16 Nurse Practitioners BEY MICHELE R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.75 0 0 0 0 0 0 1352.75 0 0 1003989768 1386958064 10 Physicians FENZL CARLTON R 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.89 0 10244.74 0 0 0 0 0 0 10253.63 0 0 1003989830 1346355450 16 Nurse Practitioners THOMAS JENNIFER A 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.97 0 0 0 0 0 0 41.97 0 0 1003989860 1982881199 10 Physicians LOPEZ CORTES ANTHONIE W 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 6 0 7 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 19 0 18 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 19 0 18 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 438.18 0 1879.15 0 0 0 0 0 0 2401.95 0 0 1003990016 1508163643 10 Physicians BACKHUS LEILAH E 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.7 0 474.26 0 0 0 0 0 0 689.96 0 0 1003990065 1538593470 16 Nurse Practitioners WRIGHT STACY 999999999 103 Washington 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1400.48 0 0 0 0 0 0 1400.48 0 0 1003990189 1730556135 16 Nurse Practitioners THOMAS RHONDA 999999999 19 Champaign 0 0 0 0 0 2 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 4454.86 0 0 0 0 0 0 4624.1 0 0 1003990219 1184858326 10 Physicians MEISEL ADAM F 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 28 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392.62 0 1548.16 0 0 0 0 0 0 1940.78 0 0 1003990388 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1003990712 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.45 0 0 0 0 0 0 107.45 0 0 1003990718 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16579.15 0 0 0 0 0 0 0 0 0 0 0 0 0 16579.15 0 0 1003990921 91 Waiver service 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1356716989 16 Nurse Practitioners MORRIS KELLY A 999999999 200 Cook 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171.46 0 0 0 0 0 0 171.46 0 0 1003991543 1477937373 60 Pharmacies EDWARD PHARMACY 605406551 30 DuPage 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22838.7 0 0 0 22838.7 0 0 1003991614 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 0 0 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 1346.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1346.16 0 0 1003991776 28 Waiver service provider--Supportive living facility (HFS) 12 Bond 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1818.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1818.38 0 0 1003992050 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.66 0 0 0 0 0 0 20.66 0 0 1003992162 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21921.99 0 0 0 0 0 0 0 0 0 0 0 0 0 21921.99 0 0 1003992274 1962711937 10 Physicians BHANDARKAR AMIT W 999999999 200 Cook 0 0 Orthopedic Surgery 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5907.17 0 0 0 0 0 0 5907.17 0 0 1003992284 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.58 0 0 0 0 0 0 44.58 0 0 1003992302 1356753016 89 Physician Assistant Only(Encounter Only) OTTENHEIMER JENNAFER 999999999 200 Cook 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643.31 0 0 0 0 0 0 643.31 0 0 1003992830 1558762237 16 Nurse Practitioners SAND RACHEL 606118709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399.76 0 0 0 0 0 0 399.76 0 0 1003992840 1982870317 10 Physicians SORIN LUDA 606313222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11143.68 0 0 0 0 0 0 11143.68 0 0 1003992975 89 Physician Assistant Only(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003993597 1376798140 25 Audiologists PACER JOSEPH 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DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11132.08 0 0 0 0 0 0 0 0 0 0 0 0 0 11132.08 0 0 1003994278 1326448523 16 Nurse Practitioners PARK HELEN H 606930623 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 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 1757.93 0 0 0 0 0 0 1757.93 0 0 1003994440 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 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 14089.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14089.14 0 0 1003994810 1437401718 89 Physician Assistant Only(Encounter Only) SHAH BINITA 606123714 200 Cook 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2615.23 0 0 0 0 0 0 2615.23 0 0 1003994892 1023106093 89 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0 0 0 0 0 0 0 0 0 0 0 7458.36 0 179.05 0 0 0 0 0 0 7637.41 0 0 1004007603 1144274853 11 Dentists WRZOSEK MARIUSZ 601545716 200 Cook 0 0 Maxillofacial Surgery 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18018.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18018.62 0 0 1004007633 1174902696 16 Nurse Practitioners MARMON ASHLEY R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.3 0 0 0 0 0 0 328.3 0 0 1004007658 10 Physicians 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004008069 1861871246 33 Nursing Facilities PEARL PAVILION 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4416 0 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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 0 688.03 0 0 0 0 0 0 688.03 0 0 1004009129 1699858704 16 Nurse Practitioners NACION KARLA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 801.6 0 0 0 0 0 0 801.6 0 0 1004009286 1912386236 10 Physicians VARNADO ERRIN L 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 284.49 0 0 0 0 0 0 3.94 0 2134.01 0 0 0 0 0 0 2422.44 0 0 1004009287 1588817605 89 Physician Assistant Only(Encounter Only) NABAVI SEYED MAHMOUD 606313222 200 Cook 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1402.26 0 0 0 0 0 0 1402.26 0 0 1004009348 92 Waiver service provider--Disability (DHS/DRS) 39 Greene 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 1 0 47 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 6.3 0 915.74 0 0 0 0 0 0 922.04 0 0 1004106998 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 21695.16 0 0 0 0 0 0 0 0 0 0 0 0 0 21695.16 0 0 1004107036 16 Nurse Practitioners 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004107375 1952423865 89 Physician Assistant Only(Encounter Only) SIKORA-JACKSON ANN 606123714 200 Cook 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2345.61 0 0 0 0 0 0 2345.61 0 0 1004107428 1588083844 16 Nurse Practitioners SPEZIA AMANDA 616151941 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1004108461 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 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 0 583.83 583.83 0 0 1004108811 1740576909 10 Physicians SAENZ JOSE B 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1216.21 0 0 0 0 0 0 1216.21 0 0 1004108851 1487808523 89 Physician Assistant Only(Encounter Only) BOZYLINSKY KATHERINE 999999999 200 Cook 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 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 0 181.51 0 0 0 0 0 0 181.51 0 0 1004108891 1467831867 10 Physicians CRIHFIELD ANASTASIA M 999999999 200 Cook 0 0 General Practice 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4730.92 0 0 0 0 0 0 4730.92 0 0 1004109068 1528358660 10 Physicians KOKANOVIC OBRAD 999999999 852 Wisconsin 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 0 237 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 0 996.69 0 0 0 0 0 0 996.69 0 0 1004109309 1972730695 11 Dentists LURIA JAMIE 999999999 200 Cook 0 0 Maxillofacial Surgery 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2683.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2683.39 0 0 1004109350 1619351434 16 Nurse Practitioners MEDVED DIANA S 999999999 200 Cook 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 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 0 627.94 0 0 0 0 0 0 627.94 0 0 1004109600 1245601244 16 Nurse Practitioners MARKLEY BRANDELYNN B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843.68 0 0 0 0 0 0 843.68 0 0 1004109612 10 Physicians 50 Jersey 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.4 0 0 0 0 0 0 368.4 0 0 1004109953 1902288566 12 Optometrists ZIELINSKI PATRICIA 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.53 0 0 0 0 0 0 61.53 0 0 1004110069 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1960.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1960.1 0 0 1004110146 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15139.83 0 0 0 0 0 0 0 0 0 0 0 0 0 15139.83 0 0 1004110165 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2271.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2271.99 0 0 1004110532 1669854576 16 Nurse Practitioners KENDRIGAN TIFFANY E 999999999 30 DuPage 0 0 0 0 0 1 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 5016.5 0 0 0 0 0 0 5022.9 0 0 1004110590 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22969.45 0 0 0 0 0 0 0 0 0 0 0 0 0 22969.45 0 0 1004110607 1740575091 10 Physicians NEWMAN JASON M 999999999 65 Madison 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3783.23 0 0 0 0 0 0 3783.23 0 0 1004110627 91 Waiver service provider--Adults (DHS/DDD) 51 Jo Daviess 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22990.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22990.47 0 0 1004110678 1245575042 16 Nurse Practitioners WOODS TRACY 999999999 200 Cook 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 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1113.26 0 0 0 0 0 0 1113.26 0 0 1004110881 1831364272 10 Physicians ABCARIAN ARIANE M 999999999 200 Cook 0 0 Surgery General 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 0 137.65 0 0 0 0 0 0 137.65 0 0 1004111108 1760778468 10 Physicians ONTROP NATHAN 999999999 200 Cook 0 0 Psychiatry 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9328.21 0 0 0 0 0 0 9328.21 0 0 1004111241 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14232.79 0 0 0 0 0 0 0 0 0 0 0 0 0 14232.79 0 0 1004111322 1174783880 10 Physicians ARMSTRONG LUCAS C 618223741 19 Champaign 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 21 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.01 0 5569.19 0 0 0 0 0 0 6033.2 0 0 1004111380 1326297987 10 Physicians ENOE CHRISTOPHER 605155641 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4465.46 0 0 0 0 0 0 4465.46 0 0 1004111733 1013273614 10 Physicians IBRAHEEM ABIOLA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 993.69 0 0 0 0 0 0 993.69 0 0 1004111839 4004111839 92 Waiver service provider--Disability (DHS/DRS) ROYAL HOME HEALTH SRVCS INC 604452524 200 Cook 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 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 168361.47 0 0 0 0 0 0 0 0 0 0 0 0 0 168361.47 0 0 1004111881 1306224076 33 Nursing Facilities SYMPHONY OF SOUTH SHORE 606492612 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 653 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 16018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2269897.6 0 0 0 0 0 0 0 2269897.6 0 0 1004111951 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2039.86 0 0 0 0 0 0 0 0 0 0 0 0 0 2039.86 0 0 1004111962 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 15987.54 0 0 0 0 0 0 0 0 0 0 0 0 0 15987.54 0 0 1004112192 1649566407 10 Physicians MISBAH SHAHEEN F 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 177.09 0 0 0 0 0 0 59.08 0 1174.67 0 0 0 0 0 0 1410.84 0 0 1004112229 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2763.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2763.83 0 0 1004112293 1437526852 16 Nurse Practitioners RIDER JONATHAN 503061455 106 Whiteside 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 5995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7891.76 0 0 0 0 0 0 7891.76 0 0 1004112833 10 Physicians 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.97 0 0 0 0 0 0 121.97 0 0 1004112915 1962760041 16 Nurse Practitioners BECKERT HEATHER 999999999 33 Effingham 0 0 0 0 0 4 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 368.09 0 0 0 0 0 0 0 0 1122.49 0 0 0 0 0 0 1490.58 0 0 1004113030 1134430465 10 Physicians FAROOQUI FARHAN 605638113 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.89 0 0 0 0 0 0 522.89 0 0 1004113556 10 Physicians 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.01 0 8533.32 0 0 0 0 8582.33 0 0 1004124523 1437468857 10 Physicians LANG GABRIEL 999999999 826 Missouri 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 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 2481.65 0 0 0 0 0 0 2481.65 0 0 1004124920 1013950419 16 Nurse Practitioners WALSH KATHERINE W 999999999 57 Lake 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 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 0 743.28 0 0 0 0 0 0 743.28 0 0 1004125163 1639364474 10 Physicians MEHROTRA AMIT K 616151941 80 Peoria 0 0 Internal Medicine 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 0 768 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 9757.26 0 0 0 0 0 0 9757.26 0 0 1004125304 1952356701 89 Physician Assistant Only(Encounter Only) KAPER CHERISE L 999999999 200 Cook 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 12.63 0 0 0 0 0 0 12.63 0 0 1004125653 1346506839 10 Physicians AUBERT GREGORY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 801.18 0 0 0 0 0 0 801.18 0 0 1004125818 1376717603 10 Physicians MAILEY BRIAN A 627949639 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 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 54342.94 0 0 0 0 0 0 54342.94 0 0 1004125851 1255771358 10 Physicians ANDERSON GREGORY O 999999999 200 Cook 0 0 Internal Medicine 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 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10437.95 0 0 0 0 0 0 10437.95 0 0 1004126248 1093076036 10 Physicians CARPENTER JOSHUA 616151941 80 Peoria 0 0 Family Practice 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 0 235 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 3454.86 0 0 0 0 0 0 3454.86 0 0 1004126458 1790041101 10 Physicians FOLK JESSICA M. 999999999 200 Cook 0 0 Emergency Medicine 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 0 112 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 3023.23 0 0 0 0 0 0 3023.23 0 0 1004126611 1972993434 16 Nurse Practitioners LEE CHRISTINE 49155500 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.82 0 0 0 0 0 0 211.82 0 0 1004126850 1871856617 11 Dentists DILLARD MELVIN 622052325 96 St Clair 0 0 Orthodontist 0 0 18 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 11299.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11299.5 0 0 1004126923 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6554 0 0 0 0 0 0 0 0 0 0 0 0 0 6554 0 0 1004127198 1467707182 10 Physicians SINGH SMITA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5572.03 0 0 0 0 0 0 5572.03 0 0 1004127276 89 Physician Assistant Only(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.76 0 0 0 0 0 0 189.76 0 0 1004127283 10 Physicians 80 Peoria 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.91 0 0 0 0 0 0 72.91 0 0 1004127374 1740255348 10 Physicians GROSS BRIAN M 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 819.68 0 0 0 0 0 0 819.68 0 0 1004127402 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1006.68 0 0 0 0 0 0 1006.68 0 0 1004127568 1386001097 16 Nurse Practitioners ZUECK JOSEPH 999999999 108 Williamson 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 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 0 504.28 0 0 0 0 0 0 504.28 0 0 1004127797 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3663 0 0 0 0 0 0 0 0 0 0 0 0 0 3663 0 0 1004127988 1164455127 89 Physician Assistant Only(Encounter Only) FRALEY MELISSA E 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 136.44 0 0 0 0 0 0 136.44 0 0 1004128273 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 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 1082.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1082.5 0 0 1004128296 1730594037 16 Nurse Practitioners RINEHART STEPHANIE 503061455 91 Sangamon 0 0 0 0 0 5 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 338.66 0 0 0 0 0 0 0 0 2132.19 0 0 0 0 0 0 2470.85 0 0 1004128396 1902273717 16 Nurse Practitioners JONES TAMMI 999999999 96 St Clair 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3262.32 0 0 0 0 0 0 3262.32 0 0 1004128755 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16378.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16378.66 0 0 1004128846 1336568278 12 Optometrists KOSTOPOULOS ANASTASIA 606042992 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 7 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.17 0 87.84 0 0 0 0 276.01 0 0 1004128943 1215330360 89 Physician Assistant Only(Encounter Only) NFUNDOAK MANYI 606313222 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448.5 0 0 0 0 0 0 448.5 0 0 1004129029 1659757888 16 Nurse Practitioners OLDAKER YVONNE 999999999 200 Cook 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45557.14 0 0 0 0 0 0 45557.14 0 0 1004129401 1568669901 10 Physicians GUZMAN PEREZCARRILLO GLORIA 631101016 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 94 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4156.03 0 55.97 0 0 0 0 0 0 4212 0 0 1004129515 4004129515 90 Waiver service provider--Elderly (DOA) XILIN ASSOCIATION 605638531 30 DuPage 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 1830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162052.8 0 0 0 0 0 0 0 0 0 0 0 0 0 162052.8 0 0 1004129716 94 Waiver service provider--Children's support (DHS/DDD) 63 Macon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16917.32 0 0 0 0 0 0 0 0 0 0 0 0 0 16917.32 0 0 1004129726 1912246380 16 Nurse Practitioners NYONLY BAI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2051.62 0 0 0 0 0 0 2051.62 0 0 1004129795 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 172.96 0 0 0 0 0 0 172.96 0 0 1004129801 1578819249 10 Physicians GURUNG REENA 999999999 53 Kane 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 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 0 462.94 0 0 0 0 0 0 462.94 0 0 1004130176 1669673216 10 Physicians ELGAMAL MOHAMED HOSNY 999999999 200 Cook 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 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 3797.3 0 0 0 0 0 0 3797.3 0 0 1004130463 1053525527 89 Physician Assistant Only(Encounter Only) ROGOWSKI WENDY A 999999999 200 Cook 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 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 0 129.24 0 0 0 0 0 0 129.24 0 0 1004130556 1144452327 89 Physician Assistant Only(Encounter Only) MARITOTE AMY L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481.41 0 0 0 0 0 0 481.41 0 0 1004130936 1003824061 30 General Hospitals PARKLAND HEALTH CENTER- FARMIN 636401921 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 2 0 0 0 2 0 0 0 0 0 0 0 0 0 511.76 0 0 0 0 0 0 0 0 112.8 0 0 0 0 0 624.56 0 0 1004130961 1174813133 10 Physicians WALENTIK ANNE C 999999999 66 Marion 0 0 Pediatrics 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 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 2646.76 0 0 0 0 0 0 2646.76 0 0 1004131092 1417106519 89 Physician Assistant Only(Encounter Only) MEERSMAN MICHELENE 999999999 53 Kane 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4021.33 0 0 0 0 0 0 4021.33 0 0 1004131202 1760873939 16 Nurse Practitioners BUCKHALTER BRANDY C 999999999 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.87 0 0 0 0 0 0 235.87 0 0 1004131355 1427286822 10 Physicians VEENSTRA BENJAMIN R. 606123714 200 Cook 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4197.02 0 0 0 0 0 0 4197.02 0 0 1004131428 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1992.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1992.6 0 0 1004131723 1184031254 24 Speech Therapists LEV NATALIE 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3729.36 3729.36 0 0 1004131732 13 Podiatrists 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.29 0 0 0 0 0 0 31.29 0 0 1004131746 1699040774 10 Physicians ARSHAD HUMA 999999999 30 DuPage 0 0 Family Practice 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.06 0 0 0 0 0 0 188.06 0 0 1004131759 1518120575 10 Physicians ROWE ANTHONY J 480381125 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 58 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308.3 0 7.87 0 0 0 0 0 0 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Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 22466.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22466.4 0 0 1004132409 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8503.13 0 0 0 0 0 0 0 0 0 0 0 0 0 8503.13 0 0 1004132472 16 Nurse Practitioners 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004132915 1023003720 30 General Hospitals KATH SHAW BETHEA HOSP 999999999 60 Lee DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42207.16 0 0 0 0 0 0 0 0 0 42207.16 0 0 1004132933 1679535637 30 General Hospitals SWEDISH COVENANT HOSPITAL 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 1 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 459.52 0 0 0 0 0 0 0 177476.04 0 0 0 0 0 0 0 0 0 177935.56 0 0 1004132936 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.58 0 0 0 0 0 0 3.58 0 0 1004133155 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 117.77 0 0 0 0 0 0 117.77 0 0 1004133196 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.84 0 0 0 0 0 0 192.84 0 0 1004164280 10 Physicians 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.85 0 0 0 0 0 0 290.85 0 0 1004165008 1932506458 87 Psychologist(Encounter Only) COOK PAMELA 999999999 54 Kankakee 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 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 1138.27 0 0 0 0 0 0 1138.27 0 0 1004165227 1023425816 11 Dentists SARRAFEE SARA 999999999 200 Cook 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16882.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16882.03 0 0 1004165588 1396070801 89 Physician Assistant Only(Encounter Only) HEDSTROM AMY 999999999 200 Cook 0 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1004166409 1598020836 10 Physicians BAILEY WILLIAM 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 773.05 0 0 0 0 0 0 773.05 0 0 1004166503 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26852.5 0 0 0 0 0 0 0 0 0 0 0 0 0 26852.5 0 0 1004166523 1780063362 11 Dentists RICHARDSON SARAH E 300676405 200 Cook 0 0 General Dentistry 0 0 25 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 3274.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3274.42 0 0 1004166918 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1459.56 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 0 579.68 0 0 0 0 0 0 579.68 0 0 1004167896 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 220.2 0 0 0 0 0 0 220.2 0 0 1004168064 10 Physicians 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.76 0 0 0 0 0 0 89.76 0 0 1004168465 30 General Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.36 0 0 1004168539 28 Waiver service provider--Supportive living facility (HFS) 31 Edgar 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30576.23 0 0 0 0 0 0 0 0 0 0 0 0 0 30576.23 0 0 1004168594 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.12 0 0 0 0 0 0 51.12 0 0 1004168799 10 Physicians 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004168824 1306152806 11 Dentists LODHI TANIA G 604821649 200 Cook 0 0 General Dentistry 0 0 54 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10742.3 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 11118.65 0 0 1004169238 1205089166 10 Physicians COOKSEY JESSICA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1291.22 0 0 0 0 0 0 1291.22 0 0 1004169550 86 Clinical Social Worker(Encounter 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Cook 0 0 General Dentistry 0 0 32 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 7608.98 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 7985.33 0 0 1004191815 1427493246 30 General Hospitals FRANCISCAN HEALTHCARE MUNSTER 999999999 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 2 0 0 0 319 0 0 0 0 150 0 0 0 181 0 0 0 0 0 2 0 0 0 444 0 0 0 0 157 0 0 0 279 0 0 0 0 0 2 0 0 0 444 0 0 0 0 832 0 0 0 279 0 0 0 0 0 0 0 0 0 65567.88 0 0 0 0 145713.81 0 0 0 17478.89 0 0 0 0 0 228760.58 0 0 1004191931 1144270265 60 Pharmacies BANDY''S PHARMACY II 999999999 66 Marion 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 1696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65497.05 0 0 0 65497.05 0 0 1004191979 91 Waiver service provider--Adults (DHS/DDD) 54 Kankakee 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 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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 0 757.64 0 0 0 0 0 0 757.64 0 0 1004192836 1104118249 10 Physicians HARRISON KALLIE L 631418573 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289.68 0 1427.23 0 0 0 0 0 0 1716.91 0 0 1004193101 1780823500 60 Pharmacies EXACT CARE PHARMACY LLC 441256134 836 Ohio 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 0 888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16131.48 0 0 0 16131.48 0 0 1004193203 1730429408 10 Physicians PULIMI SANDEEP 605155641 30 DuPage 0 0 Internal Medicine 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 0 235 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 3543.03 0 0 0 0 0 0 3543.03 0 0 1004193233 1609143288 10 Physicians LO BETTY 999999999 34 Fayette 0 0 General Practice 0 0 0 1 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 1064.17 0 0 0 0 0 0 1066.35 0 0 1004193342 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17079.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17079.04 0 0 1004193934 1275814881 16 Nurse Practitioners BENEKE RHONDA 999999999 45 Henry 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 0 148 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 0 739.43 0 0 0 0 0 0 739.43 0 0 1004193967 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8529.24 0 0 0 0 0 0 0 0 0 0 0 0 0 8529.24 0 0 1004194188 1790913036 10 Physicians SHAH AVANI V. 999999999 815 Indiana 0 0 0 0 0 9 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 57.6 0 0 0 0 0 0 0 0 13292.38 0 0 0 0 0 0 13349.98 0 0 1004194467 1154353498 86 Clinical Social Worker(Encounter Only) ALA REBECCA A 999999999 80 Peoria 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3909.41 0 0 0 0 0 0 3909.41 0 0 1004194780 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12737.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12737.39 0 0 1004194814 1376932400 89 Physician Assistant Only(Encounter Only) FILIP BAILEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565.68 0 0 0 0 0 0 565.68 0 0 1004194941 1265820526 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES MATTOON NO 619386105 24 Coles 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35757.99 0 0 0 0 0 0 0 0 0 0 0 0 0 35757.99 0 0 1004194969 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 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 14916.51 0 0 0 0 0 0 0 0 0 0 0 0 0 14916.51 0 0 1004195037 1538538129 89 Physician Assistant Only(Encounter Only) WASHBURN KRISTA D 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 682.44 0 0 0 0 0 0 682.44 0 0 1004195068 1861876260 12 Optometrists RUPP CHELSIE L 606165132 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7054.26 0 907.68 0 0 0 0 7961.94 0 0 1004195127 94 Waiver service provider--Children's support (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11783.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11783.1 0 0 1004195243 1386708493 10 Physicians BENNETT KIMBERLY 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 15.7 0 221.42 0 0 0 0 0 0 321.74 0 0 1004195638 1841553294 10 Physicians LEVINE REBECCA 999999999 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.3 0 0 0 0 0 0 320.3 0 0 1004196037 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28226.88 0 0 0 0 0 0 0 0 0 0 0 0 0 28226.88 0 0 1004196051 1316997042 13 Podiatrists PONTON STEPHEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1570 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10793.77 0 0 0 0 0 0 10793.77 0 0 1004196093 1477751055 10 Physicians RAMANAVARAPU VIDYA 600162359 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2293.62 0 0 0 0 0 0 2293.62 0 0 1004196395 1417352527 48 Rural Health Clinics JCH MEDICAL GROUP HARDIN 620470610 16 Calhoun 0 1 0 61 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 3909.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3909.45 0 0 1004196959 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24083.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24083.37 0 0 1004196994 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22474.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22474.54 0 0 1004197181 1588611800 10 Physicians RIETI ROBERT A 999999999 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 308.61 0 0 0 0 0 0 308.61 0 0 1004197381 1356645667 10 Physicians GEORGE LINDSEY C 618226217 19 Champaign 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410.5 0 1307.45 0 0 0 0 0 0 1717.95 0 0 1004197467 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4828.23 0 0 0 0 0 0 0 0 0 0 0 0 0 4828.23 0 0 1004197471 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1004197491 1477844082 10 Physicians STOSIC MILENA 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 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 1393.25 0 0 0 0 0 0 1393.25 0 0 1004197669 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7108.56 0 0 0 0 0 0 0 0 0 0 0 0 0 7108.56 0 0 1004197673 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17172.44 0 0 0 0 0 0 0 0 0 0 0 0 0 17172.44 0 0 1004197679 1396113312 47 Local Education Agencies SALT FORK COMMUNITY UNIT SCHOO 999999999 100 Vermilion 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 690 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 690 0 0 0 0 576.76 0 0 0 0 0 0 0 0 0 0 0 0 0 14273.01 0 14849.77 0 0 1004197906 89 Physician Assistant Only(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.68 0 0 0 0 0 0 211.68 0 0 1004197988 1508185521 10 Physicians PUGELY ANDREW J 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 6 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 6107.16 0 0 0 0 0 0 6107.16 0 0 1004198253 10 Physicians 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.41 0 0 0 0 0 0 66.41 0 0 1004198337 1356717391 36 Community mental health provider FAMILY COUNSELING CENTER INC 999999999 11 Alexander 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 4266.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18733.87 0 0 23000.03 0 0 1004198345 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11342.7 0 0 0 0 0 0 0 0 0 0 0 0 0 11342.7 0 0 1004198553 1083016752 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 617616165 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.52 0 19017.38 0 0 0 0 19098.9 0 0 1004198569 1861768590 10 Physicians LI YIEN 999999999 200 Cook 0 0 Internal Medicine 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1452.36 0 0 0 0 0 0 1452.36 0 0 1004198579 1508154774 89 Physician Assistant Only(Encounter Only) LECLAIR BRIDGET 606313222 200 Cook 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2981.88 0 0 0 0 0 0 2981.88 0 0 1004198721 1801255849 70 Ambulance Service Providers HSHS RESCUE FLIGHT 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15510 0 0 0 0 0 0 15510 0 0 1004198891 1639541931 33 Nursing Facilities THE GROVE OF LAGRANGE PARK LIV 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 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 1804.31 0 0 0 0 0 0 1804.31 0 0 1004199854 1932450285 10 Physicians MAKSIMOVICH DANIEL 999999999 63 Macon 0 0 Anesthesiology 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376.28 0 0 0 0 0 0 1376.28 0 0 1004200167 10 Physicians 96 St Clair 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 531.17 0 0 0 0 0 0 531.17 0 0 1004200262 1588942775 89 Physician Assistant Only(Encounter Only) RIEMENSCHNEIDER MAGDELINE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.08 0 0 0 0 0 0 255.08 0 0 1004200283 1770919235 12 Optometrists FAROOQI AMREEN 601875111 30 DuPage 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 72 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3199.94 0 2283.84 0 0 0 0 5483.78 0 0 1004200358 1487881025 10 Physicians BALASH JENNIFER 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.8 0 1098.74 0 0 0 0 0 0 1242.54 0 0 1004200428 1821485335 16 Nurse Practitioners ROHDE JAIME 601228942 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2701.23 0 0 0 0 0 0 2701.23 0 0 1004200672 1871969485 70 Ambulance Service Providers LOYOLA MEDICINE TRANSPORT LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98260.2 0 0 0 0 0 0 98260.2 0 0 1004200766 87 Psychologist(Encounter Only) 200 Cook 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399.69 0 0 0 0 0 0 399.69 0 0 1004225932 10 Physicians 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 0 0 0 0 73.4 0 0 1004226089 10 Physicians 89 Rock Island 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.28 0 0 0 0 0 0 33.28 0 0 1004226235 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17954.58 0 0 0 0 0 0 0 0 0 0 0 0 0 17954.58 0 0 1004226277 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 0 0 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 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0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2842.7 0 0 0 0 0 0 2842.7 0 0 1004226786 1760840417 16 Nurse Practitioners HILL LESLIE A 999999999 28 De Witt 0 0 0 0 0 2 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 4191.26 0 0 0 0 0 0 4360.5 0 0 1004226933 1184057630 16 Nurse Practitioners ISHMAEL CASSIE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1459.68 0 0 0 0 0 0 1459.68 0 0 1004227410 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.17 0 0 0 0 0 0 0 0 0 0 0 0 0 168.17 0 0 1004227579 1205116282 16 Nurse Practitioners RIVERA PRISCILLA 606071644 200 Cook 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 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 0 188.01 0 0 0 0 0 0 188.01 0 0 1004227650 1366605776 10 Physicians LASTRA ALEJANDRA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 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 2093.56 0 0 0 0 0 0 2093.56 0 0 1004228007 1942603907 89 Physician Assistant Only(Encounter Only) MARSAGLIA KILEY 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 70.71 0 0 0 0 0 0 0 0 1474.51 0 0 0 0 0 0 1545.22 0 0 1004228362 1942457734 89 Physician Assistant Only(Encounter Only) MACZKO REBECCA 999999999 30 DuPage 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 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 85.58 0 0 0 0 0 0 85.58 0 0 1004228531 10 Physicians 200 Cook 0 0 Pediatric Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.58 0 0 0 0 0 0 237.58 0 0 1004228588 1356660203 10 Physicians MICIC DEJAN 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1533.1 0 0 0 0 0 0 1533.1 0 0 1004228773 1679721179 89 Physician Assistant Only(Encounter Only) PARKS ELIZABETH A 999999999 108 Williamson 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 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 0 198.28 0 0 0 0 0 0 198.28 0 0 1004228834 1245489244 10 Physicians DOGAN-BAG VAHIDE 604611021 200 Cook 0 0 General Practice 0 0 0 6 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 215.07 0 0 0 0 0 0 0 0 365.2 0 0 0 0 0 0 580.27 0 0 1004229088 10 Physicians 91 Sangamon 0 0 Gastroenterology 0 0 0 0 0 0 0 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 23.11 0 0 0 0 0 0 23.11 0 0 1004229132 91 Waiver service provider--Adults (DHS/DDD) 33 Effingham 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258.16 0 0 0 0 0 0 0 0 0 0 0 0 0 258.16 0 0 1004229335 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.2 0 0 1004229744 1649660200 16 Nurse Practitioners TOPPER TARA A 999999999 200 Cook 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2756.22 0 0 0 0 0 0 2756.22 0 0 1004229757 16 Nurse Practitioners 109 Winnebago 0 0 0 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(DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1516.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1516.58 0 0 1004230715 1487026787 33 Nursing Facilities THE GROVE AT THE LAKE 600992661 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1381570.34 0 0 0 0 0 0 0 1381570.34 0 0 1004231164 1891720140 16 Nurse Practitioners HUSKE THERESE M. 999999999 200 Cook 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 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 2269.95 0 0 0 0 0 0 2269.95 0 0 1004231203 86 Clinical Social Worker(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302.24 0 0 0 0 0 0 302.24 0 0 1004231218 10 Physicians 200 Cook 0 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0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004232890 1235527854 16 Nurse Practitioners HIGDON KYLE 629023988 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790.24 0 0 0 0 0 0 790.24 0 0 1004232945 91 Waiver service provider--Adults (DHS/DDD) 826 Missouri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19071.53 0 0 0 0 0 0 0 0 0 0 0 0 0 19071.53 0 0 1004233249 1154734101 12 Optometrists BANNA CHRISTOPHER 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1379.01 0 0 0 0 0 0 1379.01 0 0 1004233727 1750750311 16 Nurse Practitioners CURRY TATUM R 999999999 57 Lake 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 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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 0 473.28 0 0 0 0 0 0 473.28 0 0 1004236350 1992109565 24 Speech Therapists HOLST KATELYN J 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30352.92 30352.92 0 0 1004236462 1598154247 16 Nurse Practitioners KLUEVER MARY J 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.59 0 0 0 0 0 0 630.59 0 0 1004236814 1669736021 10 Physicians HAZRA ANIRUDDHA 999999999 200 Cook 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 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 1263.25 0 0 0 0 0 0 1263.25 0 0 1004236857 1962642744 89 Physician Assistant Only(Encounter Only) SNEED JACLYN N 999999999 200 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JADA H 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275.77 0 0 0 0 0 0 275.77 0 0 1004251261 1972962561 16 Nurse Practitioners TAYLOR LOGAN W 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2200.33 0 0 0 0 0 0 2200.33 0 0 1004251481 1932584620 16 Nurse Practitioners MAGIERA VIOLETTA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 182.58 0 0 0 0 0 0 0 0 1181.39 0 0 0 0 0 0 1363.97 0 0 1004251634 1306203856 36 Community mental health provider KISHHEALTH SYSTEM BEHAVIORAL S 999999999 27 Dekalb 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 2033 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1287 0 0 2033 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1287 0 0 222117.52 0 0 0 0 0 0 0 0 0 0 0 0 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91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20343.74 0 0 0 0 0 0 0 0 0 0 0 0 0 20343.74 0 0 1004252525 1972778603 10 Physicians TROMBLY RYAN 606313222 63 Macon 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18136.96 0 0 0 0 0 0 18136.96 0 0 1004252842 1881766947 10 Physicians YANGO EUGENIO MARIA 600891385 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 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 1528.76 0 0 0 0 0 0 1528.76 0 0 1004253557 10 Physicians 10 Adams 0 0 0 0 0 0 0 0 0 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 0 549.74 0 0 0 0 0 0 549.74 0 0 1004253885 1609289040 10 Physicians LEVENHAGEN RYAN J 999999999 200 Cook 0 0 Internal Medicine 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 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3501.2 0 0 0 0 0 0 3501.2 0 0 1004253935 1689671166 10 Physicians LATER PAUL E 999999999 200 Cook 0 0 Neurology 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6068.44 0 0 0 0 0 0 6068.44 0 0 1004254024 1518219757 16 Nurse Practitioners DOWNS AMANDA K. 602011718 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.62 0 0 0 0 0 0 130.62 0 0 1004254164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22898.82 0 0 0 0 0 0 0 0 0 0 0 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0 0 1004255905 23 Occupational Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.98 552.98 0 0 1004256023 1225327984 10 Physicians SIEGERT JAMES 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 6 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.38 0 12109.86 0 0 0 0 0 0 12314.24 0 0 1004256028 1558593095 10 Physicians MANDA KRISHNA 999999999 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4922.37 0 0 0 0 0 0 4922.37 0 0 1004256120 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 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 34389.94 0 0 0 0 0 0 0 0 0 0 0 0 0 34389.94 0 0 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0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24025.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24025.75 0 0 1004267862 1174530968 89 Physician Assistant Only(Encounter Only) PAULS ERIK 999999999 200 Cook 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 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 0 482.67 0 0 0 0 0 0 482.67 0 0 1004267965 1497114508 16 Nurse Practitioners LATHITHAM CHRIS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571.31 0 0 0 0 0 0 571.31 0 0 1004267968 4004267968 91 Waiver service provider--Adults (DHS/DDD) MEINHOFER IRA 999999999 200 Cook 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 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118355.35 0 0 0 0 0 0 0 0 0 0 0 0 0 118355.35 0 0 1004268270 1568723583 10 Physicians SUSAN PAOLA 606751611 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 3 0 46 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 105 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 105 0 0 0 0 0 0 0 0 0 75.3 0 0 0 0 0 0 25.2 0 2230.98 0 0 0 0 0 0 2331.48 0 0 1004268308 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.63 0 0 0 0 0 0 113.63 0 0 1004268518 33 Nursing Facilities 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26821.16 0 0 0 0 0 0 0 26821.16 0 0 1004268523 1275683500 89 Physician Assistant Only(Encounter Only) ALHAMED SHARIF Y 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252.84 0 0 0 0 0 0 252.84 0 0 1004268913 10 Physicians 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 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 1 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 1113.26 0 0 0 0 0 0 1118.43 0 0 1004270823 1073863148 16 Nurse Practitioners KATELLO SUSAN M 999999999 200 Cook 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437.21 0 0 0 0 0 0 437.21 0 0 1004270879 1093979387 10 Physicians AKBAR ASRA 999999999 80 Peoria 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11197.64 0 0 0 0 0 0 11197.64 0 0 1004270949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21062.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21062.25 0 0 1004270960 1346441367 16 Nurse Practitioners ORTWIG KURT W. 602011718 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 24.6 0 0 0 0 0 0 0 0 298.61 0 0 0 0 0 0 323.21 0 0 1004271136 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22743.16 0 0 0 0 0 0 0 0 0 0 0 0 0 22743.16 0 0 1004271680 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4843.3 0 0 0 0 0 0 0 0 0 0 0 0 0 4843.3 0 0 1004271681 1770943243 91 Waiver service provider--Adults (DHS/DDD) ZOSEL JENNIFER 999999999 200 Cook 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 1794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141718.8 0 0 0 0 0 0 0 0 0 0 0 0 0 141718.8 0 0 1004271765 1336205798 30 General Hospitals FRANCISCAN ST ANTHONY HEALTH C 999999999 815 Indiana 0 0 0 0 0 0 33 0 0 0 0 14 0 0 0 7 0 0 0 0 0 0 0 0 0 37 0 0 0 0 14 0 0 0 8 0 0 0 0 0 0 0 0 0 37 0 0 0 0 231 0 0 0 8 0 0 0 0 0 0 0 0 0 7440.45 0 0 0 0 90819.61 0 0 0 577.64 0 0 0 0 0 98837.7 0 0 1004271921 1356733760 16 Nurse Practitioners HILBURGER KRISTEN 999999999 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.87 0 0 0 0 0 0 71.87 0 0 1004271933 1134483936 10 Physicians TENEGRA JOHNNY C 999999999 30 DuPage 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.91 0 0 0 0 0 0 1203.91 0 0 1004272185 1548558729 10 Physicians SHETH NEERAL K. 606751611 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665.56 0 0 0 0 0 0 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1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30351.32 0 0 0 0 0 0 0 0 0 0 0 0 0 30351.32 0 0 1004272671 1265897755 16 Nurse Practitioners HORNUNG ANDREW J 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 136.84 0 0 0 0 0 0 0 0 2239.58 0 0 0 0 0 0 2376.42 0 0 1004272746 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004272928 1891033304 10 Physicians JASTHI PRATHIMA K 627047452 91 Sangamon 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 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3651.86 0 0 0 0 0 0 3651.86 0 0 1004273158 91 Waiver service provider--Adults (DHS/DDD) 46 Iroquois 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23505.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23505.3 0 0 1004273561 1902109267 89 Physician Assistant Only(Encounter Only) WASSINK BRETT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.72 0 0 0 0 0 0 86.72 0 0 1004273709 1417219437 10 Physicians GADRINAB-JONES KRYSTLE 606781034 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 105.23 0 0 0 0 0 0 5.22 0 961.11 0 0 0 0 0 0 1071.56 0 0 1004273741 1326420563 30 General Hospitals FRESENIUS MEDICAL CARE MCLEAN 617013534 72 McLean DIALYSIS Outpatient dialysis centers. 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 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37848.45 0 0 0 0 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523 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13885.74 0 55.97 0 0 0 0 0 0 13941.71 0 0 1004274582 1992189104 12 Optometrists PATEL SHREYA V 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.66 0 0 0 0 0 0 198.66 0 0 1004274756 1265557888 63 Other Providers of Medical Equipment/Supplies (Non-registered) CRANIAL TECHNOLOGIES INC 601485690 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17758.91 0 0 0 0 0 0 17758.91 0 0 1004274795 1871624668 10 Physicians RICHTER ERIK 606751162 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278.45 0 0 0 0 0 0 0 0 278.45 0 0 1004274842 1427331347 13 Podiatrists KALK JASON 602011700 200 Cook 0 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0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.58 0 0 0 0 0 0 15.58 0 0 1004283245 1023245693 10 Physicians FAN DI 600650451 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 18 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272.14 0 339.32 0 0 0 0 0 0 611.46 0 0 1004283372 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 34.33 0 0 0 0 0 0 34.33 0 0 1004283447 1326437633 11 Dentists SYED MAZHER 600771310 200 Cook 0 0 General Dentistry 0 0 599 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1625 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1625 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 52832.11 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 53584.81 0 0 1004283590 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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Therapists ABEJUELA MICHELLE L 600506411 71 McHenry 0 0 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 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41311.76 41311.76 0 0 1004307039 1033476585 10 Physicians KHAN BILAL A 999999999 200 Cook 0 0 Emergency Medicine 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 0 159 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 3750.48 0 0 0 0 0 0 3750.48 0 0 1004307062 1184002867 16 Nurse Practitioners WALKER CELINE 627949639 91 Sangamon 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.65 0 0 0 0 0 0 1361.65 0 0 1004307188 1275762262 10 Physicians ACKERMAN PAUL D 999999999 200 Cook 0 0 Neurology Surgery 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians BALLARD LESLIE M 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 12414.9 0 0 0 0 0 0 12414.9 0 0 1004308558 1508938044 30 General Hospitals PROGRESS WEST HOSPITAL 633682208 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 5 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 767.47 0 0 0 0 0 0 0 0 388.08 0 0 0 0 0 1155.55 0 0 1004308704 1336436203 10 Physicians ELSHAFEI ANAS 605238723 30 DuPage 0 0 Internal Medicine 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1208.53 0 0 0 0 0 0 1208.53 0 0 1004308888 1659743516 16 Nurse Practitioners WALKER JENNIFER L. 623014038 10 Adams 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 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1004309951 1265856264 16 Nurse Practitioners KRIEDEMANN LORIE A 999999999 200 Cook 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 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 0 530.85 0 0 0 0 0 0 530.85 0 0 1004309965 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 0 0 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 6099.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6099.92 0 0 1004310013 1912385683 33 Nursing Facilities SYMPHONY AT MIDWAY 606324333 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 440 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 10870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1619143.47 0 0 0 0 0 0 0 1619143.47 0 0 1004310521 1164506267 10 Physicians TORQUATI ALFONSO 606751611 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 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 1956.11 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Sangamon 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3601.57 0 0 0 0 0 0 3601.57 0 0 1004337965 1114309465 60 Pharmacies FIRST FAMILY PHARMACY PLUS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96738.49 0 0 0 96738.49 0 0 1004338164 1720315021 16 Nurse Practitioners THORPE DAVID C 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.91 0 0 0 0 0 0 109.91 0 0 1004338200 1033214416 30 General Hospitals COMMUNITY FIRST MEDICAL CENTER 606344403 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 4 0 0 0 1248 0 0 0 0 750 0 0 0 860 0 0 0 0 0 4 0 0 0 1696 0 0 0 0 678 0 0 0 1612 0 0 0 0 0 4 0 0 0 1696 0 0 0 0 4875 0 0 0 1647 0 0 0 0 0 146.81 0 0 0 242032.15 0 0 0 0 2424524.8 0 0 0 157234.13 0 0 0 0 0 2823937.89 0 5945 1004339013 1306207139 16 Nurse Practitioners HUEGEN KARA A 999999999 200 Cook 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1661.78 0 0 0 0 0 0 1661.78 0 0 1004339082 1861657785 10 Physicians MOHAMMED TABRAIZ 999999999 53 Kane 0 0 Internal Medicine 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 0 108 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 2470.45 0 0 0 0 0 0 2470.45 0 0 1004339129 1528443702 30 General Hospitals SSM HEALTH ST. LOUIS UNIVERSIT 631041016 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 22 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28216.65 0 0 0 0 0 0 0 0 0 28216.65 0 0 1004339220 1558399238 10 Physicians GUPTA MANISH 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 1 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3161.39 0 0 0 0 0 0 3161.39 0 0 1004339275 1073838868 10 Physicians GREEN LAUREN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 121 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283.16 0 3947.94 0 0 0 0 0 0 5231.1 0 0 1004339489 1265667083 89 Physician Assistant Only(Encounter Only) MOORE JOHN P 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.9 0 0 0 0 0 0 204.9 0 0 1004339599 60 Pharmacies 836 Ohio 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662.58 0 0 69605.02 0 0 0 70267.6 0 0 1004339802 1255737433 16 Nurse Practitioners ADAMS MARY ANNE A 606781034 200 Cook 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 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 1114.34 0 0 0 0 0 0 1114.34 0 0 1004340239 1093003014 10 Physicians GOODENOW ANNE 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 92.05 0 0 0 0 0 0 0 0 551.36 0 0 0 0 0 0 643.41 0 0 1004340408 1982972535 23 Occupational Therapists REHAK JUSTINE 193483109 55 Kendall 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 56 0 0 0 0 0 0 0 0 0 0 0 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Nurse Practitioners ALUMONA GLORIA N 999999999 200 Cook 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 832.5 0 0 0 0 0 0 832.5 0 0 1004342846 1376937474 16 Nurse Practitioners TIGLAO RONA M. 999999999 200 Cook 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4209.35 0 0 0 0 0 0 4209.35 0 0 1004342865 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.48 0 0 0 0 0 0 132.48 0 0 1004342993 1083844542 10 Physicians PROKOPIV HALYNA 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1550.11 0 0 0 0 0 0 1550.11 0 0 1004343022 91 Waiver service provider--Adults (DHS/DDD) 49 Jefferson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7424.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7424.4 0 0 1004343129 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004343279 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 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 0 420.74 0 0 0 0 0 0 0 0 0 0 0 0 0 420.74 0 0 1004343340 1306057310 10 Physicians ABBAS MOHAMMED A 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.4 0 429.3 0 0 0 0 0 0 472.7 0 0 1004343444 1376805077 10 Physicians ZIEMER ANNA L 999999999 19 Champaign 0 0 0 0 0 74 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AMY 605066222 53 Kane 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.31 0 1326.11 0 0 0 0 0 0 1377.42 0 0 1004365687 1649648833 33 Nursing Facilities CITADEL CARE CENTER-KANKAKEE 609012932 54 Kankakee 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670406.11 0 0 0 0 0 0 0 670406.11 0 0 1004365831 91 Waiver service provider--Adults (DHS/DDD) 69 Massac 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24862.06 0 0 0 0 0 0 0 0 0 0 0 0 0 24862.06 0 0 1004365861 1043500259 10 Physicians MALONE ANDREW F 631600352 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.14 0 0 0 0 0 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91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20915.73 0 0 0 0 0 0 0 0 0 0 0 0 0 20915.73 0 0 1004366914 1184739294 89 Physician Assistant Only(Encounter Only) KELSO FRANCOIS M 999999999 109 Winnebago 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 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 0 151.07 0 0 0 0 0 0 151.07 0 0 1004367082 1174819478 10 Physicians SUNGURLU SARAH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5592.87 0 0 0 0 0 0 5592.87 0 0 1004367580 1326006537 16 Nurse Practitioners PAWLIK SYLVIA 999999999 109 Winnebago 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 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5668.39 0 0 0 0 0 0 5668.39 0 0 1004367664 1336552199 22 Physical Therapists FOX NICOLE A 999999999 30 DuPage 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 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15430.95 15430.95 0 0 1004367719 1427345321 10 Physicians SUNDERBRUCH MICHAEL T 528092441 816 Iowa 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 505.23 0 0 0 0 0 0 505.23 0 0 1004368116 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25348.62 0 0 0 0 0 0 0 0 0 0 0 0 0 25348.62 0 0 1004368477 10 Physicians 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004368478 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13357.64 0 0 0 0 0 0 0 0 0 0 0 0 0 13357.64 0 0 1004368784 1831558386 23 Occupational Therapists JENISCH STEPHANIE 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10279.65 10279.65 0 0 1004368786 1821406257 16 Nurse Practitioners DALY CARRIE 601262816 30 DuPage 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 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 0 160.46 0 0 0 0 0 0 160.46 0 0 1004369488 1881077048 89 Physician Assistant Only(Encounter Only) JONAS DANIEL 999999999 53 Kane 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 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 2053.85 0 0 0 0 0 0 2053.85 0 0 1004369738 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22843.38 0 0 0 0 0 0 0 0 0 0 0 0 0 22843.38 0 0 1004369859 1033535968 16 Nurse Practitioners KURIA KEVIN 999999999 10 Adams 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004370013 10 Physicians 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004370270 16 Nurse Practitioners 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 42.14 0 0 1004370313 10 Physicians 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.79 0 0 0 0 0 0 81.79 0 0 1004370400 1376605279 46 Ambulatory Surgical Treatment Centers MIDWEST CENTER FOR DAY SURGERY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.85 0 0 0 0 0 122.85 0 0 1004370522 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 23436.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23436.94 0 0 1004370554 1043699184 89 Physician Assistant Only(Encounter Only) AHUJA ANUPRIT K 606313222 200 Cook 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 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 0 622.2 0 0 0 0 0 0 622.2 0 0 1004370757 1154641876 10 Physicians ARCEO-MENDOZA ROD MARIANNE 606910263 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 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 1820.39 0 0 0 0 0 0 1820.39 0 0 1004370820 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10793.64 0 0 0 0 0 0 0 0 0 0 0 0 0 10793.64 0 0 1004370821 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2764.24 0 0 0 0 0 0 2764.24 0 0 1004370900 1073586657 89 Physician Assistant Only(Encounter Only) ROSEN STEVEN M 999999999 10 Adams 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 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1805.61 0 0 0 0 0 0 1805.61 0 0 1004371192 1396133658 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES OF RANTOUL 618662663 19 Champaign 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53417.7 0 0 0 0 0 0 0 0 0 0 0 0 0 53417.7 0 0 1004371387 1922342484 16 Nurse Practitioners BALUCATING AMORY 618012529 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 955.65 0 0 0 0 0 0 955.65 0 0 1004371419 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8502.64 0 0 0 0 0 0 0 0 0 0 0 0 0 8502.64 0 0 1004371537 1710355565 16 Nurse Practitioners WITKUS AMY E 999999999 28 De Witt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1411.85 0 0 0 0 0 0 1411.85 0 0 1004371625 1568869469 16 Nurse Practitioners CLOSSER MEGHAN M 606313222 58 La Salle 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 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 0 914.36 0 0 0 0 0 0 914.36 0 0 1004371766 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25118.76 0 0 0 0 0 0 0 0 0 0 0 0 0 25118.76 0 0 1004371851 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 185.96 0 0 0 0 0 0 185.96 0 0 1004372298 1558750026 10 Physicians BALABANOVA ANNA V 999999999 200 Cook 0 0 Family Practice 0 0 0 11 0 0 0 0 0 0 6 0 76 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 7 0 133 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 7 0 133 0 0 0 0 0 0 0 0 0 340.55 0 0 0 0 0 0 18.14 0 3289.5 0 0 0 0 0 0 3648.19 0 0 1004372964 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004373346 1558494724 89 Physician Assistant Only(Encounter Only) BETTS DAVINA M 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 0 481.4 0 0 0 0 0 0 481.4 0 0 1004373498 1245472844 89 Physician Assistant Only(Encounter Only) BRADY MARISA C 999999999 200 Cook 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 754.34 0 0 0 0 0 0 754.34 0 0 1004373596 1942603352 16 Nurse Practitioners STEED JERUSHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.11 0 0 0 0 0 0 181.11 0 0 1004373600 1316176704 10 Physicians HALABI CARMEN M 631600352 97 Stephenson 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 286 0 0 1004373984 1942541149 10 Physicians CELLA JENNA M 999999999 40 Grundy 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 91.02 0 0 0 0 0 0 0 0 2945.22 0 0 0 0 0 0 3036.24 0 0 1004373988 1831567015 33 Nursing Facilities CITADEL CARE CENTER-ELGIN 601236429 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134050.05 0 0 0 0 0 0 0 134050.05 0 0 1004374011 1336545854 16 Nurse Practitioners WAGGONER SCOTT A 298413862 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1579.95 0 0 0 0 0 0 1579.95 0 0 1004374244 1659608941 10 Physicians YEE LYNN M. 606253500 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 35 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036.65 0 1368.61 0 0 0 0 0 0 2405.26 0 0 1004374271 1336416767 10 Physicians JOSHI JIGAR V 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618.6 0 0 0 0 0 0 618.6 0 0 1004374309 91 Waiver service provider--Adults (DHS/DDD) 55 Kendall 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4949.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4949.08 0 0 1004374519 1184970386 10 Physicians EASTIN HALEY E 999999999 19 Champaign 0 0 Pediatrics 0 0 0 82 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 6968.86 0 0 0 0 0 0 0 0 2240.53 0 0 0 0 0 0 9209.39 0 0 1004374531 1548663909 16 Nurse Practitioners STROMBECK JULIETTE 611086479 109 Winnebago 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 0 535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5077.72 0 0 0 0 0 0 5077.72 0 0 1004374781 1003283755 16 Nurse Practitioners MURDOCK RACHEL 999999999 91 Sangamon 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 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 0 626.34 0 0 0 0 0 0 626.34 0 0 1004374904 1760453369 16 Nurse Practitioners HUCKABEE NICOLE 999999999 108 Williamson 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 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 0 283.67 0 0 0 0 0 0 283.67 0 0 1004375291 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004375322 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 1394.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1394.19 0 0 1004375326 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1137.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1137.75 0 0 1004375352 1609138643 10 Physicians JESINSKIS LARISA 999999999 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 5.48 0 0 0 0 0 0 0 0 947.2 0 0 0 0 0 0 952.68 0 0 1004375416 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Physicians SAMANIEGO EDGAR A 999999999 816 Iowa 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 6 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 1159.33 0 0 0 0 0 0 1159.33 0 0 1004376284 1366830432 16 Nurse Practitioners GRADMAN EDWARD 117472358 24 Coles 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 953.16 0 0 0 0 0 0 953.16 0 0 1004376403 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004376601 1992951743 10 Physicians BRINKMAN AARON 999999999 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.54 0 0 0 0 0 0 188.54 0 0 1004376743 10 Physicians 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TALBERT ROBERT J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 638 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10079.58 0 0 0 0 0 0 0 0 10079.58 0 0 1004392299 1396753406 89 Physician Assistant Only(Encounter Only) GARSON JENNIFER 999999999 200 Cook 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896.59 0 0 0 0 0 0 896.59 0 0 1004392364 1366888208 16 Nurse Practitioners WALSH JENNIFER 999999999 30 DuPage 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 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3561.5 0 0 0 0 0 0 3561.5 0 0 1004392383 1982820148 10 Physicians YAZDAN PEDRAM 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 97 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4411.57 0 67.22 0 0 0 0 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31.01 0 0 1004395263 1942562889 10 Physicians HOWSE CHRISTOPHER J. 999999999 80 Peoria 0 1 General Practice 0 0 0 19 0 0 0 0 0 0 27 0 118 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 31 0 282 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 31 0 282 0 0 0 0 0 0 0 0 0 1902.12 0 0 0 0 0 0 255.02 0 4682.42 0 0 0 0 0 0 6839.56 0 0 1004395327 1770841678 10 Physicians LEE EUGENE C 601545716 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 1801.81 0 0 0 0 0 0 1871.33 0 0 1004395735 1376974527 40 Federally Qualified Health Centers WABASH VALLEY HEALTH CENTER 478071648 815 Indiana 0 0 0 24 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4612.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4612.83 0 0 1004395852 1861885675 16 Nurse Practitioners KASSIM OLADIMEJI M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5514.64 0 0 0 0 0 0 5514.64 0 0 1004395957 1093197410 16 Nurse Practitioners CROSS MELANIE 999999999 66 Marion 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 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5964.89 0 0 0 0 0 0 5964.89 0 0 1004395962 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.42 386.42 0 0 1004395971 1699934240 10 Physicians MEDDY JODEE 520016388 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1321.78 0 0 0 0 0 0 1321.78 0 0 1004396012 1265584155 34 State-operated facility (DHS) WILLIAM FOX DEVELOPMENTAL CTR 604201322 61 Livingston 0 0 0 0 0 0 0 0 0 0 74 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23061.24 0 0 0 0 0 0 0 0 0 0 0 0 0 23061.24 0 0 1004404817 1629337571 10 Physicians CHU CHRISTINE 999999999 19 Champaign 0 1 Pediatrics 0 0 0 89 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 8123.05 0 0 0 0 0 0 0 0 2912.69 0 0 0 0 0 0 11035.74 0 0 1004404859 1114180296 10 Physicians DRINKA EVA 999999999 835 North Dakota 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2848.29 0 0 0 0 0 0 0 0 2848.29 0 0 1004404919 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5219.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5219.58 0 0 1004405255 1093075434 10 Physicians NUCKOLS HANNAH R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 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200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 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 4840.37 0 0 0 0 0 0 4840.37 0 0 1004448033 1417362823 16 Nurse Practitioners YAGER DEBORAH 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334.15 0 0 0 0 0 0 334.15 0 0 1004448285 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 24.25 0 0 1004448525 1093007171 10 Physicians MARTIN KEVIN M. 629023988 47 Jackson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4784.98 0 0 0 0 0 0 4784.98 0 0 1004448565 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 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 5189.48 0 0 0 0 0 0 5189.48 0 0 1004478811 1124457965 30 General Hospitals FRESENIUS MEDICAL CARE WEST FR 628964964 36 Franklin DIALYSIS Outpatient dialysis centers. 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004478830 1598950990 10 Physicians SOTO ELIEZER 999999999 57 Lake 0 0 Anesthesiology 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 0 212 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 1988.18 0 0 0 0 0 0 1988.18 0 0 1004478834 16 Nurse Practitioners 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004479296 1699164897 16 Nurse Practitioners MOLINA LOUINA N 731279742 200 Cook 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 44 0 0 0 0 0 0 0 0 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0 0 0 0 2 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.58 0 4891.84 0 0 0 0 0 0 4957.42 0 0 1004484035 1790825040 10 Physicians OTENG-BEDIAKO EVELYN 999999999 53 Kane 0 0 Anesthesiology 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 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.05 0 3167.84 0 0 0 0 0 0 3205.89 0 0 1004484040 1336525831 23 Occupational Therapists CRAIN EFFANEY 999999999 36 Franklin 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 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38873.27 38873.27 0 0 1004484119 30 General Hospitals 72 McLean DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.29 0 0 0 0 0 47.29 0 0 1004484120 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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0 0 0 478 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2400.64 0 45.12 0 0 0 0 0 0 2445.76 0 0 1004503453 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26613.82 0 0 0 0 0 0 0 0 0 0 0 0 0 26613.82 0 0 1004503719 1073827267 16 Nurse Practitioners BLUMMER STEFANIE 605275965 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.68 0 0 0 0 0 0 105.68 0 0 1004503724 1396157723 16 Nurse Practitioners JOHNSTON JESSICA L 999999999 58 La Salle 0 0 0 0 0 2 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 170.27 0 0 0 0 0 0 0 0 6750.17 0 0 0 0 0 0 6920.44 0 0 1004503907 1801852454 89 Physician Assistant Only(Encounter Only) MANNING KERRI A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1752.45 0 0 0 0 0 0 1752.45 0 0 1004505061 1992779664 61 Independent Laboratories "EUROFINS NTD, LLC" 117474211 833 New York 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 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2662.23 0 0 0 0 0 0 0 0 2662.23 0 0 1004505091 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004505297 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.68 0 0 0 0 0 0 540.68 0 0 1004505485 1043551807 16 Nurse Practitioners KEANE MARY 606781034 200 Cook 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 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 0 333.96 0 0 0 0 0 0 333.96 0 0 1004505534 1225410574 16 Nurse Practitioners OLEGARIO JULIEANNE F 999999999 200 Cook 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 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 0 314.92 0 0 0 0 0 0 314.92 0 0 1004505790 1467737924 10 Physicians SHARMA ASHLEY 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 783.28 0 0 0 0 0 0 783.28 0 0 1004505794 28 Waiver service provider--Supportive living facility (HFS) 64 Macoupin 0 0 0 0 0 0 0 3 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 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41016.73 0 0 0 0 0 0 0 0 0 0 0 0 0 41016.73 0 0 1004506040 1235506106 60 Pharmacies MORELAND AND DEVITT PHARMACY 626181219 18 Cass 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 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Ophthalmology 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4703.64 0 0 0 0 0 0 4703.64 0 0 1004506556 1134511132 16 Nurse Practitioners HUSSEY MELANIE A 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366.51 0 0 0 0 0 0 366.51 0 0 1004506650 1306089024 10 Physicians PRANGE JESSICA 628814263 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2286.21 0 0 0 0 0 0 2286.21 0 0 1004506693 1265759922 10 Physicians WELT CASSIE 527224159 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619.3 0 0 0 0 0 0 619.3 0 0 1004507376 1477923746 16 Nurse Practitioners HACKL MEGAN 999999999 55 Kendall 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 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 0 472.27 0 0 0 0 0 0 472.27 0 0 1004507415 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22739.43 0 0 0 0 0 0 0 0 0 0 0 0 0 22739.43 0 0 1004507560 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9738.96 0 0 0 0 0 0 0 0 0 0 0 0 0 9738.96 0 0 1004507975 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18086.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18086.25 0 0 1004508466 1174844096 89 Physician Assistant Only(Encounter Only) ABEL GRETA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 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 0 935.68 0 0 0 0 0 0 935.68 0 0 1004508504 10 Physicians 20 Christian 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004508546 1598152019 40 Federally Qualified Health Centers "COMMUNITY HEALTH CARE, INC" 999999999 816 Iowa 0 1 0 57 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 9838.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9838.36 0 0 1004508671 1285860817 10 Physicians FENG JINGYANG 606123714 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.68 0 0 0 0 0 0 0 0 95.68 0 0 1004508759 1932209129 10 Physicians XIA LING 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.89 0 0 0 0 0 0 0 0 198.89 0 0 1004508834 1295905107 10 Physicians SONTI GAYATRI 611081673 109 Winnebago 0 0 Neurology Surgery 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5860.69 0 0 0 0 0 0 5860.69 0 0 1004509046 1477918613 16 Nurse Practitioners BURCENSKI SHERYL L 999999999 107 Will 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629.87 0 0 0 0 0 0 629.87 0 0 1004509167 1770959504 16 Nurse Practitioners DUNCAN MELISSA A 999999999 89 Rock Island 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 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4208.99 0 0 0 0 0 0 4208.99 0 0 1004509295 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 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 0 147.89 0 0 0 0 0 0 0 0 0 0 0 0 0 147.89 0 0 1004509365 1750446142 24 Speech Therapists LEDESMA ELLEN 605380702 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90243.53 90243.53 0 0 1004509460 1710365085 16 Nurse Practitioners ORTIZ LIDIA 606071644 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.07 0 0 0 0 0 0 224.07 0 0 1004509837 1023074051 16 Nurse Practitioners TREFTZ SHEILA 606781034 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 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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 0 191.57 191.57 0 0 1004583514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3180.55 0 0 0 0 0 0 0 0 0 0 0 0 0 3180.55 0 0 1004584006 1053607424 10 Physicians HARKENSEE TRACY ANNE 999999999 200 Cook 0 0 Emergency Medicine 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 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6170.37 0 0 0 0 0 0 6170.37 0 0 1004584315 1396160990 88 Other behavior health professional SCHWARTZ BRADLEY 999999999 200 Cook 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 0 110 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 3387.6 0 0 0 0 0 0 3387.6 0 0 1004584450 1801874664 89 Physician Assistant Only(Encounter Only) WILLIAMS DAN E 999999999 200 Cook 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 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 56.95 0 0 0 0 0 0 56.95 0 0 1004584469 1730387705 10 Physicians KIRK TYLER Q 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3243.92 0 0 0 0 0 0 3243.92 0 0 1004584858 1063434876 60 Pharmacies CVS PHARMACY #16325 601911338 30 DuPage 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40261.71 0 0 0 40261.71 0 0 1004585057 1942520127 10 Physicians GREENSPAN MICHAEL B. 999999999 63 Macon 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3564.52 0 0 0 0 0 0 3564.52 0 0 1004585248 1013382209 16 Nurse Practitioners ALBERT SHERRI L 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MCCARTAN MARY JO 999999999 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 636.1 0 29.28 0 0 0 0 665.38 0 0 1004586567 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.17 0 0 0 0 0 0 69.17 0 0 1004586931 1689099830 16 Nurse Practitioners PATEL SWETABEN 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 654.83 0 0 0 0 0 0 654.83 0 0 1004587224 91 Waiver service provider--Adults (DHS/DDD) 815 Indiana 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14621.46 0 0 0 0 0 0 0 0 0 0 0 0 0 14621.46 0 0 1004587380 92 Waiver service 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0 581.34 0 0 1004588057 1306829445 10 Physicians JOHNSON MICHAEL 999999999 200 Cook 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8883.73 0 0 0 0 0 0 8883.73 0 0 1004588317 92 Waiver service provider--Disability (DHS/DRS) 49 Jefferson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36045.01 0 0 0 0 0 0 0 0 0 0 0 0 0 36045.01 0 0 1004588414 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13481.5 0 0 0 0 0 0 0 0 0 0 0 0 0 13481.5 0 0 1004588560 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28519.49 0 0 0 0 0 0 0 0 0 0 0 0 0 28519.49 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1004589527 1588018311 16 Nurse Practitioners ERIKSSON JOANN H. 999999999 200 Cook 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 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 0 143.85 0 0 0 0 0 0 143.85 0 0 1004589565 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23034.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23034.5 0 0 1004589740 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23683.86 0 0 0 0 0 0 0 0 0 0 0 0 0 23683.86 0 0 1004589770 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 115.89 0 0 0 0 0 0 115.89 0 0 1004589897 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622263104 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 3261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2180.35 0 0 0 2180.35 0 0 1004591775 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24160.78 0 0 0 0 0 0 0 0 0 0 0 0 0 24160.78 0 0 1004591809 1699174060 16 Nurse Practitioners BRITVIC MICHELE L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304.76 0 0 0 0 0 0 304.76 0 0 1004592122 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004592125 1992155022 40 Federally Qualified Health Centers LAKE COUNTY HEALTH DEPARTMENT 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Assistant Only(Encounter Only) TAYLOR BRETT M 999999999 54 Kankakee 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 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 0 617.7 0 0 0 0 0 0 617.7 0 0 1004592861 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23782.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23782.52 0 0 1004592925 1215387113 11 Dentists SAGADRACA TOMMY 999999999 30 DuPage 0 0 General Dentistry 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4736.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4736.05 0 0 1004592930 1407847882 63 Other Providers of Medical Equipment/Supplies (Non-registered) "ACTIVSTYLE, INC." 606431018 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569120.35 0 0 0 0 0 0 569120.35 0 0 1004593561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17149.27 0 0 0 0 0 0 0 0 0 0 0 0 0 17149.27 0 0 1004593588 1295964872 10 Physicians ZACHARIAH AMIT 999999999 54 Kankakee 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6135.1 0 0 0 0 0 0 6135.1 0 0 1004593595 1952702474 16 Nurse Practitioners SANTOS VIVIANE M 999999999 80 Peoria 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664.54 0 0 0 0 0 0 664.54 0 0 1004593802 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20001.93 0 0 0 0 0 0 0 0 0 0 0 0 0 20001.93 0 0 1004594135 92 Waiver service provider--Disability (DHS/DRS) 44 Henderson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38568.7 0 0 0 0 0 0 0 0 0 0 0 0 0 38568.7 0 0 1004594328 1528446812 65 Independent Diagnostic Testing Facility (IDTF) PREMIER MRI OF SCHAUMBURG 999999999 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 694.95 0 0 0 0 0 0 0 0 694.95 0 0 1004594382 10 Physicians 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.6 0 0 0 0 0 0 1.6 0 0 1004594386 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8407.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8407.65 0 0 1004594634 1285861187 10 Physicians HAN IAN C 999999999 50 Jersey 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.26 0 228.12 0 0 0 0 0 0 232.38 0 0 1004594713 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.93 0 0 0 0 0 0 221.93 0 0 1004594827 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004595327 1790732097 89 Physician Assistant Only(Encounter Only) BOEHM IVEN 999999999 94 Shelby 0 0 0 0 0 3 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 91.02 0 0 0 0 0 0 0 0 7503.76 0 0 0 0 0 0 7594.78 0 0 1004595333 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 943.26 0 0 0 0 0 0 0 0 0 0 0 0 0 943.26 0 0 1004595358 1720246515 11 Dentists YOUSEF FARZIN 999999999 200 Cook 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10600.49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10600.49 0 0 1004595490 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 670.1 0 0 0 0 0 0 0 0 0 0 0 0 0 670.1 0 0 1004595680 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15330.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15330.99 0 0 1004595856 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1004595869 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7722.46 0 0 0 0 0 0 0 0 0 0 0 0 0 7722.46 0 0 1004596112 1629529334 16 Nurse Practitioners KERZAN TRACY L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004596434 1356634505 10 Physicians LICHTOR STEPHANIE A 999999999 30 DuPage 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2403.98 0 0 0 0 0 0 2403.98 0 0 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0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5280.8 0 0 0 0 0 0 5280.8 0 0 1004608063 1427328798 89 Physician Assistant Only(Encounter Only) LESLEY GLENN MEGAN C 999999999 72 McLean 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1280.17 0 0 0 0 0 0 1280.17 0 0 1004608237 1982982096 10 Physicians SOOD KANIKA 999999999 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5159.36 0 0 0 0 0 0 5159.36 0 0 1004608558 1902149982 10 Physicians SHAH MAULIN G 999999999 80 Peoria 0 1 Family Practice 0 0 0 15 0 0 0 0 0 0 28 0 94 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 55 0 205 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 55 0 205 0 0 0 0 0 0 0 0 0 1113.54 0 0 0 0 0 0 558.49 0 3340.51 0 0 0 0 0 0 5012.54 0 0 1004608596 1346319001 16 Nurse Practitioners HOLTHAUS ANGELA J 999999999 58 La Salle 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 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 0 966.49 0 0 0 0 0 0 966.49 0 0 1004609062 1205276698 10 Physicians MESSER ELIZABETH S 999999999 68 Mason 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1877.59 0 0 0 0 0 0 1877.59 0 0 1004609183 1053678557 89 Physician Assistant Only(Encounter Only) PATEL NILAM M 999999999 200 Cook 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 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 1757.15 0 0 0 0 0 0 1757.15 0 0 1004609448 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15971.38 0 0 0 0 0 0 0 0 0 0 0 0 0 15971.38 0 0 1004609640 1861768905 89 Physician Assistant Only(Encounter Only) GERLING HILLARY A 999999999 826 Missouri 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1374.71 0 0 0 0 0 0 1374.71 0 0 1004609713 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 20 0 0 1004610110 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4743.24 0 0 0 0 0 0 0 0 0 0 0 0 0 4743.24 0 0 1004610146 23 Occupational Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.16 224.16 0 0 1004610272 1821546870 16 Nurse Practitioners ZAURA GABRIELLE 999999999 200 Cook 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 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 0 250.93 0 0 0 0 0 0 250.93 0 0 1004610399 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9994.35 0 0 0 0 0 0 0 0 0 0 0 0 0 9994.35 0 0 1004610554 1326369265 10 Physicians ALEEM ALEXANDER WILLIAM 999999999 10 Adams 0 0 Orthopedic Surgery 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 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 1915.07 0 0 0 0 0 0 1915.07 0 0 1004610613 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29019.1 0 0 0 0 0 0 0 0 0 0 0 0 0 29019.1 0 0 1004610909 23 Occupational Therapists 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1027.4 1027.4 0 0 1004611042 1194112755 16 Nurse Practitioners REIMMITZ CATHERINE 999999999 200 Cook 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 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 0 269.96 0 0 0 0 0 0 269.96 0 0 1004611160 1023462785 16 Nurse Practitioners DANTZLER TOCARRA 999999999 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.22 0 0 0 0 0 0 106.22 0 0 1004611560 1295757086 60 Pharmacies CVS PHARMACY #16280 601391971 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21929 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17096.42 0 0 0 17096.42 0 0 1004611646 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17265.88 0 0 0 0 0 0 0 0 0 0 0 0 0 17265.88 0 0 1004611731 1326402942 10 Physicians PARMAR KARMA P 999999999 200 Cook 0 0 Internal Medicine 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2118.08 0 0 0 0 0 0 2118.08 0 0 1004611853 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 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 3616.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3616.24 0 0 1004612290 89 Physician Assistant Only(Encounter Only) 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1004612309 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.19 0 0 0 0 0 0 13.19 0 0 1004612384 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 804.14 0 0 0 0 0 0 0 0 0 0 0 0 0 804.14 0 0 1004612431 1982065470 16 Nurse Practitioners WANG GRIZAELLA A 999999999 200 Cook 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 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 0 187.62 0 0 0 0 0 0 187.62 0 0 1004612707 92 Waiver service provider--Disability (DHS/DRS) 96 St Clair 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14018.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14018.8 0 0 1004612777 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14157.59 0 0 0 0 0 0 0 0 0 0 0 0 0 14157.59 0 0 1004612837 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.41 0 0 0 0 0 0 62.41 0 0 1004612957 1780053421 16 Nurse Practitioners ARCHER AARON J. 999999999 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1034.59 0 0 0 0 0 0 1034.59 0 0 1004613082 1023245115 10 Physicians SATO TAKASHI S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 18 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609.56 0 8.81 0 0 0 0 0 0 618.37 0 0 1004613161 1649484072 89 Physician Assistant Only(Encounter Only) NORRIS ARLENE J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1629.49 0 0 0 0 0 0 1629.49 0 0 1004613248 1013375351 89 Physician Assistant Only(Encounter Only) SHEA MELANIE 999999999 200 Cook 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 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 1455.04 0 0 0 0 0 0 1455.04 0 0 1004613354 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 11267.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11267.78 0 0 1004613373 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23101.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23101.32 0 0 1004613384 1801296108 16 Nurse Practitioners WACKT AMANDA C 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 70.7 0 0 0 0 0 0 0 0 1924.91 0 0 0 0 0 0 1995.61 0 0 1004613423 1477635092 10 Physicians AHMAD HOMAA 999999999 200 Cook 0 0 Internal Medicine 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 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 0 513.66 0 0 0 0 0 0 513.66 0 0 1004613443 1629369566 10 Physicians MARTIN APRYL N 999999999 19 Champaign 0 0 Anesthesiology 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 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 7661.58 0 0 0 0 0 0 7661.58 0 0 1004613590 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60186.45 0 0 0 0 0 0 0 0 0 0 0 0 0 60186.45 0 0 1004613673 1609211952 10 Physicians HANSON KEITH A 999999999 80 Peoria 0 0 Pediatrics 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5472.95 0 0 0 0 0 0 5472.95 0 0 1004613836 1831551829 16 Nurse Practitioners HAWKINS ABBEY E 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.44 0 0 0 0 0 0 219.44 0 0 1004613869 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12462.28 0 0 0 0 0 0 0 0 0 0 0 0 0 12462.28 0 0 1004614105 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25645.07 0 0 0 0 0 0 0 0 0 0 0 0 0 25645.07 0 0 1004614139 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34971.91 0 0 0 0 0 0 0 0 0 0 0 0 0 34971.91 0 0 1004614218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10614.66 0 0 0 0 0 0 0 0 0 0 0 0 0 10614.66 0 0 1004614253 1619104098 40 Federally Qualified Health Centers AUNT MARTHA'S YOUTH SERVICE CE 999999999 200 Cook 0 0 0 36 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2293.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2293.09 0 0 1004614279 10 Physicians 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.63 0 0 0 0 0 0 78.63 0 0 1004614322 1508167925 89 Physician Assistant Only(Encounter Only) QUNELL ALISON L 999999999 200 Cook 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 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 1006.31 0 0 0 0 0 0 1006.31 0 0 1004614662 1760837256 12 Optometrists PATEL JAYMENI H 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875.92 0 0 0 0 0 0 875.92 0 0 1004614786 1245599984 10 Physicians KOHLHAPP CAROLINE R 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 193.46 0 0 0 0 0 0 20.92 0 517.37 0 0 0 0 0 0 731.75 0 0 1004614875 91 Waiver service provider--Adults (DHS/DDD) 826 Missouri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17635.38 0 0 0 0 0 0 0 0 0 0 0 0 0 17635.38 0 0 1004614981 1649536186 10 Physicians WYSZOMIRSKI MICHELLE ANGELA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 7283.64 0 0 0 0 0 0 7355.54 0 0 1004615093 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350.63 0 0 0 0 0 0 350.63 0 0 1004615225 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12130.7 0 0 0 0 0 0 0 0 0 0 0 0 0 12130.7 0 0 1004615574 1629052881 10 Physicians CHEROMCHA DAVID P. 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 924.14 0 0 0 0 0 0 924.14 0 0 1004616332 1609071349 10 Physicians TAN ALAN 999999999 200 Cook 0 0 Internal Medicine 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 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 1394.88 0 0 0 0 0 0 1394.88 0 0 1004616409 22 Physical Therapists 65 Madison 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 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 1311.44 1311.44 0 0 1004616426 1073715744 10 Physicians KLINK JOSEPH C 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834.81 0 0 0 0 0 0 834.81 0 0 1004616499 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29454.52 0 0 0 0 0 0 0 0 0 0 0 0 0 29454.52 0 0 1004616516 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20275.99 0 0 0 0 0 0 0 0 0 0 0 0 0 20275.99 0 0 1004616574 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 20527.27 0 0 0 0 0 0 0 0 0 0 0 0 0 20527.27 0 0 1004616593 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21624.04 0 0 0 0 0 0 0 0 0 0 0 0 0 21624.04 0 0 1004616605 1972973626 89 Physician Assistant Only(Encounter Only) CASLOW NATHAN D 999999999 47 Jackson 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3241.24 0 0 0 0 0 0 3241.24 0 0 1004616754 1417979121 60 Pharmacies CVS PHARMACY #16771 606184635 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 4652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.44 0 0 9097.87 0 0 0 9230.31 0 0 1004616883 1437304888 10 Physicians YOUSSEF NANCY 999999999 200 Cook 0 0 Family Practice 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 3 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.69 0 185.19 0 0 0 0 0 0 186.88 0 0 1004616925 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2992.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2992.42 0 0 1004616991 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 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 0 170.17 0 0 0 0 0 0 170.17 0 0 1004617013 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 3136.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3136.01 0 0 1004617102 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64734.6 0 0 0 0 0 0 0 0 0 0 0 0 0 64734.6 0 0 1004617252 1306292271 10 Physicians LIN WINNIE 999999999 200 Cook 0 0 Pediatrics 0 0 0 27 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 2108.53 0 0 0 0 0 0 0 0 1671.84 0 0 0 0 0 0 3780.37 0 0 1004617259 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004617600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2611.32 0 0 0 0 0 0 0 0 0 0 0 0 0 2611.32 0 0 1004618016 1508216540 16 Nurse Practitioners JOHNSON ERIKA KIRSTIN 999999999 57 Lake 0 0 0 0 0 32 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 2625.92 0 0 0 0 0 0 0 0 3367.68 0 0 0 0 0 0 5993.6 0 0 1004618211 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.76 0 0 0 0 0 0 37.76 0 0 1004618343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004618459 1023350519 13 Podiatrists NAGESH DARSHAN 999999999 200 Cook 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 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2374.53 0 0 0 0 0 0 2374.53 0 0 1004618946 91 Waiver service provider--Adults (DHS/DDD) 36 Franklin 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6766.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6766.2 0 0 1004618998 1063756138 16 Nurse Practitioners HUSCH ERIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1257.35 0 0 0 0 0 0 1257.35 0 0 1004619038 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 8508.81 0 0 0 0 0 0 0 0 0 0 0 0 0 8508.81 0 0 1004619188 93 Waiver service provider--HIV/AIDS (DHS/DRS) 23 Clinton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20825.62 0 0 0 0 0 0 0 0 0 0 0 0 0 20825.62 0 0 1004619328 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16851.68 0 0 0 0 0 0 0 0 0 0 0 0 0 16851.68 0 0 1004619329 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004619547 1912162900 10 Physicians AHMED MONA 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 225 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3063.35 0 311.9 0 0 0 0 0 0 3375.25 0 0 1004619699 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27805.52 0 0 0 0 0 0 0 0 0 0 0 0 0 27805.52 0 0 1004619703 60 Pharmacies 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111436.66 0 0 0 111436.66 0 0 1004619819 1306236310 13 Podiatrists TRUNCALE KRISTEN 999999999 200 Cook 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594.61 0 0 0 0 0 0 594.61 0 0 1004620026 1598153512 89 Physician Assistant Only(Encounter Only) KNOBLAUCH KORTE B 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 1759.36 0 0 0 0 0 0 1765.76 0 0 1004620498 1891051439 10 Physicians LENON ANGELA L 999999999 200 Cook 0 0 Internal Medicine 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 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4084.52 0 0 0 0 0 0 4084.52 0 0 1004620776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4647.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4647.14 0 0 1004621019 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24420 0 0 0 0 0 0 0 0 0 0 0 0 0 24420 0 0 1004621040 91 Waiver service provider--Adults (DHS/DDD) 23 Clinton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17973.12 0 0 0 0 0 0 0 0 0 0 0 0 0 17973.12 0 0 1004621777 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 2599.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2599.83 0 0 1004621818 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22170.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22170.04 0 0 1004621914 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25671 0 0 0 0 0 0 0 0 0 0 0 0 0 25671 0 0 1004622542 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2889.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2889.7 0 0 1004622635 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22800.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22800.42 0 0 1004622898 1700160959 10 Physicians BRIGGS BRANDEN J 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 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 8674.58 0 0 0 0 0 0 8674.58 0 0 1004623145 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25558.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25558.2 0 0 1004623253 1790707503 60 Pharmacies CVS PHARMACY #16305 604401508 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7934.64 0 0 0 7934.64 0 0 1004623276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22603.53 0 0 0 0 0 0 0 0 0 0 0 0 0 22603.53 0 0 1004623391 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501.18 0 0 0 0 0 0 501.18 0 0 1004623431 92 Waiver service provider--Disability (DHS/DRS) 102 Warren 0 0 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 4219.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4219.37 0 0 1004623550 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19952.5 0 0 0 0 0 0 0 0 0 0 0 0 0 19952.5 0 0 1004623616 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5016.53 0 0 0 0 0 0 0 0 0 0 0 0 0 5016.53 0 0 1004623709 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.93 0 0 1004624827 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.99 0 0 0 0 0 0 3.99 0 0 1004624875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4471.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4471.45 0 0 1004624997 1902349202 16 Nurse Practitioners SHRODE KIMBERLY 999999999 80 Peoria 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 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 0 723.83 0 0 0 0 0 0 723.83 0 0 1004625118 30 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 471 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004625552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 950.53 0 0 0 0 0 0 0 0 0 0 0 0 0 950.53 0 0 1004625625 1437457405 10 Physicians HUTCHINSON RYAN 999999999 24 Coles 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004625756 1073856449 10 Physicians WALKER AMANDA 999999999 19 Champaign 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1895.48 0 0 0 0 0 0 1895.48 0 0 1004625922 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22041.73 0 0 0 0 0 0 0 0 0 0 0 0 0 22041.73 0 0 1004626080 1710206131 10 Physicians KAMINSKI JAN PAWEL 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4096.72 0 0 0 0 0 0 4096.72 0 0 1004626173 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 59.25 0 0 0 0 0 0 59.25 0 0 1004626309 1427505197 10 Physicians HYNES KELLY K 999999999 200 Cook 0 0 Orthopedic Surgery 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10813.88 0 0 0 0 0 0 10813.88 0 0 1004626410 1578018792 16 Nurse Practitioners KERBOW DAVID W 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3498.36 0 0 0 0 0 0 3498.36 0 0 1004626488 1639345598 10 Physicians HARSHA VARDHAN SINDHUJA 999999999 200 Cook 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 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 6163.43 0 0 0 0 0 0 6163.43 0 0 1004626593 1649242736 10 Physicians ALKHAS ADDIE 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 1212.91 0 0 0 0 0 0 1212.91 0 0 1004626625 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21359.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21359.8 0 0 1004626654 1033399241 89 Physician Assistant Only(Encounter Only) HUDSON AUBREY 999999999 19 Champaign 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1426.15 0 0 0 0 0 0 1426.15 0 0 1004627059 1275625865 16 Nurse Practitioners NORRIS PAMELA J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 474.52 0 0 0 0 0 0 474.52 0 0 1004627085 1407016249 10 Physicians ROUTSON HONG SUE 999999999 200 Cook 0 0 Pediatrics 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 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36812.9 0 0 0 0 0 0 36812.9 0 0 1004627127 4004627127 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 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 5986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391768.86 0 0 0 0 0 0 0 0 0 0 0 0 0 391768.86 0 0 1004627250 1548612187 24 Speech Therapists MELCHER SARAH 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2783.58 2783.58 0 0 1004627510 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12441 0 0 0 0 0 0 0 0 0 0 0 0 0 12441 0 0 1004627638 1770970964 91 Waiver service provider--Adults (DHS/DDD) HARSY ANGELA R 999999999 96 St Clair 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 2094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105173.61 0 0 0 0 0 0 0 0 0 0 0 0 0 105173.61 0 0 1004627679 1427070135 60 Pharmacies CVS PHARMACY #16724 600902239 57 Lake 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10728.25 0 0 0 10728.25 0 0 1004627999 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31727.08 0 0 0 0 0 0 0 0 0 0 0 0 0 31727.08 0 0 1004628111 1174896633 87 Psychologist(Encounter Only) LAVIGNE JOSHUA 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 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 0 252.19 0 0 0 0 0 0 252.19 0 0 1004628284 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 195.36 0 0 0 0 0 0 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200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004646056 1932556131 16 Nurse Practitioners GAGNI THARA A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617.03 0 0 0 0 0 0 1617.03 0 0 1004646253 98 Waiver service provider--TBI (DHS/DRS) 103 Washington 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47859.52 0 0 0 0 0 0 0 0 0 0 0 0 0 47859.52 0 0 1004646424 1235422304 89 Physician Assistant Only(Encounter Only) THOMPSON ASHLEY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.07 0 0 0 0 0 0 1031.07 0 0 1004646479 1912988759 10 Physicians MISAWA KYOKO 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 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 4076.42 0 0 0 0 0 0 4076.42 0 0 1004646627 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.45 0 0 0 0 0 0 46.45 0 0 1004646691 1669747390 63 Other Providers of Medical Equipment/Supplies (Non-registered) "3RD ST MEDICAL SUPPLY,INC." 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16531.31 0 0 0 0 0 0 16531.31 0 0 1004646742 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 5821.61 0 0 0 0 0 0 0 0 0 0 0 0 0 5821.61 0 0 1004646770 1467765495 10 Physicians BRINCKERHOFF BEAU 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 3212.28 0 0 0 0 0 0 3212.28 0 0 1004646784 1366754699 10 Physicians LOPEZ GREGORY 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 34 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 857.46 0 7927.2 0 0 0 0 0 0 8784.66 0 0 1004646841 1790071553 10 Physicians OSTERAAS NICHOLAS 999999999 200 Cook 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2427.01 0 0 0 0 0 0 2427.01 0 0 1004646935 1104361328 91 Waiver service provider--Adults (DHS/DDD) MATHEW CHERYL 999999999 200 Cook 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 0 887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64324.8 0 0 0 0 0 0 0 0 0 0 0 0 0 64324.8 0 0 1004647027 1447699368 10 Physicians PAIK JOHN M 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7005.66 0 0 0 0 0 0 7005.66 0 0 1004647132 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1004648205 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 6299.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6299.63 0 0 1004648280 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16935.27 0 0 0 0 0 0 0 0 0 0 0 0 0 16935.27 0 0 1004648370 16 Nurse Practitioners 59 Lawrence 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004648651 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 2394.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2394.91 0 0 1004648682 1992845747 16 Nurse Practitioners MIRZA RUTH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.27 0 0 0 0 0 0 135.27 0 0 1004648801 92 Waiver service provider--Disability (DHS/DRS) 36 Franklin 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48373.83 0 0 0 0 0 0 0 0 0 0 0 0 0 48373.83 0 0 1004648967 1427373638 10 Physicians WARIS MOHAMMAD S. 999999999 19 Champaign 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 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 0 917.02 0 0 0 0 0 0 917.02 0 0 1004649107 1285181149 16 Nurse Practitioners CRAIG DIANE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.05 0 0 0 0 0 0 155.05 0 0 1004649179 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369.42 0 0 0 0 0 0 369.42 0 0 1004649312 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718.04 718.04 0 0 1004649729 1770957490 30 General Hospitals HAMMOND DIALYSIS CENTER 999999999 815 Indiana DIALYSIS Outpatient dialysis centers. 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1224.36 0 0 0 0 0 1224.36 0 0 1004649846 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.25 0 0 1004649851 1467793463 10 Physicians JAFRI SANA 999999999 200 Cook 0 0 Internal Medicine 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 0 152 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 2358.37 0 0 0 0 0 0 2358.37 0 0 1004649880 4004649880 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892142.29 0 0 0 0 0 0 0 0 0 0 0 0 0 892142.29 0 0 1004650172 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6043.05 0 0 0 0 0 0 0 0 0 0 0 0 0 6043.05 0 0 1004650249 10 Physicians 816 Iowa 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.12 0 0 0 0 0 0 153.12 0 0 1004650279 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 21981.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21981.9 0 0 1004650320 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12283.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12283.58 0 0 1004650343 10 Physicians 24 Coles 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004650616 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4753.76 0 0 0 0 0 0 0 0 0 0 0 0 0 4753.76 0 0 1004650645 1992026181 10 Physicians HENDERSON JOSEPH 999999999 30 DuPage 0 0 Pediatrics 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4840.6 0 0 0 0 0 0 4840.6 0 0 1004650753 1194197186 16 Nurse Practitioners ENGELKE KATHERINE J 999999999 200 Cook 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 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 0 712.82 0 0 0 0 0 0 712.82 0 0 1004651035 1700288990 89 Physician Assistant Only(Encounter Only) STANG ASHTYN C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1833.61 0 0 0 0 0 0 1833.61 0 0 1004651257 1881099265 16 Nurse Practitioners TARUC KRISTEN R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004651362 1932554862 24 Speech Therapists RAZIM MEGAN M 999999999 200 Cook 0 0 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 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62149.45 62149.45 0 0 1004651386 1033573605 60 Pharmacies MEIJER PHARMACY #289 999999999 57 Lake 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 0 750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27594.6 0 0 0 27594.6 0 0 1004651501 1215313721 23 Occupational Therapists GRIFFIN JULIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22753.34 22753.34 0 0 1004651507 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11857.7 0 0 0 0 0 0 0 0 0 0 0 0 0 11857.7 0 0 1004651615 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1004651670 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 20 0 0 1004651711 1669815809 10 Physicians SEGEL BRETT 999999999 200 Cook 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 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 1151.38 0 0 0 0 0 0 1151.38 0 0 1004652051 1629434345 36 Community mental health provider CENTERSTONE OF ILLINOIS 999999999 65 Madison 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 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73162.33 0 0 73162.33 0 0 1004652628 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8408.56 0 0 0 0 0 0 0 0 0 0 0 0 0 8408.56 0 0 1004653008 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7889.04 0 0 0 0 0 0 0 0 0 0 0 0 0 7889.04 0 0 1004653070 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 0 0 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 1630.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1630.01 0 0 1004653154 1578814414 89 Physician Assistant Only(Encounter Only) TRIPP KATRINA L 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3030.86 0 0 0 0 0 0 3030.86 0 0 1004653192 1285745711 89 Physician Assistant Only(Encounter Only) PETERSON MATTHEW ROBERT 999999999 19 Champaign 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4610.36 0 0 0 0 0 0 4610.36 0 0 1004653276 1710113253 10 Physicians RAJESWARAN SHANKAR 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 29 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410.53 0 10839.5 0 0 0 0 0 0 11250.03 0 0 1004653291 10 Physicians 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 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 66.44 0 0 0 0 0 0 66.44 0 0 1004653675 91 Waiver service provider--Adults (DHS/DDD) 77 Morgan 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2559.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2559.6 0 0 1004653688 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 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 78.24 0 0 0 0 0 0 0 0 78.24 0 0 1004653830 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8514 0 0 0 0 0 0 0 0 0 0 0 0 0 8514 0 0 1004653927 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 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 23374.01 0 0 0 0 0 0 0 0 0 0 0 0 0 23374.01 0 0 1004653998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4524.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.36 0 0 1004654100 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20369.09 0 0 0 0 0 0 0 0 0 0 0 0 0 20369.09 0 0 1004654232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18033.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18033.4 0 0 1004654403 1730455643 10 Physicians SHAKERI NAHZININE 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3774.44 0 0 0 0 0 0 3774.44 0 0 1004654511 1013070440 89 Physician Assistant Only(Encounter Only) WRIGLEY KIM C 999999999 200 Cook 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.92 0 0 0 0 0 0 215.92 0 0 1004654573 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 888.6 0 0 0 0 0 0 0 0 0 0 0 0 0 888.6 0 0 1004654658 1154564607 10 Physicians HAAS KEVIN P 999999999 53 Kane 0 0 Internal Medicine 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2761.15 0 0 0 0 0 0 2761.15 0 0 1004654893 89 Physician Assistant Only(Encounter Only) 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 78.09 0 0 1004655226 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 16624.83 0 0 0 0 0 0 0 0 0 0 0 0 0 16624.83 0 0 1004655341 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36950.85 0 0 0 0 0 0 0 0 0 0 0 0 0 36950.85 0 0 1004655378 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 9811.64 0 0 0 0 0 0 0 0 0 0 0 0 0 9811.64 0 0 1004655408 1871665380 30 General Hospitals SSM HEALTH ST. JOSEPH HOSPITAL 633671366 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 7 0 0 0 0 10 0 0 0 7 0 0 0 0 0 0 0 0 0 7 0 0 0 0 10 0 0 0 19 0 0 0 0 0 0 0 0 0 7 0 0 0 0 32 0 0 0 19 0 0 0 0 0 0 0 0 0 531.35 0 0 0 0 9081.95 0 0 0 164.03 0 0 0 0 0 9777.33 0 0 1004655501 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 590.07 0 0 0 0 0 0 0 0 0 0 0 0 0 590.07 0 0 1004655679 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208.62 0 0 0 0 0 0 208.62 0 0 1004655714 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12321.69 0 0 0 0 0 0 0 0 0 0 0 0 0 12321.69 0 0 1004655773 1912228685 10 Physicians ROJAS ANA MARIE 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11898.18 0 0 0 0 0 0 11898.18 0 0 1004656162 1992152680 24 Speech Therapists MACIEL ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3962.69 3962.69 0 0 1004656355 1891043162 10 Physicians PAREKH KEYUR M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1219 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1984 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1984 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13687.33 0 1157.99 0 0 0 0 0 0 14845.32 0 0 1004656532 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 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 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(DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12000.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12000.1 0 0 1004660111 1861897381 89 Physician Assistant Only(Encounter Only) GALLOWAY JACOB L 999999999 200 Cook 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147.5 0 0 0 0 0 0 2147.5 0 0 1004660174 1023429636 10 Physicians ABDELRHMAN TAMER R 999999999 200 Cook 0 0 Radiation Oncology 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 0 128 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 2847.33 0 0 0 0 0 0 2847.33 0 0 1004660234 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47924.34 0 0 0 0 0 0 0 0 0 0 0 0 0 47924.34 0 0 1004660486 1780021774 10 Physicians ZABAD AHMAD 999999999 91 Sangamon 0 0 Internal Medicine 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 0 233 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 4171.55 0 0 0 0 0 0 4171.55 0 0 1004660528 1780075010 30 General Hospitals MEDICAL DISTRICT HOME DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41023.65 0 0 0 0 0 41023.65 0 0 1004660652 1962945543 70 Ambulance Service Providers ARCH AIR MEDICAL SERVICE 999999999 826 Missouri 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 16920 0 0 0 0 0 0 16920 0 0 1004660972 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 716.09 0 0 0 0 0 0 0 0 0 0 0 0 0 716.09 0 0 1004661126 1457615577 10 Physicians MACKEY JOSEPH R. 999999999 80 Peoria 0 0 Internal Medicine 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7878.68 0 0 0 0 0 0 7878.68 0 0 1004661320 1326419912 60 Pharmacies SMITHTON PHARMACY 999999999 96 St Clair 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7586.38 0 0 0 7586.38 0 0 1004661655 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12832.27 0 0 0 0 0 0 0 0 0 0 0 0 0 12832.27 0 0 1004661916 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 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 2361.09 0 0 0 0 0 0 0 0 0 0 0 0 0 2361.09 0 0 1004661948 89 Physician Assistant Only(Encounter Only) 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 42.14 0 0 1004662088 1063675551 10 Physicians RAINS MARTIN G 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 757.68 0 0 0 0 0 0 757.68 0 0 1004662194 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26161.22 0 0 0 0 0 0 0 0 0 0 0 0 0 26161.22 0 0 1004662450 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31077.32 0 0 0 0 0 0 0 0 0 0 0 0 0 31077.32 0 0 1004662718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 1004662955 1982867388 10 Physicians RAMIREZ MIGUEL 616151941 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 43 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456.51 0 8524.07 0 0 0 0 0 0 8980.58 0 0 1004663060 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1004663411 1629202114 16 Nurse Practitioners WINTER LISA C 999999999 65 Madison 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 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 0 138 0 0 0 0 0 0 138 0 0 1004664255 1417307539 91 Waiver service provider--Adults (DHS/DDD) HALL KENDRA 999999999 96 St Clair 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134363.8 0 0 0 0 0 0 0 0 0 0 0 0 0 134363.8 0 0 1004664423 1710142237 10 Physicians TOMAN JORDAN E 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 396 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9510.55 0 3079.51 0 0 0 0 0 0 12590.06 0 0 1004664504 1346561123 10 Physicians VERCILLO KRISTIN N 999999999 57 Lake 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 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 1629.55 0 0 0 0 0 0 1629.55 0 0 1004664611 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 187.79 0 0 0 0 0 0 0 0 0 0 0 0 0 187.79 0 0 1004664627 1992004527 10 Physicians GIARDINA JOSEPH D 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 17 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.26 0 1500.94 0 0 0 0 0 0 1612.2 0 0 1004664659 1962848366 10 Physicians BALMOORI NEHA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.1 0 0 0 0 0 0 233.1 0 0 1004664844 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15616.59 0 0 0 0 0 0 0 0 0 0 0 0 0 15616.59 0 0 1004664847 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004664879 1245221092 63 Other Providers of Medical Equipment/Supplies (Non-registered) VERUS HEALTHCARE LLC 370272872 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4532.47 0 0 0 0 0 0 4532.47 0 0 1004664991 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 21987.42 0 0 0 0 0 0 0 0 0 0 0 0 0 21987.42 0 0 1004665193 1841422482 10 Physicians GEISSEN NICOLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231.81 0 0 0 0 0 0 1231.81 0 0 1004665276 92 Waiver service provider--Disability (DHS/DRS) 23 Clinton 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5183.09 0 0 0 0 0 0 0 0 0 0 0 0 0 5183.09 0 0 1004665487 1770886723 89 Physician Assistant Only(Encounter Only) WILKIN MATTHEW 999999999 200 Cook 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 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 0 110.66 0 0 0 0 0 0 110.66 0 0 1004665534 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 48561.02 0 0 0 0 0 0 0 0 0 0 0 0 0 48561.02 0 0 1004665539 1720433048 16 Nurse Practitioners JONES MARY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3944.26 0 0 0 0 0 0 3944.26 0 0 1004665689 1245252956 60 Pharmacies CVS PHARMACY 16742 605855415 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4719.7 0 0 0 4719.7 0 0 1004665698 1033570262 75 Department of Alcohol and Substance Abuse Provider CENTERSTONE OF ILLINOIS 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 75318.86 0 0 75318.86 0 0 1004666665 1750624185 10 Physicians MEDENICA IRENA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1737.98 0 0 0 0 0 0 1737.98 0 0 1004666840 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10364.08 0 0 0 0 0 0 0 0 0 0 0 0 0 10364.08 0 0 1004667024 1073923942 16 Nurse Practitioners SCHMIT DANYEL 999999999 19 Champaign 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124.76 0 0 0 0 0 0 2124.76 0 0 1004667025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1778.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1778.99 0 0 1004667127 30 General Hospitals 836 Ohio ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 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 0 223.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.54 0 0 1004667187 1275926545 16 Nurse Practitioners WHITE SARAH E 999999999 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1183.27 0 0 0 0 0 0 1183.27 0 0 1004667481 1881949576 10 Physicians MAYNARD-WATTS ADELLE 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.56 0 210.09 0 0 0 0 0 0 219.65 0 0 1004667772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 193.77 0 0 0 0 0 0 0 0 0 0 0 0 0 193.77 0 0 1004668058 1750836300 16 Nurse Practitioners BUSTLE LINDSAY 999999999 19 Champaign 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 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 1407.89 0 0 0 0 0 0 1407.89 0 0 1004668104 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 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0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2588.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2588.18 0 0 1004669163 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20300.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20300.44 0 0 1004669235 1639468416 10 Physicians BAILEY BRENDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3124.54 0 0 0 0 0 0 3124.54 0 0 1004669247 92 Waiver service provider--Disability (DHS/DRS) 100 Vermilion 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9166.25 0 0 0 0 0 0 0 0 0 0 0 0 0 9166.25 0 0 1004669543 1093889792 86 Clinical Social Worker(Encounter Only) NIMKE ANGELA 999999999 58 La Salle 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49040.34 0 0 0 49040.34 0 0 1004670689 1750303541 60 Pharmacies CVS PHARMACY #16196 627046517 91 Sangamon 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 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11559.17 0 0 0 11559.17 0 0 1004670726 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17877.35 0 0 0 0 0 0 0 0 0 0 0 0 0 17877.35 0 0 1004670803 1235227851 13 Podiatrists BIALON-OSTER BEATA 999999999 53 Kane 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1069.55 0 0 0 0 0 0 1069.55 0 0 1004670968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25563.67 0 0 0 0 0 0 0 0 0 0 0 0 0 25563.67 0 0 1004671275 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24912.47 0 0 0 0 0 0 0 0 0 0 0 0 0 24912.47 0 0 1004671429 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14783.62 0 0 0 0 0 0 0 0 0 0 0 0 0 14783.62 0 0 1004671529 1104286392 16 Nurse Practitioners KIRKWOOD SELENA 999999999 200 Cook 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 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 0 306.48 0 0 0 0 0 0 306.48 0 0 1004671911 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238.61 0 0 0 0 0 0 0 0 0 0 0 0 0 238.61 0 0 1004671922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8418.15 0 0 0 0 0 0 0 0 0 0 0 0 0 8418.15 0 0 1004672057 1376999292 11 Dentists HACKNEY HENRY 999999999 200 Cook 0 0 General Dentistry 0 0 51 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 12859.28 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 13611.98 0 0 1004672069 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12957.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12957.57 0 0 1004672122 1487676276 60 Pharmacies CVS PHARMACY #16279 601943894 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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JOHNNIE D 999999999 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449.66 0 0 0 0 0 0 449.66 0 0 1004673279 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.75 0 0 1004673315 1346689114 10 Physicians BILLINGTON JOSHUA 999999999 91 Sangamon 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 288.76 0 0 0 0 0 0 0 0 347.89 0 0 0 0 0 0 636.65 0 0 1004673406 24 Speech Therapists 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1300.26 1300.26 0 0 1004673427 10 Physicians 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 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 0 117.4 0 0 0 0 0 0 117.4 0 0 1004673679 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15397.37 0 0 0 0 0 0 0 0 0 0 0 0 0 15397.37 0 0 1004673849 1801248414 36 Community mental health provider AID ELM STREET 999999999 71 McHenry 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3114 0 0 827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3114 0 0 38823.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297141.71 0 0 335965.31 0 0 1004673882 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20086.83 0 0 0 0 0 0 0 0 0 0 0 0 0 20086.83 0 0 1004673908 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7119 0 0 0 0 0 0 0 0 0 0 0 0 0 7119 0 0 1004673909 1659669240 10 Physicians BHATTI RAVINDER PAL S 999999999 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.43 0 0 0 0 0 0 1948.43 0 0 1004674091 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 768.88 0 0 0 0 0 0 0 0 0 0 0 0 0 768.88 0 0 1004674183 1073944872 16 Nurse Practitioners NWAWUEZE JOSEPHINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.21 0 0 0 0 0 0 431.21 0 0 1004674257 1992009575 16 Nurse Practitioners FRENS JOEL 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492.13 0 0 0 0 0 0 492.13 0 0 1004674272 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5410.34 0 0 0 0 0 0 0 0 0 0 0 0 0 5410.34 0 0 1004674374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23674.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23674.7 0 0 1004674420 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 6669.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6669.98 0 0 1004674500 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16788.22 0 0 0 0 0 0 0 0 0 0 0 0 0 16788.22 0 0 1004674534 1649646993 23 Occupational Therapists ELEFF MELISSA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10622.28 10622.28 0 0 1004674593 1588115497 16 Nurse Practitioners BAKER MICHELLE R 999999999 91 Sangamon 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2904.03 0 0 0 0 0 0 2904.03 0 0 1004674762 1629426002 36 Community mental health provider ROSECRANCE CHAMPAIGN/URBANA 999999999 19 Champaign 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 0 0 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1438 0 0 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1438 0 0 165195.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156149.84 0 0 321345.82 0 0 1004674842 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004675046 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 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 0 452.62 0 0 0 0 0 0 0 0 0 0 0 0 0 452.62 0 0 1004675135 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 1004675195 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6720.18 0 0 0 0 0 0 0 0 0 0 0 0 0 6720.18 0 0 1004675223 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39951.39 0 0 0 0 0 0 0 0 0 0 0 0 0 39951.39 0 0 1004675242 4004675242 98 Waiver service provider--TBI (DHS/DRS) "HELP AT HOME, LLC" 999999999 200 Cook 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 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401811.07 0 0 0 0 0 0 0 0 0 0 0 0 0 401811.07 0 0 1004675687 1306286950 10 Physicians BLANFORD CHRISTOPHER T 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933.22 0 0 0 0 0 0 933.22 0 0 1004675920 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22282.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22282.2 0 0 1004675930 1578848925 16 Nurse Practitioners RINGENBERG ALYSE C 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 839.22 0 0 0 0 0 0 845.62 0 0 1004676006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22024.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22024.35 0 0 1004676144 1295987345 89 Physician Assistant Only(Encounter Only) GRIMALDI ANGELA M 999999999 19 Champaign 0 0 0 0 0 8 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 708.04 0 0 0 0 0 0 0 0 1004.33 0 0 0 0 0 0 1712.37 0 0 1004676194 1033131743 60 Pharmacies CVS PHARMACY #17121 604519533 107 Will 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1820 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2911.92 0 0 0 2911.92 0 0 1004676523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2817.09 0 0 0 0 0 0 0 0 0 0 0 0 0 2817.09 0 0 1004676694 1790074318 10 Physicians SJOBERG BRETT P 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402.56 0 0 0 0 0 0 0 0 402.56 0 0 1004676709 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7595.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7595.35 0 0 1004676753 1588861389 10 Physicians LIGHTFOOT ANDREW P 999999999 89 Rock Island 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.71 0 351.46 0 0 0 0 0 0 368.17 0 0 1004676968 1760927107 91 Waiver service provider--Adults (DHS/DDD) SATERAE TERRY S 999999999 30 DuPage 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 1018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150138.3 0 0 0 0 0 0 0 0 0 0 0 0 0 150138.3 0 0 1004677091 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.24 0 0 0 0 0 0 95.24 0 0 1004677254 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12113.09 0 0 0 0 0 0 0 0 0 0 0 0 0 12113.09 0 0 1004677275 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4464.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4464.89 0 0 1004677393 1821463522 16 Nurse Practitioners BRUNFELDT ANGELA C 999999999 200 Cook 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 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2182.17 0 0 0 0 0 0 2182.17 0 0 1004677475 92 Waiver service provider--Disability (DHS/DRS) 44 Henderson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45201.38 0 0 0 0 0 0 0 0 0 0 0 0 0 45201.38 0 0 1004677526 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23516.46 0 0 0 0 0 0 0 0 0 0 0 0 0 23516.46 0 0 1004677606 1467794040 10 Physicians KHAN AMBAREEN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375.18 0 0 0 0 0 0 375.18 0 0 1004678085 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16152.15 0 0 0 0 0 0 0 0 0 0 0 0 0 16152.15 0 0 1004678253 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14253.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14253.14 0 0 1004678399 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28743.88 0 0 0 0 0 0 0 0 0 0 0 0 0 28743.88 0 0 1004678511 1215041454 89 Physician Assistant Only(Encounter Only) STEELY MEGAN M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452.72 0 0 0 0 0 0 452.72 0 0 1004678522 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10871.35 0 0 0 0 0 0 0 0 0 0 0 0 0 10871.35 0 0 1004678562 1194979237 75 Department of Alcohol and Substance Abuse Provider ROSECRANCE HARRISON -DETOX A2 999999999 109 Winnebago 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 22 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 24184.83 0 0 24184.83 0 0 1004678578 1225263858 10 Physicians KIMCHI EITAN Z 999999999 200 Cook 0 0 Psychiatry 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 0 178 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 2773.36 0 0 0 0 0 0 2773.36 0 0 1004678852 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6785.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6785.86 0 0 1004679449 1386724235 89 Physician Assistant Only(Encounter Only) WADE JOSHUA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4691.15 0 0 0 0 0 0 4691.15 0 0 1004679624 1376665224 65 Independent Diagnostic Testing Facility (IDTF) "ULTRASOUND OF BELVIDERE, LLC" 999999999 13 Boone 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523.35 0 0 0 0 0 0 0 0 523.35 0 0 1004679626 1376830901 12 Optometrists LOY STEPHANIE A 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.98 0 15.04 0 0 0 0 87.02 0 0 1004679682 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5609.45 0 0 0 0 0 0 0 0 0 0 0 0 0 5609.45 0 0 1004679772 98 Waiver service provider--TBI (DHS/DRS) 65 Madison 0 0 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 2096.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2096.39 0 0 1004679895 1821541558 16 Nurse Practitioners RIZZO TERI L 999999999 19 Champaign 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3376.06 0 0 0 0 0 0 3376.06 0 0 1004680380 1790139384 16 Nurse Practitioners FORD JENNA N 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1436.4 0 0 0 0 0 0 1436.4 0 0 1004680410 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 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 31.75 0 0 0 0 0 0 31.75 0 0 1004680581 4004680581 90 Waiver service provider--Elderly (DOA) GAREDA LLC 999999999 200 Cook 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 0 677 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 65128.44 0 0 0 0 0 0 0 0 0 0 0 0 0 65128.44 0 0 1004680638 1093071094 10 Physicians DUMICH SARA A 999999999 200 Cook 0 0 Family Practice 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 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 1210.2 0 0 0 0 0 0 1210.2 0 0 1004680639 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15689.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15689.1 0 0 1004680957 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004681122 1871047209 36 Community mental health provider CUNNINGHAM CHILDREN'S HOME 999999999 19 Champaign 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 413.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19198.97 0 0 19612.05 0 0 1004681413 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7269.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7269.35 0 0 1004681481 1033276324 89 Physician Assistant Only(Encounter Only) YOUNG JULIE 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1884.3 0 0 0 0 0 0 1884.3 0 0 1004681523 1043678899 10 Physicians OZGEN MOCAN BURCE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12987.27 0 0 0 0 0 0 0 0 12987.27 0 0 1004681569 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40372.85 0 0 0 0 0 0 0 0 0 0 0 0 0 40372.85 0 0 1004681843 1164978987 89 Physician Assistant Only(Encounter Only) MADURA RACHEL E 999999999 200 Cook 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271.29 0 0 0 0 0 0 271.29 0 0 1004682006 94 Waiver service provider--Children's support (DHS/DDD) 852 Wisconsin 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4224 0 0 0 0 0 0 0 0 0 0 0 0 0 4224 0 0 1004682259 1932493277 10 Physicians VERMYLEN JULIA L. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1386.72 0 0 0 0 0 0 1386.72 0 0 1004682303 1740632058 16 Nurse Practitioners COLLETTA LENA A. 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 0 0 285.12 0 0 0 0 0 0 298 0 0 1004682470 1992196703 16 Nurse Practitioners GUTIERREZ SCOTT 999999999 91 Sangamon 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 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 1895.86 0 0 0 0 0 0 1895.86 0 0 1004682516 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.48 0 0 0 0 0 0 0 0 0 0 0 0 0 260.48 0 0 1004682739 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19551.59 0 0 0 0 0 0 0 0 0 0 0 0 0 19551.59 0 0 1004682789 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33939.72 0 0 0 0 0 0 0 0 0 0 0 0 0 33939.72 0 0 1004683077 1336464536 10 Physicians MARKOVINA STEPHANIE 999999999 105 White 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1363.16 0 0 0 0 0 0 1363.16 0 0 1004683081 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21693.84 0 0 0 0 0 0 0 0 0 0 0 0 0 21693.84 0 0 1004683115 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 12985.55 0 0 0 0 0 0 0 0 0 0 0 0 0 12985.55 0 0 1004683161 1518410521 91 Waiver service provider--Adults (DHS/DDD) ERBACHER HANNAH LE 999999999 200 Cook 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 2376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162649.81 0 0 0 0 0 0 0 0 0 0 0 0 0 162649.81 0 0 1004683326 1558810960 40 Federally Qualified Health Centers LEGACY MEDICAL CARE INC 999999999 200 Cook 0 0 0 303 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 975 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 975 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97107.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97107.41 0 0 1004683354 1942435292 10 Physicians AYRES ERINN R. 999999999 65 Madison 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 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 0 737.33 0 0 0 0 0 0 737.33 0 0 1004683601 1568791234 16 Nurse Practitioners DOHMAN-SCHMIDLER KELLI 999999999 72 McLean 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 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 0 752.82 0 0 0 0 0 0 752.82 0 0 1004683683 91 Waiver service provider--Adults (DHS/DDD) 826 Missouri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 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 18157.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18157.45 0 0 1004683707 1497107940 24 Speech Therapists SWIERENGA KAITLIN 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 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 14433.95 14433.95 0 0 1004683906 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25429 0 0 0 0 0 0 0 0 0 0 0 0 0 25429 0 0 1004683979 1720178007 89 Physician Assistant Only(Encounter Only) MORLAND DAVID D 999999999 200 Cook 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 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 0 613.85 0 0 0 0 0 0 613.85 0 0 1004683984 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13871.02 0 0 0 0 0 0 0 0 0 0 0 0 0 13871.02 0 0 1004683991 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004684017 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3174.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3174.6 0 0 1004684095 10 Physicians 109 Winnebago 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004684145 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37761.04 0 0 0 0 0 0 0 0 0 0 0 0 0 37761.04 0 0 1004684156 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25763.32 0 0 0 0 0 0 0 0 0 0 0 0 0 25763.32 0 0 1004684390 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21733.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21733.8 0 0 1004684715 1124079249 10 Physicians EDWARDS JOHN D 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 5 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.28 0 2757.33 0 0 0 0 0 0 2767.61 0 0 1004684892 1134561178 10 Physicians CABANTING MARIE J 999999999 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2886.18 0 0 0 0 0 0 2886.18 0 0 1004684939 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10201.39 0 0 0 0 0 0 0 0 0 0 0 0 0 10201.39 0 0 1004685046 1104222611 89 Physician Assistant Only(Encounter Only) SIMMONS ERICA E 999999999 200 Cook 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 0 107 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 4229.08 0 0 0 0 0 0 4229.08 0 0 1004685076 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25063.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25063.33 0 0 1004685223 1073979654 16 Nurse Practitioners COYNE SARAH 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1004685273 16 Nurse Practitioners 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268.05 0 0 0 0 0 0 268.05 0 0 1004685278 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59052.03 0 0 0 0 0 0 0 0 0 0 0 0 0 59052.03 0 0 1004685349 94 Waiver service provider--Children's support (DHS/DDD) 826 Missouri 0 0 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 2186.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2186.25 0 0 1004685426 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 24156.44 0 0 0 0 0 0 0 0 0 0 0 0 0 24156.44 0 0 1004685442 1902158975 89 Physician Assistant Only(Encounter Only) BURNS DEBORAH A 999999999 49 Jefferson 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 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1216.55 0 0 0 0 0 0 1216.55 0 0 1004685600 1235577727 13 Podiatrists LOVATO PETER F 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.05 0 0 0 0 0 0 326.05 0 0 1004685676 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24969.45 0 0 0 0 0 0 0 0 0 0 0 0 0 24969.45 0 0 1004685754 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.08 0 0 0 0 0 0 1.08 0 0 1004685787 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232.45 0 0 0 0 0 0 232.45 0 0 1004685913 1326453093 10 Physicians KAWIOR DAVID J 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 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 6102.39 0 0 0 0 0 0 6102.39 0 0 1004686027 1801286745 16 Nurse Practitioners VERPLOEGH JENNIFER 999999999 200 Cook 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1511.99 0 0 0 0 0 0 1511.99 0 0 1004686062 1912133836 10 Physicians YOO JENNY Y 999999999 53 Kane 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3991.89 0 0 0 0 0 0 3991.89 0 0 1004686222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31525.09 0 0 0 0 0 0 0 0 0 0 0 0 0 31525.09 0 0 1004686475 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23441.37 0 0 0 0 0 0 0 0 0 0 0 0 0 23441.37 0 0 1004686860 1437399391 10 Physicians KULKARNI ABHISHEK 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13682.28 0 0 0 0 0 0 13682.28 0 0 1004687033 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20543.14 0 0 0 0 0 0 0 0 0 0 0 0 0 20543.14 0 0 1004687538 1699900092 10 Physicians RAMAKRISHNA RAVI 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 290 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3640.71 0 1652.16 0 0 0 0 0 0 5292.87 0 0 1004687586 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25689.84 0 0 0 0 0 0 0 0 0 0 0 0 0 25689.84 0 0 1004687955 1881900306 63 Other Providers of Medical Equipment/Supplies (Non-registered) A SPECIALTY DIABETIC SUPPLIER 999999999 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46700.7 0 0 0 0 0 0 46700.7 0 0 1004688205 1053698340 16 Nurse Practitioners TAYLOR SUSAN L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 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 1734.98 0 0 0 0 0 0 1734.98 0 0 1004688496 1720492507 16 Nurse Practitioners MATTOX WILLIAM S 999999999 200 Cook 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 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229.64 0 0 0 0 0 0 229.64 0 0 1004688706 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 501.48 0 0 0 0 0 0 0 0 0 0 0 0 0 501.48 0 0 1004689109 1689804486 11 Dentists LI WONG CARMEN P 999999999 98 Tazewell 0 0 General Dentistry 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12507.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12507.8 0 0 1004689262 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23890.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23890.9 0 0 1004689662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35748.19 0 0 0 0 0 0 0 0 0 0 0 0 0 35748.19 0 0 1004689671 1801899935 10 Physicians FOCHIOS DEAN 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 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 2068.76 0 0 0 0 0 0 2068.76 0 0 1004689705 1558681577 10 Physicians BERTUMEN J. BRADFORD H 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2006.69 0 0 0 0 0 0 2006.69 0 0 1004690164 1700998622 89 Physician Assistant Only(Encounter Only) STEFFEN JENNY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1141.27 0 0 0 0 0 0 1141.27 0 0 1004690221 1215184726 10 Physicians GANDRA BABUJI R 999999999 89 Rock Island 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1624.1 0 0 0 0 0 0 1624.1 0 0 1004690224 1376869347 10 Physicians OSMANOVIC SENAD 999999999 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 18 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 1475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 1475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412.02 0 68149.31 0 0 0 0 0 0 68561.33 0 0 1004690595 1962865626 16 Nurse Practitioners GREENAWAY SARAH S 999999999 30 DuPage 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892.22 0 0 0 0 0 0 892.22 0 0 1004690643 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 13752.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13752.9 0 0 1004690899 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.06 0 0 0 0 0 0 101.06 0 0 1004690960 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30677.03 0 0 0 0 0 0 0 0 0 0 0 0 0 30677.03 0 0 1004690968 75 Department of Alcohol and Substance Abuse Provider 103 Washington 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2275.18 0 0 2275.18 0 0 1004691080 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6884.62 0 0 0 0 0 0 0 0 0 0 0 0 0 6884.62 0 0 1004691163 16 Nurse Practitioners 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1004691245 1639497530 10 Physicians MCGONAGILL PATRICK W 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.2 0 0 0 0 0 0 591.2 0 0 1004691273 1922559897 60 Pharmacies POEHLER'S PHARMACY LLC 999999999 33 Effingham 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 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7747.15 0 0 0 7747.15 0 0 1004691949 1144518069 10 Physicians MCKEE ALEXIS 999999999 91 Sangamon 0 0 Internal Medicine 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 91.16 0 0 0 0 0 0 91.16 0 0 1004691958 1598738635 89 Physician Assistant Only(Encounter Only) BLAIR TRINA G 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 103.61 0 0 0 0 0 0 103.61 0 0 1004691980 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1352.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.09 0 0 1004692126 1386199511 16 Nurse Practitioners OLESEN JENNIFER 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1290.77 0 0 0 0 0 0 1290.77 0 0 1004692169 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 14.02 0 0 0 0 0 0 14.02 0 0 1004692173 1568659449 89 Physician Assistant Only(Encounter Only) KAUTH JESSICA 999999999 200 Cook 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 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8713.64 0 0 0 0 0 0 8713.64 0 0 1004692178 1780024125 10 Physicians KIMBELL KAYLA J 999999999 109 Winnebago 0 1 Family Practice 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3809.16 0 0 0 0 0 0 3809.16 0 0 1004692222 1124040936 60 Pharmacies CVS PHARMACY # 16451 600872231 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 15467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.68 0 0 9168 0 0 0 9321.68 0 0 1004692430 1396290045 11 Dentists PRABHA MEGHANA V 999999999 200 Cook 0 0 General Dentistry 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29262.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29262.16 0 0 1004692522 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 104.96 0 0 1004692532 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15693.92 0 0 0 0 0 0 0 0 0 0 0 0 0 15693.92 0 0 1004692683 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24944.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24944.57 0 0 1004692820 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22247.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22247.13 0 0 1004693173 1477009249 16 Nurse Practitioners SCHNEIDER TRESSA L 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.76 0 0 0 0 0 0 93.76 0 0 1004693338 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2924.06 0 0 0 0 0 0 0 0 0 0 0 0 0 2924.06 0 0 1004693462 1073531547 16 Nurse Practitioners ORTEGA MICHELLE G 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366.96 0 0 0 0 0 0 366.96 0 0 1004693469 1285926949 90 Waiver service provider--Elderly (DOA) "DESTINY HEALTHCARE SERVICE, IN" 999999999 200 Cook 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 9354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910903.89 0 0 0 0 0 0 0 0 0 0 0 0 0 910903.89 0 0 1004693773 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5934.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5934.86 0 0 1004693830 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20469 0 0 0 0 0 0 0 0 0 0 0 0 0 20469 0 0 1004693898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4737.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4737.9 0 0 1004694019 1174624415 10 Physicians STEPHEN JACOB 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.85 0 4174.39 0 0 0 0 0 0 4234.24 0 0 1004694162 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69790.52 0 0 0 0 0 0 0 0 0 0 0 0 0 69790.52 0 0 1004694250 1831493816 10 Physicians WONG JOSHUA 999999999 815 Indiana 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 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 4346.58 0 0 0 0 0 0 4346.58 0 0 1004694439 10 Physicians 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423.64 0 0 0 0 0 0 423.64 0 0 1004694574 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1244.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1244.15 0 0 1004694596 1477840882 63 Other Providers of Medical Equipment/Supplies (Non-registered) CORK MEDICAL LLC 999999999 30 DuPage 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 0 879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32711.58 0 0 0 0 0 0 32711.58 0 0 1004694749 1861803595 10 Physicians IBRAHIM RUKAYATU 999999999 831 New Jersey 0 0 0 0 0 28 0 0 0 0 0 0 6 0 56 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 10 0 73 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 10 0 73 0 0 0 0 0 0 0 0 0 1477.74 0 0 0 0 0 0 44 0 1813.3 0 0 0 0 0 0 3335.04 0 0 1004694882 1578940110 16 Nurse Practitioners SIMS DESAREY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4775.3 0 0 0 0 0 0 4775.3 0 0 1004695324 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19846.57 0 0 0 0 0 0 0 0 0 0 0 0 0 19846.57 0 0 1004695462 1144526963 89 Physician Assistant Only(Encounter Only) HAERTLING DEVIN 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8284.35 0 0 0 0 0 0 8284.35 0 0 1004695565 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 3.36 0 0 0 0 0 0 3.36 0 0 1004695579 1063754158 10 Physicians KOWALSKA ANETA 999999999 80 Peoria 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 52 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 1078.88 0 0 0 0 0 0 1081.48 0 0 1004695676 1255684072 16 Nurse Practitioners KEYSTER TRACI 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994.18 0 0 0 0 0 0 994.18 0 0 1004695903 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 962.92 0 0 0 0 0 0 0 0 0 0 0 0 0 962.92 0 0 1004696140 4004696140 90 Waiver service provider--Elderly (DOA) ANGEL HOME HEALTH AGENCY SERVI 999999999 200 Cook 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 0 983 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 983 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102110.58 0 0 0 0 0 0 0 0 0 0 0 0 0 102110.58 0 0 1004696193 1659677557 89 Physician Assistant Only(Encounter Only) HAIGHT MARTA 999999999 52 Johnson 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 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 0 969.95 0 0 0 0 0 0 969.95 0 0 1004696403 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.38 0 0 0 0 0 0 0 0 0 0 0 0 0 110.38 0 0 1004697018 1578013462 11 Dentists BALI AKANKSHA 999999999 200 Cook 0 0 General Dentistry 0 0 192 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1092 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1092 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 32043.08 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 33548.48 0 0 1004697280 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.47 0 0 0 0 0 0 106.47 0 0 1004697415 1831534460 10 Physicians GORTHY GOPINATH 999999999 47 Jackson 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410.89 0 0 0 0 0 0 410.89 0 0 1004697862 1053532002 10 Physicians IBRAHIM NAFISA B 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 21 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.8 0 563.19 0 0 0 0 0 0 683.99 0 0 1004698403 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 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 42697.55 0 0 0 0 0 0 0 0 0 0 0 0 0 42697.55 0 0 1004698571 1316918287 30 General Hospitals MMC PSYCHIATRIC UNIT 999999999 91 Sangamon DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 1 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 2657 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222376.18 0 0 0 0 0 0 0 0 0 222376.18 0 0 1004698586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12711.18 0 0 0 0 0 0 0 0 0 0 0 0 0 12711.18 0 0 1004698610 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 0 122.8 0 0 0 0 0 0 122.8 0 0 1004698862 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3402.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3402.56 0 0 1004698935 1114238979 10 Physicians MIKHAYEL MADI 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 76 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 974.14 0 3.92 0 0 0 0 0 0 978.06 0 0 1004698964 1194183517 60 Pharmacies NORTH PARK PHARMACY 999999999 200 Cook 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1372.82 0 0 0 1372.82 0 0 1004699053 92 Waiver service provider--Disability (DHS/DRS) 27 Dekalb 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20793.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20793.44 0 0 1004699232 10 Physicians 63 Macon 0 0 0 0 0 0 0 0 0 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 0 188.22 0 0 0 0 0 0 188.22 0 0 1004699353 1447589650 89 Physician Assistant Only(Encounter Only) WILLIAMS TIFFANI L 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 168.89 0 0 0 0 0 0 0 0 2181.35 0 0 0 0 0 0 2350.24 0 0 1004699457 89 Physician Assistant Only(Encounter Only) 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.45 0 0 0 0 0 0 46.45 0 0 1004699625 1871688341 10 Physicians PHILLIP DERWIN A 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 7 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.27 0 17380.49 0 0 0 0 0 0 17413.76 0 0 1004699870 1871951038 63 Other Providers of Medical Equipment/Supplies (Non-registered) BIONIC PROSTHETICS AND ORTHOTI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773.79 0 11346.23 0 0 0 0 12120.02 0 0 1004699950 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19094.08 0 0 0 0 0 0 0 0 0 0 0 0 0 19094.08 0 0 1004700098 1255642047 10 Physicians RIAZ AHSUN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 30 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127.64 0 9921.79 0 0 0 0 0 0 10049.43 0 0 1004700208 1548581440 10 Physicians MAI HANH 999999999 200 Cook 0 0 Internal Medicine 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3397.94 0 0 0 0 0 0 3397.94 0 0 1004700613 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31157.49 0 0 0 0 0 0 0 0 0 0 0 0 0 31157.49 0 0 1004700658 1740692227 89 Physician Assistant Only(Encounter Only) JONES ISAAC R. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.52 0 0 0 0 0 0 97.52 0 0 1004700661 1457650723 89 Physician Assistant Only(Encounter Only) MODGLIN ALLISON JEAN 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.54 0 0 0 0 0 0 125.54 0 0 1004700714 1174545883 60 Pharmacies CVS PHARMACY #16529 600351728 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1492.05 0 0 0 1492.05 0 0 1004701039 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22685.36 0 0 0 0 0 0 0 0 0 0 0 0 0 22685.36 0 0 1004701116 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24678.29 0 0 0 0 0 0 0 0 0 0 0 0 0 24678.29 0 0 1004701202 10 Physicians 89 Rock Island 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.95 0 0 0 0 0 0 9.95 0 0 1004702279 1861851438 60 Pharmacies WALGREENS #21287 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 1536 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 68844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276.27 0 0 218495.08 0 0 0 218771.35 0 0 1004702435 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5941.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5941.96 0 0 1004702455 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14317.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14317.02 0 0 1004702562 1942666169 16 Nurse Practitioners WEST SHERI L. 999999999 79 Ogle 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004702563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42811.33 0 0 0 0 0 0 0 0 0 0 0 0 0 42811.33 0 0 1004702793 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11058.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11058.84 0 0 1004702945 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 12673.06 0 0 0 0 0 0 0 0 0 0 0 0 0 12673.06 0 0 1004703006 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23719.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23719.96 0 0 1004703047 1821103995 10 Physicians VANTERPOOL KISHA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 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 83.23 0 0 0 0 0 0 83.23 0 0 1004703185 1689935397 30 General Hospitals SOUTH SHORE HOSPITAL CORP 606171124 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 69 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 0 746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11751.48 0 0 0 0 0 0 0 0 0 11751.48 0 0 1004703225 1811371347 11 Dentists GADDE MADHAVI 999999999 200 Cook 0 0 General Dentistry 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3352.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3352.7 0 0 1004703345 1255581641 10 Physicians AEDDULA NAROTHAMA R 999999999 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 0 156 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 1484.68 0 0 0 0 0 0 1484.68 0 0 1004703387 1528309879 10 Physicians HOHNER ELITA 999999999 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 996.58 0 0 0 0 0 0 996.58 0 0 1004703418 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004703814 1194181040 16 Nurse Practitioners SCHULDT SAMANTHA N 999999999 200 Cook 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3580.49 0 0 0 0 0 0 3580.49 0 0 1004703827 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15271.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15271.21 0 0 1004703858 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 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 0 205.4 0 0 0 0 0 0 205.4 0 0 1004704207 1356712558 89 Physician Assistant Only(Encounter Only) ZAKARIA MUSTAFA 999999999 200 Cook 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 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 3319.68 0 0 0 0 0 0 3319.68 0 0 1004704300 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 24.25 0 0 1004704524 1407304199 16 Nurse Practitioners DEFREESE LORI A 999999999 80 Peoria 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.05 0 0 0 0 0 0 374.05 0 0 1004704660 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8006.62 0 0 0 0 0 0 0 0 0 0 0 0 0 8006.62 0 0 1004705275 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23772.53 0 0 0 0 0 0 0 0 0 0 0 0 0 23772.53 0 0 1004705591 1811031370 10 Physicians ALEXIEV BORISLAV A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 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 2150.26 0 0 0 0 0 0 0 0 2150.26 0 0 1004705849 1730413717 10 Physicians THORPE MICHAEL P 999999999 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 856.91 0 0 0 0 0 0 856.91 0 0 1004705873 1487855425 89 Physician Assistant Only(Encounter Only) COLOMB SARAH 999999999 200 Cook 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 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 0 402.01 0 0 0 0 0 0 402.01 0 0 1004705903 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004705963 1881970036 89 Physician Assistant Only(Encounter Only) FOUCHE MICHELLE M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18924.57 0 0 0 0 0 0 18924.57 0 0 1004706022 1326415845 16 Nurse Practitioners DUKEMAN HANNAH J 999999999 22 Clay 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 0 171 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 1164.83 0 0 0 0 0 0 1164.83 0 0 1004706747 1376565168 60 Pharmacies CVS PHARMACY #16286 604624725 200 Cook 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2211.75 0 0 0 2211.75 0 0 1004706981 10 Physicians 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.57 0 0 0 0 0 0 0.57 0 0 1004707005 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004707106 1902068810 89 Physician Assistant Only(Encounter Only) LEIGH KARRIE K 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 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 1232.78 0 0 0 0 0 0 1232.78 0 0 1004707108 1639338114 10 Physicians PHUAH CHAI-LING 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 7 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 3018.35 0 0 0 0 0 0 3018.35 0 0 1004707109 1225585904 70 Ambulance Service Providers AIR EVAC EMS INC 999999999 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5983.16 0 0 0 0 0 0 5983.16 0 0 1004707404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3360.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3360.3 0 0 1004707537 1215102322 10 Physicians CHURYLA ANDREI 999999999 53 Kane 0 0 Thoracic Surgery 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 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 8779.97 0 0 0 0 0 0 8779.97 0 0 1004707695 1861786261 10 Physicians SCHNEIDER DANIEL E. 999999999 10 Adams 0 0 Urology 0 0 0 0 0 0 0 0 0 0 16 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.41 0 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0 0 0 0 159.63 0 0 1004708395 1821546581 16 Nurse Practitioners LAMB CHERYL L 999999999 30 DuPage 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 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6564.35 0 0 0 0 0 0 6564.35 0 0 1004708435 1982061669 16 Nurse Practitioners CACELLO ELIZABETH 999999999 40 Grundy 0 0 0 0 0 1 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 1717.88 0 0 0 0 0 0 1767.88 0 0 1004708908 94 Waiver service provider--Children's support (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5654.31 0 0 0 0 0 0 0 0 0 0 0 0 0 5654.31 0 0 1004708949 93 Waiver service provider--HIV/AIDS (DHS/DRS) 823 Michigan 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 1004709005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1412.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1412.61 0 0 1004709165 1992175715 16 Nurse Practitioners REIDER JACLYN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470.66 0 0 0 0 0 0 470.66 0 0 1004709434 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15345.69 0 0 0 0 0 0 0 0 0 0 0 0 0 15345.69 0 0 1004709439 4004709439 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 735 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4998430.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4998430.26 0 0 1004709697 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15290.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15290.99 0 0 1004709756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5512.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5512.8 0 0 1004709864 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22473.33 0 0 0 0 0 0 0 0 0 0 0 0 0 22473.33 0 0 1004710196 1447696125 10 Physicians MARTIN ASHLEY J 999999999 10 Adams 0 0 Emergency Medicine 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 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6293.06 0 0 0 0 0 0 6293.06 0 0 1004710594 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 22245.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22245.76 0 0 1004711071 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8796.13 0 0 0 0 0 0 0 0 0 0 0 0 0 8796.13 0 0 1004711121 1962717579 10 Physicians ISA FURQUAAN M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 386 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9072.86 0 931.69 0 0 0 0 0 0 10004.55 0 0 1004711287 1881857282 10 Physicians BULLOCK TREVOR MICHAEL 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 2 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569.5 0 0 0 0 0 0 569.5 0 0 1004711652 1942590906 10 Physicians TURAKHIA SAMIR 999999999 19 Champaign 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 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5222.58 0 0 0 0 0 0 0 0 5222.58 0 0 1004711713 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22303.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22303.6 0 0 1004711825 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5253.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5253.6 0 0 1004711855 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11184.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11184.25 0 0 1004711866 1851834196 16 Nurse Practitioners THIBODEAU MEGAN M. 999999999 80 Peoria 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 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 0 269.14 0 0 0 0 0 0 269.14 0 0 1004711941 1942300033 89 Physician Assistant Only(Encounter Only) UNDERWOOD AMY E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 366.78 0 0 0 0 0 0 366.78 0 0 1004712003 1881145357 40 Federally Qualified Health Centers SIHF HEALTHCARE 999999999 24 Coles 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27527.63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27527.63 0 0 1004712106 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1004712200 1427502350 11 Dentists MARJAN LOOLUL 999999999 200 Cook 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 981 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 29467.19 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 30972.59 0 0 1004712360 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.68 0 0 0 0 0 0 40.68 0 0 1004712429 1194199331 16 Nurse Practitioners KENNY MEGAN 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1575.38 0 0 0 0 0 0 1575.38 0 0 1004713158 1316969124 60 Pharmacies CVS PHARMACY #16351 613541013 58 La Salle 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5801.14 0 0 0 5801.14 0 0 1004713196 1750369914 89 Physician Assistant Only(Encounter Only) HANS THOMAS S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.19 0 0 0 0 0 0 209.19 0 0 1004713449 1881919736 10 Physicians BACHTA KELLY E. 999999999 200 Cook 0 0 Internal Medicine 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.18 0 0 0 0 0 0 174.18 0 0 1004713516 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 4.7 0 0 0 0 0 0 4.7 0 0 1004713830 1447611009 16 Nurse Practitioners HENDERSON KERRI 999999999 10 Adams 0 0 0 0 0 3 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 3 0 0 0 0 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0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797.49 0 0 0 0 0 0 797.49 0 0 1004714591 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12389.07 0 0 0 0 0 0 0 0 0 0 0 0 0 12389.07 0 0 1004714729 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17314.73 0 0 0 0 0 0 0 0 0 0 0 0 0 17314.73 0 0 1004714741 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15847.31 0 0 0 0 0 0 0 0 0 0 0 0 0 15847.31 0 0 1004714792 1700339173 11 Dentists GRANT MARY 999999999 200 Cook 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25689.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25689.41 0 0 1004714806 1417209768 16 Nurse Practitioners GARRETT BRENDA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728.52 0 0 0 0 0 0 728.52 0 0 1004714813 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3892 0 0 0 0 0 0 0 0 0 0 0 0 0 3892 0 0 1004715050 1992797625 89 Physician Assistant Only(Encounter Only) HAYDEN GARY 999999999 24 Coles 0 0 0 0 0 9 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 649.89 0 0 0 0 0 0 0 0 2945.34 0 0 0 0 0 0 3595.23 0 0 1004715058 98 Waiver service provider--TBI (DHS/DRS) 82 Piatt 0 0 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 2801.88 0 0 0 0 0 0 0 0 0 0 0 0 0 2801.88 0 0 1004715190 1437518081 16 Nurse Practitioners HALCOMB AIMEE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 440.06 0 0 0 0 0 0 440.06 0 0 1004715227 23 Occupational Therapists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 0 638.5 638.5 0 0 1004715308 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 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 21.15 21.15 0 0 1004715367 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21233.23 0 0 0 0 0 0 0 0 0 0 0 0 0 21233.23 0 0 1004715509 1316394968 36 Community mental health provider JEWISH CHILD AND FAMILY SERVIC 999999999 200 Cook 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 377.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12666.94 0 0 13044.1 0 0 1004715556 30 General Hospitals 815 Indiana DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004715600 1780683003 10 Physicians BERGER RICHARD 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 619 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17540.47 0 150.03 0 0 0 0 0 0 17690.5 0 0 1004715733 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8339.16 0 0 0 0 0 0 0 0 0 0 0 0 0 8339.16 0 0 1004715745 1700135126 10 Physicians MAJDIZADEH SHIRIN 618012529 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6027.91 0 0 0 0 0 0 6027.91 0 0 1004715983 1295034478 10 Physicians JAIN ROHAN K 999999999 91 Sangamon 0 0 Anesthesiology 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1558.49 0 0 0 0 0 0 1558.49 0 0 1004715986 1912361361 16 Nurse Practitioners SZAFRANSKI ALICIA M 999999999 80 Peoria 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 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 0 650.17 0 0 0 0 0 0 650.17 0 0 1004716196 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2278.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2278.5 0 0 1004716365 1699036731 10 Physicians WILLIAMS TIMOTHY J 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474.8 0 0 0 0 0 0 474.8 0 0 1004716380 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9630.46 0 0 0 0 0 0 0 0 0 0 0 0 0 9630.46 0 0 1004716452 1346506532 10 Physicians ZHOU XIAOLONG 999999999 200 Cook 0 0 Dermatology 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 0 126 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 1125.18 0 0 0 0 0 0 1125.18 0 0 1004716608 1518362946 16 Nurse Practitioners PATTERSON AMANDA L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1116.31 0 0 0 0 0 0 1116.31 0 0 1004716621 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22710.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22710.6 0 0 1004716738 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21222.53 0 0 0 0 0 0 0 0 0 0 0 0 0 21222.53 0 0 1004716942 1881616597 60 Pharmacies CVS PHARMACY #16922 611151681 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28183.96 0 0 0 28183.96 0 0 1004716952 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24472.13 0 0 0 0 0 0 0 0 0 0 0 0 0 24472.13 0 0 1004717478 1225122047 30 General Hospitals SOUTHERN ILLINOIS HOSPITAL SER 999999999 108 Williamson DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81787.43 0 0 0 0 0 0 0 0 0 81787.43 0 0 1004717511 1316030679 89 Physician Assistant Only(Encounter Only) SAYLOR RICHARD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3222.51 0 0 0 0 0 0 3222.51 0 0 1004717552 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14700.84 0 0 0 0 0 0 0 0 0 0 0 0 0 14700.84 0 0 1004717663 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25224.08 0 0 0 0 0 0 0 0 0 0 0 0 0 25224.08 0 0 1004717704 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1700.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1700.21 0 0 1004718119 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1004718317 1821420779 86 Clinical Social Worker(Encounter Only) LUNT KELLI 999999999 10 Adams 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 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 0 803.65 0 0 0 0 0 0 803.65 0 0 1004718470 1063671634 10 Physicians HEXOM BRADEN J 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2989.09 0 0 0 0 0 0 2989.09 0 0 1004718597 1215959929 60 Pharmacies CVS PHARMACY #17067 601072332 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28809.73 0 0 0 28809.73 0 0 1004718933 91 Waiver service provider--Adults (DHS/DDD) 31 Edgar 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17319.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17319.04 0 0 1004719131 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 1790.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.8 0 0 1004719225 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004719324 16 Nurse Practitioners 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004719859 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.49 0 0 0 0 0 0 0 0 0 0 0 0 0 48.49 0 0 1004720051 1043650526 10 Physicians CAMPAGNOLI TANIA 999999999 200 Cook 0 0 Internal Medicine 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004720081 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 716.46 0 0 0 0 0 0 0 0 0 0 0 0 0 716.46 0 0 1004720118 75 Department of Alcohol and Substance Abuse Provider 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.01 0 0 686.01 0 0 1004720244 1700252822 16 Nurse Practitioners MOREDOCK SASHA L 999999999 80 Peoria 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002.21 0 0 0 0 0 0 1002.21 0 0 1004720476 1043297401 30 General Hospitals MERCY HOSPITAL MEDICAL CENTER 606162315 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 1190.2 0 0 0 0 0 0 0 0 28766.63 0 0 0 0 0 0 0 0 0 29956.83 0 0 1004720494 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5880.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5880.69 0 0 1004720499 10 Physicians 839 Pennsylvania 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241.3 0 0 0 0 0 0 241.3 0 0 1004720595 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10012.87 0 0 0 0 0 0 0 0 0 0 0 0 0 10012.87 0 0 1004720821 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49755.87 0 0 0 0 0 0 0 0 0 0 0 0 0 49755.87 0 0 1004721101 1477743813 89 Physician Assistant Only(Encounter Only) ROTH MICHELLE L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1465.87 0 0 0 0 0 0 1465.87 0 0 1004721296 1306205141 16 Nurse Practitioners PINKERTON ERIN D 999999999 102 Warren 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.95 0 0 0 0 0 0 83.95 0 0 1004721392 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20523.36 0 0 0 0 0 0 0 0 0 0 0 0 0 20523.36 0 0 1004721499 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12062.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12062.4 0 0 1004721646 1326488685 10 Physicians RYNERSON ZACHARY 999999999 53 Kane 0 0 Emergency Medicine 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 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 0 749.92 0 0 0 0 0 0 749.92 0 0 1004721647 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11234.38 0 0 0 0 0 0 0 0 0 0 0 0 0 11234.38 0 0 1004721856 1821244880 16 Nurse Practitioners ELSESSER BRIAN A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187.31 0 0 0 0 0 0 187.31 0 0 1004722112 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1555.64 0 0 0 0 0 0 1555.64 0 0 1004722177 1528518602 16 Nurse Practitioners FENNER AGNES A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336 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 2388.2 0 0 0 0 0 0 2388.2 0 0 1004722519 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10970.91 0 0 0 0 0 0 0 0 0 0 0 0 0 10970.91 0 0 1004722555 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12949.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12949.42 0 0 1004722604 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22417.56 0 0 0 0 0 0 0 0 0 0 0 0 0 22417.56 0 0 1004722683 1972663466 89 Physician Assistant Only(Encounter Only) ACOSTA ROSALVA 600312632 57 Lake 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.09 0 0 0 0 0 0 1147.09 0 0 1004722891 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 911.68 0 0 0 0 0 0 0 0 0 0 0 0 0 911.68 0 0 1004723146 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14525.29 0 0 0 0 0 0 0 0 0 0 0 0 0 14525.29 0 0 1004723227 1376982371 10 Physicians ADAMS PHILLIP M 999999999 815 Indiana 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 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 1030.86 0 0 0 0 0 0 1030.86 0 0 1004723534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18563.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18563.25 0 0 1004723732 1861836033 10 Physicians THOMAS GEORGE N 999999999 91 Sangamon 0 0 Internal Medicine 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 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 1476.69 0 0 0 0 0 0 1476.69 0 0 1004723869 1063868313 10 Physicians ARNETT MAWUSI J 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.38 0 0 0 0 0 0 169.38 0 0 1004723886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 849.22 0 0 0 0 0 0 0 0 0 0 0 0 0 849.22 0 0 1004723914 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 4207.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4207.89 0 0 1004724130 1669813762 10 Physicians MAVANI NIRAJ K 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4456.69 0 0 0 0 0 0 4456.69 0 0 1004724927 1467705392 89 Physician Assistant Only(Encounter Only) MACK KYLIE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.34 0 0 0 0 0 0 125.34 0 0 1004724994 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1154.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1154.55 0 0 1004725274 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 0 751.65 0 0 0 0 0 0 0 0 0 0 0 0 0 751.65 0 0 1004725382 1508810771 89 Physician Assistant Only(Encounter Only) SCARDINA ANTHONY J 999999999 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.85 0 0 0 0 0 0 224.85 0 0 1004725578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.11 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.11 0 0 1004725673 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1664.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1664.12 0 0 1004725687 1477930568 63 Other Providers of Medical Equipment/Supplies (Non-registered) "SCHECK AND SIRESS PROSTHETICS," 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2206.39 0 21196.47 0 0 0 0 23402.86 0 0 1004725700 1326255837 10 Physicians MCGUIRE CHRISTINE A 999999999 200 Cook 0 0 Pediatrics 0 0 0 24 0 0 0 0 0 0 7 0 18 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 13 0 23 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 13 0 23 0 0 0 0 0 0 0 0 0 1776.61 0 0 0 0 0 0 151.16 0 1220.81 0 0 0 0 0 0 3148.58 0 0 1004725876 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14725.26 0 0 0 0 0 0 0 0 0 0 0 0 0 14725.26 0 0 1004725893 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16182.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16182.35 0 0 1004725985 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22839.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22839.2 0 0 1004726174 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27560.09 0 0 0 0 0 0 0 0 0 0 0 0 0 27560.09 0 0 1004726242 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7343.57 0 0 0 0 0 0 0 0 0 0 0 0 0 7343.57 0 0 1004726272 1689098261 16 Nurse Practitioners JONES MEGHAN 999999999 50 Jersey 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 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 0 561.88 0 0 0 0 0 0 561.88 0 0 1004726357 1821530643 55 Early Intervention Services GORDON TORY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23703.91 0 0 0 0 0 0 23703.91 0 0 1004726454 1801818612 60 Pharmacies CVS PHARMACY #16287 605254162 200 Cook 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5690.19 0 0 0 5690.19 0 0 1004726746 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28377.27 0 0 0 0 0 0 0 0 0 0 0 0 0 28377.27 0 0 1004726762 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.32 0 0 0 0 0 0 83.32 0 0 1004726778 1669929931 11 Dentists GOPE USHA 999999999 200 Cook 0 0 General Dentistry 0 0 151 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 690 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 690 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 21556.99 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 21933.34 0 0 1004726876 1750833356 16 Nurse Practitioners GLASS MELISSA M 999999999 200 Cook 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 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 0 222.33 0 0 0 0 0 0 222.33 0 0 1004726903 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6267.07 0 0 0 0 0 0 0 0 0 0 0 0 0 6267.07 0 0 1004727018 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13053.48 0 0 0 0 0 0 0 0 0 0 0 0 0 13053.48 0 0 1004727028 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16498.31 0 0 0 0 0 0 0 0 0 0 0 0 0 16498.31 0 0 1004727098 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2152.82 0 0 0 0 0 0 0 0 0 0 0 0 0 2152.82 0 0 1004727267 86 Clinical Social Worker(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 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 57.33 0 0 0 0 0 0 57.33 0 0 1004727272 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25022.36 0 0 0 0 0 0 0 0 0 0 0 0 0 25022.36 0 0 1004727879 1932561156 10 Physicians BEITING KIMBERLY J 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.17 0 0 0 0 0 0 217.17 0 0 1004728050 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 0 0 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 0 131.75 0 0 0 0 0 0 0 0 0 0 0 0 0 131.75 0 0 1004728275 1013196682 89 Physician Assistant Only(Encounter Only) JAEGLE COURTNEY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.01 0 0 0 0 0 0 81.01 0 0 1004728527 1013390491 16 Nurse Practitioners BUESSER JULIA 999999999 57 Lake 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359.08 0 0 0 0 0 0 359.08 0 0 1004728767 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 507.21 0 0 0 0 0 0 507.21 0 0 1004728787 1073581872 30 General Hospitals HARRISBURG MEDICAL CENTER INC 629462718 90 Saline DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 60 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 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175467.57 0 0 0 0 0 0 0 0 0 175467.57 0 0 1004728794 91 Waiver service provider--Adults (DHS/DDD) 22 Clay 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24934.36 0 0 0 0 0 0 0 0 0 0 0 0 0 24934.36 0 0 1004728862 1053643064 87 Psychologist(Encounter Only) BAKER JOHN 618012529 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 821.26 0 0 0 0 0 0 821.26 0 0 1004728959 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5222.11 0 0 0 0 0 0 0 0 0 0 0 0 0 5222.11 0 0 1004728960 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24387.44 0 0 0 0 0 0 0 0 0 0 0 0 0 24387.44 0 0 1004729051 1205386687 11 Dentists BONTRAGER KYLIE R 999999999 10 Adams 0 0 General Dentistry 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2749.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2749.61 0 0 1004729159 1467748673 10 Physicians GERBER BENJAMIN R. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 5180.85 0 0 0 0 0 0 5180.85 0 0 1004729187 16 Nurse Practitioners 105 White 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.82 0 0 0 0 0 0 59.82 0 0 1004729210 1750749826 16 Nurse Practitioners WYNN SHAWN M 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1822.31 0 0 0 0 0 0 1822.31 0 0 1004729273 1306397542 89 Physician Assistant Only(Encounter Only) CLAPP TRENTON D 999999999 88 Richland 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 0 128 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 1531.56 0 0 0 0 0 0 1531.56 0 0 1004729323 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24741.25 0 0 0 0 0 0 0 0 0 0 0 0 0 24741.25 0 0 1004729421 1831376961 10 Physicians SAID BELAL H 999999999 40 Grundy 0 0 Internal Medicine 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 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810.4 0 0 0 0 0 0 810.4 0 0 1004729441 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10562.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10562.02 0 0 1004729746 16 Nurse Practitioners 15 Bureau 0 0 0 0 0 0 0 0 0 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 46.71 0 0 0 0 0 0 46.71 0 0 1004729800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 673.34 0 0 0 0 0 0 0 0 0 0 0 0 0 673.34 0 0 1004729809 1124331236 10 Physicians DINES MARSHALL L 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 150 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.9 0 7167.65 0 0 0 0 0 0 8247.55 0 0 1004729905 1982933974 16 Nurse Practitioners GONZALEZ JENNIFER L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2688.5 0 0 0 0 0 0 2688.5 0 0 1004729957 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 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 35.41 0 0 0 0 0 0 35.41 0 0 1004729959 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30617.03 0 0 0 0 0 0 0 0 0 0 0 0 0 30617.03 0 0 1004730142 1578875647 10 Physicians MILLER CORY S 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 5 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.92 0 0 0 0 0 0 0 0 117.92 0 0 1004730147 1285861435 10 Physicians WATSON JONATHAN 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.15 0 3528.6 0 0 0 0 0 0 3616.75 0 0 1004730753 1497022586 16 Nurse Practitioners LEGUILLON MELISSA D 999999999 53 Kane 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112.45 0 0 0 0 0 0 1112.45 0 0 1004731167 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.62 0 0 0 0 0 0 0 0 0 0 0 0 0 104.62 0 0 1004731434 1013364926 16 Nurse Practitioners SHANNON KRISTIN W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648.76 0 0 0 0 0 0 648.76 0 0 1004731533 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25639.44 0 0 0 0 0 0 0 0 0 0 0 0 0 25639.44 0 0 1004731614 1912929704 60 Pharmacies CVS PHARMACY #16281 601601611 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 4656 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7057.01 0 0 0 7057.01 0 0 1004731646 1376890376 89 Physician Assistant Only(Encounter Only) PARKER AMANDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1579.02 0 0 0 0 0 0 1579.02 0 0 1004731733 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20064.15 0 0 0 0 0 0 0 0 0 0 0 0 0 20064.15 0 0 1004731862 1568514289 10 Physicians REDDY HARI 999999999 98 Tazewell 0 0 Radiology Diagnosis 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.72 0 0 0 0 0 0 0 0 1125.72 0 0 1004731928 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7541.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7541.8 0 0 1004731995 1093143869 89 Physician Assistant Only(Encounter Only) HOLWEY NICHOLAS 999999999 200 Cook 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 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 2248.97 0 0 0 0 0 0 2248.97 0 0 1004732209 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23016 0 0 0 0 0 0 0 0 0 0 0 0 0 23016 0 0 1004732396 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 3304.63 0 0 0 0 0 0 0 0 0 0 0 0 0 3304.63 0 0 1004732404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26241.23 0 0 0 0 0 0 0 0 0 0 0 0 0 26241.23 0 0 1004732570 92 Waiver service provider--Disability (DHS/DRS) 23 Clinton 0 0 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 34349.63 0 0 0 0 0 0 0 0 0 0 0 0 0 34349.63 0 0 1004733158 1437549938 10 Physicians HOLLETT KIRSTEN LEIGH 999999999 200 Cook 0 0 Pediatrics 0 0 0 43 0 0 0 0 0 0 15 0 60 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 23 0 76 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 23 0 76 0 0 0 0 0 0 0 0 0 3778.2 0 0 0 0 0 0 707.01 0 3914.82 0 0 0 0 0 0 8400.03 0 0 1004733482 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142750.28 0 0 0 0 0 0 0 0 0 0 0 0 0 142750.28 0 0 1004733522 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2172.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2172.33 0 0 1004733728 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 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 0 369.38 0 0 0 0 0 0 369.38 0 0 1004733754 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24863.63 0 0 0 0 0 0 0 0 0 0 0 0 0 24863.63 0 0 1004733765 1770031841 16 Nurse Practitioners BECKER BARBARA D 999999999 200 Cook 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 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 1355.79 0 0 0 0 0 0 1355.79 0 0 1004734004 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359.74 0 0 0 0 0 0 0 0 0 0 0 0 0 359.74 0 0 1004734247 10 Physicians 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1994.9 0 0 0 0 0 0 1994.9 0 0 1004734395 1538591169 22 Physical Therapists RAND MEGAN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.02 202.02 0 0 1004734617 1194015016 10 Physicians ZAFAR ABU-BAKAR 999999999 19 Champaign 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.03 0 12893.34 0 0 0 0 0 0 12899.37 0 0 1004734693 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004734841 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10537.23 0 0 0 0 0 0 0 0 0 0 0 0 0 10537.23 0 0 1004734872 1124229737 16 Nurse Practitioners WINKE LINDA M. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.68 0 0 0 0 0 0 18.68 0 0 1004735257 10 Physicians 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 384.9 0 0 0 0 0 0 384.9 0 0 1004735353 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004735719 65 Independent Diagnostic Testing Facility (IDTF) 200 Cook 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1004735789 92 Waiver service provider--Disability (DHS/DRS) 90 Saline 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24948.94 0 0 0 0 0 0 0 0 0 0 0 0 0 24948.94 0 0 1004735872 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23862.91 0 0 0 0 0 0 0 0 0 0 0 0 0 23862.91 0 0 1004736343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25624.57 0 0 0 0 0 0 0 0 0 0 0 0 0 25624.57 0 0 1004736410 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14770.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14770.02 0 0 1004736497 1508076126 10 Physicians KAO PATRICIA F 999999999 50 Jersey 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1004736625 16 Nurse Practitioners 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004736869 1992934517 10 Physicians HUBBARD DAVID 999999999 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514.35 0 0 0 0 0 0 514.35 0 0 1004736909 86 Clinical Social Worker(Encounter Only) 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 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 0 312.88 0 0 0 0 0 0 312.88 0 0 1004737152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23527.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23527.28 0 0 1004737195 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 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 0 337.81 0 0 0 0 0 0 0 0 0 0 0 0 0 337.81 0 0 1004737280 1437606019 16 Nurse Practitioners RANA PAYAL K 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.53 0 0 0 0 0 0 297.53 0 0 1004737536 98 Waiver service provider--TBI (DHS/DRS) 34 Fayette 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 917.81 0 0 0 0 0 0 0 0 0 0 0 0 0 917.81 0 0 1004737565 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 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 1009.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1009.04 0 0 1004737679 23 Occupational Therapists 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 930.42 930.42 0 0 1004737975 1649631425 63 Other Providers of Medical Equipment/Supplies (Non-registered) DEPARTMENT OF ORTHOPEDIC SURGE 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.27 0 397.25 0 0 0 0 431.52 0 0 1004738294 1770949067 16 Nurse Practitioners DUDKO ALEKSANDRA 999999999 53 Kane 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 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 61.64 0 0 0 0 0 0 61.64 0 0 1004738394 1477943819 60 Pharmacies ILLINOIS CANCERCARE PHARMACY 999999999 56 Knox 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84838.08 0 0 0 84838.08 0 0 1004738540 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.73 0 0 0 0 0 0 43.73 0 0 1004738666 1881840783 89 Physician Assistant Only(Encounter Only) ABE KAZUKO 999999999 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 633.32 0 0 0 0 0 0 633.32 0 0 1004738767 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523.21 0 0 0 0 0 0 523.21 0 0 1004739034 1144697715 16 Nurse Practitioners KASHANI KELLY 999999999 200 Cook 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 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 0 369.79 0 0 0 0 0 0 369.79 0 0 1004739197 1417339631 16 Nurse Practitioners SZKODA ANNA 999999999 200 Cook 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 0 156 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 2890.42 0 0 0 0 0 0 2890.42 0 0 1004739230 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7975.65 0 0 0 0 0 0 0 0 0 0 0 0 0 7975.65 0 0 1004739473 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1523.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1523.52 0 0 1004739546 1467806513 10 Physicians BROZEK JOSHUA A 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 10 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.5 0 9389.14 0 0 0 0 0 0 9541.64 0 0 1004739884 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1473.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1473.27 0 0 1004739909 1790125193 10 Physicians VORIS JOHN 999999999 98 Tazewell 0 0 Internal Medicine 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1195.92 0 0 0 0 0 0 1195.92 0 0 1004740111 1609225358 16 Nurse Practitioners MIGON TIFFANY 999999999 200 Cook 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 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 0 297.34 0 0 0 0 0 0 297.34 0 0 1004740144 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5710.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5710.32 0 0 1004740239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19591.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19591.86 0 0 1004740381 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 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 10731.91 0 0 0 0 0 0 0 0 0 0 0 0 0 10731.91 0 0 1004740504 1669639076 10 Physicians RAHMAN FAIZ U 999999999 200 Cook 0 1 Pediatrics 0 0 0 52 0 0 0 0 0 0 2 0 56 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 2 0 81 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 2 0 81 0 0 0 0 0 0 0 0 0 5325.06 0 0 0 0 0 0 4.64 0 4416.42 0 0 0 0 0 0 9746.12 0 0 1004740542 1033668959 22 Physical Therapists SABATKA CHRISTI A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068.72 1068.72 0 0 1004740606 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5643.53 0 0 0 0 0 0 0 0 0 0 0 0 0 5643.53 0 0 1004740689 1487661955 89 Physician Assistant Only(Encounter Only) LEE WARREN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9005.71 0 0 0 0 0 0 9005.71 0 0 1004740717 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 4392.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4392.12 0 0 1004740930 1023198785 60 Pharmacies "PHARMACY PLUS, INC" 620821344 39 Greene 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 11238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.04 0 0 23271.04 0 0 0 23313.08 0 0 1004741216 1710150438 10 Physicians ASI KHALED 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 9 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.86 0 2927.23 0 0 0 0 0 0 2928.09 0 0 1004741295 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 720.82 0 0 0 0 0 0 0 0 0 0 0 0 0 720.82 0 0 1004741375 1336377001 10 Physicians GUPTA NEHA V. 999999999 200 Cook 0 0 Psychiatry 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3078.64 0 0 0 0 0 0 3078.64 0 0 1004741525 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341.84 0 0 0 0 0 0 0 0 0 0 0 0 0 341.84 0 0 1004741620 1033304928 89 Physician Assistant Only(Encounter Only) WHEELER JAMES N 999999999 10 Adams 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 0 147 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 1176.05 0 0 0 0 0 0 1176.05 0 0 1004741708 1003057936 10 Physicians TOUGH-DESAPRI KRISTI 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921.4 0 0 0 0 0 0 921.4 0 0 1004741723 1952323768 60 Pharmacies CVS PHARMACY #16348 612656871 89 Rock Island 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 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29330 0 0 0 29330 0 0 1004742058 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23189.93 0 0 0 0 0 0 0 0 0 0 0 0 0 23189.93 0 0 1004742311 1205295144 10 Physicians JOVA ADRIAN G 999999999 30 DuPage 0 0 Internal Medicine 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1118.94 0 0 0 0 0 0 1118.94 0 0 1004742345 48 Rural Health Clinics 90 Saline 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.06 0 0 1004742574 1104116847 10 Physicians LAI YING HAO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5560.97 0 0 0 0 0 0 5560.97 0 0 1004742630 1689120065 89 Physician Assistant Only(Encounter Only) ROTH LAUREN E 999999999 53 Kane 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 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 0 267.74 0 0 0 0 0 0 267.74 0 0 1004742777 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253.86 0 0 0 0 0 0 253.86 0 0 1004742807 1114379443 91 Waiver service provider--Adults (DHS/DDD) KESHET 999999999 200 Cook 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 7239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683180.13 0 0 0 0 0 0 0 0 0 0 0 0 0 683180.13 0 0 1004743013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.72 0 0 0 0 0 0 0 0 0 0 0 0 0 91.72 0 0 1004743293 1750834743 88 Other behavior health professional MCCANN THOMAS P 999999999 200 Cook 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 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12039.39 0 0 0 0 0 0 12039.39 0 0 1004743717 1013121383 16 Nurse Practitioners TESTA CHRISTINE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 988.02 0 0 0 0 0 0 988.02 0 0 1004743744 22 Physical Therapists 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.98 25.98 0 0 1004744007 1689023319 55 Early Intervention Services MCMAHAN KATIE M 999999999 30 DuPage 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 0 123 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 6985.73 0 0 0 0 0 0 6985.73 0 0 1004744218 87 Psychologist(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400.37 0 0 0 0 0 0 400.37 0 0 1004744267 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512.59 0 0 0 0 0 0 0 0 0 0 0 0 0 512.59 0 0 1004744457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4830.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4830.85 0 0 1004744542 1336450048 89 Physician Assistant Only(Encounter Only) GILLESPIE ANGELA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004744543 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14049.75 0 0 0 0 0 0 0 0 0 0 0 0 0 14049.75 0 0 1004744548 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3801.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3801.33 0 0 1004744571 1043659071 10 Physicians VIRPARIA SONIA K 999999999 200 Cook 0 0 Family Practice 0 0 0 7 0 0 0 0 0 0 8 0 58 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 12 0 91 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 12 0 91 0 0 0 0 0 0 0 0 0 538.31 0 0 0 0 0 0 256.9 0 2075.87 0 0 0 0 0 0 2871.08 0 0 1004745122 10 Physicians 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.16 0 0 0 0 0 0 124.16 0 0 1004745191 1720067051 16 Nurse Practitioners DUDAK PHILIP 999999999 200 Cook 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 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 0 226.18 0 0 0 0 0 0 226.18 0 0 1004745262 1013243161 12 Optometrists KALLADANTHYIL ANN S 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5656.02 0 2518.52 0 0 0 0 8174.54 0 0 1004745343 1285925248 10 Physicians SIDDIQUI NASIR 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 99 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2598.87 0 453.04 0 0 0 0 0 0 3051.91 0 0 1004745479 11 Dentists 200 Cook 0 0 Pedodontics 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 0 378.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.65 0 0 1004745482 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20930.84 0 0 0 0 0 0 0 0 0 0 0 0 0 20930.84 0 0 1004745508 75 Department of Alcohol and Substance Abuse Provider 14 Brown 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1314.87 0 0 1314.87 0 0 1004745563 1164700183 10 Physicians SECOR JESSICA L 999999999 80 Peoria 0 0 Vascular Surgery 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 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 0 671.46 0 0 0 0 0 0 671.46 0 0 1004745584 1457789315 16 Nurse Practitioners OETOMO AUDREY 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1804.08 0 0 0 0 0 0 1804.08 0 0 1004745654 1063702116 89 Physician Assistant Only(Encounter Only) MATSCHULLAT KRISTY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342.11 0 0 0 0 0 0 342.11 0 0 1004745748 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8627.32 0 0 0 0 0 0 0 0 0 0 0 0 0 8627.32 0 0 1004745780 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 917.82 0 0 0 0 0 0 0 0 0 0 0 0 0 917.82 0 0 1004745824 1578019634 16 Nurse Practitioners WATSON-EVANS HOLLY N 999999999 53 Kane 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 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 0 732.29 0 0 0 0 0 0 732.29 0 0 1004746035 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.6 0 182.06 0 0 0 0 0 0 194.66 0 0 1004746125 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15179.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15179.21 0 0 1004746183 1043531528 10 Physicians TSANG REBECCA W 999999999 200 Cook 0 0 Internal Medicine 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 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4618.3 0 0 0 0 0 0 4618.3 0 0 1004746524 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1947.33 0 0 0 0 0 0 1947.33 0 0 1004746813 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15661.31 0 0 0 0 0 0 0 0 0 0 0 0 0 15661.31 0 0 1004746897 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5844.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5844.52 0 0 1004747139 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20613.85 0 0 0 0 0 0 0 0 0 0 0 0 0 20613.85 0 0 1004747162 1942527031 10 Physicians PASTORINI CRISTHINE STEPHANIE 999999999 10 Adams 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 199 0 0 1004747434 1053867317 11 Dentists BRADY D JAMIESON 999999999 200 Cook 0 0 General Dentistry 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.14 0 0 1004748099 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11643.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11643.06 0 0 1004748224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5299.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5299.46 0 0 1004748452 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12774.7 0 0 0 0 0 0 0 0 0 0 0 0 0 12774.7 0 0 1004748613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34431.84 0 0 0 0 0 0 0 0 0 0 0 0 0 34431.84 0 0 1004748914 1063678852 10 Physicians CHAOUKI AHMAD SAMI 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 7705.31 0 0 0 0 0 0 7718.11 0 0 1004749087 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.56 0 0 0 0 0 0 0 0 0 0 0 0 0 49.56 0 0 1004749414 1417307901 12 Optometrists RIZVI NAZ 999999999 27 Dekalb 0 0 Diagnostic Pharmaceutical Agents 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1805.12 0 0 0 0 0 0 1805.12 0 0 1004749700 16 Nurse Practitioners 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 176.23 0 0 0 0 0 0 176.23 0 0 1004749723 92 Waiver service provider--Disability (DHS/DRS) 52 Johnson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2962.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2962.55 0 0 1004749742 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004750111 94 Waiver service provider--Children's support (DHS/DDD) 46 Iroquois 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2122.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2122.2 0 0 1004750322 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004750396 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 114.4 0 0 0 0 0 0 0 0 0 0 0 0 0 114.4 0 0 1004750431 1043518244 10 Physicians MEAH SANA S 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 1419.38 0 0 0 0 0 0 1425.68 0 0 1004750975 1346694957 75 Department of Alcohol and Substance Abuse Provider "CORNERSTONE SERVICES, INC" 999999999 107 Will 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 0 529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26901.1 0 0 26901.1 0 0 1004751217 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 1004751385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32437.98 0 0 0 0 0 0 0 0 0 0 0 0 0 32437.98 0 0 1004751516 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004751804 1164719050 10 Physicians DANEK JUSTIN T 999999999 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2460.8 0 0 0 0 0 0 2460.8 0 0 1004751819 1679892707 10 Physicians HOLST ASHLEE K 999999999 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242.36 0 0 0 0 0 0 242.36 0 0 1004751848 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26382.95 0 0 0 0 0 0 0 0 0 0 0 0 0 26382.95 0 0 1004751916 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17598.68 0 0 0 0 0 0 0 0 0 0 0 0 0 17598.68 0 0 1004752002 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17718.05 0 0 0 0 0 0 0 0 0 0 0 0 0 17718.05 0 0 1004752089 89 Physician Assistant Only(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004752093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18697.58 0 0 0 0 0 0 0 0 0 0 0 0 0 18697.58 0 0 1004752136 1528421187 23 Occupational Therapists TANZILLO KYLE 999999999 22 Clay 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 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004752236 1750721676 11 Dentists JABBAR MOHAMMED 999999999 200 Cook 0 0 General Dentistry 0 0 245 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1337 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1337 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 46095.86 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 46848.56 0 0 1004752594 1730197005 89 Physician Assistant Only(Encounter Only) STARR EMILY F 999999999 200 Cook 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358.1 0 0 0 0 0 0 358.1 0 0 1004752635 1013289610 60 Pharmacies GENOA HEALTHCARE LLC 611031573 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135713.78 0 0 0 135713.78 0 0 1004752651 1942565593 13 Podiatrists KNIGHT JESSICA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466.09 0 0 0 0 0 0 466.09 0 0 1004752893 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1252.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1252.78 0 0 1004752990 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 11874.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11874.06 0 0 1004753043 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004753061 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6975.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6975.4 0 0 1004753095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3767.89 0 0 0 0 0 0 0 0 0 0 0 0 0 3767.89 0 0 1004753257 1083162432 40 Federally Qualified Health Centers ARCHVIEW MEDICAL CENTER 999999999 96 St Clair 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2510.93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2510.93 0 0 1004753305 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.82 0 0 0 0 0 0 45.82 0 0 1004753333 1912286345 89 Physician Assistant Only(Encounter Only) RIEMMA LAURA ELLEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 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 5224.33 0 0 0 0 0 0 5224.33 0 0 1004753400 1174772594 10 Physicians KENYON DIANA 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 37 0 45 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 146 0 128 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 146 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2967.25 0 8741.89 0 0 0 0 0 0 11709.14 0 0 1004753442 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23594.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23594.92 0 0 1004753468 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.22 0 0 0 0 0 0 266.22 0 0 1004753773 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 2643.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2643.35 0 0 1004753835 1316331408 89 Physician Assistant Only(Encounter Only) PHILLIPS JAYME L. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465.4 0 0 0 0 0 0 465.4 0 0 1004753988 1689023889 16 Nurse Practitioners NAWROT AGNES G 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 254.9 0 0 0 0 0 0 0 0 601.32 0 0 0 0 0 0 856.22 0 0 1004754029 1215398128 16 Nurse Practitioners ABERCROMBIE SARA E 999999999 63 Macon 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2909 0 0 0 0 0 0 2909 0 0 1004754037 1497149694 10 Physicians BAHRANI NEDA O 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 374.33 0 0 0 0 0 0 0 0 656.25 0 0 0 0 0 0 1030.58 0 0 1004754995 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 11501.65 0 0 0 0 0 0 0 0 0 0 0 0 0 11501.65 0 0 1004755065 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7513.24 0 0 0 0 0 0 0 0 0 0 0 0 0 7513.24 0 0 1004755344 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004755843 1750513255 10 Physicians KARAGIORGOS NIKOLAOS 999999999 19 Champaign 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 9 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.19 0 2936.66 0 0 0 0 0 0 3027.85 0 0 1004756021 1154798999 12 Optometrists HUTTNER BRENNA J 999999999 89 Rock Island 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 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 0 903.03 0 0 0 0 0 0 903.03 0 0 1004756145 30 General Hospitals 803 Arizona ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 876.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876.29 0 0 1004756222 1235578410 16 Nurse Practitioners COBB KATHRYN L 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.46 0 0 0 0 0 0 152.46 0 0 1004756275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22048.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22048.47 0 0 1004756795 1740509496 60 Pharmacies CVS PHARMACY #17437 606405660 200 Cook 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50521.77 0 0 0 50521.77 0 0 1004756816 1669839304 89 Physician Assistant Only(Encounter Only) FECHNER EMILY 999999999 200 Cook 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 0 840.75 0 0 0 0 0 0 840.75 0 0 1004756819 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.12 0 0 0 0 0 0 147.12 0 0 1004757129 1013323096 10 Physicians REMEDIOS SMITH KIMBERLY 999999999 200 Cook 0 0 Pediatrics 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 0 156 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 22426.57 0 0 0 0 0 0 22426.57 0 0 1004757171 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9189.33 0 0 0 0 0 0 0 0 0 0 0 0 0 9189.33 0 0 1004757181 1265980932 16 Nurse Practitioners BETA SANDRA 999999999 200 Cook 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 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 0 723.38 0 0 0 0 0 0 723.38 0 0 1004757195 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15194.34 0 0 0 0 0 0 0 0 0 0 0 0 0 15194.34 0 0 1004757223 1912450792 16 Nurse Practitioners SANGER RACHEL L 999999999 10 Adams 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 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 0 303.44 0 0 0 0 0 0 303.44 0 0 1004757387 1205296811 24 Speech Therapists MCCURREN STEPHANIE 999999999 36 Franklin 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 0 163 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 11717.63 11717.63 0 0 1004757442 1659733822 89 Physician Assistant Only(Encounter Only) WOODRUFF CATHERINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004757619 1770931495 16 Nurse Practitioners HILL ASHLEY 999999999 91 Sangamon 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 786.15 0 0 0 0 0 0 786.15 0 0 1004757884 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.98 0 0 0 0 0 0 50.98 0 0 1004757970 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004758006 1902257322 11 Dentists PATEL BRIJESH 999999999 71 McHenry 0 0 General Dentistry 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27803.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27803.83 0 0 1004758147 1407300627 16 Nurse Practitioners MCKEE KAMIE 999999999 70 McDonough 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 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 0 117.98 0 0 0 0 0 0 117.98 0 0 1004758561 1649237959 89 Physician Assistant Only(Encounter Only) NITA ADELIN 999999999 200 Cook 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 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7579.84 0 0 0 0 0 0 7579.84 0 0 1004758586 1093155772 10 Physicians SHAKEEL FAIZAN 999999999 200 Cook 0 0 Emergency Medicine 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5009.28 0 0 0 0 0 0 5009.28 0 0 1004758762 1093167322 89 Physician Assistant Only(Encounter Only) SINGH RUBY K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.89 0 0 0 0 0 0 125.89 0 0 1004758808 89 Physician Assistant Only(Encounter Only) 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.55 0 0 0 0 0 0 4.55 0 0 1004758911 1518318765 22 Physical Therapists TARENCE JESSICA N 999999999 200 Cook 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 0 156 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 10488.59 10488.59 0 0 1004759243 1356792956 16 Nurse Practitioners GAMBLIN JESSICA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 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 13735.39 0 0 0 0 0 0 13735.39 0 0 1004759296 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18449.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18449.2 0 0 1004759479 1538172739 89 Physician Assistant Only(Encounter Only) ACKERT KIMBERLY D 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1392.91 0 0 0 0 0 0 1392.91 0 0 1004759622 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24517.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24517.68 0 0 1004759685 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.34 0 0 1004759736 10 Physicians 60 Lee 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004760060 92 Waiver service provider--Disability (DHS/DRS) 99 Union 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14841.81 0 0 0 0 0 0 0 0 0 0 0 0 0 14841.81 0 0 1004760242 1013271618 10 Physicians TAPON PHILIPPE 999999999 200 Cook 0 0 Psychiatry 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11538.08 0 0 0 0 0 0 11538.08 0 0 1004760292 1851683122 10 Physicians FABRIZIUS RYAN G 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427.31 0 0 0 0 0 0 427.31 0 0 1004760304 72 Taxicabs and Livery Companies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.91 0 0 0 0 0 0 1312.91 0 0 1004760617 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6731.78 0 0 0 0 0 0 0 0 0 0 0 0 0 6731.78 0 0 1004760832 1760611149 89 Physician Assistant Only(Encounter Only) PAINTER STEPHANIE A 999999999 19 Champaign 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 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 1009.02 0 0 0 0 0 0 1009.02 0 0 1004760940 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004760994 1538386149 89 Physician Assistant Only(Encounter Only) KOVACIC KATHERINE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1143.82 0 0 0 0 0 0 1143.82 0 0 1004760995 1295143675 10 Physicians LEE YI-SHAN 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 21 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 603.85 0 9.19 0 0 0 0 0 0 613.04 0 0 1004761072 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23133.66 0 0 0 0 0 0 0 0 0 0 0 0 0 23133.66 0 0 1004761089 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 2289.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2289.79 0 0 1004761601 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13133.89 0 0 0 0 0 0 0 0 0 0 0 0 0 13133.89 0 0 1004761676 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1004761715 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11037.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11037.84 0 0 1004762009 1235423328 10 Physicians SHEEHAN STEVEN T 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.47 0 0 0 0 0 0 103.47 0 0 1004762435 1083900989 10 Physicians ROSENBERG JONATHAN REUBEN 999999999 200 Cook 0 0 Internal Medicine 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 0 111 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 3365.62 0 0 0 0 0 0 3365.62 0 0 1004762724 1619912979 10 Physicians COPLEY PATRICIA D 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250.59 0 0 0 0 0 0 250.59 0 0 1004762877 1295022515 10 Physicians TOLAYMAT ABDULLAH 999999999 80 Peoria 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 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 5668.04 0 0 0 0 0 0 5668.04 0 0 1004762918 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004762941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 779.73 0 0 0 0 0 0 0 0 0 0 0 0 0 779.73 0 0 1004762974 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15938.12 0 0 0 0 0 0 0 0 0 0 0 0 0 15938.12 0 0 1004763101 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4944.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4944.22 0 0 1004763166 1811258593 16 Nurse Practitioners VOGT RICHARD S 999999999 64 Macoupin 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 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 0 663.62 0 0 0 0 0 0 663.62 0 0 1004763281 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.12 0 0 0 0 0 0 0 0 0 0 0 0 0 251.12 0 0 1004763582 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.41 0 0 0 0 0 0 28.41 0 0 1004763721 92 Waiver service provider--Disability (DHS/DRS) 23 Clinton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3664.18 0 0 0 0 0 0 0 0 0 0 0 0 0 3664.18 0 0 1004763987 87 Psychologist(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.83 0 0 0 0 0 0 135.83 0 0 1004764467 1679027247 16 Nurse Practitioners COSTA ADEKUNBI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1244 0 0 0 0 0 0 1244 0 0 1004764481 1093268427 16 Nurse Practitioners ZITRICK ALLISON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004764803 1295993012 10 Physicians LITWILLER ABIGAIL R. 999999999 200 Cook 0 0 Obstetric-Gynecology 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 1611.93 0 0 0 0 0 0 1611.93 0 0 1004764957 91 Waiver service provider--Adults (DHS/DDD) 34 Fayette 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24933.26 0 0 0 0 0 0 0 0 0 0 0 0 0 24933.26 0 0 1004764981 1770825853 10 Physicians PATEL MANALI A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1182.26 0 0 0 0 0 0 1182.26 0 0 1004764994 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.08 0 0 0 0 0 0 64.08 0 0 1004765147 1841555414 10 Physicians BART NICCOLE 999999999 200 Cook 0 0 Emergency Medicine 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9727.45 0 0 0 0 0 0 9727.45 0 0 1004765283 1376913574 89 Physician Assistant Only(Encounter Only) MAINE EMILY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1134.31 0 0 0 0 0 0 1134.31 0 0 1004765791 1457807646 16 Nurse Practitioners TAYLOR EMILY 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 1 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 0 751.58 0 0 0 0 0 0 751.58 0 0 1004765805 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 121.07 0 0 0 0 0 0 121.07 0 0 1004766014 1972729689 22 Physical Therapists ANAND MAYA 999999999 200 Cook 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 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 0 151.97 151.97 0 0 1004766082 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 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 5052.83 0 0 0 0 0 0 0 0 0 0 0 0 0 5052.83 0 0 1004766477 16 Nurse Practitioners 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.19 0 0 0 0 0 0 13.19 0 0 1004766627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18898.58 0 0 0 0 0 0 0 0 0 0 0 0 0 18898.58 0 0 1004766745 1477903276 16 Nurse Practitioners FRUTH ERIN E 999999999 200 Cook 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 903.43 0 0 0 0 0 0 903.43 0 0 1004766785 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26089.11 0 0 0 0 0 0 0 0 0 0 0 0 0 26089.11 0 0 1004766802 1225387194 89 Physician Assistant Only(Encounter Only) ABRAHAM DANIELLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.43 0 0 0 0 0 0 67.43 0 0 1004766952 1124121371 89 Physician Assistant Only(Encounter Only) CORNICK JACINDA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 711.19 0 0 0 0 0 0 711.19 0 0 1004766960 1780898940 16 Nurse Practitioners DUEBNER PAULA V 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.06 0 0 0 0 0 0 191.06 0 0 1004766992 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23059.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23059.5 0 0 1004767053 10 Physicians 92 Schuyler 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004767173 1023223310 89 Physician Assistant Only(Encounter Only) PATEL AMEE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7346.7 0 0 0 0 0 0 7346.7 0 0 1004767212 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.51 0 0 0 0 0 0 130.51 0 0 1004767307 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 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 43.54 0 0 0 0 0 0 43.54 0 0 1004767571 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.42 0 0 0 0 0 0 86.42 0 0 1004767651 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 9673.39 0 0 0 0 0 0 0 0 0 0 0 0 0 9673.39 0 0 1004767705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29112.27 0 0 0 0 0 0 0 0 0 0 0 0 0 29112.27 0 0 1004768067 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13047.67 0 0 0 0 0 0 0 0 0 0 0 0 0 13047.67 0 0 1004768198 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5800.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5800.95 0 0 1004768251 1053563643 89 Physician Assistant Only(Encounter Only) WARNECKE NICHOLAS 999999999 80 Peoria 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22654.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22654.8 0 0 1004769435 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 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 71.18 71.18 0 0 1004769637 1609848282 89 Physician Assistant Only(Encounter Only) RIGGS KEVIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1301.17 0 0 0 0 0 0 1301.17 0 0 1004769722 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19746.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19746.38 0 0 1004769751 1548321953 10 Physicians NICKLAY-CATALAN JANICE M 999999999 89 Rock Island 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2332.59 0 0 0 0 0 0 2332.59 0 0 1004770042 92 Waiver service provider--Disability (DHS/DRS) 79 Ogle 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38145.5 0 0 0 0 0 0 0 0 0 0 0 0 0 38145.5 0 0 1004770137 1073875571 10 Physicians PHARAON BEDER 999999999 30 DuPage 0 0 Internal Medicine 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 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 1861.33 0 0 0 0 0 0 1861.33 0 0 1004770699 1376991851 60 Pharmacies "SUPER CARE PHARMACY, INC" 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15643.66 0 0 0 15643.66 0 0 1004770722 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20950.85 0 0 0 0 0 0 0 0 0 0 0 0 0 20950.85 0 0 1004770974 1477764744 10 Physicians PATEL VINAY M 999999999 10 Adams 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 10 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.6 0 1525.86 0 0 0 0 0 0 1538.46 0 0 1004771037 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 1004771048 1134578354 60 Pharmacies CVS PHARMACY #17683 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978.72 0 0 0 978.72 0 0 1004771116 61 Independent Laboratories 845 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1004772324 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22077.59 0 0 0 0 0 0 0 0 0 0 0 0 0 22077.59 0 0 1004772345 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1936.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1936.89 0 0 1004772358 1588989826 10 Physicians ARI MIM 999999999 30 DuPage 0 0 Internal Medicine 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 0 147 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 4277.31 0 0 0 0 0 0 4277.31 0 0 1004772455 91 Waiver service provider--Adults (DHS/DDD) 106 Whiteside 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5616.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5616.75 0 0 1004772529 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004772950 1295026441 10 Physicians DELANEY KRISTIE S 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615.22 0 1848.38 0 0 0 0 0 0 2463.6 0 0 1004773093 1831331990 10 Physicians ZHOU AMY W 999999999 200 Cook 0 0 Internal Medicine 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2426.44 0 0 0 0 0 0 2426.44 0 0 1004773518 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2005.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2005.08 0 0 1004773643 10 Physicians 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004773700 1053609248 13 Podiatrists DAVID GELBMANN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15362.77 0 0 0 0 0 0 15362.77 0 0 1004773922 1730204686 16 Nurse Practitioners FARWELL DAWN E. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.66 0 0 0 0 0 0 201.66 0 0 1004774037 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9130.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9130.26 0 0 1004774068 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1664.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1664.52 0 0 1004774175 60 Pharmacies 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187284.92 0 0 0 187284.92 0 0 1004774338 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22248.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22248.57 0 0 1004774373 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2755.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2755.6 0 0 1004774390 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10625.19 0 0 0 0 0 0 0 0 0 0 0 0 0 10625.19 0 0 1004774582 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44928.4 0 0 0 0 0 0 0 0 0 0 0 0 0 44928.4 0 0 1004774780 1104298314 16 Nurse Practitioners RYAN MORGAN L 999999999 89 Rock Island 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 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 0 795.66 0 0 0 0 0 0 795.66 0 0 1004774857 1053750851 10 Physicians MACDONALD ASHLEY 999999999 91 Sangamon 0 0 General Practice 0 0 0 3 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 153.68 0 0 0 0 0 0 5.22 0 634.22 0 0 0 0 0 0 793.12 0 0 1004774902 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 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 50.15 50.15 0 0 1004774907 1902912314 16 Nurse Practitioners COPE NOELLE R 999999999 24 Coles 0 0 0 0 0 72 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 8054.34 0 0 0 0 0 0 0 0 7900.97 0 0 0 0 0 0 15955.31 0 0 1004775022 1316316276 16 Nurse Practitioners KRUTHOFF COURTNEY N. 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 0 166.82 0 0 0 0 0 0 166.82 0 0 1004775033 1427378900 10 Physicians CHILDERS ADRIENNE L 999999999 65 Madison 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9642.24 0 0 0 0 0 0 9642.24 0 0 1004775044 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 743.76 0 0 0 0 0 0 0 0 0 0 0 0 0 743.76 0 0 1004775387 1942543558 10 Physicians GAYNOR BRYAN R. 999999999 53 Kane 0 0 Internal Medicine 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.56 0 0 0 0 0 0 1855.56 0 0 1004775507 1508314279 16 Nurse Practitioners BUTLER AMANDA E 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.46 0 0 0 0 0 0 210.46 0 0 1004775753 1083965008 10 Physicians PADILLA SOFIA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12857.16 0 0 0 0 0 0 12857.16 0 0 1004775765 60 Pharmacies 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.9 0 0 0 87.9 0 0 1004775820 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 0 0 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 3223.43 0 0 0 0 0 0 0 0 0 0 0 0 0 3223.43 0 0 1004776272 1194099036 10 Physicians CHAUDHRY SABA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 19 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.32 0 455.2 0 0 0 0 0 0 661.52 0 0 1004776352 1114963394 10 Physicians LIU ZHAO 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2987.24 0 0 0 0 0 0 2987.24 0 0 1004776455 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 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 25616.64 0 0 0 0 0 0 0 0 0 0 0 0 0 25616.64 0 0 1004776501 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24308.34 0 0 0 0 0 0 0 0 0 0 0 0 0 24308.34 0 0 1004776553 13 Podiatrists 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.23 0 0 0 0 0 0 24.23 0 0 1004776589 1639424476 89 Physician Assistant Only(Encounter Only) EGLI DIANE N 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 54.2 0 0 0 0 0 0 54.2 0 0 1004776822 1427400993 10 Physicians AL KHOURY BASHAR 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 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 3127.98 0 0 0 0 0 0 3127.98 0 0 1004776926 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15256.03 0 0 0 0 0 0 0 0 0 0 0 0 0 15256.03 0 0 1004776979 1730528167 10 Physicians JONNA SUSHMA R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 789.47 0 0 0 0 0 0 789.47 0 0 1004777133 1639457054 89 Physician Assistant Only(Encounter Only) BLAND KAYLA 999999999 106 Whiteside 0 0 0 0 0 5 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 339.82 0 0 0 0 0 0 0 0 2061.08 0 0 0 0 0 0 2400.9 0 0 1004777151 1548689284 10 Physicians WISINSKI BRANDON P 999999999 80 Peoria 0 0 Emergency Medicine 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200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.9 0 0 0 0 0 0 165.9 0 0 1004777526 1609817220 30 General Hospitals HIGHLAND PARK HOSPITAL 600352433 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 466 0 0 0 0 396 0 0 0 1503 0 0 0 0 0 0 0 0 0 596 0 0 0 0 496 0 0 0 3137 0 0 0 0 0 0 0 0 0 596 0 0 0 0 2472 0 0 0 3137 0 0 0 0 0 0 0 0 0 121289.79 0 0 0 0 1067011.2 0 0 0 670298.35 0 0 0 0 0 1858599.34 0 0 1004777902 1528434719 16 Nurse Practitioners HEBERT LORETTA A 999999999 55 Kendall 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 656.41 0 0 0 0 0 0 671.01 0 0 1004777905 1124486790 16 Nurse Practitioners ASTLEFORD ANGELA 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 0 160.05 0 0 0 0 0 0 160.05 0 0 1004777989 1023349131 89 Physician Assistant Only(Encounter Only) SIRGEDAS LAURA O. 999999999 200 Cook 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 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 0 467.9 0 0 0 0 0 0 467.9 0 0 1004778120 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 180.21 0 0 0 0 0 0 180.21 0 0 1004778562 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17398.24 0 0 0 0 0 0 0 0 0 0 0 0 0 17398.24 0 0 1004778591 1609211481 10 Physicians AL KASSEM HATEM 999999999 30 DuPage 0 0 Internal Medicine 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2139.19 0 0 0 0 0 0 2139.19 0 0 1004778747 1891956983 60 Pharmacies CVS PHARMACY #17473 622083416 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10832 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16170.89 0 0 0 16170.89 0 0 1004778892 1851740559 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC" 627034331 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94493.4 0 0 94493.4 0 0 1004779025 1346565991 10 Physicians FARAG MARK A 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1826.05 0 0 0 0 0 0 1826.05 0 0 1004779135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6280.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6280.79 0 0 1004779596 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15419.33 0 0 0 0 0 0 0 0 0 0 0 0 0 15419.33 0 0 1004779914 1700232394 60 Pharmacies ILLINOIS CANCERCARE PHARMACY 999999999 58 La Salle 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31531.46 0 0 0 31531.46 0 0 1004780036 1164784559 10 Physicians O''CONNELL JESSICA S. 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 539.38 0 0 0 0 0 0 611.28 0 0 1004780086 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7807.93 0 0 0 0 0 0 0 0 0 0 0 0 0 7807.93 0 0 1004780095 30 General Hospitals 823 Michigan ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555.95 0 0 1004780651 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18977.75 0 0 0 0 0 0 0 0 0 0 0 0 0 18977.75 0 0 1004780768 1710433768 16 Nurse Practitioners CORBIN KATHERINE 999999999 91 Sangamon 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 0 112 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 1589.82 0 0 0 0 0 0 1589.82 0 0 1004780959 1487791521 10 Physicians LEU DAVID 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1586.08 0 0 0 0 0 0 1586.08 0 0 1004781466 10 Physicians 70 McDonough 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004781804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24702.05 0 0 0 0 0 0 0 0 0 0 0 0 0 24702.05 0 0 1004781866 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20320.78 0 0 0 0 0 0 0 0 0 0 0 0 0 20320.78 0 0 1004781953 1659717221 10 Physicians HUR JENNIFER I 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 30 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 30 0 0 0 0 0 0 0 0 0 88.7 0 0 0 0 0 0 2.32 0 665.19 0 0 0 0 0 0 756.21 0 0 1004782011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1558.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1558.24 0 0 1004782276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21925.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21925.8 0 0 1004782411 1467475749 60 Pharmacies CVS PHARMACY #17030 600604267 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13491.42 0 0 0 13491.42 0 0 1004782570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 31029.02 0 0 0 0 0 0 0 0 0 0 0 0 0 31029.02 0 0 1004782779 1730370586 10 Physicians KHAN KHURRAM 999999999 200 Cook 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409.96 0 0 0 0 0 0 1409.96 0 0 1004783091 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.15 0 0 0 0 0 0 0 0 12.15 0 0 1004783127 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 9350.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9350.2 0 0 1004783275 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20813.98 0 0 0 0 0 0 0 0 0 0 0 0 0 20813.98 0 0 1004783375 10 Physicians 81 Perry 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1900 0 0 0 0 0 0 1900 0 0 1004783618 1922451681 16 Nurse Practitioners COUCH JUSTIN J 999999999 61 Livingston 0 0 0 0 0 1 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 1 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 2848.5 0 0 0 0 0 0 2848.5 0 0 1004783762 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4530.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4530.81 0 0 1004783912 1578918561 16 Nurse Practitioners TINDALL LISA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6409.69 0 0 0 0 0 0 6409.69 0 0 1004783947 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23428.07 0 0 0 0 0 0 0 0 0 0 0 0 0 23428.07 0 0 1004783952 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4119 0 0 0 0 0 0 0 0 0 0 0 0 0 4119 0 0 1004783954 1083969059 24 Speech Therapists MENDOZA M CHRISTINE B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 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 11530.56 11530.56 0 0 1004784113 1285894782 10 Physicians BROSTROM VALERIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 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 1511.79 0 0 0 0 0 0 0 0 1511.79 0 0 1004784217 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37915.54 0 0 0 0 0 0 0 0 0 0 0 0 0 37915.54 0 0 1004784369 1841643285 11 Dentists VILDAVER ELIOT J 999999999 71 McHenry 0 0 General Dentistry 0 0 155 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 963 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 963 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 25607.31 0 0 0 0 0 0 0 0 0 0 0 4892.55 0 0 0 0 30499.86 0 0 1004784456 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 3206.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3206.24 0 0 1004784482 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22459.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22459.5 0 0 1004784618 1548638737 89 Physician Assistant Only(Encounter Only) SAYLOR ALAINE 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5425.5 0 0 0 0 0 0 5425.5 0 0 1004784644 1982008454 89 Physician Assistant Only(Encounter Only) TSANG SWING 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 622.11 0 0 0 0 0 0 622.11 0 0 1004785046 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1381.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1381.9 0 0 1004785171 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30837.38 0 0 0 0 0 0 0 0 0 0 0 0 0 30837.38 0 0 1004785183 1740433291 10 Physicians BOPANNA SURAJ 999999999 97 Stephenson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.16 0 8248.7 0 0 0 0 0 0 8260.86 0 0 1004785356 1497131072 12 Optometrists ANDERSON BRADEN G. 999999999 91 Sangamon 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 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4198.54 0 0 0 0 0 0 4198.54 0 0 1004785422 1548565625 10 Physicians MOHIUDDIN SALMAN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 524 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12386.09 0 952.23 0 0 0 0 0 0 13338.32 0 0 1004785647 1366784753 10 Physicians CRISPIN MAUREEN K 999999999 30 DuPage 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 458.35 0 0 0 0 0 0 0 0 357.91 0 0 0 0 0 0 816.26 0 0 1004785664 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 14424.54 0 0 0 0 0 0 0 0 0 0 0 0 0 14424.54 0 0 1004785764 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004785782 16 Nurse Practitioners 44 Henderson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004785791 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30100.47 0 0 0 0 0 0 0 0 0 0 0 0 0 30100.47 0 0 1004785884 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22881.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22881.58 0 0 1004786123 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23346.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23346.85 0 0 1004786170 92 Waiver service provider--Disability (DHS/DRS) 99 Union 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29305.36 0 0 0 0 0 0 0 0 0 0 0 0 0 29305.36 0 0 1004786306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23388.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23388.95 0 0 1004786324 1477865582 10 Physicians SHAH KARAN 999999999 200 Cook 0 0 Radiation Oncology 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521.35 0 0 0 0 0 0 521.35 0 0 1004786688 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24010.05 0 0 0 0 0 0 0 0 0 0 0 0 0 24010.05 0 0 1004786741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004786875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12342 0 0 0 0 0 0 0 0 0 0 0 0 0 12342 0 0 1004786904 1295198372 10 Physicians YAO SHUANG A 999999999 200 Cook 0 0 Family Practice 0 0 0 13 0 0 0 0 0 0 3 0 52 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 68 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 68 0 0 0 0 0 0 0 0 0 813.69 0 0 0 0 0 0 12.52 0 1040.59 0 0 0 0 0 0 1866.8 0 0 1004787088 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25307.86 0 0 0 0 0 0 0 0 0 0 0 0 0 25307.86 0 0 1004787150 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15233.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15233.21 0 0 1004787366 1225583388 16 Nurse Practitioners GREIMAN TIFFANY L. 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004787520 92 Waiver service provider--Disability (DHS/DRS) 13 Boone 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24842.9 0 0 0 0 0 0 0 0 0 0 0 0 0 24842.9 0 0 1004787735 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 4499.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4499.66 0 0 1004787862 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24910.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24910.42 0 0 1004787963 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6444.72 0 0 0 0 0 0 0 0 0 0 0 0 0 6444.72 0 0 1004788493 1871949842 91 Waiver service provider--Adults (DHS/DDD) HAWKINS CILA CARE CORPORATION 999999999 200 Cook 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 7494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1189043.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1189043.53 0 0 1004788583 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22654.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22654.58 0 0 1004788668 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27384.43 0 0 0 0 0 0 0 0 0 0 0 0 0 27384.43 0 0 1004788847 1083029433 12 Optometrists SOBIN ADAM D 999999999 72 McLean 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 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 1194.09 0 0 0 0 0 0 1194.09 0 0 1004788900 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23728.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23728.1 0 0 1004789035 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22988.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22988.76 0 0 1004789227 1558617308 60 Pharmacies CVS PHARMACY 17634 606072905 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2082.44 0 0 0 2082.44 0 0 1004789457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24833.82 0 0 0 0 0 0 0 0 0 0 0 0 0 24833.82 0 0 1004789741 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.9 0 0 0 0 0 0 0 0 0 0 0 0 0 87.9 0 0 1004789802 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28582.27 0 0 0 0 0 0 0 0 0 0 0 0 0 28582.27 0 0 1004789957 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.21 0 0 0 0 0 0 222.21 0 0 1004790059 1952563926 10 Physicians MARTIN ANGELA H 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.94 0 399.07 0 0 0 0 0 0 414.01 0 0 1004790064 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5313.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5313.74 0 0 1004790137 30 General Hospitals 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 3 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 385.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385.62 0 0 1004790195 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1654.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1654.79 0 0 1004790267 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21338.76 0 0 0 0 0 0 0 0 0 0 0 0 0 21338.76 0 0 1004790293 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23598.75 0 0 0 0 0 0 0 0 0 0 0 0 0 23598.75 0 0 1004790428 1760859292 16 Nurse Practitioners MARKEY TRACIE M 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.09 0 0 0 0 0 0 217.09 0 0 1004790665 1558500579 89 Physician Assistant Only(Encounter Only) ANAGNOS CYNTHIA A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 789.52 0 0 0 0 0 0 789.52 0 0 1004790676 1508918095 10 Physicians BIDIUC MARTHA 999999999 66 Marion 0 0 Psychiatry 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 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2629.29 0 0 0 0 0 0 2629.29 0 0 1004790677 1023245859 10 Physicians DAS KOUSHIK K 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1981.85 0 0 0 0 0 0 1981.85 0 0 1004790700 1457807661 24 Speech Therapists QUAIVER LINDSEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19843.3 19843.3 0 0 1004791175 1558641662 16 Nurse Practitioners KESLER MEGAN M 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 4 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20092.54 0 0 0 0 0 0 0 0 0 0 0 0 0 20092.54 0 0 1004791604 1457787855 10 Physicians NGENE JOHN I 999999999 63 Macon 0 0 Internal Medicine 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 0 254 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 3671.22 0 0 0 0 0 0 3671.22 0 0 1004791916 1255705794 16 Nurse Practitioners FANUCCHI JESSICA 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 92.2 0 0 0 0 0 0 0 0 6752.37 0 0 0 0 0 0 6844.57 0 0 1004791946 1477579563 89 Physician Assistant Only(Encounter Only) FINNEGAN DAVID C 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 111.19 0 0 0 0 0 0 0 0 2096.21 0 0 0 0 0 0 2207.4 0 0 1004792148 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 108.34 0 0 0 0 0 0 0 0 283.49 0 0 0 0 0 0 391.83 0 0 1004792327 1235441635 10 Physicians HLUBOCKY JAMES F 999999999 25 Crawford 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 1 1005 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1291 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1291 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.54 12855.52 0 394.97 0 0 0 0 0 0 13256.03 0 0 1004792353 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 688.59 0 0 0 0 0 0 0 0 0 0 0 0 0 688.59 0 0 1004792371 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1004792424 12 Optometrists 30 DuPage 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 14 0 0 1004792442 1033498266 10 Physicians ASGHAR RABIA 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 2 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1874.76 0 0 0 0 0 0 1874.76 0 0 1004792495 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.49 0 0 0 0 0 0 67.49 0 0 1004792588 1619244175 46 Ambulatory Surgical Treatment Centers BARRINGTON PAIN & SPINE INSTIT 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 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 8720.93 0 0 0 0 0 8720.93 0 0 1004792651 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004792654 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1469.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1469.1 0 0 1004792844 1548620149 10 Physicians FICKER MARIA G 999999999 63 Macon 0 0 Internal Medicine 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 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 1112.73 0 0 0 0 0 0 1112.73 0 0 1004793370 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3164.91 0 0 0 0 0 0 0 0 0 0 0 0 0 3164.91 0 0 1004793436 16 Nurse Practitioners 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.17 0 0 0 0 0 0 69.17 0 0 1004793450 1134597677 16 Nurse Practitioners RUSCO JENNIFER A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.23 0 0 0 0 0 0 181.23 0 0 1004793479 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24566.79 0 0 0 0 0 0 0 0 0 0 0 0 0 24566.79 0 0 1004794025 1457647133 10 Physicians DONENBERG MERRICK J. 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4030.06 0 0 0 0 0 0 4030.06 0 0 1004794212 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9335.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9335.34 0 0 1004794226 10 Physicians 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 201.66 0 0 0 0 0 0 201.66 0 0 1004794647 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13683.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13683.93 0 0 1004794816 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31575.42 0 0 0 0 0 0 0 0 0 0 0 0 0 31575.42 0 0 1004794993 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88146.42 0 0 0 0 0 0 0 0 0 0 0 0 0 88146.42 0 0 1004795016 1467516732 10 Physicians MACNEALY GREGORY A. 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1329.45 0 0 0 0 0 0 0 0 1329.45 0 0 1004795356 1457712929 16 Nurse Practitioners CREED HEATHER 999999999 57 Lake 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270.47 0 0 0 0 0 0 270.47 0 0 1004795372 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41120.04 0 0 0 0 0 0 0 0 0 0 0 0 0 41120.04 0 0 1004795428 1205219607 16 Nurse Practitioners KRIEGER-JOHNSEN MICHELE L 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 752.54 0 0 0 0 0 0 848.99 0 0 1004795831 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23240.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23240.7 0 0 1004795890 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 379.21 0 0 0 0 0 0 0 0 0 0 0 0 0 379.21 0 0 1004795919 1710243142 10 Physicians JENNINGS VALERIE L 999999999 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227.42 0 123471.37 0 0 0 0 0 0 123698.79 0 0 1004795973 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27238.78 0 0 0 0 0 0 0 0 0 0 0 0 0 27238.78 0 0 1004796347 1720329121 10 Physicians FROST ERIK J 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416.66 0 0 0 0 0 0 416.66 0 0 1004796404 1619238086 10 Physicians THOMAS TENY PHILIP 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 358.48 0 0 0 0 0 0 371.28 0 0 1004796764 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16357.33 0 0 0 0 0 0 0 0 0 0 0 0 0 16357.33 0 0 1004797023 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 19219.2 0 0 0 0 0 0 0 0 0 0 0 0 0 19219.2 0 0 1004797248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 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 9146.41 0 0 0 0 0 0 0 0 0 0 0 0 0 9146.41 0 0 1004797280 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13165.29 0 0 0 0 0 0 0 0 0 0 0 0 0 13165.29 0 0 1004797600 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14737.47 0 0 0 0 0 0 0 0 0 0 0 0 0 14737.47 0 0 1004797661 30 General Hospitals 815 Indiana DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940.89 0 0 0 0 0 940.89 0 0 1004798283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758.86 0 0 0 0 0 0 0 0 0 0 0 0 0 758.86 0 0 1004798583 1659827491 89 Physician Assistant Only(Encounter Only) LEUNG YONG L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.25 0 0 0 0 0 0 1539.25 0 0 1004798594 1508165705 10 Physicians SON CHRISTINA 999999999 30 DuPage 0 0 Radiation Oncology 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11310.97 0 0 0 0 0 0 11310.97 0 0 1004798677 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 11522.98 0 0 0 0 0 0 0 0 0 0 0 0 0 11522.98 0 0 1004798763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15921.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15921.81 0 0 1004799068 1316306152 16 Nurse Practitioners NIEWIAROWSKI KETINA M. 999999999 200 Cook 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3361.76 0 0 0 0 0 0 3361.76 0 0 1004799347 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20978.58 0 0 0 0 0 0 0 0 0 0 0 0 0 20978.58 0 0 1004799462 1891787594 63 Other Providers of Medical Equipment/Supplies (Non-registered) BREG 999999999 805 California 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1663.05 0 6545.39 0 0 0 0 8208.44 0 0 1004799631 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13883.02 0 0 0 0 0 0 0 0 0 0 0 0 0 13883.02 0 0 1004799893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23138.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23138.8 0 0 1004800100 1114914199 89 Physician Assistant Only(Encounter Only) THOMANN ROBERT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372.73 0 0 0 0 0 0 372.73 0 0 1004800119 1063524023 89 Physician Assistant Only(Encounter Only) FRITZ JULIE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1468.55 0 0 0 0 0 0 1468.55 0 0 1004800436 1033421953 10 Physicians SAEED ASIM MOHAMMED 731436348 200 Cook 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 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 0 965.03 0 0 0 0 0 0 965.03 0 0 1004800521 1174978282 16 Nurse Practitioners WAGNER LINDSAY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 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 0 577.36 0 0 0 0 0 0 577.36 0 0 1004800708 89 Physician Assistant Only(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004801434 4004801434 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 4401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512565 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512565 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55768166.57 0 0 0 0 0 0 0 0 0 0 0 0 0 55768166.57 0 0 1004801450 1770953150 89 Physician Assistant Only(Encounter Only) EMMERICH JOSEPH 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2956.87 0 0 0 0 0 0 2956.87 0 0 1004801650 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38454.23 0 0 0 0 0 0 0 0 0 0 0 0 0 38454.23 0 0 1004801651 1174751978 10 Physicians ANDRADE AMBAR A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 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 2600.84 0 0 0 0 0 0 2600.84 0 0 1004801713 1245601418 16 Nurse Practitioners BROOKS CLAIRE 999999999 200 Cook 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243.88 0 0 0 0 0 0 1243.88 0 0 1004801749 1386987170 10 Physicians BAIG BENAZIR 999999999 200 Cook 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4138.17 0 0 0 0 0 0 4138.17 0 0 1004802025 1194006528 25 Audiologists HAN JANET 999999999 91 Sangamon 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356.01 356.01 0 0 1004802571 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2364.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2364.35 0 0 1004802631 22 Physical Therapists 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788.4 788.4 0 0 1004802731 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25027.68 0 0 0 0 0 0 0 0 0 0 0 0 0 25027.68 0 0 1004802755 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7179.67 0 0 0 0 0 0 0 0 0 0 0 0 0 7179.67 0 0 1004802806 1750640587 10 Physicians YAN DIANA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4215.34 0 0 0 0 0 0 4215.34 0 0 1004802856 1669777074 10 Physicians WAN ALAN 999999999 53 Kane 0 0 Internal Medicine 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3361.89 0 0 0 0 0 0 3361.89 0 0 1004802891 1720438377 91 Waiver service provider--Adults (DHS/DDD) OCCHIUZZO CHRISTINA 999999999 19 Champaign 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 1321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74026.15 0 0 0 0 0 0 0 0 0 0 0 0 0 74026.15 0 0 1004803024 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 0 242.21 0 0 0 0 0 0 0 0 0 0 0 0 0 242.21 0 0 1004803352 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4520.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4520.34 0 0 1004803459 1356895809 16 Nurse Practitioners MEYERS KERRA 999999999 80 Peoria 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.66 0 0 0 0 0 0 1995.66 0 0 1004803465 1043519697 10 Physicians PATEL KEVIN H 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.37 0 27633.77 0 0 0 0 0 0 27720.14 0 0 1004803578 1306380555 16 Nurse Practitioners HARRIS KIMBERLY M 999999999 109 Winnebago 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 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2515.56 0 0 0 0 0 0 2515.56 0 0 1004803646 1548600240 10 Physicians PATEL KUNAL 999999999 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18211.84 0 0 0 0 0 0 18211.84 0 0 1004803679 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9727.01 0 0 0 0 0 0 0 0 0 0 0 0 0 9727.01 0 0 1004803854 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16231.6 0 0 0 0 0 0 0 0 0 0 0 0 0 16231.6 0 0 1004804220 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2437.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2437.14 0 0 1004804283 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17938.18 0 0 0 0 0 0 0 0 0 0 0 0 0 17938.18 0 0 1004804408 1548572670 10 Physicians PATEL PAYAL 999999999 200 Cook 0 0 Allergy-Immunization 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5322.13 0 0 0 0 0 0 5322.13 0 0 1004804519 1871968859 16 Nurse Practitioners GERLACH BRADLEY T. 999999999 200 Cook 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 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 0 267.78 0 0 0 0 0 0 267.78 0 0 1004804564 1750660692 10 Physicians HARTUNG MICHAEL P 999999999 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.78 0 42.14 0 0 0 0 0 0 119.92 0 0 1004804590 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21573.92 0 0 0 0 0 0 0 0 0 0 0 0 0 21573.92 0 0 1004804739 1073965570 16 Nurse Practitioners DANENBERGER HILLARY D 999999999 91 Sangamon 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316.13 0 0 0 0 0 0 316.13 0 0 1004805179 1275089302 91 Waiver service provider--Adults (DHS/DDD) BRANDA VICTORIA 999999999 91 Sangamon 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 1005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86332.44 0 0 0 0 0 0 0 0 0 0 0 0 0 86332.44 0 0 1004805664 23 Occupational Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2429.18 2429.18 0 0 1004806385 1689053712 10 Physicians OMERY MURAD M 999999999 200 Cook 0 0 Pediatrics 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 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 2015.28 0 0 0 0 0 0 2015.28 0 0 1004806442 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1790.25 0 0 1004806509 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23870.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23870.55 0 0 1004807011 1275797078 10 Physicians BAUMANN REBECCA L 999999999 37 Fulton 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.82 0 1215.93 0 0 0 0 0 0 1299.75 0 0 1004807175 89 Physician Assistant Only(Encounter Only) 89 Rock Island 0 0 0 0 0 0 0 0 0 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 31.01 0 0 0 0 0 0 31.01 0 0 1004807229 1336588342 10 Physicians DANIEL CALEB 999999999 71 McHenry 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 29 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1694.99 0 2000.12 0 0 0 0 0 0 3695.11 0 0 1004807246 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31314.22 0 0 0 0 0 0 0 0 0 0 0 0 0 31314.22 0 0 1004807348 1801245022 10 Physicians APPLEMAN MEAGAN D 999999999 200 Cook 0 0 Pediatrics 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5949.98 0 0 0 0 0 0 5949.98 0 0 1004807365 93 Waiver service provider--HIV/AIDS (DHS/DRS) 27 Dekalb 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27924.54 0 0 0 0 0 0 0 0 0 0 0 0 0 27924.54 0 0 1004807399 1558714840 12 Optometrists HEATH JACOB R 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.29 0 87.84 0 0 0 0 371.13 0 0 1004807444 1982044962 10 Physicians LAL HAREESH 999999999 19 Champaign 0 0 Internal Medicine 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 0 289 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 3635.01 0 0 0 0 0 0 3635.01 0 0 1004807647 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 130.64 0 0 0 0 0 0 130.64 0 0 1004808108 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1004808500 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23430.17 0 0 0 0 0 0 0 0 0 0 0 0 0 23430.17 0 0 1004808800 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20396.37 0 0 0 0 0 0 0 0 0 0 0 0 0 20396.37 0 0 1004808813 1861605321 16 Nurse Practitioners ZEEK DIANE M 999999999 53 Kane 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805.53 0 0 0 0 0 0 805.53 0 0 1004808881 1720446594 16 Nurse Practitioners ABBOTT ALLISON E. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.22 0 0 0 0 0 0 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1004809547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2357.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2357.74 0 0 1004809820 1609132984 10 Physicians KIM THERESA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1307.58 0 0 0 0 0 0 1307.58 0 0 1004809836 1659716728 10 Physicians MAN ANDREA M 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241.84 0 0 0 0 0 0 241.84 0 0 1004809950 1205032893 10 Physicians HORST JENNIFER A 999999999 36 Franklin 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 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 1065.9 0 0 0 0 0 0 1065.9 0 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1205145299 16 Nurse Practitioners MOLLOY ANNE 999999999 200 Cook 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1644.49 0 0 0 0 0 0 1644.49 0 0 1004811790 1154550994 10 Physicians WILBANKS LESLIE 999999999 98 Tazewell 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.57 0 0 0 0 0 0 256.57 0 0 1004811900 1174614267 10 Physicians ARBER DANIEL 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539.89 0 0 0 0 0 0 0 0 539.89 0 0 1004811948 1306074364 10 Physicians SAMUELS JORDAN S 999999999 57 Lake 0 0 Neurology 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 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1644.74 0 0 0 0 0 0 1644.74 0 0 1004812023 1962572396 30 General Hospitals SSM HEALTH ST MARYS HOSPITAL S 631171811 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 PERINATAL LEVEL III CENTER 1 0 0 0 83 0 0 0 0 890 0 0 0 301 0 0 0 0 0 1 0 0 0 95 0 0 0 0 189 0 0 0 802 0 0 0 0 0 1 0 0 0 95 0 0 0 0 1179 0 0 0 828 0 0 0 0 0 0 0 0 0 19822.75 0 0 0 0 1012925.18 0 0 0 321181.24 0 0 0 0 0 1353929.17 0 24800.49 1004812156 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 3312.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3312.59 0 0 1004812511 1710332754 87 Psychologist(Encounter Only) BALDASSARRE MEGAN 999999999 57 Lake 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004812557 1225353717 10 Physicians MILHOUSE OLUFENWA 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.2 0 261.28 0 0 0 0 0 0 261.48 0 0 1004812659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21353.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21353.01 0 0 1004812848 1003256686 10 Physicians HOKS MICHAEL A 999999999 24 Coles 0 0 Emergency Medicine 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 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 1160.53 0 0 0 0 0 0 1160.53 0 0 1004813030 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 71.2 0 0 0 0 0 0 71.2 0 0 1004813390 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.89 0 0 0 0 0 0 180.89 0 0 1004813443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14710.46 0 0 0 0 0 0 0 0 0 0 0 0 0 14710.46 0 0 1004813589 1346565470 10 Physicians CHANDRA PRIYA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 24 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 3146.42 0 0 0 0 0 0 3146.42 0 0 1004813776 91 Waiver service provider--Adults (DHS/DDD) 66 Marion 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25137.28 0 0 0 0 0 0 0 0 0 0 0 0 0 25137.28 0 0 1004813816 1457660961 16 Nurse Practitioners HOWARD JENETRIA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 290.61 0 0 0 0 0 0 290.61 0 0 1004814000 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10199.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10199.41 0 0 1004814103 1770503542 89 Physician Assistant Only(Encounter Only) JELINEK ADAM K 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731.66 0 0 0 0 0 0 731.66 0 0 1004814756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4588.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4588.25 0 0 1004814907 1164785770 10 Physicians BELTRAN ERIK JOHN 999999999 200 Cook 0 0 Neurology 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 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 1428.87 0 0 0 0 0 0 1428.87 0 0 1004815236 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41945.35 0 0 0 0 0 0 0 0 0 0 0 0 0 41945.35 0 0 1004815244 1437171147 60 Pharmacies CVS PHARMACY #16682 600183621 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8928 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8914.77 0 0 0 8914.77 0 0 1004815252 1790051969 10 Physicians DOWNING ALEXANDRA C 606118709 200 Cook 0 0 Pediatrics 0 0 0 6 0 0 0 0 0 0 3 0 8 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 790.94 0 0 0 0 0 0 46.3 0 459.7 0 0 0 0 0 0 1296.94 0 0 1004815796 1508121344 12 Optometrists THORPE KLINSKY CLAIRE M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.2 0 145.95 0 0 0 0 802.15 0 0 1004816668 10 Physicians 81 Perry 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1004816683 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1636.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1636.18 0 0 1004816864 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004816907 1144681743 97 Waiver service provider--Children's residential (DHS/DDD) VANDER PLUYM MARIA 600674791 200 Cook 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1968 0 0 0 0 0 0 0 0 0 0 0 0 0 1968 0 0 1004817477 1245239417 89 Physician Assistant Only(Encounter Only) MOORMAN CHRISTOPHER D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.86 0 0 0 0 0 0 109.86 0 0 1004817725 1871542811 89 Physician Assistant Only(Encounter Only) BRYANT MICHAEL A 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 0 589.24 0 0 0 0 0 0 589.24 0 0 1004817766 1639539752 10 Physicians DANG QUOC T 999999999 63 Macon 0 0 0 0 0 8 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 412.27 0 0 0 0 0 0 0 0 1916.34 0 0 0 0 0 0 2328.61 0 0 1004817776 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0 0 0 0 0 0 0 0 0 0 4181.3 0 0 0 0 0 0 4181.3 0 0 1004818449 1952764631 24 Speech Therapists NORKIEWICZ MORGAN 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 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 15954.41 15954.41 0 0 1004818456 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 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 2437.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2437.29 0 0 1004818639 1942755368 16 Nurse Practitioners HORNE CHRISTINE L 999999999 80 Peoria 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12411.89 0 0 0 0 0 0 12411.89 0 0 1004818650 1790042349 10 Physicians CHOWDHURY NAYEEMA 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32454.94 0 0 0 0 0 0 0 0 0 0 0 0 0 32454.94 0 0 1004819297 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21509.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21509.01 0 0 1004819337 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.27 0 0 0 0 0 0 102.27 0 0 1004819364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2077.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2077.3 0 0 1004819388 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769.72 0 0 0 0 0 0 769.72 0 0 1004819394 1972821734 10 Physicians NEILL KEVIN G 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 285 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2447.21 0 34.89 0 0 0 0 0 0 2482.1 0 0 1004819425 1154743540 16 Nurse Practitioners KOLWEY JENNIFER M 999999999 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274.97 0 0 0 0 0 0 274.97 0 0 1004819573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24087 0 0 0 0 0 0 0 0 0 0 0 0 0 24087 0 0 1004819646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7343.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7343.35 0 0 1004819696 1083168447 16 Nurse Practitioners MERILA KATHERINE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353.64 0 0 0 0 0 0 353.64 0 0 1004820519 1447602313 91 Waiver service provider--Adults (DHS/DDD) WARNICKI DANIEL D 999999999 107 Will 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 2286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101326.94 0 0 0 0 0 0 0 0 0 0 0 0 0 101326.94 0 0 1004820727 1619340122 91 Waiver service provider--Adults (DHS/DDD) AURORA HOME CARE INC. 999999999 200 Cook 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002300.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1002300.62 0 0 1004821139 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9726.09 0 0 0 0 0 0 0 0 0 0 0 0 0 9726.09 0 0 1004821149 1578953972 89 Physician Assistant Only(Encounter Only) MEDICI BROOK 999999999 200 Cook 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2307.86 0 0 0 0 0 0 2307.86 0 0 1004821220 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31455.11 0 0 0 0 0 0 0 0 0 0 0 0 0 31455.11 0 0 1004821245 1407239478 16 Nurse Practitioners PASSNO RYANE M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004821253 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36172.04 0 0 0 0 0 0 0 0 0 0 0 0 0 36172.04 0 0 1004821331 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 24.25 0 0 1004821505 1457514101 10 Physicians JESTER ANDREA L 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1173.22 0 0 0 0 0 0 1173.22 0 0 1004821666 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 2437.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2437.57 0 0 1004821701 1952665085 10 Physicians KINCADE RAMON 999999999 200 Cook 0 0 Emergency Medicine 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3293.81 0 0 0 0 0 0 3293.81 0 0 1004822039 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.65 0 0 0 0 0 0 0 0 0 0 0 0 0 22258.65 0 0 1004822078 1295175438 10 Physicians SUBRAMANIYAN GOWRI 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1586.44 0 0 0 0 0 0 1586.44 0 0 1004822179 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33251 0 0 0 0 0 0 0 0 0 0 0 0 0 33251 0 0 1004822359 1447316336 60 Pharmacies CVS PHARMACY #17205 601923717 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2619.23 0 0 0 2619.23 0 0 1004822426 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19476.08 0 0 0 0 0 0 0 0 0 0 0 0 0 19476.08 0 0 1004822482 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46434.09 0 0 0 0 0 0 0 0 0 0 0 0 0 46434.09 0 0 1004822569 1629041660 89 Physician Assistant Only(Encounter Only) MCNAMARA CAROLE S 999999999 19 Champaign 0 0 0 0 0 1 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1827.83 0 0 0 0 0 0 1859.98 0 0 1004822597 1497018477 10 Physicians HATHAWAY SAMANTHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7095.52 0 0 0 0 0 0 7095.52 0 0 1004822980 1518318617 11 Dentists BATSAIKHAN TSERMAA 999999999 816 Iowa 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15658.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15658.82 0 0 1004823492 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.76 0 0 0 0 0 0 17.76 0 0 1004823511 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7527.65 0 0 0 0 0 0 0 0 0 0 0 0 0 7527.65 0 0 1004823547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1103.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1103.85 0 0 1004823963 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21703.82 0 0 0 0 0 0 0 0 0 0 0 0 0 21703.82 0 0 1004823984 1821199910 13 Podiatrists JACOBY KENNETH 999999999 53 Kane 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 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 0 356.83 0 0 0 0 0 0 356.83 0 0 1004824296 1902156409 89 Physician Assistant Only(Encounter Only) CLINE JOHN C 999999999 200 Cook 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 0 675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 675 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11329.79 0 0 0 0 0 0 11329.79 0 0 1004824374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9626.65 0 0 0 0 0 0 0 0 0 0 0 0 0 9626.65 0 0 1004824508 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 8275.22 0 0 0 0 0 0 0 0 0 0 0 0 0 8275.22 0 0 1004824666 1699128892 16 Nurse Practitioners HOWELL HEATHER L 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 196.11 0 0 0 0 0 0 0 0 1906.63 0 0 0 0 0 0 2102.74 0 0 1004824814 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7905.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7905.91 0 0 1004825562 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19786.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19786.38 0 0 1004825766 1932335130 10 Physicians RUGGIERI RAFAEL 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 2 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2179.01 0 0 0 0 0 0 2179.01 0 0 1004825861 1154876498 16 Nurse Practitioners LOPEZ KIMBERLY K 999999999 200 Cook 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1595.04 0 0 0 0 0 0 1595.04 0 0 1004826150 1396028296 89 Physician Assistant Only(Encounter Only) NEHART NATALIE N 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004826443 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13074.64 0 0 0 0 0 0 0 0 0 0 0 0 0 13074.64 0 0 1004826638 1902243215 10 Physicians PATEL BHAKTI 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6820.06 0 0 0 0 0 0 6820.06 0 0 1004826644 1467645390 10 Physicians ZLOWODZKI MICHAEL 999999999 63 Macon 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13173.12 0 0 0 0 0 0 13173.12 0 0 1004826740 1811251739 10 Physicians DONELAN EMILY A. 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.76 0 3217.68 0 0 0 0 0 0 3264.44 0 0 1004826923 1588713440 30 General Hospitals OSF SAINT ELIZABETH MEDICAL CE 613501604 58 La Salle ARS-PD Hospitals paid a Per Diem rate. 0 0 General Hospital - Adult and Child 6 0 0 0 1388 0 0 0 0 843 0 0 0 1960 0 0 0 0 0 16 0 0 0 2306 0 0 0 0 403 0 0 0 6223 0 0 0 0 0 26 0 0 0 2306 0 0 0 0 1180 0 0 0 6223 0 0 0 0 0 645.33 0 0 0 379272.33 0 0 0 0 383129.46 0 0 0 615555.56 0 0 0 0 0 1378602.68 0 7561.62 1004827038 1457515314 10 Physicians HU YUHNING 999999999 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 495.92 0 0 0 0 0 0 495.92 0 0 1004827162 1326380908 10 Physicians VERMA SEEMA 999999999 53 Kane 0 0 Internal Medicine 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 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 0 663.57 0 0 0 0 0 0 663.57 0 0 1004827266 1487873808 10 Physicians BRADLEY SARA M. 999999999 200 Cook 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403.86 0 0 0 0 0 0 403.86 0 0 1004827285 1801047196 16 Nurse Practitioners JOEHL HILLARIE E 999999999 200 Cook 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 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 0 0 0 0 0 0 0 0 0 0 1004827359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15509.74 0 0 0 0 0 0 0 0 0 0 0 0 0 15509.74 0 0 1004827643 1245469808 10 Physicians HOYME DEREK 999999999 109 Winnebago 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391.33 0 0 0 0 0 0 391.33 0 0 1004827714 1629432299 16 Nurse Practitioners KARLOV DARA M. 999999999 53 Kane 0 0 Child/Adolescent Psychiatry Residency 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11965.39 0 0 0 0 0 0 11965.39 0 0 1004827747 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19349.75 0 0 0 0 0 0 0 0 0 0 0 0 0 19349.75 0 0 1004827794 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11030.77 0 0 0 0 0 0 0 0 0 0 0 0 0 11030.77 0 0 1004827859 1790967164 10 Physicians DESAI AMI V 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1522.71 0 0 0 0 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837.15 837.15 0 0 1004830732 1588921035 10 Physicians BHAYANI NATASHA 999999999 200 Cook 0 0 Pediatrics 0 0 0 59 0 0 0 0 0 0 33 0 44 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 126 0 78 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 126 0 78 0 0 0 0 0 0 0 0 0 4230.99 0 0 0 0 0 0 1532 0 3184.04 0 0 0 0 0 0 8947.03 0 0 1004831197 1194158188 10 Physicians KATARIA KRISHAN 999999999 19 Champaign 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 0 184 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 3201.18 0 0 0 0 0 0 3201.18 0 0 1004831420 1629335781 10 Physicians ANGELES DEXTER 999999999 15 Bureau 0 1 Internal Medicine 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1368.36 0 0 0 0 0 0 1368.36 0 0 1004831549 1275954778 16 Nurse Practitioners WEBB KARLA 628013655 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1004833288 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25421.22 0 0 0 0 0 0 0 0 0 0 0 0 0 25421.22 0 0 1004833368 1174513253 10 Physicians PATEL ANIL G 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.84 0 0 0 0 0 0 0 0 155.84 0 0 1004833411 1770819591 10 Physicians KOMMURI ANAND 999999999 80 Peoria 0 0 Internal Medicine 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 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 1581.44 0 0 0 0 0 0 1581.44 0 0 1004833513 1477511541 10 Physicians FORTUNATO JOHN 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 24 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 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0 0 25909.8 0 0 0 0 0 0 0 0 0 0 0 0 0 25909.8 0 0 1004834312 1477006351 16 Nurse Practitioners ALM CARL J 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.91 0 0 0 0 0 0 180.91 0 0 1004834384 1679917868 10 Physicians SETHI MICHAEL A 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 917.55 0 0 0 0 0 0 917.55 0 0 1004834399 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 3893.15 0 0 0 0 0 0 0 0 0 0 0 0 0 3893.15 0 0 1004834461 1780076679 16 Nurse Practitioners MCKINLEY KATHERINE C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 15 0 0 1004834592 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17398.69 0 0 0 0 0 0 0 0 0 0 0 0 0 17398.69 0 0 1004834842 1336373406 10 Physicians SPIER ADDIE 999999999 200 Cook 0 0 Internal Medicine 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 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2352.99 0 0 0 0 0 0 2352.99 0 0 1004835027 4004835027 91 Waiver service provider--Adults (DHS/DDD) BURKHART RACHEL 999999999 200 Cook 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 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28660.14 0 0 0 0 0 0 0 0 0 0 0 0 0 28660.14 0 0 1004835093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24444.93 0 0 0 0 0 0 0 0 0 0 0 0 0 24444.93 0 0 1004835100 1083061469 36 Community mental health provider ROSECRANCE CHAMPAIGN/URBANA 999999999 19 Champaign 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 378.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20764.79 0 0 21143.71 0 0 1004835131 1457800435 16 Nurse Practitioners KURIEN ANGELA 999999999 200 Cook 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 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 0 178.25 0 0 0 0 0 0 178.25 0 0 1004835150 1255621496 10 Physicians LEVIN ANNA 999999999 10 Adams 0 0 Dermatology 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 0 233 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 3537.45 0 0 0 0 0 0 3537.45 0 0 1004835254 1306145099 10 Physicians TRIPATHY SHREEPADA 999999999 63 Macon 0 0 Pediatrics 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6955.44 0 0 0 0 0 0 6955.44 0 0 1004835447 1164875449 89 Physician Assistant Only(Encounter Only) GUILFOIL RYAN L 999999999 200 Cook 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 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 1392.81 0 0 0 0 0 0 1392.81 0 0 1004835532 1114969813 89 Physician Assistant Only(Encounter Only) NATYSHOK STEPHANIE 999999999 108 Williamson 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 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3854.84 0 0 0 0 0 0 3854.84 0 0 1004835686 1659771863 16 Nurse Practitioners MUCCI JUSTINE E 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 160.75 0 0 0 0 0 0 0 0 1663.48 0 0 0 0 0 0 1824.23 0 0 1004835780 61 Independent Laboratories 811 Georgia 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397.32 0 0 0 0 0 0 0 0 397.32 0 0 1004836222 1447558127 89 Physician Assistant Only(Encounter Only) PROKOP KARIE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.34 0 0 0 0 0 0 233.34 0 0 1004836529 1093119802 16 Nurse Practitioners BATTISTONI DANIELLE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551.62 0 0 0 0 0 0 551.62 0 0 1004836591 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6542.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6542.55 0 0 1004836603 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9743.19 0 0 0 0 0 0 0 0 0 0 0 0 0 9743.19 0 0 1004836739 1780772012 89 Physician Assistant Only(Encounter Only) MORAN MARK 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3287.75 0 0 0 0 0 0 3287.75 0 0 1004837219 1710396395 16 Nurse Practitioners KIMLER CASEY M 999999999 80 Peoria 0 0 0 0 0 6 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 407.72 0 0 0 0 0 0 0 0 572.36 0 0 0 0 0 0 980.08 0 0 1004837644 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12107.12 0 0 0 0 0 0 0 0 0 0 0 0 0 12107.12 0 0 1004837645 1730460965 10 Physicians DOANE BRIAN 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4067.9 0 0 0 0 0 0 4067.9 0 0 1004837890 1720366636 10 Physicians TAGLIA LAUREN 999999999 53 Kane 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 616.28 0 0 0 0 0 0 616.28 0 0 1004837953 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18315.24 0 0 0 0 0 0 0 0 0 0 0 0 0 18315.24 0 0 1004837978 4004837978 72 Taxicabs and Livery Companies "EXPRESS CHARTER, LLC" 999999999 200 Cook 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 3480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20007.24 0 0 0 0 0 0 20007.24 0 0 1004837998 1437590411 12 Optometrists BENKESER ANGELA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496.58 0 0 0 0 0 0 496.58 0 0 1004838007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22928.78 0 0 0 0 0 0 0 0 0 0 0 0 0 22928.78 0 0 1004838067 1528394624 10 Physicians BANSAL SANJAY BANSAL 999999999 30 DuPage 0 0 Pediatrics 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 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 3117.66 0 0 0 0 0 0 3117.66 0 0 1004838398 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 0 0 0 0 73.4 0 0 1004838421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2185.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.67 0 0 1004839156 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.6 0 0 0 0 0 0 22.6 0 0 1004839180 92 Waiver service provider--Disability (DHS/DRS) 98 Tazewell 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15875.87 0 0 0 0 0 0 0 0 0 0 0 0 0 15875.87 0 0 1004839434 1306214697 16 Nurse Practitioners MOONEY KELSIE M. 999999999 63 Macon 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 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 78.68 0 0 0 0 0 0 78.68 0 0 1004839568 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 8947.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8947.4 0 0 1004839808 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3345.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3345.6 0 0 1004839823 1063419679 89 Physician Assistant Only(Encounter Only) FULK JOHN D 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2817.12 0 0 0 0 0 0 2817.12 0 0 1004839859 1629407366 89 Physician Assistant Only(Encounter Only) PATEL NIKI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619.32 0 0 0 0 0 0 619.32 0 0 1004840249 1467765578 10 Physicians BINDAL ANILA 999999999 200 Cook 0 0 Internal Medicine 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168.3 0 0 0 0 0 0 1168.3 0 0 1004840336 1003278581 16 Nurse Practitioners FLESHER BETHANI J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 487.84 0 0 0 0 0 0 487.84 0 0 1004840510 1326484767 10 Physicians VEGA OCTAVIO A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.88 0 4791.45 0 0 0 0 0 0 4833.33 0 0 1004840546 1659696870 10 Physicians TAJUDEEN BOBBY A. 999999999 200 Cook 0 0 Otolaryngology 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 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10510.26 0 0 0 0 0 0 10510.26 0 0 1004840565 1659529196 10 Physicians SHAABAN HADI F 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 3 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12167.97 0 0 0 0 0 0 12167.97 0 0 1004840759 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9594.05 0 0 0 0 0 0 0 0 0 0 0 0 0 9594.05 0 0 1004840946 1457808032 16 Nurse Practitioners HALL KERRY 999999999 19 Champaign 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2521.71 0 0 0 0 0 0 2521.71 0 0 1004840968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4875.79 0 0 0 0 0 0 0 0 0 0 0 0 0 4875.79 0 0 1004841172 1912296708 10 Physicians SIDDIQUI MARIAM A. 999999999 200 Cook 0 0 Internal Medicine 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 0 104 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 1087.25 0 0 0 0 0 0 1087.25 0 0 1004841220 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18518.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18518.5 0 0 1004841275 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20202.7 0 0 0 0 0 0 0 0 0 0 0 0 0 20202.7 0 0 1004841315 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 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 36 36 0 0 1004841366 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20097.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20097.66 0 0 1004841550 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17425.1 0 0 0 0 0 0 0 0 0 0 0 0 0 17425.1 0 0 1004841744 1235426230 10 Physicians NARANG DISHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 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 2671.6 0 0 0 0 0 0 2671.6 0 0 1004841753 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15951.56 0 0 0 0 0 0 0 0 0 0 0 0 0 15951.56 0 0 1004841946 1225108533 10 Physicians LUCCHESI ARCHANA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.41 0 0 0 0 0 0 0 0 100.41 0 0 1004842452 1659634640 10 Physicians LOBERG ANDREA R 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.66 0 86632.39 0 0 0 0 0 0 86652.05 0 0 1004842531 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4883.42 0 0 0 0 0 0 0 0 0 0 0 0 0 4883.42 0 0 1004842777 1639517485 10 Physicians LITKOWSKI PATRICIA E 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004842817 1760708416 10 Physicians THYPARAMPIL PREETI J. 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 906.84 0 0 0 0 0 0 906.84 0 0 1004843073 1306189204 10 Physicians GIANCARLO JOSEPH 999999999 107 Will 0 1 Pediatrics 0 0 0 29 0 0 0 0 0 0 26 0 37 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 65 0 56 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 65 0 56 0 0 0 0 0 0 0 0 0 2677.93 0 0 0 0 0 0 1809.68 0 3227.34 0 0 0 0 0 0 7714.95 0 0 1004843108 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 9593.65 0 0 0 0 0 0 0 0 0 0 0 0 0 9593.65 0 0 1004843201 91 Waiver service provider--Adults (DHS/DDD) 822 Massachusetts 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21463.42 0 0 0 0 0 0 0 0 0 0 0 0 0 21463.42 0 0 1004843211 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11076.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11076.62 0 0 1004843227 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7907.05 0 0 0 0 0 0 0 0 0 0 0 0 0 7907.05 0 0 1004843550 1083068928 11 Dentists LAZARI PAUL 999999999 200 Cook 0 0 Orthodontist 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9810 0 0 1004843927 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7803.59 0 0 0 0 0 0 0 0 0 0 0 0 0 7803.59 0 0 1004843980 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33749.34 0 0 0 0 0 0 0 0 0 0 0 0 0 33749.34 0 0 1004844030 1124477435 55 Early Intervention Services BIEZE LISA 999999999 200 Cook 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 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 2952.56 0 0 0 0 0 0 2952.56 0 0 1004844166 1467808089 16 Nurse Practitioners BEANE ASHLEY 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 298.16 0 0 0 0 0 0 0 0 1076.97 0 0 0 0 0 0 1375.13 0 0 1004844350 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 1004844485 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 21892.53 0 0 0 0 0 0 0 0 0 0 0 0 0 21892.53 0 0 1004844543 16 Nurse Practitioners 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.1 0 0 0 0 0 0 246.1 0 0 1004845365 1336583079 10 Physicians MULYE ANITA D. 999999999 200 Cook 0 0 Internal Medicine 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 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2260.52 0 0 0 0 0 0 2260.52 0 0 1004845535 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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0 General Dentistry 0 0 46 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5841.47 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 6217.82 0 0 1004847726 1023245925 10 Physicians RIZVI ASGHAR PAIN 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 8 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3414.75 0 0 0 0 0 0 3414.75 0 0 1004847771 1447594296 89 Physician Assistant Only(Encounter Only) HAJEK KRISTINA N 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.96 0 0 0 0 0 0 540.96 0 0 1004847829 1689696494 60 Pharmacies CVS PHARMACY #16350 607144621 200 Cook 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2074.2 0 0 0 2074.2 0 0 1004847943 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.57 0 0 0 0 0 0 47.57 0 0 1004849563 1912358565 16 Nurse Practitioners VAUGHAN MELEAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004849656 1568629616 10 Physicians PATEL TARAL K 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5200.71 0 0 0 0 0 0 5200.71 0 0 1004849857 1528405982 10 Physicians TOGUEM SERGE 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 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 6589.52 0 0 0 0 0 0 6589.52 0 0 1004850041 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10148.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10148.18 0 0 1004850297 10 Physicians 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.63 0 0 0 0 0 0 78.63 0 0 1004850577 1487745055 86 Clinical Social Worker(Encounter Only) MADRIGAL CESAR 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2489.77 0 0 0 0 0 0 2489.77 0 0 1004850757 1184026940 16 Nurse Practitioners MCKENNA EMILY K 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3869.58 0 0 0 0 0 0 3869.58 0 0 1004850808 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 9135.14 0 0 0 0 0 0 0 0 0 0 0 0 0 9135.14 0 0 1004850910 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22936.74 0 0 0 0 0 0 0 0 0 0 0 0 0 22936.74 0 0 1004851226 1952799405 16 Nurse Practitioners " SMAGA ANNA" 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.33 0 0 0 0 0 0 310.33 0 0 1004851754 1194179721 40 Federally Qualified Health Centers ACCESS EVANSTON FAMILY HEALTH 999999999 200 Cook 0 0 0 576 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2310 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2310 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164454.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164454.64 0 0 1004851807 1144603382 60 Pharmacies FRANCISCAN OUTPATIENT PHARMACY 999999999 815 Indiana 0 0 0 0 0 0 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0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 491 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23073.01 0 35.18 0 0 0 0 0 0 23108.19 0 0 1004852415 1689088114 10 Physicians KUKULSKI PAUL 999999999 200 Cook 0 0 Emergency Medicine 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 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6779.55 0 0 0 0 0 0 6779.55 0 0 1004852446 1396188520 10 Physicians SARFRAZ SARAH 999999999 107 Will 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2294.81 0 0 0 0 0 0 2294.81 0 0 1004852563 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 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 0 334.8 0 0 0 0 0 0 334.8 0 0 1004853416 1437411659 10 Physicians ALMEIDA MONICA MERCON TEZOLIN 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1004854695 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 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 0 436.86 0 0 0 0 0 0 436.86 0 0 1004855133 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541.12 0 0 0 0 0 0 541.12 0 0 1004855163 1215318555 16 Nurse Practitioners ABANO ROSEVIMINDA M 999999999 200 Cook 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 0 188.02 0 0 0 0 0 0 188.02 0 0 1004855237 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004855238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1461.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1461.9 0 0 1004857581 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27086.02 0 0 0 0 0 0 0 0 0 0 0 0 0 27086.02 0 0 1004857703 1457640328 10 Physicians HAMPOLE ASHWIN V 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 365 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10050.37 0 548.89 0 0 0 0 0 0 10599.26 0 0 1004857710 1881828804 86 Clinical Social Worker(Encounter Only) LAKATOS TINA 999999999 53 Kane 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3651.32 0 0 0 0 0 0 3651.32 0 0 1004857830 10 Physicians 47 Jackson 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 3 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.44 0 3190.25 0 0 0 0 0 0 3203.69 0 0 1004858442 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17095.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17095.43 0 0 1004858463 1912197831 10 Physicians SHAIK IBRAHIM 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 658 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 658 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7920.16 0 0 0 0 0 0 7920.16 0 0 1004858527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29154.78 0 0 0 0 0 0 0 0 0 0 0 0 0 29154.78 0 0 1004858564 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 2783.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2783.02 0 0 1004859130 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4014.92 0 0 0 0 0 0 0 0 0 0 0 0 0 4014.92 0 0 1004859132 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004859158 1255682670 16 Nurse Practitioners LESIEWICZ MORGAN 999999999 98 Tazewell 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 181.23 0 0 0 0 0 0 187.63 0 0 1004859225 1306028451 10 Physicians KOSURI SATYAJIT 999999999 30 DuPage 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 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 1510.63 0 0 0 0 0 0 1510.63 0 0 1004859273 1598752628 89 Physician Assistant Only(Encounter Only) CARROLL KORI L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 833.41 0 0 0 0 0 0 833.41 0 0 1004859333 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16963.58 0 0 0 0 0 0 0 0 0 0 0 0 0 16963.58 0 0 1004859480 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2435.94 0 0 0 0 0 0 0 0 0 0 0 0 0 2435.94 0 0 1004859806 1518114313 10 Physicians SIMON PATRICK E 999999999 53 Kane 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.36 0 0 0 0 0 0 190.36 0 0 1004860134 1295176295 89 Physician Assistant Only(Encounter Only) HATHWAY ZACHARY A 999999999 852 Wisconsin 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1614.45 0 0 0 0 0 0 1614.45 0 0 1004860195 1154879385 89 Physician Assistant Only(Encounter Only) KELLER CHLOE E 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 3157.28 0 0 0 0 0 0 3235.15 0 0 1004860204 1780996561 10 Physicians COLVIN BRYANNE N 999999999 80 Peoria 0 0 Pediatrics 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8818.93 0 0 0 0 0 0 8818.93 0 0 1004860270 1275767386 10 Physicians ZAHRADNIK ERIN K 999999999 30 DuPage 0 0 Psychiatry 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4021.22 0 0 0 0 0 0 4021.22 0 0 1004860701 1053768051 16 Nurse Practitioners MILKEVITCH BRETT 999999999 200 Cook 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 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 0 660.22 0 0 0 0 0 0 660.22 0 0 1004860714 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15868.93 0 0 0 0 0 0 0 0 0 0 0 0 0 15868.93 0 0 1004860823 10 Physicians 74 Mercer 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1004861142 1881147940 70 Ambulance Service Providers POLO FIRE PROTECTION DISTRICT 999999999 79 Ogle 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 0 123 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 54330.51 0 0 0 0 0 0 54330.51 0 0 1004861237 1447396981 22 Physical Therapists KEIL AARON 999999999 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519.1 519.1 0 0 1004861293 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 767.07 0 0 0 0 0 0 0 0 0 0 0 0 0 767.07 0 0 1004861331 10 Physicians 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.56 0 0 0 0 0 0 15.56 0 0 1004861417 1669837001 16 Nurse Practitioners DUSEK AMY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.71 0 0 0 0 0 0 7.71 0 0 1004861478 1710438320 16 Nurse Practitioners KNUUTI KIMBERLEY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1543.39 0 0 0 0 0 0 1543.39 0 0 1004861527 1962757799 16 Nurse Practitioners FRENCH KIMBERLY L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 754.3 0 0 0 0 0 0 754.3 0 0 1004861692 1902218308 16 Nurse Practitioners FORYS HEATHER 999999999 33 Effingham 0 0 0 0 0 4 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 928 0 0 0 0 0 0 992.3 0 0 1004861835 1528036985 10 Physicians WAGNER ANDREW F. 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25007.83 0 0 0 0 0 0 25007.83 0 0 1004862896 1063885556 16 Nurse Practitioners WAGNER JENNY M. 999999999 80 Peoria 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677.1 0 0 0 0 0 0 677.1 0 0 1004862901 1659829273 23 Occupational Therapists RUCKER GRACE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 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 11743.84 11743.84 0 0 1004863006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19881.87 0 0 0 0 0 0 0 0 0 0 0 0 0 19881.87 0 0 1004863064 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54847.06 0 0 0 0 0 0 0 0 0 0 0 0 0 54847.06 0 0 1004863189 1538339320 11 Dentists LUMPKIN ANTHONY G 999999999 200 Cook 0 0 General Dentistry 0 0 128 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 7543.97 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 10178.42 0 0 1004863239 1639547672 16 Nurse Practitioners HARTNETT DEIRDRE 999999999 200 Cook 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 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 0 603.23 0 0 0 0 0 0 603.23 0 0 1004863375 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34296.7 0 0 0 0 0 0 0 0 0 0 0 0 0 34296.7 0 0 1004864009 91 Waiver service provider--Adults (DHS/DDD) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16768.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16768.4 0 0 1004864010 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18289.35 0 0 0 0 0 0 0 0 0 0 0 0 0 18289.35 0 0 1004864157 1578970851 10 Physicians RADISH AARON C 999999999 88 Richland 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 4958.93 0 0 0 0 0 0 5023.23 0 0 1004864278 1710353149 16 Nurse Practitioners BARON TOVA 999999999 200 Cook 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 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 1675.01 0 0 0 0 0 0 1675.01 0 0 1004864291 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3208.43 0 0 0 0 0 0 3208.43 0 0 1004864631 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33341.22 0 0 0 0 0 0 0 0 0 0 0 0 0 33341.22 0 0 1004864637 1871803387 89 Physician Assistant Only(Encounter Only) STUCKY AMANDA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1422.5 0 0 0 0 0 0 1422.5 0 0 1004865092 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354.92 0 0 0 0 0 0 354.92 0 0 1004865229 1689930968 10 Physicians LESER ERIC 999999999 200 Cook 0 0 Emergency Medicine 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 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 2352.43 0 0 0 0 0 0 2352.43 0 0 1004865278 1497040208 10 Physicians ADEKOYA EMINAJULO 999999999 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 8 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.88 0 3663.69 0 0 0 0 0 0 3688.57 0 0 1004865471 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 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 14241.3 0 0 0 0 0 0 0 0 0 0 0 0 0 14241.3 0 0 1004865628 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1153.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1153.58 0 0 1004865636 1255796371 16 Nurse Practitioners WASHINGTON TABITHA 999999999 53 Kane 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2935.48 0 0 0 0 0 0 2935.48 0 0 1004865701 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41668.48 0 0 0 0 0 0 0 0 0 0 0 0 0 41668.48 0 0 1004865749 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6993.43 0 0 0 0 0 0 0 0 0 0 0 0 0 6993.43 0 0 1004865792 1437597846 10 Physicians CUNNINGHAM MICHELLE 999999999 200 Cook 0 0 Pediatrics 0 0 0 31 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 2809.31 0 0 0 0 0 0 81.13 0 1216.68 0 0 0 0 0 0 4107.12 0 0 1004865999 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869.92 0 0 0 0 869.92 0 0 1004866128 16 Nurse Practitioners 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.25 0 0 0 0 0 0 37.25 0 0 1004866148 1083168066 16 Nurse Practitioners DURKIN COLLEEN E 999999999 200 Cook 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 0 114 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 1162.53 0 0 0 0 0 0 1162.53 0 0 1004866242 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 4 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 0 159.2 159.2 0 0 1004866427 1912353962 91 Waiver service provider--Adults (DHS/DDD) "ACCESS COMMUNITY EXPERIENCE, I" 999999999 200 Cook 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 2773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514833.21 0 0 0 0 0 0 0 0 0 0 0 0 0 514833.21 0 0 1004866992 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3173.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3173.62 0 0 1004867438 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004867807 1053536219 10 Physicians AHMED IMDAD 999999999 807 Connecticut 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.5 0 0 0 0 0 0 135.5 0 0 1004867938 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14477.91 0 0 0 0 0 0 0 0 0 0 0 0 0 14477.91 0 0 1004867989 1548608136 10 Physicians IYER SNEHA 999999999 200 Cook 0 0 Pediatrics 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6602.72 0 0 0 0 0 0 6602.72 0 0 1004868011 1821439316 10 Physicians KITLAS ROLAND 999999999 57 Lake 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 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11818.76 0 0 0 0 0 0 11818.76 0 0 1004868270 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18755.18 0 0 0 0 0 0 0 0 0 0 0 0 0 18755.18 0 0 1004868318 1619286382 89 Physician Assistant Only(Encounter Only) ROSE STACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 830.33 0 0 0 0 0 0 830.33 0 0 1004868384 1235436288 10 Physicians BASHIR AHMAD S 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1611.71 0 0 0 0 0 0 1611.71 0 0 1004868450 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23965.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23965.2 0 0 1004868513 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004868777 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 116.58 0 0 0 0 0 0 0 0 0 0 0 0 0 116.58 0 0 1004869115 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 151.49 0 0 0 0 0 0 151.49 0 0 1004869215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8136.96 0 0 0 0 0 0 0 0 0 0 0 0 0 8136.96 0 0 1004869948 1336480078 10 Physicians RABOR SAMUEL F 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4011.28 0 0 0 0 0 0 4011.28 0 0 1004870054 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 4176.48 0 0 0 0 0 0 0 0 0 0 0 0 0 4176.48 0 0 1004870296 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19297.59 0 0 0 0 0 0 0 0 0 0 0 0 0 19297.59 0 0 1004870520 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2773.66 0 0 0 0 0 0 0 0 0 0 0 0 0 2773.66 0 0 1004870561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21135.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21135.8 0 0 1004870611 10 Physicians 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 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 0 178.52 0 0 0 0 0 0 178.52 0 0 1004870767 1063504165 30 General Hospitals LOYOLA UNIVERSITY MEDICAL CENT 601533328 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64483.99 0 0 0 0 0 64483.99 0 0 1004870808 1184063349 10 Physicians BREYTMAN DMITRIY 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371.76 0 0 0 0 0 0 371.76 0 0 1004870809 98 Waiver service provider--TBI (DHS/DRS) 103 Washington 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.41 0 0 0 0 0 0 0 0 0 0 0 0 0 75.41 0 0 1004871368 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.22 0 0 0 0 0 0 0 0 0 0 0 0 0 55.22 0 0 1004871692 1326313768 10 Physicians BASKIN RACHEL 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 10 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.05 0 2950.02 0 0 0 0 0 0 2978.07 0 0 1004871808 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 10264.54 0 0 0 0 0 0 0 0 0 0 0 0 0 10264.54 0 0 1004872208 10 Physicians 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004872354 1528404407 10 Physicians YASIN JAMIL 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3024.24 0 0 0 0 0 0 3024.24 0 0 1004872356 1891074555 10 Physicians RAWAL ANKIT 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3778.13 0 0 0 0 0 0 3778.13 0 0 1004872428 1902220148 11 Dentists TANG MINGHUI 999999999 200 Cook 0 0 General Dentistry 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15457.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15457.84 0 0 1004872469 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.39 0 0 0 0 0 0 5.39 0 0 1004872514 1942296413 12 Optometrists SHIPLE JENNIFFER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271.6 0 87.84 0 0 0 0 359.44 0 0 1004872773 1326109992 89 Physician Assistant Only(Encounter Only) DALTON NICOLE M 999999999 80 Peoria 0 0 0 0 0 13 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 1169.79 0 0 0 0 0 0 0 0 6038.22 0 0 0 0 0 0 7208.01 0 0 1004872875 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21823.4 0 0 0 0 0 0 0 0 0 0 0 0 0 21823.4 0 0 1004872910 1033588223 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS & ORTHOTICS 527221641 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277.12 0 9421.29 0 0 0 0 9698.41 0 0 1004872932 1124224076 11 Dentists BAKMAN MAYYA 600625800 200 Cook 0 0 General Dentistry 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47772.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47772.68 0 0 1004873033 1043471477 10 Physicians ZEBALLOS-CHAVEZ ROCIO 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599.25 0 0 0 0 0 0 599.25 0 0 1004873045 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23761.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23761.5 0 0 1004873206 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18518.79 0 0 0 0 0 0 0 0 0 0 0 0 0 18518.79 0 0 1004873286 1295198661 16 Nurse Practitioners OSUDE NNEKA 999999999 57 Lake 0 0 0 0 0 4 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 247.11 0 0 0 0 0 0 0 0 1428.54 0 0 0 0 0 0 1675.65 0 0 1004873320 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27334.79 0 0 0 0 0 0 0 0 0 0 0 0 0 27334.79 0 0 1004873440 1649364290 89 Physician Assistant Only(Encounter Only) SHILS PHILIPPE N 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 831.58 0 0 0 0 0 0 831.58 0 0 1004873550 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26195.25 0 0 0 0 0 0 0 0 0 0 0 0 0 26195.25 0 0 1004873620 1235472820 10 Physicians KWAK TOMMY J 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6166.75 0 0 0 0 0 0 6166.75 0 0 1004874033 1689125924 75 Department of Alcohol and Substance Abuse Provider GATEWAY FOUNDATION INC JOLIET 999999999 107 Will 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 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 5850.98 0 0 5850.98 0 0 1004874095 16 Nurse Practitioners 22 Clay 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.63 0 0 0 0 0 0 147.63 0 0 1004874111 10 Physicians 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004874148 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1004874320 1366529240 10 Physicians BENNETT JR. NELSON E. 999999999 200 Cook 0 0 Urology 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.85 0 0 0 0 0 0 1312.85 0 0 1004874469 1942658927 16 Nurse Practitioners SETLAK JESSICA 999999999 200 Cook 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.25 0 0 0 0 0 0 4524.25 0 0 1004874677 1902161086 10 Physicians THAI LEO 999999999 80 Peoria 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24487.59 0 0 0 0 0 0 24487.59 0 0 1004874716 1215390414 16 Nurse Practitioners MCALLISTER BROOKE A 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438.4 0 0 0 0 0 0 438.4 0 0 1004874889 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004875109 92 Waiver service provider--Disability (DHS/DRS) 93 Scott 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5590.24 0 0 0 0 0 0 0 0 0 0 0 0 0 5590.24 0 0 1004875451 4004875451 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 888 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3611677.02 0 0 0 0 0 0 0 0 0 0 0 0 0 3611677.02 0 0 1004875532 1437449238 10 Physicians FATIMA NAZNEEN 999999999 200 Cook 0 0 Clinical Pathology 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1070.9 0 0 0 0 0 0 0 0 1070.9 0 0 1004876195 98 Waiver service provider--TBI (DHS/DRS) 823 Michigan 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728 0 0 0 0 0 0 0 0 0 0 0 0 0 728 0 0 1004876303 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 9777.21 0 0 0 0 0 0 0 0 0 0 0 0 0 9777.21 0 0 1004876622 1083978118 10 Physicians DHARAMDASANI NISHA 999999999 200 Cook 0 0 Family Practice 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1248.03 0 0 0 0 0 0 1248.03 0 0 1004876649 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004877038 1497069306 10 Physicians CHOW JARVA 999999999 200 Cook 0 0 Anesthesiology 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5755.41 0 0 0 0 0 0 5755.41 0 0 1004877126 1790919751 10 Physicians BOWKER RAKHEE M. 999999999 200 Cook 0 0 Pediatrics 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 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38530.91 0 0 0 0 0 0 38530.91 0 0 1004877899 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2310.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2310.39 0 0 1004878165 1679924567 10 Physicians KRUKOWSKI ADRIAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2099.04 0 0 0 0 0 0 2099.04 0 0 1004878209 10 Physicians 89 Rock Island 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.64 0 13.49 0 0 0 0 0 0 119.13 0 0 1004878253 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10903.07 0 0 0 0 0 0 0 0 0 0 0 0 0 10903.07 0 0 1004878342 1265642466 16 Nurse Practitioners SASSO KAREN M 999999999 57 Lake 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 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 65.87 0 0 0 0 0 0 65.87 0 0 1004878537 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12868.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12868.1 0 0 1004878731 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2638.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2638.54 0 0 1004879241 1851658777 10 Physicians SELVARAJ KAVITHA 999999999 200 Cook 0 0 Pediatrics 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2516.16 0 0 0 0 0 0 2516.16 0 0 1004879340 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24050.86 0 0 0 0 0 0 0 0 0 0 0 0 0 24050.86 0 0 1004879350 92 Waiver service provider--Disability (DHS/DRS) 17 Carroll 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7391.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7391.74 0 0 1004879536 1306112453 10 Physicians RO STEVE I 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3218.98 0 0 0 0 0 0 3218.98 0 0 1004879696 1043405608 89 Physician Assistant Only(Encounter Only) PURVES DAVID 999999999 91 Sangamon 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231.28 0 0 0 0 0 0 1231.28 0 0 1004879765 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6944 0 0 0 0 0 0 0 0 0 0 0 0 0 6944 0 0 1004879904 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17316.59 0 0 0 0 0 0 0 0 0 0 0 0 0 17316.59 0 0 1004879954 1629417274 11 Dentists PATEL DHAVAL M 999999999 200 Cook 0 0 General Dentistry 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1846.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1846.6 0 0 1004880191 1407255540 89 Physician Assistant Only(Encounter Only) LILLIE ANNA 999999999 24 Coles 0 0 0 0 0 3 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 177.72 0 0 0 0 0 0 0 0 4789.95 0 0 0 0 0 0 4967.67 0 0 1004880329 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1692.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1692.35 0 0 1004880536 1356887012 91 Waiver service provider--Adults (DHS/DDD) WILLIAMS MAYA C 999999999 107 Will 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139700.2 0 0 0 0 0 0 0 0 0 0 0 0 0 139700.2 0 0 1004881161 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24200.78 0 0 0 0 0 0 0 0 0 0 0 0 0 24200.78 0 0 1004881266 1851748883 16 Nurse Practitioners KELLEY MEGAN 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264.28 0 0 0 0 0 0 264.28 0 0 1004881378 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.24 0 0 0 0 0 0 87.24 0 0 1004881389 98 Waiver service provider--TBI (DHS/DRS) 815 Indiana 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22690.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22690.54 0 0 1004881470 1205120136 10 Physicians DWIVEDI ANJANA 999999999 66 Marion 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1645.87 0 0 0 0 0 0 1645.87 0 0 1004881939 1942645692 10 Physicians CHAWLA HITANSHU 999999999 41 Hamilton 0 0 Internal Medicine 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 0 176 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 1428.65 0 0 0 0 0 0 1428.65 0 0 1004882022 1386005635 16 Nurse Practitioners HUMMEL RANDI 999999999 65 Madison 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 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 78.34 0 0 0 0 0 0 78.34 0 0 1004882050 1700107232 10 Physicians WHITEHURST BRANDT D 999999999 91 Sangamon 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 0 233 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 17778.37 0 0 0 0 0 0 17778.37 0 0 1004882110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22310.11 0 0 0 0 0 0 0 0 0 0 0 0 0 22310.11 0 0 1004882151 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35160.99 0 0 0 0 0 0 0 0 0 0 0 0 0 35160.99 0 0 1004882198 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 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 2456.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2456.44 0 0 1004882611 1356892004 89 Physician Assistant Only(Encounter Only) SMITH JOSHUA L 999999999 36 Franklin 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263.43 0 0 0 0 0 0 263.43 0 0 1004882689 1407251622 46 Ambulatory Surgical Treatment Centers THE ORTHOPAEDIC INSTITUTE SURG 999999999 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.5 0 0 0 0 0 378.5 0 0 1004882834 1366806374 16 Nurse Practitioners FLAGG SHELLY M 999999999 91 Sangamon 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 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4967.85 0 0 0 0 0 0 4967.85 0 0 1004883084 1881034403 10 Physicians AMIR KHAN MOHAMMED M 999999999 53 Kane 0 0 Emergency Medicine 0 0 0 1 0 0 0 0 0 0 61 0 97 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 75 0 107 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 75 0 107 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 573.78 0 3621.61 0 0 0 0 0 0 4280.01 0 0 1004883087 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 5193.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5193.62 0 0 1004883222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9553.93 0 0 0 0 0 0 0 0 0 0 0 0 0 9553.93 0 0 1004883383 1255728432 16 Nurse Practitioners HAN JENNIFER D. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 541.62 0 0 0 0 0 0 541.62 0 0 1004883526 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20952.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20952.5 0 0 1004883541 1629395322 10 Physicians GARG KITTU J 999999999 200 Cook 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862.32 0 0 0 0 0 0 862.32 0 0 1004883917 1881915437 10 Physicians SHAH RAJIV K 999999999 96 St Clair 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396.2 0 0 0 0 0 0 396.2 0 0 1004884183 1902246309 10 Physicians HILL MELISSA M 999999999 40 Grundy 0 1 Pediatrics 0 0 0 26 0 0 0 0 0 0 5 0 38 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 7 0 53 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 7 0 53 0 0 0 0 0 0 0 0 0 2695.46 0 0 0 0 0 0 15.54 0 2845.46 0 0 0 0 0 0 5556.46 0 0 1004884241 1649252537 89 Physician Assistant Only(Encounter Only) LOHRMAN MARY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 250.67 0 0 0 0 0 0 250.67 0 0 1004884340 1609216548 10 Physicians FORE LAUREN L 999999999 31 Edgar 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 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 0 251.5 0 0 0 0 0 0 251.5 0 0 1004884442 1942201330 89 Physician Assistant Only(Encounter Only) HUSTON HERBERT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 995.53 0 0 0 0 0 0 995.53 0 0 1004884734 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 136.36 0 0 0 0 0 0 136.36 0 0 1004884740 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.9 0 0 0 0 0 0 0 0 0 0 0 0 0 87.9 0 0 1004884811 1386199396 89 Physician Assistant Only(Encounter Only) SOMMER JENNIFER 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Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26235.22 0 0 0 0 0 0 0 0 0 0 0 0 0 26235.22 0 0 1004885229 10 Physicians 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.35 0 0 0 0 0 0 109.35 0 0 1004885249 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 5305.39 0 0 0 0 0 0 0 0 0 0 0 0 0 5305.39 0 0 1004885262 1598787202 60 Pharmacies CVS PHARMACY #17009 606052159 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12703.75 0 0 0 12703.75 0 0 1004886039 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34394.47 0 0 0 0 0 0 0 0 0 0 0 0 0 34394.47 0 0 1004886051 1184166001 16 Nurse Practitioners LOPEZ JOSH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3130.57 0 0 0 0 0 0 3130.57 0 0 1004886344 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 276.54 0 0 0 0 0 0 276.54 0 0 1004886412 1720434772 16 Nurse Practitioners SPIELMAN SUSAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004886739 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 454.37 0 0 0 0 0 0 0 0 0 0 0 0 0 454.37 0 0 1004886878 10 Physicians 81 Perry 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 503.34 0 0 0 0 0 0 503.34 0 0 1004887002 4004887002 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 1081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9583524.42 0 0 0 0 0 0 0 0 0 0 0 0 0 9583524.42 0 0 1004887193 36 Community mental health provider 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 125.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1859.69 0 0 1985.41 0 0 1004887306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30124.85 0 0 0 0 0 0 0 0 0 0 0 0 0 30124.85 0 0 1004887415 1366997561 16 Nurse Practitioners AMPADU ROSE O 999999999 30 DuPage 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.24 0 0 0 0 0 0 1712.24 0 0 1004887447 1427338409 10 Physicians GORSI SHAMAILA B 999999999 45 Henry 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 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3570.36 0 0 0 0 0 0 3570.36 0 0 1004887489 1194968602 16 Nurse Practitioners URY NICOLE 999999999 57 Lake 0 0 0 0 0 26 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 2346.76 0 0 0 0 0 0 0 0 2836.4 0 0 0 0 0 0 5183.16 0 0 1004887556 1164891818 89 Physician Assistant Only(Encounter Only) KOENIG CHRISTOPHER J 999999999 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318.24 0 0 0 0 0 0 1318.24 0 0 1004887561 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 1370.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.89 0 0 1004887845 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 403.69 0 0 0 0 0 0 0 0 0 0 0 0 0 403.69 0 0 1004887958 1538315106 10 Physicians HE MAI 999999999 30 DuPage 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 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 3724.84 0 0 0 0 0 0 0 0 3724.84 0 0 1004888125 1134590938 91 Waiver service provider--Adults (DHS/DDD) ORNELAS KASEY 999999999 200 Cook 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 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127641.39 0 0 0 0 0 0 0 0 0 0 0 0 0 127641.39 0 0 1004888553 1326438987 16 Nurse Practitioners HUGHETT ELIZABETH A 999999999 57 Lake 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 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 2022.23 0 0 0 0 0 0 2022.23 0 0 1004888646 1740677582 16 Nurse Practitioners CARTWRIGHT SHELLY R 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 0 0 2442.87 0 0 0 0 0 0 2462.45 0 0 1004888770 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2295.48 0 0 0 0 0 0 0 0 0 0 0 0 0 2295.48 0 0 1004888845 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6318.88 0 0 0 0 0 0 0 0 0 0 0 0 0 6318.88 0 0 1004888888 1053632786 10 Physicians LAI JESSICA 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 48 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781.19 0 8919.88 0 0 0 0 0 0 9701.07 0 0 1004888951 1437502192 16 Nurse Practitioners SPEIRER JENNIFER 999999999 61 Livingston 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2030.59 0 0 0 0 0 0 2030.59 0 0 1004889098 1255754040 16 Nurse Practitioners DE TRATTO KATIE L. 999999999 200 Cook 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.18 0 0 0 0 0 0 867.18 0 0 1004889208 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18255.59 0 0 0 0 0 0 0 0 0 0 0 0 0 18255.59 0 0 1004889742 1245252055 60 Pharmacies CVS PHARMACY #16324 614011343 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50567.68 0 0 0 50567.68 0 0 1004889774 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22551.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22551.28 0 0 1004889987 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2338.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2338.84 0 0 1004890162 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17332.23 0 0 0 0 0 0 0 0 0 0 0 0 0 17332.23 0 0 1004890217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599.98 0 0 0 0 0 0 0 0 0 0 0 0 0 599.98 0 0 1004890583 1528318128 16 Nurse Practitioners WIGANT REBECCA 999999999 80 Peoria 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 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 0 0 0 0 0 0 0 0 0 0 1004890708 1760404479 60 Pharmacies CVS PHARMACY #17166 606086107 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26998.58 0 0 0 26998.58 0 0 1004890783 1790727410 89 Physician Assistant Only(Encounter Only) METTILLE SUSAN M 999999999 80 Peoria 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 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 0 363.86 0 0 0 0 0 0 363.86 0 0 1004891047 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.34 0 0 0 0 0 0 197.34 0 0 1004891069 1568697035 10 Physicians JACKSON KATHRYN E. 999999999 200 Cook 0 0 Pediatrics 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 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 1634.51 0 0 0 0 0 0 1634.51 0 0 1004891319 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4895.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4895.52 0 0 1004891619 1619243607 10 Physicians ZUCKERMAN MATTHEW A 601262816 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 39 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.11 0 5153.32 0 0 0 0 0 0 5456.43 0 0 1004891826 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.85 0 0 0 0 0 0 35.85 0 0 1004892002 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12681.93 0 0 0 0 0 0 0 0 0 0 0 0 0 12681.93 0 0 1004892151 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1004892437 91 Waiver service provider--Adults (DHS/DDD) 52 Johnson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 23365.87 0 0 0 0 0 0 0 0 0 0 0 0 0 23365.87 0 0 1004892732 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19551.7 0 0 0 0 0 0 0 0 0 0 0 0 0 19551.7 0 0 1004892989 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10138.95 0 0 0 0 0 0 0 0 0 0 0 0 0 10138.95 0 0 1004893162 1902249311 10 Physicians MALAKKLA NANDITHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6207.94 0 0 0 0 0 0 6207.94 0 0 1004893326 1093957110 10 Physicians NUTHAKKI PRITI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284.04 0 0 0 0 0 0 1284.04 0 0 1004893354 1578916599 11 Dentists KOLENCHERRY ANNA 999999999 200 Cook 0 0 General Dentistry 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4287.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4287.18 0 0 1004893404 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22234.38 0 0 0 0 0 0 0 0 0 0 0 0 0 22234.38 0 0 1004893441 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25636.58 0 0 0 0 0 0 0 0 0 0 0 0 0 25636.58 0 0 1004893741 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 6009.28 0 0 0 0 0 0 0 0 0 0 0 0 0 6009.28 0 0 1004893771 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004893791 63 Other Providers of Medical Equipment/Supplies (Non-registered) 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171 0 0 0 0 0 0 1171 0 0 1004894020 30 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004894067 1558701235 10 Physicians BURNS KATHARINE M 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 4 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.17 0 2847.42 0 0 0 0 0 0 2864.59 0 0 1004894733 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30142.97 0 0 0 0 0 0 0 0 0 0 0 0 0 30142.97 0 0 1004894752 1104260827 63 Other Providers of Medical Equipment/Supplies (Non-registered) VERUS HEALTHCARE LLC 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101262.82 0 0 0 0 0 0 101262.82 0 0 1004894996 1013366970 60 Pharmacies ST BERNARD HOSPITAL AMBULATORY 999999999 200 Cook 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8328.12 0 0 0 8328.12 0 0 1004895039 1134577794 70 Ambulance Service Providers CITY OF ALTON FIRE DEPARTMENT 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 289400.29 0 0 0 0 0 0 289400.29 0 0 1004895180 1891042552 10 Physicians KOTHAWALA AZHAR M 999999999 109 Winnebago 0 0 Anesthesiology 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 1881.66 0 0 0 0 0 0 1881.66 0 0 1004895296 1487993390 89 Physician Assistant Only(Encounter Only) UPHOFF JENNIFER 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.39 0 0 0 0 0 0 965.39 0 0 1004895485 1336373828 10 Physicians FELDER JOHN M 999999999 10 Adams 0 0 Plastic Surgery 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418.03 0 0 0 0 0 0 1418.03 0 0 1004895490 1891136222 10 Physicians MUTNEJA HEMANT 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.89 0 0 0 0 0 0 90.89 0 0 1004895518 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 3864.93 0 0 0 0 0 0 0 0 0 0 0 0 0 3864.93 0 0 1004895529 1265893051 16 Nurse Practitioners DAILEY ROBIN A 999999999 91 Sangamon 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1094.32 0 0 0 0 0 0 1094.32 0 0 1004895568 1851759971 89 Physician Assistant Only(Encounter Only) STUCKEY KEVIN 999999999 30 DuPage 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 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 1856.36 0 0 0 0 0 0 1856.36 0 0 1004895864 1689078875 16 Nurse Practitioners COLBY ANNE MARIE 606781034 200 Cook 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 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 0 376.69 0 0 0 0 0 0 376.69 0 0 1004895901 1497799639 16 Nurse Practitioners GATTO LINDA S 999999999 27 Dekalb 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 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 30.47 0 0 0 0 0 0 30.47 0 0 1004896166 1003201419 10 Physicians TJONG VEHNIAH K 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 32 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187.64 0 4536.75 0 0 0 0 0 0 4724.39 0 0 1004896384 1285081224 60 Pharmacies MEDICENTER PHARMACY 628842163 36 Franklin 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3935.31 0 0 0 3935.31 0 0 1004896455 1245538636 10 Physicians SCHIEKE MOIRA 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.61 0 0 0 0 0 0 0 0 173.61 0 0 1004896636 1710027792 10 Physicians QUBAIAH OSAMA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327.09 0 0 0 0 0 0 327.09 0 0 1004896894 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15687.13 0 0 0 0 0 0 0 0 0 0 0 0 0 15687.13 0 0 1004897074 92 Waiver service provider--Disability (DHS/DRS) 54 Kankakee 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6963.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6963.63 0 0 1004897094 92 Waiver service provider--Disability (DHS/DRS) 77 Morgan 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26587.53 0 0 0 0 0 0 0 0 0 0 0 0 0 26587.53 0 0 1004897178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3310.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3310.09 0 0 1004897327 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23076.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23076.9 0 0 1004897345 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11856.29 0 0 0 0 0 0 0 0 0 0 0 0 0 11856.29 0 0 1004897374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 484.99 0 0 0 0 0 0 0 0 0 0 0 0 0 484.99 0 0 1004897733 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29933.55 0 0 0 0 0 0 0 0 0 0 0 0 0 29933.55 0 0 1004897963 1386901106 10 Physicians STEED MAURA 999999999 200 Cook 0 0 Internal Medicine 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 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1774.11 0 0 0 0 0 0 1774.11 0 0 1004898016 1518410794 16 Nurse Practitioners HAGERTY MARK 999999999 200 Cook 0 0 0 0 0 29 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 1020.64 0 0 0 0 0 0 0 0 5896.64 0 0 0 0 0 0 6917.28 0 0 1004898017 4004898017 90 Waiver service provider--Elderly (DOA) ANGEL HOME HEALTH AGENCY SERVI 999999999 200 Cook 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 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112677.63 0 0 0 0 0 0 0 0 0 0 0 0 0 112677.63 0 0 1004898150 1770947756 16 Nurse Practitioners ELLINGTON VIOLET 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 33.22 0 0 0 0 0 0 0 0 517.78 0 0 0 0 0 0 551 0 0 1004898167 91 Waiver service provider--Adults (DHS/DDD) 844 Tennessee 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560.11 0 0 0 0 0 0 0 0 0 0 0 0 0 560.11 0 0 1004898354 1619331311 16 Nurse Practitioners HUDGINS RACHAEL H 999999999 80 Peoria 0 0 0 0 0 11 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 802.88 0 0 0 0 0 0 0 0 2050.75 0 0 0 0 0 0 2853.63 0 0 1004898753 1295898591 89 Physician Assistant Only(Encounter Only) TANNER DAWN CLARISSE 616151941 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.36 0 0 0 0 0 0 386.36 0 0 1004898980 1144242850 60 Pharmacies CVS PHARMACY #17002 605275538 30 DuPage 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3307.53 0 0 0 3307.53 0 0 1004899012 12 Optometrists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.45 0 0 0 0 0 0 46.45 0 0 1004899125 1770783599 10 Physicians URUBUSI JOY 999999999 35 Ford 0 0 Psychiatry 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 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 1547.08 0 0 0 0 0 0 1547.08 0 0 1004899260 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14207.74 0 0 0 0 0 0 0 0 0 0 0 0 0 14207.74 0 0 1004899363 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16662.94 0 0 0 0 0 0 0 0 0 0 0 0 0 16662.94 0 0 1004899561 1548716269 11 Dentists KABAR LINA 999999999 200 Cook 0 0 General Dentistry 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6856.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6856.35 0 0 1004899619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24567.98 0 0 0 0 0 0 0 0 0 0 0 0 0 24567.98 0 0 1004899681 1053785790 16 Nurse Practitioners KROOS AMY L 999999999 109 Winnebago 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 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 1074.42 0 0 0 0 0 0 1074.42 0 0 1004899698 4004899698 90 Waiver service provider--Elderly (DOA) "ACTIVE DAY IN, INC." 999999999 200 Cook 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 2956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200392.74 0 0 0 0 0 0 0 0 0 0 0 0 0 200392.74 0 0 1004899765 1174733224 10 Physicians WIARDA KAREN P 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.6 0 10849.4 0 0 0 0 0 0 10873 0 0 1004899917 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19829.04 0 0 0 0 0 0 0 0 0 0 0 0 0 19829.04 0 0 1004900004 1326442724 16 Nurse Practitioners VILLEGAS ALICIA 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.33 0 0 0 0 0 0 152.33 0 0 1004900115 1467689281 10 Physicians TOTONCHI SAMER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 18 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.72 0 5991.03 0 0 0 0 0 0 6043.75 0 0 1004900224 1730561150 63 Other Providers of Medical Equipment/Supplies (Non-registered) BIONIC PROSTHETICS AND ORTHOTI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 0 39098.43 0 0 0 0 39367.43 0 0 1004900277 1700832326 89 Physician Assistant Only(Encounter Only) VEASEY REBECCA ELLEN 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354.01 0 0 0 0 0 0 354.01 0 0 1004900349 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 1994.33 0 0 0 0 0 0 1994.33 0 0 1004900470 1225216997 10 Physicians MACK MICHAEL D 520016388 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184 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 6994.81 0 0 0 0 0 0 6994.81 0 0 1004900483 16 Nurse Practitioners 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004900522 10 Physicians 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004900579 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1030.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1030.22 0 0 1004900633 1689027666 16 Nurse Practitioners KELLING CYNTHIA B 999999999 109 Winnebago 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.26 0 0 0 0 0 0 406.26 0 0 1004900695 1346616372 16 Nurse Practitioners MULLER JAMIE L 999999999 62 Logan 0 0 0 0 0 1 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 1121.88 0 0 0 0 0 0 1191.4 0 0 1004900829 4004900829 91 Waiver service provider--Adults (DHS/DDD) SELF DIRECTED SUPPORTS 999999999 72 McLean 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 0 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30622.15 0 0 0 0 0 0 0 0 0 0 0 0 0 30622.15 0 0 1004900959 1780961615 16 Nurse Practitioners WATERS CAROL 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.73 0 0 0 0 0 0 207.73 0 0 1004901085 1508278896 16 Nurse Practitioners LONG SHIREEN 999999999 200 Cook 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145.25 0 0 0 0 0 0 145.25 0 0 1004901672 1992148704 10 Physicians GOMEZ-TIMANA LUCY E 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1185.01 0 0 0 0 0 0 1185.01 0 0 1004901679 1912453895 89 Physician Assistant Only(Encounter Only) PATE DAVID DYLAN 999999999 91 Sangamon 0 0 0 0 0 4 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 274.7 0 0 0 0 0 0 0 0 2481.93 0 0 0 0 0 0 2756.63 0 0 1004901824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27238.85 0 0 0 0 0 0 0 0 0 0 0 0 0 27238.85 0 0 1004901837 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17573.54 0 0 0 0 0 0 0 0 0 0 0 0 0 17573.54 0 0 1004901961 1356387658 16 Nurse Practitioners VATEV CHRISTINE C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1634.5 0 0 0 0 0 0 1634.5 0 0 1004902068 1538139225 89 Physician Assistant Only(Encounter Only) MCFARLIN DANNY 999999999 19 Champaign 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 0 104 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 1194.52 0 0 0 0 0 0 1194.52 0 0 1004902102 1013342039 89 Physician Assistant Only(Encounter Only) HALL BRITNEY N. 999999999 47 Jackson 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 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 2102.02 0 0 0 0 0 0 2102.02 0 0 1004902127 1659655124 61 Independent Laboratories PATHNOSTICS 999999999 805 California 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111309.82 0 0 0 0 0 0 0 0 111309.82 0 0 1004902184 1851748248 89 Physician Assistant Only(Encounter Only) MARTINEZ HECTOR 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 301.41 0 0 0 0 0 0 333.56 0 0 1004902199 1457648347 13 Podiatrists MAY KELLY 999999999 107 Will 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 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 0 114.27 0 0 0 0 0 0 114.27 0 0 1004902286 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 27039.77 0 0 0 0 0 0 0 0 0 0 0 0 0 27039.77 0 0 1004902470 16 Nurse Practitioners 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.89 0 0 0 0 0 0 15.89 0 0 1004902778 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23230.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23230.29 0 0 1004902808 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16661.91 0 0 0 0 0 0 0 0 0 0 0 0 0 16661.91 0 0 1004902884 92 Waiver service provider--Disability (DHS/DRS) 34 Fayette 0 0 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 4718.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4718.4 0 0 1004903154 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27414.68 0 0 0 0 0 0 0 0 0 0 0 0 0 27414.68 0 0 1004903447 1639331655 10 Physicians RETZER ELIZABETH M 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.37 0 5881.39 0 0 0 0 0 0 5890.76 0 0 1004903657 1730445784 10 Physicians LOWN RYAN P 999999999 19 Champaign 0 0 Emergency Medicine 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 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9393.44 0 0 0 0 0 0 9393.44 0 0 1004903980 1699797407 60 Pharmacies CVS PHARMACY #17169 601554887 200 Cook 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15550.63 0 0 0 15550.63 0 0 1004904315 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 10585.43 0 0 0 0 0 0 0 0 0 0 0 0 0 10585.43 0 0 1004904374 1497080709 10 Physicians KASULA SRIKANTH 999999999 91 Sangamon 0 0 Internal Medicine 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1593.93 0 0 0 0 0 0 1593.93 0 0 1004904427 1851366496 10 Physicians REIDY JAMES J 999999999 30 DuPage 0 0 Ophthalmology 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7071.05 0 0 0 0 0 0 7071.05 0 0 1004904749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3938.55 0 0 0 0 0 0 0 0 0 0 0 0 0 3938.55 0 0 1004904807 1457588196 10 Physicians TETTEH ELIZABETH 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 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 4815.79 0 0 0 0 0 0 4815.79 0 0 1004904951 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1004905057 1255649158 10 Physicians GUPTA SACHIN 999999999 200 Cook 0 0 Pediatrics 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 0 111 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 13009.75 0 0 0 0 0 0 13009.75 0 0 1004905322 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10314.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10314.41 0 0 1004905354 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1918.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1918.79 0 0 1004905672 1710380258 16 Nurse Practitioners WIELAND STEPHANIE H 999999999 80 Peoria 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.5 0 0 0 0 0 0 1053.5 0 0 1004905720 1396144846 89 Physician Assistant Only(Encounter Only) RISEN JESSICA B 999999999 80 Peoria 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2368.87 0 0 0 0 0 0 2368.87 0 0 1004905787 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8369.14 0 0 0 0 0 0 0 0 0 0 0 0 0 8369.14 0 0 1004906055 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27789.54 0 0 0 0 0 0 0 0 0 0 0 0 0 27789.54 0 0 1004906263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2274.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2274.77 0 0 1004906265 1619230992 10 Physicians BUOY ABIGAIL G 999999999 91 Sangamon 0 0 Psychiatry 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 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13882.04 0 0 0 0 0 0 13882.04 0 0 1004906553 10 Physicians 10 Adams 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1004906606 1972586253 10 Physicians EDWARDS CHARMAINE E 999999999 87 Randolph 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 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 3205.09 0 0 0 0 0 0 3205.09 0 0 1004906919 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.46 0 0 1004906932 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 6923.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6923.91 0 0 1004907242 89 Physician Assistant Only(Encounter Only) 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1004907518 1295002715 89 Physician Assistant Only(Encounter Only) DIFFERDING CHRISTOPHER J 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3204.02 0 0 0 0 0 0 3204.02 0 0 1004907757 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16914.51 0 0 0 0 0 0 0 0 0 0 0 0 0 16914.51 0 0 1004908046 1699189878 10 Physicians VALLURIPALLI RAVI 999999999 200 Cook 0 0 Psychiatry 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 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11429.55 0 0 0 0 0 0 11429.55 0 0 1004908115 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29733.95 0 0 0 0 0 0 0 0 0 0 0 0 0 29733.95 0 0 1004908284 10 Physicians 71 McHenry 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1898.6 0 0 0 0 0 0 1898.6 0 0 1004908326 1447699186 10 Physicians NICKLESS JOHN JACK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321.52 0 848.41 0 0 0 0 0 0 1169.93 0 0 1004908392 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23657.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23657.8 0 0 1004908606 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5453.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5453.8 0 0 1004908630 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24007.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24007.57 0 0 1004908733 1821548207 16 Nurse Practitioners VETTER NICOLE L 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 161.42 0 0 0 0 0 0 0 0 613.49 0 0 0 0 0 0 774.91 0 0 1004908913 1932554714 16 Nurse Practitioners SCHUPBACH JAMIE 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3768.84 0 0 0 0 0 0 3768.84 0 0 1004909202 1871945667 16 Nurse Practitioners PFEIFFER ERIC 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 930.52 0 0 0 0 0 0 930.52 0 0 1004909258 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861.15 0 0 0 0 0 0 0 0 0 0 0 0 0 861.15 0 0 1004909343 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15548.92 0 0 0 0 0 0 0 0 0 0 0 0 0 15548.92 0 0 1004909518 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 610.92 0 0 0 0 0 0 610.92 0 0 1004909616 1033584016 97 Waiver service provider--Children's residential (DHS/DDD) AGNEW KRISTIN 604361876 107 Will 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2007.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2007.1 0 0 1004909823 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 621.99 0 0 0 0 0 0 0 0 0 0 0 0 0 621.99 0 0 1004909840 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 585.35 0 0 0 0 0 0 0 0 0 0 0 0 0 585.35 0 0 1004909872 1285099002 60 Pharmacies DRUG CENTER PHARMACY 999999999 200 Cook 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7565.57 0 0 0 7565.57 0 0 1004909898 1790122125 10 Physicians WICKS JENNIFER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468.8 0 0 0 0 0 0 468.8 0 0 1004910041 1871725515 89 Physician Assistant Only(Encounter Only) CORWIN VALERIE A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 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 1807.15 0 0 0 0 0 0 1807.15 0 0 1004910097 92 Waiver service provider--Disability (DHS/DRS) 73 Menard 0 0 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 15772.66 0 0 0 0 0 0 0 0 0 0 0 0 0 15772.66 0 0 1004910286 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004910394 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 23.76 0 0 0 0 0 0 23.76 0 0 1004910422 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43446.75 0 0 0 0 0 0 0 0 0 0 0 0 0 43446.75 0 0 1004910449 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 112.52 0 0 0 0 0 0 112.52 0 0 1004911026 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42783.62 0 0 0 0 0 0 0 0 0 0 0 0 0 42783.62 0 0 1004911112 1679898969 10 Physicians BERAKI MUSSIE 999999999 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3733.21 0 0 0 0 0 0 3733.21 0 0 1004911446 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23035.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23035.36 0 0 1004911554 1174887020 10 Physicians HUANG JINGTAO 999999999 200 Cook 0 0 Pediatrics 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 0 342 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 2956.34 0 0 0 0 0 0 2956.34 0 0 1004911562 11 Dentists 89 Rock Island 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443.45 0 0 1004911591 1821369596 16 Nurse Practitioners SCHLACK KATHLEEN F 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 5259.26 0 0 0 0 0 0 5259.26 0 0 1004911696 1124303730 16 Nurse Practitioners BABCOCK MALINDA M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 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0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647.93 0 0 0 0 0 0 647.93 0 0 1004922314 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 2994.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2994.6 0 0 1004922349 1083900294 10 Physicians ABRAHAM CHRISTOPHER D 999999999 200 Cook 0 0 Radiation Oncology 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1357.88 0 0 0 0 0 0 1357.88 0 0 1004922381 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23421 0 0 0 0 0 0 0 0 0 0 0 0 0 23421 0 0 1004922487 1174911242 16 Nurse Practitioners JONES NICHOLE M 999999999 200 Cook 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 0 237 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 1316.79 0 0 0 0 0 0 1316.79 0 0 1004922958 1801003793 10 Physicians GREEN ALEX 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12706.56 0 0 0 0 0 0 12706.56 0 0 1004923385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23974.22 0 0 0 0 0 0 0 0 0 0 0 0 0 23974.22 0 0 1004923479 25 Audiologists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.07 68.07 0 0 1004923722 1578817003 16 Nurse Practitioners FUNES IRMA E 999999999 10 Adams 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1536.44 0 0 0 0 0 0 1536.44 0 0 1004923921 1497161814 16 Nurse Practitioners ELLIOTT KRISTIN 999999999 200 Cook 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 0 108 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 0 102.14 0 0 0 0 0 0 102.14 0 0 1004924150 1740622703 10 Physicians CIPOLLA ANTHONY P 999999999 63 Macon 0 0 0 0 0 4 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 4 0 57 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 4 0 57 0 0 0 0 0 0 0 0 0 413.64 0 0 0 0 0 0 8.72 0 2017.88 0 0 0 0 0 0 2440.24 0 0 1004924203 1750839635 22 Physical Therapists MEDEMA NICHOLAS 999999999 107 Will 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 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 0 625.24 625.24 0 0 1004924343 1093169419 10 Physicians AL-ITTER QUSAI T 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.98 0 0 0 0 0 0 204.98 0 0 1004924413 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1004924416 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14000.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14000.8 0 0 1004924444 1417210519 10 Physicians ROSENBAUM KAYLEE MARIE 616151941 80 Peoria 0 0 Internal Medicine 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 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2619.9 0 0 0 0 0 0 2619.9 0 0 1004924480 1437604154 16 Nurse Practitioners BOLLAERT LINDSEY C 999999999 91 Sangamon 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.37 0 0 0 0 0 0 197.37 0 0 1004924604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11889.44 0 0 0 0 0 0 0 0 0 0 0 0 0 11889.44 0 0 1004924617 1467738005 89 Physician Assistant Only(Encounter Only) IDLE NICHOLAS R 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3335.48 0 0 0 0 0 0 3335.48 0 0 1004924628 1518288844 13 Podiatrists VAN BEEK KING JESSICA M 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3558.49 0 0 0 0 0 0 3558.49 0 0 1004924684 30 General Hospitals 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14365.41 0 0 0 0 0 14365.41 0 0 1004924725 98 Waiver service provider--TBI (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989.67 0 0 0 0 0 0 0 0 0 0 0 0 0 989.67 0 0 1004924781 16 Nurse Practitioners 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004925006 1881034809 10 Physicians KHAN MAHJABEEN 999999999 57 Lake 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 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2684.32 0 0 0 0 0 0 2684.32 0 0 1004925173 1871515585 60 Pharmacies CVS PHARMACY #17016 601773315 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15927 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15965.3 0 0 0 15965.3 0 0 1004925185 1740223031 60 Pharmacies CVS PHARMACY #17167 606594277 200 Cook 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 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30725.42 0 0 0 30725.42 0 0 1004925214 1821082751 89 Physician Assistant Only(Encounter Only) KRUG KELLEY A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097.57 0 0 0 0 0 0 1097.57 0 0 1004925358 1669472312 89 Physician Assistant Only(Encounter Only) HARALDSSON CATHERINE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.98 0 0 0 0 0 0 291.98 0 0 1004925953 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.82 0 0 0 0 0 0 45.82 0 0 1004925959 1295192805 16 Nurse Practitioners COPELAND TAMARA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1872.14 0 0 0 0 0 0 1872.14 0 0 1004926105 10 Physicians 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.51 0 0 0 0 0 0 0 0 26.51 0 0 1004926153 1598031239 10 Physicians THOMPSON KATHERINE 999999999 91 Sangamon 0 0 Internal Medicine 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 0 114 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 2231.91 0 0 0 0 0 0 2231.91 0 0 1004926694 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.85 0 0 0 0 0 0 236.85 0 0 1004926744 1659723211 36 Community mental health provider MATHERS COMMUNITY MENTAL HEALT 999999999 71 McHenry 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 138.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19183.16 0 0 19321.6 0 0 1004926805 1427406859 36 Community mental health provider ROSECRANCE CHAMPAIGN/URBANA 999999999 19 Champaign 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4579.55 0 0 4579.55 0 0 1004926895 1770034878 86 Clinical Social Worker(Encounter Only) ROEDL TAMMIE 999999999 19 Champaign 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1420.56 0 0 0 0 0 0 1420.56 0 0 1004927267 1558728337 16 Nurse Practitioners DIERKER SHANNA J 999999999 10 Adams 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 0 217 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 1579.9 0 0 0 0 0 0 1579.9 0 0 1004927269 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6138.96 0 0 0 0 0 0 0 0 0 0 0 0 0 6138.96 0 0 1004927505 1275080871 89 Physician Assistant Only(Encounter Only) GILL CARINA 999999999 19 Champaign 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 812.11 0 0 0 0 0 0 812.11 0 0 1004927602 16 Nurse Practitioners 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004927636 1356683809 10 Physicians BADKE COLLEEN 999999999 200 Cook 0 0 Pediatrics 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31612.5 0 0 0 0 0 0 31612.5 0 0 1004927711 1407205685 70 Ambulance Service Providers CORTLAND COMMUNITY FIRE PROTEC 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14076.68 0 0 0 0 0 0 14076.68 0 0 1004927749 1063806412 16 Nurse Practitioners LOVIN NICOLE M 999999999 200 Cook 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 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 7.45 0 0 0 0 0 0 7.45 0 0 1004928050 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30887.42 0 0 0 0 0 0 0 0 0 0 0 0 0 30887.42 0 0 1004928123 1457794182 10 Physicians BERTINO ANNE-MARIE 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 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 2626.35 0 0 0 0 0 0 2626.35 0 0 1004928176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 971.11 0 0 0 0 0 0 0 0 0 0 0 0 0 971.11 0 0 1004928259 1952641946 39 Hospice HSHS HOSPICE SOUTHERN ILLINOIS 999999999 33 Effingham 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204453.13 0 0 0 0 0 0 0 0 0 0 0 204453.13 0 0 1004928283 1285074385 10 Physicians KUMAR VINEET 999999999 47 Jackson 0 0 General Practice 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 0 285 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 4286.42 0 0 0 0 0 0 4286.42 0 0 1004928380 1255446886 89 Physician Assistant Only(Encounter Only) ERTHALL PHILLIP R. 999999999 200 Cook 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 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 0 841.76 0 0 0 0 0 0 841.76 0 0 1004928397 1134671324 60 Pharmacies MORELAND AND DEVITT 999999999 18 Cass 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9878.97 0 0 0 9878.97 0 0 1004928789 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14433.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14433.02 0 0 1004928934 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24900.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24900.75 0 0 1004928964 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10093.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10093.6 0 0 1004929008 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29188.19 0 0 0 0 0 0 0 0 0 0 0 0 0 29188.19 0 0 1004929078 1306000765 89 Physician Assistant Only(Encounter Only) ATKINS TRISHA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5884.43 0 0 0 0 0 0 5884.43 0 0 1004929447 1841578143 89 Physician Assistant Only(Encounter Only) OHNESORGE AMANDA J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309.88 0 0 0 0 0 0 309.88 0 0 1004929591 1720344104 10 Physicians SINGLETON ROBERT E 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3832.34 0 0 0 0 0 0 3832.34 0 0 1004929709 1104813997 89 Physician Assistant Only(Encounter Only) AYCOCK SHARON E 999999999 80 Peoria 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.8 0 0 0 0 0 0 1079.8 0 0 1004929796 1841533908 10 Physicians KANU LOVELLA DURU 999999999 200 Cook 0 0 Family Practice 0 0 0 7 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 160 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 160 0 0 0 0 0 0 0 0 0 448.9 0 0 0 0 0 0 14.31 0 4048 0 0 0 0 0 0 4511.21 0 0 1004930404 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29162.89 0 0 0 0 0 0 0 0 0 0 0 0 0 29162.89 0 0 1004930442 1700197704 11 Dentists LIGAS ERIK J 999999999 200 Cook 0 0 General Dentistry 0 0 29 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2732.08 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 3484.78 0 0 1004930472 1770826240 10 Physicians REBEDEW KATHRYN 999999999 65 Madison 0 0 0 0 0 12 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 1155.17 0 0 0 0 0 0 8.8 0 1308.96 0 0 0 0 0 0 2472.93 0 0 1004930620 30 General Hospitals 815 Indiana DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004931144 1972525780 60 Pharmacies CVS PHARMACY #16327 609149324 54 Kankakee 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 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11088.07 0 0 0 11088.07 0 0 1004931286 10 Physicians 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.74 0 0 0 0 0 0 163.74 0 0 1004931551 90 Waiver service provider--Elderly (DOA) 839 Pennsylvania 0 0 0 0 0 0 0 5 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 15731.53 0 0 0 0 0 0 0 0 0 0 0 0 0 15731.53 0 0 1004931593 1306216098 16 Nurse Practitioners PRECIADO JOY R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298.92 0 0 0 0 0 0 298.92 0 0 1004931749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41882.9 0 0 0 0 0 0 0 0 0 0 0 0 0 41882.9 0 0 1004931795 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 50.06 0 0 0 0 0 0 0 0 0 0 0 0 0 50.06 0 0 1004931811 1043663834 11 Dentists PATEL AMEE 999999999 200 Cook 0 0 General Dentistry 0 0 157 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 20929.23 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 21681.93 0 0 1004932078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 912.97 0 0 0 0 0 0 0 0 0 0 0 0 0 912.97 0 0 1004932164 1902184591 10 Physicians ISSA NAOUM 999999999 30 DuPage 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6149.29 0 0 0 0 0 0 6149.29 0 0 1004932257 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276.47 0 0 0 0 0 0 276.47 0 0 1004932461 22 Physical Therapists 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 70.11 70.11 0 0 1004932512 1437227543 10 Physicians KHAN USMAN A 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4647.32 0 0 0 0 0 0 4647.32 0 0 1004932528 1144672577 16 Nurse Practitioners ABT KAREN M 999999999 108 Williamson 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239.49 0 0 0 0 0 0 239.49 0 0 1004932546 1043576903 10 Physicians OKAFOR DIONNE 999999999 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2928.18 0 0 0 0 0 0 2928.18 0 0 1004932559 11 Dentists 200 Cook 0 0 Maxillofacial Surgery 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 1740.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1740.87 0 0 1004932606 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37327.85 0 0 0 0 0 0 0 0 0 0 0 0 0 37327.85 0 0 1004932610 1538470539 10 Physicians STEMM MATTHEW 999999999 106 Whiteside 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 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 0 325.25 0 0 0 0 0 0 0 0 325.25 0 0 1004932861 98 Waiver service provider--TBI (DHS/DRS) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47337.06 0 0 0 0 0 0 0 0 0 0 0 0 0 47337.06 0 0 1004932955 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 47.62 0 0 0 0 0 0 47.62 0 0 1004932991 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26165.32 0 0 0 0 0 0 0 0 0 0 0 0 0 26165.32 0 0 1004933023 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254.27 0 0 0 0 0 0 254.27 0 0 1004933462 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 10291.78 0 0 0 0 0 0 0 0 0 0 0 0 0 10291.78 0 0 1004933520 92 Waiver service provider--Disability (DHS/DRS) 44 Henderson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17221.09 0 0 0 0 0 0 0 0 0 0 0 0 0 17221.09 0 0 1004933964 1447593470 10 Physicians VYAS SHRINAL 999999999 200 Cook 0 0 0 0 0 43 0 0 0 0 0 0 5 0 39 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 5 0 69 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 5 0 69 0 0 0 0 0 0 0 0 0 4408.2 0 0 0 0 0 0 16.04 0 2572.26 0 0 0 0 0 0 6996.5 0 0 1004934283 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11608.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11608.2 0 0 1004934285 1760776710 10 Physicians VAIDYANATHAN MAHESH 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10383.7 0 0 0 0 0 0 10383.7 0 0 1004934328 1376918649 16 Nurse Practitioners RITTER CAMERON M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.28 0 0 0 0 0 0 256.28 0 0 1004934565 1588998165 10 Physicians MULLER AARON 999999999 30 DuPage 0 0 Pediatrics 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 0 112 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 14031.72 0 0 0 0 0 0 14031.72 0 0 1004934636 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19033.15 0 0 0 0 0 0 0 0 0 0 0 0 0 19033.15 0 0 1004934939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3274.78 0 0 0 0 0 0 0 0 0 0 0 0 0 3274.78 0 0 1004935007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1462.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1462.11 0 0 1004935057 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19252.62 0 0 0 0 0 0 0 0 0 0 0 0 0 19252.62 0 0 1004935070 1659825446 11 Dentists VEDACHHIA IRUM 999999999 200 Cook 0 0 General Dentistry 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632.45 0 0 1004935183 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15023.42 0 0 0 0 0 0 0 0 0 0 0 0 0 15023.42 0 0 1004935221 1114169893 10 Physicians JAVADI POORIA 999999999 54 Kankakee 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 439 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8939.55 0 363.82 0 0 0 0 0 0 9303.37 0 0 1004935273 1245605088 16 Nurse Practitioners TAYYEBI AZAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594.39 0 0 0 0 0 0 594.39 0 0 1004935383 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 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 38754.45 0 0 0 0 0 0 0 0 0 0 0 0 0 38754.45 0 0 1004935490 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20953.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20953.95 0 0 1004935521 1710237748 89 Physician Assistant Only(Encounter Only) JELINSKI JUSTIN 999999999 53 Kane 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 1406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2744.26 0 0 0 0 0 0 2744.26 0 0 1004936009 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004936193 1881007979 10 Physicians HEALD-SARGENT TAYLOR ALIS 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068.66 0 0 0 0 0 0 1068.66 0 0 1004936272 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.04 0 0 0 0 0 0 29.04 0 0 1004936479 1598716920 10 Physicians POLCARO JOSEPH 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250.81 0 253.11 0 0 0 0 0 0 503.92 0 0 1004936691 1629421771 16 Nurse Practitioners LITTLETON DENNIS P 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.28 0 0 0 0 0 0 249.28 0 0 1004936725 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21139.58 0 0 0 0 0 0 0 0 0 0 0 0 0 21139.58 0 0 1004936820 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30679.53 0 0 0 0 0 0 0 0 0 0 0 0 0 30679.53 0 0 1004937226 1932155116 16 Nurse Practitioners STELTZER MICHELLE M. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910.32 0 0 0 0 0 0 910.32 0 0 1004937346 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16314.36 0 0 0 0 0 0 0 0 0 0 0 0 0 16314.36 0 0 1004937394 1508836107 10 Physicians PICKVANCE ELIZABETH 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 2 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.84 0 5906.2 0 0 0 0 0 0 6070.04 0 0 1004937419 92 Waiver service provider--Disability (DHS/DRS) 20 Christian 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14036.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14036.53 0 0 1004937448 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27371 0 0 0 0 0 0 0 0 0 0 0 0 0 27371 0 0 1004937519 1104227313 86 Clinical Social Worker(Encounter Only) HUNTER BASS SANDRA 999999999 200 Cook 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 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1387.99 0 0 0 0 0 0 1387.99 0 0 1004937752 1023269446 89 Physician Assistant Only(Encounter Only) KOCH ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004937841 1649584616 10 Physicians DUNSKY KATHERINE A 999999999 200 Cook 0 0 Otolaryngology 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 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 3377.91 0 0 0 0 0 0 3377.91 0 0 1004938497 1821010612 60 Pharmacies CVS PHARMACY #16282 601874529 30 DuPage 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4579.07 0 0 0 4579.07 0 0 1004938589 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26664.59 0 0 0 0 0 0 0 0 0 0 0 0 0 26664.59 0 0 1004938810 4004938810 91 Waiver service provider--Adults (DHS/DDD) LAWRENCE MELANIE 999999999 107 Will 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 0 156 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 11154.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11154.6 0 0 1004938813 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.42 0 0 0 0 0 0 126.42 0 0 1004939014 1487941092 10 Physicians HUTSON SAMUEL L 999999999 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 822 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14620.38 0 152.67 0 0 0 0 0 0 14773.05 0 0 1004939053 1275533317 89 Physician Assistant Only(Encounter Only) SNOW KEVIN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 841.58 0 0 0 0 0 0 841.58 0 0 1004939073 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8412 0 0 0 0 0 0 0 0 0 0 0 0 0 8412 0 0 1004939432 10 Physicians 109 Winnebago 0 0 Neurology 0 0 0 0 0 0 0 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 4.88 0 0 0 0 0 0 4.88 0 0 1004939808 1649221953 10 Physicians STOKES JEFFREY R 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1102.68 0 0 0 0 0 0 1102.68 0 0 1004939932 1659663581 10 Physicians WILLIAMS GRETCHEN 999999999 54 Kankakee 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 0 128 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 5076.63 0 0 0 0 0 0 5076.63 0 0 1004940070 1912347402 10 Physicians JEZIORKOWSKI CHRISTOPHER J 999999999 65 Madison 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3459.74 0 0 0 0 0 0 3459.74 0 0 1004940157 75 Department of Alcohol and Substance Abuse Provider 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.06 0 0 598.06 0 0 1004940279 1669768644 10 Physicians BUEDEFELDT-POLLARD JESSE 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 2 0 0 0 0 0 0 26 0 178 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 27 0 423 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 27 0 423 0 0 0 0 0 0 0 0 0 119.18 0 0 0 0 0 0 239.25 0 40088.73 0 0 0 0 0 0 40447.16 0 0 1004940474 1255787263 89 Physician Assistant Only(Encounter Only) DEADMOND FRANCES C 999999999 91 Sangamon 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 0 107 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 0 575.36 0 0 0 0 0 0 575.36 0 0 1004940632 1649725961 91 Waiver service provider--Adults (DHS/DDD) DECKER KATELYN 999999999 200 Cook 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6160.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6160.4 0 0 1004940797 1669639480 16 Nurse Practitioners JOHNSTON-BRUNO MARY E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306.53 0 0 0 0 0 0 306.53 0 0 1004941158 1558522128 10 Physicians DIGIACOMO III PHILIP 999999999 108 Williamson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2138.95 0 0 0 0 0 0 2138.95 0 0 1004941224 1770696890 89 Physician Assistant Only(Encounter Only) JOHNSON STACIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1703.9 0 0 0 0 0 0 1703.9 0 0 1004941292 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25452.12 0 0 0 0 0 0 0 0 0 0 0 0 0 25452.12 0 0 1004941372 16 Nurse Practitioners 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004941485 4004941485 94 Waiver service provider--Children's support (DHS/DDD) SELF DIRECTED SUPPORTS 999999999 72 McLean 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4284.63 0 0 0 0 0 0 0 0 0 0 0 0 0 4284.63 0 0 1004941546 92 Waiver service provider--Disability (DHS/DRS) 63 Macon 0 0 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 2828.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2828.38 0 0 1004942070 1093005399 10 Physicians GERSHAN SCOTT A. 999999999 200 Cook 0 0 Psychiatry 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 0 244 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 7426.09 0 0 0 0 0 0 7426.09 0 0 1004942195 1184079451 16 Nurse Practitioners RITTER AMANDA L 999999999 109 Winnebago 0 0 0 0 0 6 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 498.63 0 0 0 0 0 0 0 0 1749.1 0 0 0 0 0 0 2247.73 0 0 1004942494 1538471388 63 Other Providers of Medical Equipment/Supplies (Non-registered) BIONIC PROSTHETICS AND ORTHOTI 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.4 0 10429.69 0 0 0 0 10502.09 0 0 1004942533 1558625434 10 Physicians DAUER ANNA K 999999999 815 Indiana 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 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 0 0 0 0 0 0 0 0 0 0 1004942684 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36236.01 0 0 0 0 0 0 0 0 0 0 0 0 0 36236.01 0 0 1004942741 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21171.19 0 0 0 0 0 0 0 0 0 0 0 0 0 21171.19 0 0 1004942942 1730320326 60 Pharmacies DUNCAN SPECIALTY PHARMACY 999999999 818 Kentucky 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116953.95 0 0 0 116953.95 0 0 1004942955 1629320445 16 Nurse Practitioners WHELAN ELIZABETH 999999999 80 Peoria 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 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 1555.5 0 0 0 0 0 0 1555.5 0 0 1004943048 1881914315 10 Physicians BESSAY EMMANUEL P 999999999 845 Texas 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5360.69 0 0 0 0 0 0 5360.69 0 0 1004943288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26065.2 0 0 0 0 0 0 0 0 0 0 0 0 0 26065.2 0 0 1004943420 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11613.72 0 0 0 0 0 0 0 0 0 0 0 0 0 11613.72 0 0 1004943432 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004943453 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11585.74 0 0 0 0 0 0 0 0 0 0 0 0 0 11585.74 0 0 1004943510 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.94 0 0 0 0 0 0 16.94 0 0 1004943556 1154879690 23 Occupational Therapists RYAN BREANNA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18444.38 18444.38 0 0 1004943668 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 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 6217.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.91 0 0 1004943758 1841670437 16 Nurse Practitioners WRIGHT MARGARET 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 396.12 0 0 0 0 0 0 408.92 0 0 1004943775 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23463.89 0 0 0 0 0 0 0 0 0 0 0 0 0 23463.89 0 0 1004943832 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2452.61 0 0 0 0 0 0 0 0 0 0 0 0 0 2452.61 0 0 1004943935 1992240030 11 Dentists KATAKAMSETTI HARINI 999999999 57 Lake 0 0 General Dentistry 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5437.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5437.07 0 0 1004944026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22618.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22618.04 0 0 1004944033 1134576820 60 Pharmacies CVS PHARMACY #10951 999999999 65 Madison 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 1685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49453 0 0 0 49453 0 0 1004944073 86 Clinical Social Worker(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004944145 1245383181 70 Ambulance Service Providers BUCKLEY FIRE PROTECTION DISTRI 999999999 46 Iroquois 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 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 11338.27 0 0 0 0 0 0 11338.27 0 0 1004944157 1871943472 91 Waiver service provider--Adults (DHS/DDD) WOOD THOMAS 999999999 109 Winnebago 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7147.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7147.09 0 0 1004944202 1861669020 10 Physicians SONG SUISUI 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630.59 0 0 0 0 0 0 630.59 0 0 1004944203 1215483193 89 Physician Assistant Only(Encounter Only) CARRIER KATLYN E 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4034.02 0 0 0 0 0 0 4034.02 0 0 1004944308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31029.69 0 0 0 0 0 0 0 0 0 0 0 0 0 31029.69 0 0 1004944899 1104821446 16 Nurse Practitioners HARDEN SHARIE 999999999 44 Henderson 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3957.75 0 0 0 0 0 0 3957.75 0 0 1004944928 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12010.77 0 0 0 0 0 0 0 0 0 0 0 0 0 12010.77 0 0 1004944956 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9344.72 0 0 0 0 0 0 0 0 0 0 0 0 0 9344.72 0 0 1004945170 1093151151 10 Physicians LANGALIYA BHRANTI C 999999999 200 Cook 0 0 Internal Medicine 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 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2408.34 0 0 0 0 0 0 2408.34 0 0 1004945171 1083636799 60 Pharmacies CVS PHARMACY #16534 600044379 200 Cook 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10690.82 0 0 0 10690.82 0 0 1004945456 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.1 0 0 0 0 0 0 0 0 25.1 0 0 1004945576 1679836688 10 Physicians GRANT IAN M 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 296.77 0 0 0 0 0 0 296.77 0 0 1004945631 1154702181 48 Rural Health Clinics GIBSON AREA MEDICAL CLINIC 999999999 35 Ford 0 0 0 59 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5823.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5823.29 0 0 1004945898 1699041657 10 Physicians GOODMAN DANIEL A 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 239 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 4173.55 0 0 0 0 0 0 4173.55 0 0 1004946114 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305.83 0 0 0 0 0 0 0 0 0 0 0 0 0 305.83 0 0 1004946264 1215249545 10 Physicians LO RYAN LEE 999999999 71 McHenry 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 530 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10488.03 0 531.42 0 0 0 0 0 0 11019.45 0 0 1004946271 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1004946288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8378.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8378.68 0 0 1004946396 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14105.18 0 0 0 0 0 0 0 0 0 0 0 0 0 14105.18 0 0 1004946519 1871553784 89 Physician Assistant Only(Encounter Only) HUTCHISON RICHARD M 999999999 55 Kendall 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 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 71.07 0 0 0 0 0 0 71.07 0 0 1004946787 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.22 0 0 0 0 0 0 67.22 0 0 1004946788 10 Physicians 63 Macon 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 78.09 0 0 1004946823 1164721528 10 Physicians FAVILA EMMANUEL 999999999 200 Cook 0 0 Internal Medicine 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4640.72 0 0 0 0 0 0 4640.72 0 0 1004946921 10 Physicians 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.95 0 0 0 0 0 0 120.95 0 0 1004946942 1467827592 16 Nurse Practitioners KARR KELLY A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1318.91 0 0 0 0 0 0 1318.91 0 0 1004947091 16 Nurse Practitioners 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004947282 87 Psychologist(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004947358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 1004947475 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004947552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12110.41 0 0 0 0 0 0 0 0 0 0 0 0 0 12110.41 0 0 1004947559 1831503820 10 Physicians CRADDICK MICHAEL 999999999 45 Henry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213.29 0 0 0 0 0 0 213.29 0 0 1004947837 1295022218 10 Physicians KIDIWALA NILOFER 999999999 200 Cook 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 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2864.1 0 0 0 0 0 0 2864.1 0 0 1004947840 1326346388 10 Physicians DU KEFU 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 8 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.47 0 1160.31 0 0 0 0 0 0 1175.78 0 0 1004947896 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 898.37 0 0 0 0 0 0 0 0 0 0 0 0 0 898.37 0 0 1004947899 1942640438 10 Physicians ROSE JENNIFER 999999999 36 Franklin 0 0 Family Practice 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 0 418.18 0 0 0 0 0 0 418.18 0 0 1004947917 92 Waiver service provider--Disability (DHS/DRS) 19 Champaign 0 0 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 1196.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1196.99 0 0 1004947990 1154524973 10 Physicians NAM MOON-WOO 999999999 53 Kane 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.14 0 0 0 0 0 0 0 0 450.14 0 0 1004948187 1568760734 10 Physicians TARASOV EUGENE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6416.47 0 0 0 0 0 0 6416.47 0 0 1004948191 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004948358 1528199973 89 Physician Assistant Only(Encounter Only) SHROYER CASEY D 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 607.18 0 0 0 0 0 0 607.18 0 0 1004948422 1568751972 10 Physicians ANJUM DARAKHSHAN 999999999 40 Grundy 0 1 Pediatrics 0 0 0 22 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 2845.96 0 0 0 0 0 0 2.18 0 1316.82 0 0 0 0 0 0 4164.96 0 0 1004948771 1477735884 16 Nurse Practitioners URBAN TELVA T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2637.59 0 0 0 0 0 0 2637.59 0 0 1004948812 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7520.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7520.35 0 0 1004948827 1689926784 16 Nurse Practitioners JOHNSON SAMANTHA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284.03 0 0 0 0 0 0 284.03 0 0 1004948919 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23012.66 0 0 0 0 0 0 0 0 0 0 0 0 0 23012.66 0 0 1004949313 10 Physicians 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677.44 0 0 0 0 0 0 677.44 0 0 1004949319 1104285196 89 Physician Assistant Only(Encounter Only) FUNK STEVIE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4191.02 0 0 0 0 0 0 4191.02 0 0 1004949701 1306287214 10 Physicians SIDDIQUI OMAR 999999999 200 Cook 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 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 2254.89 0 0 0 0 0 0 2254.89 0 0 1004949703 1124339494 10 Physicians ROLLER EVAN W 999999999 30 DuPage 0 0 Anesthesiology 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 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 1336.51 0 0 0 0 0 0 1336.51 0 0 1004949950 1326338849 10 Physicians GOLDBERG DEBORAH 999999999 82 Piatt 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6203.8 0 0 0 0 0 0 6203.8 0 0 1004950019 12 Optometrists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.79 0 0 0 0 0 0 169.79 0 0 1004950110 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34852.28 0 0 0 0 0 0 0 0 0 0 0 0 0 34852.28 0 0 1004950250 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27515.58 0 0 0 0 0 0 0 0 0 0 0 0 0 27515.58 0 0 1004950559 1609222579 16 Nurse Practitioners WALLACE DEANNA L 999999999 91 Sangamon 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 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 0 505.91 0 0 0 0 0 0 505.91 0 0 1004950617 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170845.04 0 0 0 0 0 0 0 0 0 0 0 0 0 170845.04 0 0 1004950721 1992126551 63 Other Providers of Medical Equipment/Supplies (Non-registered) KELLY'S HOME MEDICAL A CAREPRO 999999999 816 Iowa 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 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5070.23 0 0 0 0 0 0 5070.23 0 0 1004950845 1518364538 89 Physician Assistant Only(Encounter Only) JAFFERY TAHIR M 999999999 200 Cook 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359.15 0 0 0 0 0 0 359.15 0 0 1004950865 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 0 795.24 0 0 0 0 0 0 0 0 0 0 0 0 0 795.24 0 0 1004950899 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004950959 1306943022 10 Physicians HAQ JUNAID 999999999 30 DuPage 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 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 6016.61 0 0 0 0 0 0 6016.61 0 0 1004951436 1720456007 16 Nurse Practitioners SIEGELE PEGGY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004951868 1043227846 89 Physician Assistant Only(Encounter Only) SEABOCH RICHARD S 999999999 80 Peoria 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1004951979 1922399807 10 Physicians ROSENBLATT ADENA 999999999 30 DuPage 0 0 Dermatology 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621.67 0 0 0 0 0 0 1621.67 0 0 1004952383 86 Clinical Social Worker(Encounter Only) 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 533.75 0 0 0 0 0 0 533.75 0 0 1004952395 92 Waiver service provider--Disability (DHS/DRS) 44 Henderson 0 0 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 2812.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2812.38 0 0 1004952474 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12445.74 0 0 0 0 0 0 0 0 0 0 0 0 0 12445.74 0 0 1004952487 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 8448.45 0 0 0 0 0 0 0 0 0 0 0 0 0 8448.45 0 0 1004952550 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 3898.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3898.64 0 0 1004952552 1659508992 10 Physicians WU ALLEN G 999999999 30 DuPage 0 0 Pediatrics 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 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40225.52 0 0 0 0 0 0 40225.52 0 0 1004952569 1730341553 10 Physicians LIU YUK MING 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20274.92 0 0 0 0 0 0 20274.92 0 0 1004952609 1508122185 10 Physicians JAMERIA ZENITH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1453.67 0 0 0 0 0 0 1453.67 0 0 1004952772 1952663031 10 Physicians JENSEN CHRISTINE 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1179.78 0 0 0 0 0 0 1179.78 0 0 1004952819 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43886.67 0 0 0 0 0 0 0 0 0 0 0 0 0 43886.67 0 0 1004952824 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14526.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14526.21 0 0 1004952869 1710973458 89 Physician Assistant Only(Encounter Only) SHARUM JOHN A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1384.47 0 0 0 0 0 0 1384.47 0 0 1004952905 1073527511 89 Physician Assistant Only(Encounter Only) REARDON THOMAS E 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698.07 0 0 0 0 0 0 698.07 0 0 1004953248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 987.79 0 0 0 0 0 0 0 0 0 0 0 0 0 987.79 0 0 1004953286 1063865400 16 Nurse Practitioners CLARY POOJA R 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 459.88 0 0 0 0 0 0 459.88 0 0 1004953423 1033662044 16 Nurse Practitioners HOOK JENNIFER J 999999999 89 Rock Island 0 0 0 0 0 3 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 202.52 0 0 0 0 0 0 0 0 1905.15 0 0 0 0 0 0 2107.67 0 0 1004953499 1528146883 89 Physician Assistant Only(Encounter Only) BERKES JAMES 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1289.41 0 0 0 0 0 0 1289.41 0 0 1004953534 1407102338 10 Physicians ABDYRAKOV ALMAZ 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1270.29 0 0 0 0 0 0 1270.29 0 0 1004953608 10 Physicians 845 Texas 0 0 0 0 0 0 0 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 4.25 0 0 0 0 0 0 0 0 4.25 0 0 1004953633 1053645184 16 Nurse Practitioners GIESEMAN ROMINA P 999999999 30 DuPage 0 0 0 0 0 12 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 882.67 0 0 0 0 0 0 0 0 920.03 0 0 0 0 0 0 1802.7 0 0 1004953784 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3041.39 0 0 0 0 0 0 0 0 0 0 0 0 0 3041.39 0 0 1004953886 1790064905 10 Physicians LACZNIAK ANDREW N 999999999 815 Indiana 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.65 0 54.18 0 0 0 0 0 0 180.83 0 0 1004953987 1073991899 86 Clinical Social Worker(Encounter Only) MCCLANATHAN LINDSEY M 999999999 109 Winnebago 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1475.02 0 0 0 0 0 0 1475.02 0 0 1004954264 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 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 1953.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1953.6 0 0 1004954362 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1039.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1039.19 0 0 1004954404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10467.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10467.18 0 0 1004954411 1336509587 16 Nurse Practitioners LAWRENCE ASHLEY 999999999 50 Jersey 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2288.1 0 0 0 0 0 0 2288.1 0 0 1004954685 1457791741 10 Physicians PADILLA NICOLE M 999999999 200 Cook 0 0 Family Practice 0 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SALZMAN RYAN 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2612.18 0 0 0 0 0 0 2612.18 0 0 1004955249 1477906980 16 Nurse Practitioners WOOD WHITNY L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 685.46 0 0 0 0 0 0 685.46 0 0 1004955324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4907.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4907.34 0 0 1004955449 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.83 0 3.64 0 0 0 0 0 0 43.47 0 0 1004955513 1467640292 89 Physician Assistant Only(Encounter Only) GALE CAROLYN J 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 871.71 0 0 0 0 0 0 871.71 0 0 1004955622 1619231396 10 Physicians DORE CAITLIN M. 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4240.31 0 0 0 0 0 0 4240.31 0 0 1004955713 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 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 13180.86 0 0 0 0 0 0 0 0 0 0 0 0 0 13180.86 0 0 1004955828 1730421884 13 Podiatrists PARK HANNAH K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 650.42 0 0 0 0 0 0 650.42 0 0 1004955842 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004955957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4097.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4097.11 0 0 1004955992 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9568.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9568.69 0 0 1004956005 1528328036 60 Pharmacies CVS PHARMACY 17643 606032802 200 Cook 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3590.63 0 0 0 3590.63 0 0 1004956014 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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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 32297.29 0 0 0 0 0 0 0 0 0 0 0 0 0 32297.29 0 0 1004957285 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.12 0 0 0 0 0 0 106.12 0 0 1004957386 1063463925 89 Physician Assistant Only(Encounter Only) RICHTER AMY L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.29 0 0 0 0 0 0 181.29 0 0 1004957510 1730348558 89 Physician Assistant Only(Encounter Only) EDDINS JENELL L. 999999999 80 Peoria 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 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 0 903.51 0 0 0 0 0 0 903.51 0 0 1004957885 12 Optometrists 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205.19 0 0 0 0 0 0 205.19 0 0 1004957982 1205122496 10 Physicians KUNREDDY REENA 999999999 53 Kane 0 0 Internal Medicine 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285.6 0 0 0 0 0 0 1285.6 0 0 1004958145 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11151.63 0 0 0 0 0 0 0 0 0 0 0 0 0 11151.63 0 0 1004958233 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16476 0 0 0 0 0 0 0 0 0 0 0 0 0 16476 0 0 1004958434 1619420635 11 Dentists ODEH SAMAR 999999999 200 Cook 0 0 General Dentistry 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13879.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13879.6 0 0 1004958483 1588977722 10 Physicians GAETANO JOHN N. 999999999 200 Cook 0 0 Internal Medicine 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4495.52 0 0 0 0 0 0 4495.52 0 0 1004958650 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22498.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22498.4 0 0 1004958651 1295101541 16 Nurse Practitioners BIGOGNO ANDREA C. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 529.96 0 0 0 0 0 0 529.96 0 0 1004958706 10 Physicians 836 Ohio 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.22 0 0 0 0 0 0 67.22 0 0 1004958737 1861414674 60 Pharmacies CVS PHARMACY #16362 618221231 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2409.56 0 0 0 2409.56 0 0 1004958747 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17405.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17405.9 0 0 1004959046 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2872.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2872.47 0 0 1004959144 1194273961 16 Nurse Practitioners KETEMA RAHEL G 999999999 200 Cook 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 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 0 882 0 0 0 0 0 0 882 0 0 1004959252 1265729818 10 Physicians JEONG DAE HYOUN 999999999 65 Madison 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 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 0 190.86 0 0 0 0 0 0 190.86 0 0 1004959260 1265885651 16 Nurse Practitioners BAILEY LAURA 999999999 200 Cook 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760.39 0 0 0 0 0 0 760.39 0 0 1004959346 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.78 0 0 0 0 0 0 130.78 0 0 1004959356 1003128372 10 Physicians ELKATTAH RAYAN A. 999999999 80 Peoria 0 0 Obstetric-Gynecology 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 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 4464.98 0 0 0 0 0 0 4464.98 0 0 1004959672 1760755748 10 Physicians IQBAL SHARIQ M 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2660.04 0 0 0 0 0 0 2660.04 0 0 1004959756 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18850.62 0 0 0 0 0 0 0 0 0 0 0 0 0 18850.62 0 0 1004959784 1972864338 10 Physicians ADAMS CARMEN 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004959853 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7016.57 0 0 0 0 0 0 0 0 0 0 0 0 0 7016.57 0 0 1004960037 1528425659 89 Physician Assistant Only(Encounter Only) HELM MELINDA 999999999 34 Fayette 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 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 0 114.84 0 0 0 0 0 0 114.84 0 0 1004960285 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 133.94 0 0 0 0 0 0 133.94 0 0 1004960350 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 5279.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5279.19 0 0 1004960681 1710433529 89 Physician Assistant Only(Encounter Only) STEVENS LEAH D 999999999 200 Cook 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5271.41 0 0 0 0 0 0 5271.41 0 0 1004960719 1063676013 10 Physicians GUZZETTA PAUL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 385 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4327.05 0 5924.04 0 0 0 0 0 0 10251.09 0 0 1004960737 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 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 42296.73 0 0 0 0 0 0 0 0 0 0 0 0 0 42296.73 0 0 1004960812 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004960847 1043665300 16 Nurse Practitioners MIDHA KRISTINA 999999999 107 Will 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 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1136.3 0 0 0 0 0 0 1136.3 0 0 1004960992 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 127.31 0 0 0 0 0 0 127.31 0 0 1004961023 1386020477 16 Nurse Practitioners MAGINOT MARY 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362.47 0 0 0 0 0 0 362.47 0 0 1004961153 1205275534 10 Physicians DEVGUN JASON 999999999 107 Will 0 0 Emergency Medicine 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 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 1473.47 0 0 0 0 0 0 1473.47 0 0 1004961307 1710099841 89 Physician Assistant Only(Encounter Only) COX DANNY M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652.5 0 0 0 0 0 0 652.5 0 0 1004961330 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15783.46 0 0 0 0 0 0 0 0 0 0 0 0 0 15783.46 0 0 1004961383 1982157780 16 Nurse Practitioners WRIGHT JEREMY 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.17 0 0 0 0 0 0 123.17 0 0 1004961515 91 Waiver service provider--Adults (DHS/DDD) 824 Minnesota 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22371.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22371.63 0 0 1004961886 1720375611 10 Physicians WAHOOD AMMAR 999999999 200 Cook 0 0 Anesthesiology 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 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3771.08 0 0 0 0 0 0 3771.08 0 0 1004961945 1427504042 16 Nurse Practitioners BENNETT CATHERINE F 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 308.69 0 0 0 0 0 0 308.69 0 0 1004962032 1255656948 10 Physicians BODDIPALLI SUREKHA V 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6284.61 0 0 0 0 0 0 6284.61 0 0 1004962092 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 18081.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18081.25 0 0 1004962208 1578914024 10 Physicians HAGER LAUREN SHANA 999999999 200 Cook 0 0 Pediatrics 0 0 0 8 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 7 0 14 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 7 0 14 0 0 0 0 0 0 0 0 0 367.12 0 0 0 0 0 0 211.47 0 451.54 0 0 0 0 0 0 1030.13 0 0 1004962366 1831542760 16 Nurse Practitioners FEHL RACHEL E 999999999 75 Monroe 0 0 0 0 0 8 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 663.73 0 0 0 0 0 0 0 0 1203.42 0 0 0 0 0 0 1867.15 0 0 1004962421 1295051860 10 Physicians BARRY SHEILA M 999999999 200 Cook 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 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4074.48 0 0 0 0 0 0 4074.48 0 0 1004962609 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10660.1 0 0 0 0 0 0 0 0 0 0 0 0 0 10660.1 0 0 1004962874 10 Physicians 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.35 0 0 0 0 0 0 0 0 14.35 0 0 1004962929 1518337716 55 Early Intervention Services VANN DEBBIE 999999999 200 Cook 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 0 894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50837.59 0 0 0 0 0 0 50837.59 0 0 1004962945 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38965.28 0 0 0 0 0 0 0 0 0 0 0 0 0 38965.28 0 0 1004963185 1407878218 60 Pharmacies CVS PHARMACY #16349 602023636 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 16366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.51 0 0 16556.78 0 0 0 16644.29 0 0 1004963225 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29037.91 0 0 0 0 0 0 0 0 0 0 0 0 0 29037.91 0 0 1004963275 10 Physicians 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2482.08 0 0 0 0 0 0 2482.08 0 0 1004963336 1710148069 60 Pharmacies CVS PHARMACY #17442 605605602 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32248.41 0 0 0 32248.41 0 0 1004963411 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12164.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12164.2 0 0 1004963509 1710225263 10 Physicians MUNOZ TOMAS 999999999 200 Cook 0 0 Pediatrics 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 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 4176.97 0 0 0 0 0 0 4176.97 0 0 1004963599 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1009.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1009.54 0 0 1004963624 1043769268 16 Nurse Practitioners MOORE MICHELLE E 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 786.17 0 0 0 0 0 0 786.17 0 0 1004963654 1538431416 16 Nurse Practitioners KALITOWSKI RHONDA M 999999999 109 Winnebago 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 0 296 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 0 331.7 0 0 0 0 0 0 331.7 0 0 1004963671 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10142.44 0 0 0 0 0 0 0 0 0 0 0 0 0 10142.44 0 0 1004963715 1023478047 16 Nurse Practitioners MILLS JENNIFER L 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 97.42 0 0 0 0 0 0 0 0 944.94 0 0 0 0 0 0 1042.36 0 0 1004963735 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23442.65 0 0 0 0 0 0 0 0 0 0 0 0 0 23442.65 0 0 1004963753 91 Waiver service provider--Adults (DHS/DDD) 15 Bureau 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23877 0 0 0 0 0 0 0 0 0 0 0 0 0 23877 0 0 1004963810 1902172919 10 Physicians XIAO XIAO 999999999 200 Cook 0 0 Pediatrics 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 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 2125.95 0 0 0 0 0 0 2125.95 0 0 1004963912 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 3528.13 0 0 0 0 0 0 0 0 0 0 0 0 0 3528.13 0 0 1004964093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23964.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23964.92 0 0 1004964178 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1373.64 0 0 0 0 0 0 1373.64 0 0 1004964324 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 0 0 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 3200.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3200.36 0 0 1004964343 1972846871 10 Physicians OMAR HINA A. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4943.32 0 0 0 0 0 0 4943.32 0 0 1004964941 55 Early Intervention Services 53 Kane 0 0 0 0 0 0 0 0 0 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 0 936.72 0 0 0 0 0 0 936.72 0 0 1004965199 1558759407 89 Physician Assistant Only(Encounter Only) HESS KARRI L 999999999 106 Whiteside 0 0 0 0 0 11 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 949.43 0 0 0 0 0 0 0 0 1945.25 0 0 0 0 0 0 2894.68 0 0 1004965373 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2483.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2483.33 0 0 1004965449 1194042283 16 Nurse Practitioners KOWALLIS JOLYN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.08 0 0 0 0 0 0 676.08 0 0 1004965470 1588955983 89 Physician Assistant Only(Encounter Only) LOYD CHRISTEL J 999999999 80 Peoria 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2708.25 0 0 0 0 0 0 2708.25 0 0 1004965500 1073970323 16 Nurse Practitioners DUGAL JENNIFER 999999999 200 Cook 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 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 3810.91 0 0 0 0 0 0 3810.91 0 0 1004965522 4004965522 72 Taxicabs and Livery Companies SAFE HAVEN TRANSIT LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16535.61 0 0 0 0 0 0 16535.61 0 0 1004965535 1699221374 16 Nurse Practitioners CAVENDER KAITLAIN A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877.34 0 0 0 0 0 0 877.34 0 0 1004965792 1093774705 89 Physician Assistant Only(Encounter Only) BERRYMAN STUART H 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1121.43 0 0 0 0 0 0 1121.43 0 0 1004965882 1750796629 10 Physicians SONBOL KHALID M 999999999 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 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 28.26 0 0 0 0 0 0 28.26 0 0 1004965968 16 Nurse Practitioners 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004966339 1912994054 89 Physician Assistant Only(Encounter Only) HYDERI NAVEED 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1456.83 0 0 0 0 0 0 1456.83 0 0 1004966462 1467848366 16 Nurse Practitioners VUCKO ERICA 999999999 200 Cook 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 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 1682.21 0 0 0 0 0 0 1682.21 0 0 1004966599 1154609030 10 Physicians DUNN NEHA M 999999999 80 Peoria 0 0 Internal Medicine 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4036.41 0 0 0 0 0 0 4036.41 0 0 1004966617 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2525.64 2525.64 0 0 1004966649 10 Physicians 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1004966678 1497869440 89 Physician Assistant Only(Encounter Only) GALLO ROBIN L 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 0 879.82 0 0 0 0 0 0 879.82 0 0 1004966680 1962424671 60 Pharmacies CVS PHARMACY #17008 607061328 200 Cook 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 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28567.59 0 0 0 28567.59 0 0 1004966857 1891032637 89 Physician Assistant Only(Encounter Only) HOOVEY ENGLE KRISTIN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 868.6 0 0 0 0 0 0 868.6 0 0 1004967197 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 23703.68 0 0 0 0 0 0 0 0 0 0 0 0 0 23703.68 0 0 1004967199 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40905.92 0 0 0 0 0 0 0 0 0 0 0 0 0 40905.92 0 0 1004967212 1376680462 89 Physician Assistant Only(Encounter Only) MARTIN GABRIEL A 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2509.76 0 0 0 0 0 0 2509.76 0 0 1004967333 1518930601 10 Physicians MORONEY JOHN W 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1902.71 0 0 0 0 0 0 1902.71 0 0 1004967335 75 Department of Alcohol and Substance Abuse Provider 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3928.58 0 0 3928.58 0 0 1004967390 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23880.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23880.83 0 0 1004967542 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18425.17 0 0 0 0 0 0 0 0 0 0 0 0 0 18425.17 0 0 1004968016 1487985883 10 Physicians SHARMA PARIKSHIT S. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.39 0 6788.12 0 0 0 0 0 0 6793.51 0 0 1004968208 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 2822.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2822.56 0 0 1004968318 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8183.45 0 0 0 0 0 0 0 0 0 0 0 0 0 8183.45 0 0 1004968341 1457704025 16 Nurse Practitioners STARK KATHY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.6 0 0 0 0 0 0 34.6 0 0 1004968353 1528225216 13 Podiatrists ZATS SVETLANA 999999999 200 Cook 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2119.93 0 0 0 0 0 0 2119.93 0 0 1004968603 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 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 0 529.13 0 0 0 0 0 0 529.13 0 0 1004968861 1528080231 60 Pharmacies CVS PHARMACY # 16568 604394755 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.17 0 0 0 279.17 0 0 1004968886 1396871687 89 Physician Assistant Only(Encounter Only) WHITE RENITA B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.66 0 0 0 0 0 0 186.66 0 0 1004968933 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24654.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24654.81 0 0 1004969047 1629466339 30 General Hospitals CHICAGO RIDGE DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4862.65 0 0 0 0 0 4862.65 0 0 1004969079 1427317668 10 Physicians VALASSIS MEGAN ELIZABETH GUETZ 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 5 0 12 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 0 0 0 100.25 0 0 0 0 0 0 351.73 0 1717.49 0 0 0 0 0 0 2169.47 0 0 1004969151 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14794.78 0 0 0 0 0 0 0 0 0 0 0 0 0 14794.78 0 0 1004969187 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23011.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23011.78 0 0 1004969276 1922394402 10 Physicians DURKEE BENJAMIN Y 999999999 109 Winnebago 0 0 Radiation Oncology 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2524.14 0 0 0 0 0 0 2524.14 0 0 1004969538 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45715.07 0 0 0 0 0 0 0 0 0 0 0 0 0 45715.07 0 0 1004969743 1144345364 13 Podiatrists ALLEN CHARLES T 999999999 200 Cook 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 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665.97 0 0 0 0 0 0 665.97 0 0 1004969771 1437583077 10 Physicians GHADIAM HARSHAVARDHAN R 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3706.69 0 0 0 0 0 0 3706.69 0 0 1004969928 1972730893 10 Physicians SHAH MIHIR B 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 165 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1734.16 0 2996.03 0 0 0 0 0 0 4730.19 0 0 1004969999 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 4 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 3542.4 0 0 0 0 0 0 0 0 0 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2334.94 0 0 1004972126 1902242076 10 Physicians OLIVERA EMMA B 999999999 200 Cook 0 1 Pediatrics 0 0 0 97 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 8677.93 0 0 0 0 0 0 0 0 5687.29 0 0 0 0 0 0 14365.22 0 0 1004972331 91 Waiver service provider--Adults (DHS/DDD) 52 Johnson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8647.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8647.38 0 0 1004972515 1417316969 16 Nurse Practitioners COOLEY SARAH R. 999999999 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 703.36 0 0 0 0 0 0 703.36 0 0 1004972618 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8104.95 0 0 0 0 0 0 0 0 0 0 0 0 0 8104.95 0 0 1004972756 1306141338 89 Physician Assistant Only(Encounter Only) GROVER ANDREW R 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547.88 0 0 0 0 0 0 547.88 0 0 1004972882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 45067.58 0 0 0 0 0 0 0 0 0 0 0 0 0 45067.58 0 0 1004973158 1952344517 16 Nurse Practitioners ROMANSKI KATHLEEN 999999999 200 Cook 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 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 0 710.62 0 0 0 0 0 0 710.62 0 0 1004973413 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 25554.37 0 0 0 0 0 0 0 0 0 0 0 0 0 25554.37 0 0 1004973546 1508237744 16 Nurse Practitioners RAITHEL DEENA R 999999999 80 Peoria 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947.88 0 0 0 0 0 0 947.88 0 0 1004973916 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16746.04 0 0 0 0 0 0 0 0 0 0 0 0 0 16746.04 0 0 1004973952 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22917.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22917.47 0 0 1004974061 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 344.65 344.65 0 0 1004974193 1104123546 10 Physicians BANZON ELEANOR 999999999 200 Cook 0 0 Internal Medicine 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528.85 0 0 0 0 0 0 528.85 0 0 1004974300 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6775.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6775.09 0 0 1004974718 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44071.18 0 0 0 0 0 0 0 0 0 0 0 0 0 44071.18 0 0 1004975066 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.41 0 0 0 0 0 0 0 0 0 0 0 0 0 107.41 0 0 1004975244 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.29 0 0 0 0 0 0 134.29 0 0 1004975256 1275967721 10 Physicians SHAIKH NADIA 999999999 80 Peoria 0 0 Pediatrics 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9820.91 0 0 0 0 0 0 9820.91 0 0 1004975480 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22450.12 0 0 0 0 0 0 0 0 0 0 0 0 0 22450.12 0 0 1004975770 1164813515 16 Nurse Practitioners ZURSKI CONNIE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1149.51 0 0 0 0 0 0 1149.51 0 0 1004975882 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 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 8272.35 0 0 0 0 0 0 0 0 0 0 0 0 0 8272.35 0 0 1004975972 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13516.59 0 0 0 0 0 0 0 0 0 0 0 0 0 13516.59 0 0 1004976090 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 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 0 528.83 0 0 0 0 0 0 0 0 0 0 0 0 0 528.83 0 0 1004976316 1265891865 16 Nurse Practitioners TONI PHILOMINA 999999999 30 DuPage 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 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3532.4 0 0 0 0 0 0 3532.4 0 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0 0 0 0 124.16 0 0 1004976872 10 Physicians 89 Rock Island 0 0 Dermatology 0 0 0 0 0 0 0 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 7.61 0 0 0 0 0 0 7.61 0 0 1004976898 1831648484 24 Speech Therapists KING SHELLY 999999999 30 DuPage 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 0 107 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 6707.42 6707.42 0 0 1004977096 94 Waiver service provider--Children's support (DHS/DDD) 49 Jefferson 0 0 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 2077.34 0 0 0 0 0 0 0 0 0 0 0 0 0 2077.34 0 0 1004977263 22 Physical Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.61 66.61 0 0 1004977315 10 Physicians 89 Rock 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0 0 5 0 61 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 7 0 109 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 7 0 109 0 0 0 0 0 0 0 0 0 1663.4 0 0 0 0 0 0 67.04 0 3155.8 0 0 0 0 0 0 4886.24 0 0 1004981534 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22735.82 0 0 0 0 0 0 0 0 0 0 0 0 0 22735.82 0 0 1004981769 1467743302 10 Physicians PANDE ANUPAM S 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.16 0 0 0 0 0 0 90.16 0 0 1004981776 1760554869 11 Dentists THAKKAR JIGNA 999999999 53 Kane 0 0 General Dentistry 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.2 0 0 1004981940 1497891683 10 Physicians PATEL RUJUTA 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2509.56 0 0 0 0 0 0 2509.56 0 0 1004982133 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8166.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8166.49 0 0 1004982147 1154876050 75 Department of Alcohol and Substance Abuse Provider WEST SUBURBS SUPR 999999999 200 Cook 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 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9174.9 0 0 9174.9 0 0 1004982400 1730323197 10 Physicians GUERRIERO REJEAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825.21 0 0 0 0 0 0 825.21 0 0 1004982739 1669634770 10 Physicians FADIA SHRUTI 999999999 63 Macon 0 0 0 0 0 2 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 12.3 0 0 0 0 0 0 6.3 0 1803.07 0 0 0 0 0 0 1821.67 0 0 1004982770 1639523921 16 Nurse Practitioners PLUE JENNIFER P 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 170.21 0 0 0 0 0 0 0 0 2218.15 0 0 0 0 0 0 2388.36 0 0 1004982789 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23941.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23941.2 0 0 1004982893 1821166059 89 Physician Assistant Only(Encounter Only) OEHLER JASON 999999999 200 Cook 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437.38 0 0 0 0 0 0 437.38 0 0 1004983063 1396023412 10 Physicians ELS DENA 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8293.58 0 0 0 0 0 0 8293.58 0 0 1004983064 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23589.73 0 0 0 0 0 0 0 0 0 0 0 0 0 23589.73 0 0 1004983208 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6504.8 0 0 0 0 0 0 0 0 0 0 0 0 0 6504.8 0 0 1004983213 1568705333 10 Physicians MCDANIEL LEVI T 999999999 101 Wabash 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 13 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.91 0 519.83 0 0 0 0 0 0 542.74 0 0 1004983297 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22295.46 0 0 0 0 0 0 0 0 0 0 0 0 0 22295.46 0 0 1004983324 10 Physicians 57 Lake 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.2 0 0 0 0 0 0 0 0 45.2 0 0 1004983863 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004983913 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48641.88 0 0 0 0 0 0 0 0 0 0 0 0 0 48641.88 0 0 1004984167 1962861187 16 Nurse Practitioners RICHARDS MORGAN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847.43 0 0 0 0 0 0 847.43 0 0 1004984452 1790074425 10 Physicians JACOBSON RYAN 999999999 200 Cook 0 0 Neurology 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1479.32 0 0 0 0 0 0 1479.32 0 0 1004984563 1740572247 10 Physicians STACKNIK CATHERINE 999999999 200 Cook 0 0 Neurology 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 0 121 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 1095.7 0 0 0 0 0 0 1095.7 0 0 1004984629 10 Physicians 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1004984659 1952368557 10 Physicians SULLIVAN JOHN P 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 155 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1466.22 0 2.67 0 0 0 0 0 0 1468.89 0 0 1004985285 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 1370.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.84 0 0 1004985475 1225581192 12 Optometrists KHALIL DEANNA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10909.85 0 0 0 0 0 0 10909.85 0 0 1004985589 10 Physicians 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.64 0 0 0 0 0 0 109.64 0 0 1004985604 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21700 0 0 0 0 0 0 0 0 0 0 0 0 0 21700 0 0 1004985657 1659671675 10 Physicians GOMBERAWALLA AMEER 999999999 200 Cook 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1367.83 0 0 0 0 0 0 1367.83 0 0 1004985668 1366893315 16 Nurse Practitioners MUENCH KATIE F 999999999 200 Cook 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1794.15 0 0 0 0 0 0 1794.15 0 0 1004985803 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23665.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23665.04 0 0 1004986087 4004986087 71 Medicar Provider GREATER CHICAGO TRANSIT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76670.96 0 0 0 0 0 0 76670.96 0 0 1004986148 1386820439 10 Physicians JONES GEORGE ALEXANDER 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1681.93 0 0 0 0 0 0 1681.93 0 0 1004986217 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14476.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14476.02 0 0 1004986220 1144203753 10 Physicians KABBANI HAIDAR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5879.6 0 0 0 0 0 0 5879.6 0 0 1004986310 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12689.06 0 0 0 0 0 0 0 0 0 0 0 0 0 12689.06 0 0 1004986313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19074.76 0 0 0 0 0 0 0 0 0 0 0 0 0 19074.76 0 0 1004986551 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 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 7918.56 0 0 0 0 0 0 0 0 0 0 0 0 0 7918.56 0 0 1004986717 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14448.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14448.5 0 0 1004986732 1902139173 10 Physicians CARLSON DUSTIN A. 999999999 200 Cook 0 0 Internal Medicine 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2310.83 0 0 0 0 0 0 2310.83 0 0 1004986810 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10233.22 0 0 0 0 0 0 0 0 0 0 0 0 0 10233.22 0 0 1004987071 1003360272 11 Dentists LIN SHAWN 999999999 816 Iowa 0 0 General Dentistry 0 0 296 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 2083 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 2083 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 103631.64 0 0 0 0 0 0 0 0 0 0 0 11290.5 0 0 0 0 114922.14 0 0 1004987127 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7768.46 0 0 0 0 0 0 0 0 0 0 0 0 0 7768.46 0 0 1004987140 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13908.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13908.98 0 0 1004987209 25 Audiologists 200 Cook 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 51.19 51.19 0 0 1004987325 1659639599 89 Physician Assistant Only(Encounter Only) KIRKENMEIER KOLETTE A 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 2172.66 0 0 0 0 0 0 2269.11 0 0 1004987431 10 Physicians 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1174.43 0 0 0 0 0 0 1174.43 0 0 1004994716 1003361114 60 Pharmacies GENESIS FIRSTMED PHARMACY 999999999 74 Mercer 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 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24122.39 0 0 0 24122.39 0 0 1004995014 1528377108 89 Physician Assistant Only(Encounter Only) KAPUT CARLY M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 208.89 0 0 0 0 0 0 208.89 0 0 1004995164 1073760716 16 Nurse Practitioners CARMACK LESLIE M 999999999 80 Peoria 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.7 0 0 0 0 0 0 256.7 0 0 1004995209 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 288 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 12 0 288 0 0 0 0 0 0 0 0 0 559.22 0 0 0 0 0 0 21.81 0 5151.81 0 0 0 0 0 0 5732.84 0 0 1004997856 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 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 0 711.68 0 0 0 0 0 0 0 0 0 0 0 0 0 711.68 0 0 1004998258 1710208798 10 Physicians HENRY JULIA M 999999999 200 Cook 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6182.49 0 0 0 0 0 0 6182.49 0 0 1004998316 4004998316 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 1986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28446940.67 0 0 0 0 0 0 0 0 0 0 0 0 0 28446940.67 0 0 1004998370 1619321015 16 Nurse Practitioners FORD MOLLY E 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.3 0 0 0 0 0 0 267.3 0 0 1004998630 1740628635 10 Physicians POPOVETSKY MITCHELL N. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618.18 0 0 0 0 0 0 618.18 0 0 1004998873 23 Occupational Therapists 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 59.73 59.73 0 0 1004998915 10 Physicians 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1004999002 1285945667 10 Physicians TABAKA COURTNEY A 999999999 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 2 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20025.3 0 0 0 0 0 0 20025.3 0 0 1004999152 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22699.81 0 0 0 0 0 0 0 0 0 0 0 0 0 22699.81 0 0 1004999386 1013389261 16 Nurse Practitioners GLENN CHRISTOPHER 999999999 200 Cook 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 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 1157.19 0 0 0 0 0 0 1157.19 0 0 1004999492 1629439815 16 Nurse Practitioners CALEY JULIE 999999999 200 Cook 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 0 233 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 0 551.33 0 0 0 0 0 0 551.33 0 0 1004999511 1174818272 13 Podiatrists THORUD JAKOB C 999999999 57 Lake 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20913.35 0 0 0 0 0 0 0 0 0 0 0 0 0 20913.35 0 0 1005006131 1265871834 10 Physicians SANDERS ERICKA 999999999 200 Cook 0 0 0 0 0 16 0 0 0 0 0 0 4 0 77 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 5 0 124 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 5 0 124 0 0 0 0 0 0 0 0 0 1280.73 0 0 0 0 0 0 12 0 4258.32 0 0 0 0 0 0 5551.05 0 0 1005006170 1528157492 10 Physicians DAVIS MATTHEW M 999999999 200 Cook 0 0 Pediatrics 0 0 0 11 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 1187.69 0 0 0 0 0 0 0 0 543.52 0 0 0 0 0 0 1731.21 0 0 1005006710 1558383349 60 Pharmacies CVS PHARMACY #16284 605403914 30 DuPage 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4095 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21925.12 0 0 0 21925.12 0 0 1005006715 1417305970 60 Pharmacies HEALTHDIRECT INSTITUTIONAL PHA 629595818 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 773 0 0 0 0 0 0 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0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6844.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6844.5 0 0 1005007033 1649606179 10 Physicians JUNIA CHRISTINE 999999999 53 Kane 0 0 Internal Medicine 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1805.85 0 0 0 0 0 0 1805.85 0 0 1005007291 1962790022 10 Physicians AOUHAB ZINEB 999999999 200 Cook 0 0 Internal Medicine 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844.15 0 0 0 0 0 0 844.15 0 0 1005007812 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1470.07 0 0 0 0 0 0 0 0 0 0 0 0 0 1470.07 0 0 1005007824 1043232853 60 Pharmacies CVS PHARMACY #17575 601152051 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11443.61 0 0 0 11443.61 0 0 1005008047 1518918879 10 Physicians CHOW MAY 999999999 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.36 0 0 0 0 0 0 464.36 0 0 1005008099 1528354842 10 Physicians CAVALLO ALLISON 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 477 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2890 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2890 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11391.53 0 286.89 0 0 0 0 0 0 11678.42 0 0 1005008189 1083640361 10 Physicians ITANI OUSSAMA 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 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 9290.59 0 0 0 0 0 0 9290.59 0 0 1005008266 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Assistant Only(Encounter Only) BALLINGER KEITH 999999999 24 Coles 0 0 0 0 0 4 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 322.51 0 0 0 0 0 0 0 0 2409.65 0 0 0 0 0 0 2732.16 0 0 1005009289 1558714154 16 Nurse Practitioners JOOS ELISE M 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 617.05 0 0 0 0 0 0 0 0 1489.45 0 0 0 0 0 0 2106.5 0 0 1005009303 1932505302 16 Nurse Practitioners COYLE SALLY N 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.06 0 0 0 0 0 0 182.06 0 0 1005009473 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.22 0 0 0 0 0 0 188.22 0 0 1005009496 1336508795 10 Physicians KHAN RUHEENA 999999999 200 Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 3 0 56 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 3 0 56 0 0 0 0 0 0 0 0 0 281.51 0 0 0 0 0 0 7.77 0 1430.58 0 0 0 0 0 0 1719.86 0 0 1005009592 1144683020 36 Community mental health provider AID DIAMOND II 999999999 55 Kendall 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609 0 0 12990.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43975.38 0 0 56965.4 0 0 1005009672 1750471595 89 Physician Assistant Only(Encounter Only) CRANICK TARAH 999999999 47 Jackson 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3175.78 0 0 0 0 0 0 3175.78 0 0 1005009737 1407390644 91 Waiver service provider--Adults (DHS/DDD) MACAK NICHOLAS A 999999999 107 Will 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 0 903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58966.2 0 0 0 0 0 0 0 0 0 0 0 0 0 58966.2 0 0 1005009998 1801153945 16 Nurse Practitioners PIPER JANE E 999999999 77 Morgan 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 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 0 761.27 0 0 0 0 0 0 761.27 0 0 1005010131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7310.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7310.25 0 0 1005010392 1700154911 75 Department of Alcohol and Substance Abuse Provider CHESTNUT HEALTH SYSTEMS 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342 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 18670.41 0 0 18670.41 0 0 1005010446 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2607.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2607.81 0 0 1005010593 1285738500 89 Physician Assistant Only(Encounter Only) MORRISON SHERRI 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1290.46 0 0 0 0 0 0 1290.46 0 0 1005010715 1922389089 89 Physician Assistant Only(Encounter Only) MARSHALL ANNE K 999999999 82 Piatt 0 0 0 0 0 3 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 231.55 0 0 0 0 0 0 0 0 3527.22 0 0 0 0 0 0 3758.77 0 0 1005010896 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 192.4 0 0 0 0 0 0 192.4 0 0 1005010898 4005010898 90 Waiver service provider--Elderly (DOA) ACTIVE DAY OF MOLINE 999999999 89 Rock Island 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 1738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102342.31 0 0 0 0 0 0 0 0 0 0 0 0 0 102342.31 0 0 1005010936 1891019196 89 Physician Assistant Only(Encounter Only) DUPITON SABINE D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242.79 0 0 0 0 0 0 242.79 0 0 1005010959 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 153.47 0 0 0 0 0 0 153.47 0 0 1005011085 1376723700 16 Nurse Practitioners MORGAN ROBERT B 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.24 0 0 0 0 0 0 43.24 0 0 1005011125 1356310825 16 Nurse Practitioners KING ALEXIS D 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.38 0 0 0 0 0 0 53.38 0 0 1005011168 91 Waiver service provider--Adults (DHS/DDD) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4871.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4871.52 0 0 1005011261 1336556083 12 Optometrists MEHTA MAANCY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1062 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1062 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9325.02 0 3894.6 0 0 0 0 13219.62 0 0 1005011730 1003274721 91 Waiver service provider--Adults (DHS/DDD) FINIGAN SUSAN J 999999999 200 Cook 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1476 0 0 0 0 0 0 0 0 0 0 0 0 0 1476 0 0 1005012006 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 20872.05 0 0 0 0 0 0 0 0 0 0 0 0 0 20872.05 0 0 1005012347 1215959028 60 Pharmacies CVS PHARMACY #16412 601485529 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4716.89 0 0 0 4716.89 0 0 1005012423 1710266655 10 Physicians RAI SWARNA P 999999999 91 Sangamon 0 0 Internal Medicine 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 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4640.89 0 0 0 0 0 0 4640.89 0 0 1005012476 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15702.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15702.81 0 0 1005012569 1831441641 89 Physician Assistant Only(Encounter Only) THAKKAR HARDIK 999999999 30 DuPage 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723.97 0 0 0 0 0 0 723.97 0 0 1005012768 1891758678 50 Home Health Agencies - In Home HSHS HOME CARE SOUTHERN ILLINO 624012166 33 Effingham 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 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60455.56 0 0 0 0 0 0 60455.56 0 0 1005013128 1396190666 16 Nurse Practitioners SCHIOPU MICHELLE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 735.68 0 0 0 0 0 0 735.68 0 0 1005013131 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27714.36 0 0 0 0 0 0 0 0 0 0 0 0 0 27714.36 0 0 1005013268 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27892.06 0 0 0 0 0 0 0 0 0 0 0 0 0 27892.06 0 0 1005013300 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.63 0 0 0 0 0 0 78.63 0 0 1005013370 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 3424.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3424.25 0 0 1005013937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 2026.33 0 0 0 0 0 0 2026.33 0 0 1005014815 1295143915 11 Dentists PATEL AVANI 999999999 30 DuPage 0 0 General Dentistry 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6102.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6102.79 0 0 1005014836 1669818415 16 Nurse Practitioners DARIN-MESSMER ASHLEY E 999999999 80 Peoria 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 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 84.23 0 0 0 0 0 0 84.23 0 0 1005014874 1033666789 16 Nurse Practitioners WOJCIAK THERESA 999999999 50 Jersey 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 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 0 550.53 0 0 0 0 0 0 550.53 0 0 1005014918 1700228947 10 Physicians KHAPER BHUPINDER P 999999999 54 Kankakee 0 1 Family Practice 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2690.69 0 0 0 0 0 0 2690.69 0 0 1005014938 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 860.48 0 0 0 0 0 0 0 0 0 0 0 0 0 860.48 0 0 1005014975 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23455.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23455.41 0 0 1005015058 1497097893 10 Physicians MORKER SUJATA A 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 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 4205.42 0 0 0 0 0 0 4205.42 0 0 1005015112 1295280303 16 Nurse Practitioners GENDRON HEIDI L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232.49 0 0 0 0 0 0 232.49 0 0 1005015115 1356897946 91 Waiver service provider--Adults (DHS/DDD) TAYLOR KARI 999999999 30 DuPage 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 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101223.46 0 0 0 0 0 0 0 0 0 0 0 0 0 101223.46 0 0 1005015121 1336539980 16 Nurse Practitioners MOSER ALLISON K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 383.53 0 0 0 0 0 0 383.53 0 0 1005015217 1659718278 10 Physicians LIANG ROLAND 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5139.24 0 0 0 0 0 0 5139.24 0 0 1005015454 1275076028 28 Waiver service provider--Supportive living facility (HFS) PONTIAC SUPPORTIVE LIVING 999999999 61 Livingston 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164213.26 0 0 0 0 0 0 0 0 0 0 0 0 0 164213.26 0 0 1005015631 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1005015637 91 Waiver service provider--Adults (DHS/DDD) 826 Missouri 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22951.01 0 0 0 0 0 0 0 0 0 0 0 0 0 22951.01 0 0 1005015873 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6497.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6497.63 0 0 1005015890 1770528374 89 Physician Assistant Only(Encounter Only) BRILES ANDREA 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1532.7 0 0 0 0 0 0 1532.7 0 0 1005016117 1144678905 16 Nurse Practitioners BRANCH LARINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456.56 0 0 0 0 0 0 456.56 0 0 1005016915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18044.09 0 0 0 0 0 0 0 0 0 0 0 0 0 18044.09 0 0 1005016990 1912333675 89 Physician Assistant Only(Encounter Only) MOHAN SHENA 999999999 200 Cook 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 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 0 932.18 0 0 0 0 0 0 932.18 0 0 1005017018 1154600104 10 Physicians LANEY ERNEST J 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 174 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15250.93 0 140.99 0 0 0 0 0 0 15391.92 0 0 1005017396 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27537.24 0 0 0 0 0 0 0 0 0 0 0 0 0 27537.24 0 0 1005017466 1609223304 16 Nurse Practitioners LAMBERT DEANNA MICHAELEEN 999999999 63 Macon 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973.81 0 0 0 0 0 0 973.81 0 0 1005017601 1053308825 10 Physicians JOHNSON ROBERT C 999999999 10 Adams 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 740.33 0 0 0 0 0 0 740.33 0 0 1005017637 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 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 2864.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2864.89 0 0 1005018291 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15450.17 0 0 0 0 0 0 0 0 0 0 0 0 0 15450.17 0 0 1005018457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11943.18 0 0 0 0 0 0 0 0 0 0 0 0 0 11943.18 0 0 1005018546 94 Waiver service provider--Children's support (DHS/DDD) 30 DuPage 0 0 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 3837.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3837.1 0 0 1005018735 1790118586 16 Nurse Practitioners KOVALASKE ANASTASIA 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3030.06 0 0 0 0 0 0 3030.06 0 0 1005018756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16332.63 0 0 0 0 0 0 0 0 0 0 0 0 0 16332.63 0 0 1005018919 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25988.64 0 0 0 0 0 0 0 0 0 0 0 0 0 25988.64 0 0 1005018964 1679914675 10 Physicians HAMMEL MITCHELL 999999999 82 Piatt 0 0 0 0 0 5 0 0 0 0 0 0 11 0 49 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 43 0 104 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 43 0 104 0 0 0 0 0 0 0 0 0 426.91 0 0 0 0 0 0 178.97 0 2633.32 0 0 0 0 0 0 3239.2 0 0 1005019014 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7247.67 0 0 0 0 0 0 0 0 0 0 0 0 0 7247.67 0 0 1005019299 91 Waiver service provider--Adults (DHS/DDD) 823 Michigan 0 0 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 2178.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2178.63 0 0 1005019467 1508256561 33 Nursing Facilities TRANSITIONAL CARE OF ARLINGTON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10382.43 0 0 0 0 0 0 0 10382.43 0 0 1005019537 1851684203 10 Physicians MANCHIKANTI KAVITA N 999999999 108 Williamson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4633.38 0 0 0 0 0 0 4633.38 0 0 1005019576 1447606223 16 Nurse Practitioners VERMA AMANDEEP S 999999999 30 DuPage 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 825.85 0 0 0 0 0 0 825.85 0 0 1005019579 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 8776.36 0 0 0 0 0 0 0 0 0 0 0 0 0 8776.36 0 0 1005019753 1104378322 11 Dentists LEE KAYOUN 999999999 19 Champaign 0 0 General Dentistry 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7116.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7116.72 0 0 1005019836 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3176.89 0 0 0 0 0 0 0 0 0 0 0 0 0 3176.89 0 0 1005020333 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.46 0 0 0 0 0 0 11.46 0 0 1005020445 1508009416 10 Physicians ZEGREAN ANCA I 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7623.75 0 0 0 0 0 0 7623.75 0 0 1005020951 1285013029 16 Nurse Practitioners THARP ANDREW P 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.82 0 0 0 0 0 0 878.82 0 0 1005021013 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23414.71 0 0 0 0 0 0 0 0 0 0 0 0 0 23414.71 0 0 1005021077 36 Community mental health provider 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 2570.45 0 0 2570.45 0 0 1005021213 10 Physicians 25 Crawford 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 158.29 0 0 0 0 0 0 0 0 158.29 0 0 1005021356 1790118370 89 Physician Assistant Only(Encounter Only) FORSBERG AMY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217.33 0 0 0 0 0 0 1217.33 0 0 1005021721 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75732.97 0 0 0 0 0 0 0 0 0 0 0 0 0 75732.97 0 0 1005022001 1548644545 16 Nurse Practitioners VANDERMAST KATELYN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 72.62 0 0 0 0 0 0 72.62 0 0 1005022039 30 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005022387 1619130754 10 Physicians HAMAD YASIR A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1005022392 1730316761 10 Physicians KELLY JEANNIE C 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 11 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.63 0 3408.37 0 0 0 0 0 0 3744 0 0 1005022648 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2692.51 0 0 0 0 0 0 0 0 0 0 0 0 0 2692.51 0 0 1005022982 1366717464 11 Dentists CHOLAKIAN SUSAN M 999999999 200 Cook 0 0 General Dentistry 0 0 4 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 134.45 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 1263.5 0 0 1005022984 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733.08 0 0 0 0 0 0 733.08 0 0 1005023300 1225411325 89 Physician Assistant Only(Encounter Only) SMITH SAMANTHA A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.68 0 0 0 0 0 0 194.68 0 0 1005023414 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26155.36 0 0 0 0 0 0 0 0 0 0 0 0 0 26155.36 0 0 1005023677 1730585514 89 Physician Assistant Only(Encounter Only) PHALEN CARA L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940.43 0 0 0 0 0 0 940.43 0 0 1005023786 1568746907 89 Physician Assistant Only(Encounter Only) DENNY JEFFREY L 999999999 80 Peoria 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 0 163 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 3255.09 0 0 0 0 0 0 3255.09 0 0 1005023921 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1648.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1648.81 0 0 1005023998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32411.01 0 0 0 0 0 0 0 0 0 0 0 0 0 32411.01 0 0 1005024762 1689011439 10 Physicians SHU LAURA G 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 1301.23 0 0 0 0 0 0 1306.4 0 0 1005024953 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16798.23 0 0 0 0 0 0 0 0 0 0 0 0 0 16798.23 0 0 1005024956 1225406119 89 Physician Assistant Only(Encounter Only) TOLOMEO VALERIE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 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 0 487.11 0 0 0 0 0 0 487.11 0 0 1005025137 4005025137 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2906807.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2906807.92 0 0 1005025343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9995.57 0 0 0 0 0 0 0 0 0 0 0 0 0 9995.57 0 0 1005025530 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12742.33 0 0 0 0 0 0 0 0 0 0 0 0 0 12742.33 0 0 1005025691 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18054.52 0 0 0 0 0 0 0 0 0 0 0 0 0 18054.52 0 0 1005025859 1326337692 10 Physicians HAYES SEAN D 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2776.53 0 0 0 0 0 0 2776.53 0 0 1005025894 1972828291 10 Physicians ELIAS YOUSSEF 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 29 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.76 0 4046.17 0 0 0 0 0 0 4172.93 0 0 1005026060 24 Speech Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 87.69 87.69 0 0 1005026386 92 Waiver service 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0 0 0 963.72 0 0 0 0 0 0 0 0 0 0 0 0 0 963.72 0 0 1005030496 1952704116 16 Nurse Practitioners QUERUBIN JANETTE 999999999 107 Will 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2461.38 0 0 0 0 0 0 2461.38 0 0 1005030596 1851736268 10 Physicians VONFROLIO STEVEN K 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 863.76 0 0 0 0 0 0 863.76 0 0 1005030681 1326590258 16 Nurse Practitioners CASPER AMANNDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339.78 0 0 0 0 0 0 339.78 0 0 1005030767 1669494456 60 Pharmacies CVS PHARMACY #16277 600611555 841 Rhode Island 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27127.76 0 0 0 27127.76 0 0 1005030978 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 4169.94 0 0 0 0 0 0 0 0 0 0 0 0 0 4169.94 0 0 1005031040 1184070401 12 Optometrists RANDHAWA HARNEET K 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1046.97 0 0 0 0 0 0 1046.97 0 0 1005031143 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11493.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11493.4 0 0 1005031372 1144533068 10 Physicians GADDIKERI SANTHOSH 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 564 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16766.41 0 93.35 0 0 0 0 0 0 16859.76 0 0 1005031403 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 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 25020.1 0 0 0 0 0 0 0 0 0 0 0 0 0 25020.1 0 0 1005031435 91 Waiver service provider--Adults (DHS/DDD) 13 Boone 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21752.54 0 0 0 0 0 0 0 0 0 0 0 0 0 21752.54 0 0 1005031664 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22956.95 0 0 0 0 0 0 0 0 0 0 0 0 0 22956.95 0 0 1005031785 1730382268 86 Clinical Social Worker(Encounter Only) SHANAHAN AMY J 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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91 Sangamon 0 0 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 1340.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1340.01 0 0 1005032295 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.73 0 0 0 0 0 0 43.73 0 0 1005032726 1912295379 10 Physicians COTE VALERIE 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6053.9 0 0 0 0 0 0 6053.9 0 0 1005032779 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.03 0 0 0 0 0 0 111.03 0 0 1005032977 1891998019 10 Physicians TOMSON TODD 999999999 53 Kane 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 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0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25177.55 0 0 0 0 0 0 0 0 0 0 0 0 0 25177.55 0 0 1005033659 1073961314 16 Nurse Practitioners KLUCH ANNIE 999999999 53 Kane 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 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 0 614.5 0 0 0 0 0 0 614.5 0 0 1005033700 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005033849 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1451.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1451.41 0 0 1005034015 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.73 0 0 0 0 0 0 39.73 0 0 1005034074 1679933196 16 Nurse Practitioners TOTH MICHAEL A 999999999 200 Cook 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 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 1157.72 0 0 0 0 0 0 1157.72 0 0 1005034205 1912355991 24 Speech Therapists SMITH NICOLE 999999999 19 Champaign 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2376.46 2376.46 0 0 1005034803 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154.42 0 0 0 0 0 0 154.42 0 0 1005035189 1124468657 13 Podiatrists ALIANELLO NICHOLAS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1848.02 0 0 0 0 0 0 1848.02 0 0 1005035216 1811211576 10 Physicians VON ZYCHLIN KARA E 999999999 200 Cook 0 0 Pediatrics 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12041.37 0 0 0 0 0 0 12041.37 0 0 1005035232 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 4833.04 0 0 0 0 0 0 0 0 0 0 0 0 0 4833.04 0 0 1005035249 1437210499 10 Physicians MARTIN ARIBBE 999999999 200 Cook 0 0 Family Practice 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 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 0 477.19 0 0 0 0 0 0 477.19 0 0 1005035261 92 Waiver service provider--Disability (DHS/DRS) 109 Winnebago 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12500.96 0 0 0 0 0 0 0 0 0 0 0 0 0 12500.96 0 0 1005035781 1225465487 16 Nurse Practitioners DIAKAKIS DIANA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.16 0 0 0 0 0 0 217.16 0 0 1005036051 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 12336.06 0 0 0 0 0 0 0 0 0 0 0 0 0 12336.06 0 0 1005036128 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.81 0 0 0 0 0 0 23.81 0 0 1005036150 1568811495 11 Dentists MATHEW SINDHU 999999999 852 Wisconsin 0 0 General Dentistry 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10521.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10521.75 0 0 1005036344 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18593.12 0 0 0 0 0 0 0 0 0 0 0 0 0 18593.12 0 0 1005036387 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 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 0 179.28 179.28 0 0 1005036563 1225337017 10 Physicians DIXIT KARAN S 999999999 200 Cook 0 0 Neurology 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 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37995.65 0 0 0 0 0 0 37995.65 0 0 1005036867 10 Physicians 200 Cook 0 0 0 0 0 0 0 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 90.4 0 0 0 0 0 0 0 0 90.4 0 0 1005036902 1013356559 13 Podiatrists GOYAL SONIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 665 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5721.97 0 0 0 0 0 0 5721.97 0 0 1005036992 1841556735 10 Physicians CYNTHIA ABBAN 999999999 57 Lake 0 0 Dermatology 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 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 0 248.22 0 0 0 0 0 0 248.22 0 0 1005037085 1285037929 89 Physician Assistant Only(Encounter Only) PETOSKEY LAUREN M 999999999 80 Peoria 0 0 0 0 0 18 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 1498.12 0 0 0 0 0 0 0 0 3504.02 0 0 0 0 0 0 5002.14 0 0 1005037273 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.4 0 0 0 0 0 0 1.4 0 0 1005037538 1083810758 89 Physician Assistant Only(Encounter Only) ZAIDE JUNIROSE V 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.66 0 0 0 0 0 0 186.66 0 0 1005037558 1366805855 16 Nurse Practitioners CLEMENTE DAN 999999999 30 DuPage 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 0 285 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 5130.17 0 0 0 0 0 0 5130.17 0 0 1005038017 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16513.69 0 0 0 0 0 0 0 0 0 0 0 0 0 16513.69 0 0 1005038056 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 0 501.41 0 0 0 0 0 0 0 0 0 0 0 0 0 501.41 0 0 1005038151 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 22824.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22824.15 0 0 1005038159 1083064299 89 Physician Assistant Only(Encounter Only) KLUCK STEVEN R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5323.65 0 0 0 0 0 0 5323.65 0 0 1005038370 1538479571 89 Physician Assistant Only(Encounter Only) PETERSON NICOLE M 999999999 19 Champaign 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 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 0 987.69 0 0 0 0 0 0 987.69 0 0 1005038553 1245593540 10 Physicians WESTON VICTORIA C. 999999999 200 Cook 0 0 Emergency Medicine 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5168.03 0 0 0 0 0 0 5168.03 0 0 1005038686 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 681.6 0 0 0 0 0 0 0 0 0 0 0 0 0 681.6 0 0 1005039272 1841639366 10 Physicians EVANS MEGAN E 999999999 200 Cook 0 0 Emergency Medicine 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 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 2636.21 0 0 0 0 0 0 2636.21 0 0 1005039465 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10826.51 0 0 0 0 0 0 0 0 0 0 0 0 0 10826.51 0 0 1005039524 1184032559 16 Nurse Practitioners ZURAWSKI CYNTHIA 999999999 200 Cook 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1767.05 0 0 0 0 0 0 1767.05 0 0 1005039657 1891942173 89 Physician Assistant Only(Encounter Only) SOWARD ALLISON 999999999 200 Cook 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 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 0 358.95 0 0 0 0 0 0 358.95 0 0 1005039796 1932375649 10 Physicians LITWILLER JONATHAN 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.22 0 0 0 0 0 0 333.22 0 0 1005039995 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5541.06 0 0 0 0 0 0 0 0 0 0 0 0 0 5541.06 0 0 1005040043 1902890932 89 Physician Assistant Only(Encounter Only) NOONAN SHERI L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695.8 0 0 0 0 0 0 695.8 0 0 1005040058 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10839.58 0 0 0 0 0 0 0 0 0 0 0 0 0 10839.58 0 0 1005040377 1407141997 10 Physicians RIFF ANDREW 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.19 0 0.02 0 0 0 0 0 0 48.21 0 0 1005040398 1538450770 10 Physicians CHU SAMUEL K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1092.54 0 0 0 0 0 0 1092.54 0 0 1005040529 10 Physicians 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.24 0 0 0 0 0 0 0 0 5.24 0 0 1005040665 1134553076 75 Department of Alcohol and Substance Abuse Provider PROVISO LEYDEN COUNCIL FOR COM 999999999 200 Cook 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 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22736.88 0 0 22736.88 0 0 1005040880 1265727051 10 Physicians REZAI PEDRAM 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 756 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1165 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1165 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13614.26 0 407.57 0 0 0 0 0 0 14021.83 0 0 1005040987 1003275918 22 Physical Therapists RABENORT CHRISTINE A 999999999 96 St Clair 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 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 3142.95 3142.95 0 0 1005041338 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 93.75 0 0 0 0 0 0 93.75 0 0 1005041385 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5377.24 0 0 0 0 0 0 0 0 0 0 0 0 0 5377.24 0 0 1005041609 4005041609 71 Medicar Provider ILLINOIS VALLEY ECNMC DEV CORP 62052 50 Jersey 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 0 791 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10504.86 0 0 0 0 0 0 10504.86 0 0 1005041722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1433.57 0 0 0 0 0 0 0 0 0 0 0 0 0 1433.57 0 0 1005042033 1972922102 11 Dentists DAWOUD YAQIN M 999999999 80 Peoria 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1267 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1267 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 47081.77 0 0 0 0 0 0 0 0 0 0 0 5326.55 0 0 0 0 52408.32 0 0 1005042202 1730528340 10 Physicians SHAH HARSH M 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 8 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.92 0 0 0 0 0 0 0 0 71.92 0 0 1005042570 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.2 0 0 0 0 0 0 110.2 0 0 1005042590 1447643341 16 Nurse Practitioners LIPE COREY L 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 2 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 0 497.4 0 0 0 0 0 0 497.4 0 0 1005042790 1053758557 10 Physicians WELCH SARAH KAY 999999999 30 DuPage 0 0 Family Practice 0 0 0 39 0 0 0 0 0 0 14 0 76 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 17 0 131 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 17 0 131 0 0 0 0 0 0 0 0 0 2867.74 0 0 0 0 0 0 103.68 0 2742.69 0 0 0 0 0 0 5714.11 0 0 1005042813 1245346535 89 Physician Assistant Only(Encounter Only) FEARDAY CARI 999999999 33 Effingham 0 0 0 0 0 33 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 2897.15 0 0 0 0 0 0 0 0 3336.79 0 0 0 0 0 0 6233.94 0 0 1005042834 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12153.02 0 0 0 0 0 0 0 0 0 0 0 0 0 12153.02 0 0 1005043034 1710329271 13 Podiatrists ROLENS JOSEPH P 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2011.34 0 0 0 0 0 0 2011.34 0 0 1005043126 24 Speech Therapists 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 2228.32 2228.32 0 0 1005043168 1023047396 10 Physicians WOLF JENNIFER M 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9294.17 0 0 0 0 0 0 9294.17 0 0 1005043391 1023376266 10 Physicians SULEIMAN HASAN O 999999999 40 Grundy 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1818.55 0 0 0 0 0 0 1818.55 0 0 1005043495 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18359.99 0 0 0 0 0 0 0 0 0 0 0 0 0 18359.99 0 0 1005043568 1720377328 10 Physicians MATHENIA NICHOLAS 999999999 63 Macon 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1421.67 0 0 0 0 0 0 1421.67 0 0 1005043776 1558636712 10 Physicians KOITA NOORAH A 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.76 0 851.11 0 0 0 0 0 0 872.87 0 0 1005043874 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 2640.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2640.11 0 0 1005043964 1174983993 36 Community mental health provider AID WATER''S EDGE 999999999 53 Kane 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 4045.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45756.9 0 0 49802.58 0 0 1005044486 1972056455 89 Physician Assistant Only(Encounter Only) FINIGAN MICHAEL K 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.57 0 0 0 0 0 0 185.57 0 0 1005044593 1972585677 10 Physicians SANDS DENNIS E 999999999 80 Peoria 0 0 Obstetric-Gynecology 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 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 0 514.39 0 0 0 0 0 0 514.39 0 0 1005044747 1669836896 16 Nurse Practitioners ILYASH LYUDMYLA 999999999 200 Cook 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 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 0 328.09 0 0 0 0 0 0 328.09 0 0 1005044952 1306189428 10 Physicians RODRIGUEZ PATRICK 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5531.52 0 0 0 0 0 0 5531.52 0 0 1005045098 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35054.45 0 0 0 0 0 0 0 0 0 0 0 0 0 35054.45 0 0 1005045515 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 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 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 1005045728 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 10899.13 0 0 0 0 0 0 0 0 0 0 0 0 0 10899.13 0 0 1005045743 1821355660 10 Physicians BADAWY SHERIF M 999999999 200 Cook 0 0 Pediatrics 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 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 1973.15 0 0 0 0 0 0 1973.15 0 0 1005045936 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10048.61 0 0 0 0 0 0 0 0 0 0 0 0 0 10048.61 0 0 1005046026 1831550417 16 Nurse Practitioners BOJAK SARAH 999999999 40 Grundy 0 0 0 0 0 4 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 369.31 0 0 0 0 0 0 0 0 887.85 0 0 0 0 0 0 1257.16 0 0 1005046255 1003219932 16 Nurse Practitioners SCHMIDGALL LINDA 999999999 50 Jersey 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 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 0 842.84 0 0 0 0 0 0 842.84 0 0 1005046335 1639622285 16 Nurse Practitioners HOLBERT TRACIE A 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433.92 0 0 0 0 0 0 433.92 0 0 1005047058 1366995227 33 Nursing Facilities CLARK MANOR CONVALESCENT CENTE 606261619 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1400541.76 0 0 0 0 0 0 0 1400541.76 0 0 1005047210 1407077852 10 Physicians WETTACH GEORGE R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 57.19 0 0 0 0 0 0 0 0 57.19 0 0 1005047360 10 Physicians 816 Iowa 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762.49 0 0 0 0 0 0 762.49 0 0 1005047533 1669791893 10 Physicians MCCONNELL MICHAEL F 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 241 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6411.17 0 377.84 0 0 0 0 0 0 6789.01 0 0 1005047724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6308.83 0 0 0 0 0 0 0 0 0 0 0 0 0 6308.83 0 0 1005047768 1174979264 16 Nurse Practitioners KAMMIN EVELYN J 999999999 30 DuPage 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 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7419.68 0 0 0 0 0 0 7419.68 0 0 1005047883 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 942.37 0 0 0 0 0 0 0 0 0 0 0 0 0 942.37 0 0 1005048026 1548586282 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0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 685.78 0 0 0 0 0 0 0 0 0 0 0 0 0 685.78 0 0 1005048981 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 0 630.06 0 0 0 0 0 0 0 0 0 0 0 0 0 630.06 0 0 1005049157 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285.53 0 0 0 0 0 0 285.53 0 0 1005049415 1275740128 10 Physicians ABDO SAMIR I 999999999 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.63 0 0 0 0 0 0 1352.63 0 0 1005049539 1275905283 16 Nurse Practitioners STRUM ROBYN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 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0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11336.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11336.34 0 0 1005050275 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11327.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11327.4 0 0 1005050547 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 7355.67 0 0 0 0 0 0 0 0 0 0 0 0 0 7355.67 0 0 1005050705 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16948.77 0 0 0 0 0 0 0 0 0 0 0 0 0 16948.77 0 0 1005050897 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2127.87 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.87 0 0 1005050974 1194165357 13 Podiatrists PATEL VIVEK N. 999999999 200 Cook 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557.22 0 0 0 0 0 0 557.22 0 0 1005051084 89 Physician Assistant Only(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.88 0 0 0 0 0 0 3.88 0 0 1005051169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17923.62 0 0 0 0 0 0 0 0 0 0 0 0 0 17923.62 0 0 1005051318 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 5923.8 0 0 1005052224 1326494683 16 Nurse Practitioners CHEWNING SARAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 3031.88 0 0 0 0 0 0 3031.88 0 0 1005052444 1982042404 10 Physicians GAO AN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479.21 0 0 0 0 0 0 479.21 0 0 1005052912 1316198963 89 Physician Assistant Only(Encounter Only) PEARMAN BRENT 999999999 19 Champaign 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2889.4 0 0 0 0 0 0 2889.4 0 0 1005053477 1437363660 10 Physicians HOSSEINZADEH POOYA 999999999 30 DuPage 0 0 Orthopedic Surgery 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 92 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians NAIK VISHRUT 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1576.8 0 0 0 0 0 0 1576.8 0 0 1005067137 1982894176 12 Optometrists BARNES ABIGAIL 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1693.06 0 385.76 0 0 0 0 2078.82 0 0 1005067141 4005067141 90 Waiver service provider--Elderly (DOA) HAVE A HEART HOMEMAKERS SERV L 999999999 200 Cook 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86097.57 0 0 0 0 0 0 0 0 0 0 0 0 0 86097.57 0 0 1005067441 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22708.61 0 0 0 0 0 0 0 0 0 0 0 0 0 22708.61 0 0 1005067648 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24596.92 0 0 0 0 0 0 0 0 0 0 0 0 0 24596.92 0 0 1005067676 1932487428 10 Physicians RAPTIS DEMETRIOS A 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2635.67 0 0 0 0 0 0 0 0 2635.67 0 0 1005067781 1629173554 10 Physicians SAID MOWAFFAQ 999999999 24 Coles 0 0 Internal Medicine 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1605.43 0 0 0 0 0 0 1605.43 0 0 1005067816 20 Registered nurse 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238.37 0 0 0 0 0 0 238.37 0 0 1005067817 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8582.35 0 0 0 0 0 0 0 0 0 0 0 0 0 8582.35 0 0 1005068089 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 24.25 0 0 1005068110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21814.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21814.48 0 0 1005068158 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22036.44 0 0 0 0 0 0 0 0 0 0 0 0 0 22036.44 0 0 1005068299 93 Waiver service provider--HIV/AIDS (DHS/DRS) 100 Vermilion 0 0 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 6524.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6524.81 0 0 1005068472 1548591712 10 Physicians JABLONSKI RENEA P 999999999 30 DuPage 0 0 Internal Medicine 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 0 154 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 1456.2 0 0 0 0 0 0 1456.2 0 0 1005068476 1710328224 13 Podiatrists LANTZ PAUL G 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2818.2 0 0 0 0 0 0 2818.2 0 0 1005068555 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.54 0 0 0 0 0 0 83.54 0 0 1005068660 1053675124 10 Physicians DHUYVETTER AMANDA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.65 0 0 0 0 0 0 174.65 0 0 1005068926 1467730192 10 Physicians SALEEM KHURRAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3059.96 0 0 0 0 0 0 3059.96 0 0 1005068976 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16876.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16876.93 0 0 1005069225 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 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 5992.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5992.14 0 0 1005069251 1154646792 10 Physicians SZCZODRY MICHAL 999999999 19 Champaign 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 14 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.7 0 9329.5 0 0 0 0 0 0 9552.2 0 0 1005069321 10 Physicians 89 Rock Island 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313.86 0 0 0 0 0 0 313.86 0 0 1005069336 1306391255 22 Physical Therapists ALDERKS CASSIE M 999999999 109 Winnebago 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511.85 511.85 0 0 1005069542 10 Physicians 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005069704 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23969.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23969.55 0 0 1005069819 1598835308 30 General Hospitals SSM HEALTH DEPAUL HOSPITAL ST 630442512 826 Missouri 0 0 General Hospital - Adult and Child 0 0 0 0 49 0 0 0 0 49 0 0 0 145 0 0 0 0 0 0 0 0 0 52 0 0 0 0 49 0 0 0 311 0 0 0 0 0 0 0 0 0 52 0 0 0 0 243 0 0 0 313 0 0 0 0 0 0 0 0 0 8117.77 0 0 0 0 73685.85 0 0 0 49847.37 0 0 0 0 0 131650.99 0 0 1005069845 16 Nurse Practitioners 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1005069921 1477003283 75 Department of Alcohol and Substance Abuse Provider LAWRENCE CO BEHAVIOR HEALTH 999999999 59 Lawrence 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5105 0 0 5105 0 0 1005070113 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 728.5 0 0 0 0 0 0 0 0 0 0 0 0 0 728.5 0 0 1005070213 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 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 91.96 91.96 0 0 1005070218 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9289.15 0 0 0 0 0 0 0 0 0 0 0 0 0 9289.15 0 0 1005070303 1235426487 10 Physicians GORANTLA SASIKANTH 999999999 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 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 3330.34 0 0 0 0 0 0 3330.34 0 0 1005070432 1477905743 24 Speech Therapists OLVERA ALYSIA A 999999999 91 Sangamon 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8219.85 8219.85 0 0 1005070974 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 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 3779.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3779.8 0 0 1005071011 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 67.22 0 0 0 0 0 0 67.22 0 0 1005071051 1467863589 10 Physicians MUSA MINHAJ 999999999 57 Lake 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 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 0 258.22 0 0 0 0 0 0 258.22 0 0 1005071275 10 Physicians 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005071480 1043452287 10 Physicians OHLANDER SAMUEL 999999999 200 Cook 0 0 Urology 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 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 2194.33 0 0 0 0 0 0 2194.33 0 0 1005071567 1174997431 16 Nurse Practitioners RANDOLPH CAITLIN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.96 0 0 0 0 0 0 163.96 0 0 1005071735 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21487.77 0 0 0 0 0 0 0 0 0 0 0 0 0 21487.77 0 0 1005071780 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.37 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.37 0 0 1005071833 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23249.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23249.32 0 0 1005072055 1619178050 10 Physicians PEARSON TONI 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1322.84 0 0 0 0 0 0 1322.84 0 0 1005072271 1740629716 10 Physicians KROLL MELISSA R 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455.12 0 0 0 0 0 0 455.12 0 0 1005072305 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20018.29 0 0 0 0 0 0 0 0 0 0 0 0 0 20018.29 0 0 1005072339 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13490.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13490.9 0 0 1005072424 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25072.15 0 0 0 0 0 0 0 0 0 0 0 0 0 25072.15 0 0 1005072472 1043671068 16 Nurse Practitioners TAYLOR JACLYN G 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040.76 0 0 0 0 0 0 1040.76 0 0 1005072504 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21937.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21937.3 0 0 1005072574 1134598758 16 Nurse Practitioners CORTEZ MARIA S 999999999 200 Cook 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 711.49 0 0 0 0 0 0 711.49 0 0 1005072741 1417397688 10 Physicians ADEOYE ORIADE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7194.14 0 0 0 0 0 0 7194.14 0 0 1005072817 1184045338 89 Physician Assistant Only(Encounter Only) WILSON MARTY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127.62 0 0 0 0 0 0 127.62 0 0 1005073020 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 68.93 0 0 0 0 0 0 68.93 0 0 1005073036 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8558.48 0 0 0 0 0 0 0 0 0 0 0 0 0 8558.48 0 0 1005073095 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14354.55 0 0 0 0 0 0 0 0 0 0 0 0 0 14354.55 0 0 1005073673 1336695550 22 Physical Therapists MARTIN OLIVIA 999999999 19 Champaign 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559.63 559.63 0 0 1005074166 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28437.27 0 0 0 0 0 0 0 0 0 0 0 0 0 28437.27 0 0 1005074191 10 Physicians 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127.31 0 0 0 0 0 0 127.31 0 0 1005074277 1083977367 10 Physicians KANG PETER 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3302.67 0 0 0 0 0 0 3302.67 0 0 1005074409 10 Physicians 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1005074446 91 Waiver service provider--Adults 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Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005074991 1649438565 16 Nurse Practitioners ASIMA SIKA S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363.5 0 0 0 0 0 0 363.5 0 0 1005075015 10 Physicians 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.3 0 0 0 0 0 0 47.3 0 0 1005075130 1619265329 10 Physicians MATTAR CALINE S 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.42 0 0 0 0 0 0 267.42 0 0 1005075219 1649628009 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 999999999 77 Morgan 0 1 0 162 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26554.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26554.56 0 0 1005075239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16064.82 0 0 0 0 0 0 0 0 0 0 0 0 0 16064.82 0 0 1005075501 1912163189 89 Physician Assistant Only(Encounter Only) OAKLEY MICAH 999999999 200 Cook 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2660.71 0 0 0 0 0 0 2660.71 0 0 1005075522 1407296171 14 Chiropractors BERNSTEIN JENNIFER 999999999 106 Whiteside 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441.01 0 0 0 0 0 0 441.01 0 0 1005075584 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23796.42 0 0 0 0 0 0 0 0 0 0 0 0 0 23796.42 0 0 1005075686 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13538.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13538.9 0 0 1005075749 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7349.49 0 0 0 0 0 0 0 0 0 0 0 0 0 7349.49 0 0 1005075754 1942566534 10 Physicians CHANDOU MELAINA 999999999 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 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 4769.37 0 0 0 0 0 0 4769.37 0 0 1005076031 1255618237 89 Physician Assistant Only(Encounter Only) LORINSKAS ALEXIS 999999999 108 Williamson 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 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5745.08 0 0 0 0 0 0 5745.08 0 0 1005076297 1962716514 89 Physician Assistant Only(Encounter Only) ZAMBRANO ANIRDNAGELA 999999999 200 Cook 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 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6117.67 0 0 0 0 0 0 6117.67 0 0 1005076414 1881662385 89 Physician Assistant Only(Encounter Only) KERR RICHARD T 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1281.79 0 0 0 0 0 0 1281.79 0 0 1005076469 1225293392 10 Physicians LEE ERICH Y. 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 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 14270.33 0 0 0 0 0 0 0 0 0 0 0 0 0 14270.33 0 0 1005077688 1821450149 10 Physicians WONG CLAIRE 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 5 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.05 0 258.15 0 0 0 0 0 0 288.2 0 0 1005077739 1013262195 10 Physicians SIDES CHARLES C 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 8 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558.3 0 2799.6 0 0 0 0 0 0 3357.9 0 0 1005077806 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 146.62 0 0 0 0 0 0 146.62 0 0 1005077873 1063966158 16 Nurse Practitioners PEDERSON JENNA 999999999 200 Cook 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3078.85 0 0 0 0 0 0 3078.85 0 0 1005077896 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 0 256.13 0 0 0 0 0 0 0 0 0 0 0 0 0 256.13 0 0 1005078129 1013372440 30 General Hospitals ADVENTHEALTH BOLINGBROOK 999999999 107 Will DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9708.21 0 0 0 0 0 0 0 0 0 9708.21 0 0 1005078805 1245506435 10 Physicians MAJID SOPHIA 999999999 200 Cook 0 0 Internal Medicine 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 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4011.25 0 0 0 0 0 0 4011.25 0 0 1005079010 1922405521 10 Physicians TONG JEFFREY L 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5522.71 0 0 0 0 0 0 5522.71 0 0 1005079126 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1627.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1627.86 0 0 1005079305 1821545385 11 Dentists SHAH SHASHI N 999999999 71 McHenry 0 0 General Dentistry 0 0 371 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 1717 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 1717 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 39509.08 0 0 0 0 0 0 0 0 0 0 0 6781.65 0 0 0 0 46290.73 0 0 1005079362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 590.24 0 0 0 0 0 0 0 0 0 0 0 0 0 590.24 0 0 1005079622 1831328038 10 Physicians ZIVIN SEAN P 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 282 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5082.98 0 3659.8 0 0 0 0 0 0 8742.78 0 0 1005079663 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 2994 0 0 0 0 0 0 0 0 0 0 0 0 0 2994 0 0 1005079700 1275992851 60 Pharmacies SAV-MOR PHARMACY 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11307.3 0 0 0 11307.3 0 0 1005080080 1912037201 89 Physician Assistant Only(Encounter Only) HAYDEN FREDERICK K 999999999 200 Cook 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 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 0 864.33 0 0 0 0 0 0 864.33 0 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0 0 0 0 0 0 78.63 0 0 1005081088 1629287966 10 Physicians TROTTER ANDREW 999999999 200 Cook 0 0 Internal Medicine 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2390.55 0 0 0 0 0 0 2390.55 0 0 1005081391 1265718993 89 Physician Assistant Only(Encounter Only) SEYMOURE RALPH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8836.71 0 0 0 0 0 0 8836.71 0 0 1005081467 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3532.76 0 0 0 0 0 0 0 0 0 0 0 0 0 3532.76 0 0 1005081492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 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Jefferson 0 0 0 0 0 1 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 1431.42 0 0 0 0 0 0 1528.02 0 0 1005083343 16 Nurse Practitioners 44 Henderson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.23 0 0 0 0 0 0 12.23 0 0 1005083404 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8912.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8912.2 0 0 1005083530 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23677.56 0 0 0 0 0 0 0 0 0 0 0 0 0 23677.56 0 0 1005083706 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 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224.08 0 0 0 0 0 0 224.08 0 0 1005084436 1750753844 16 Nurse Practitioners FARNAN CHRISTOPHER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 369.12 0 0 0 0 0 0 369.12 0 0 1005084687 1013376581 16 Nurse Practitioners TURNER JACQUELINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270.3 0 0 0 0 0 0 270.3 0 0 1005084698 1871940775 91 Waiver service provider--Adults (DHS/DDD) DINWIDDIE CHRISTABEL 999999999 200 Cook 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 1093 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1093 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142743.2 0 0 0 0 0 0 0 0 0 0 0 0 0 142743.2 0 0 1005084787 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10226.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10226.79 0 0 1005084902 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 226.06 0 0 0 0 0 0 0 0 0 0 0 0 0 226.06 0 0 1005084936 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 8412.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8412.49 0 0 1005084958 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24824.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24824.75 0 0 1005085015 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4246.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4246.32 0 0 1005085310 1861853327 91 Waiver service provider--Adults (DHS/DDD) SCHEHR ASHLEY 999999999 200 Cook 0 0 0 0 0 0 0 6 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 0 712.18 0 0 0 0 0 0 0 0 0 0 0 0 0 712.18 0 0 1005085618 1437597093 10 Physicians MARTINEZ EDMUNDO 999999999 80 Peoria 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 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38693.35 0 0 0 0 0 0 38693.35 0 0 1005085743 10 Physicians 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 156 0 0 0 0 0 0 156 0 0 1005086007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17930.44 0 0 0 0 0 0 0 0 0 0 0 0 0 17930.44 0 0 1005086343 92 Waiver service provider--Disability (DHS/DRS) 88 Richland 0 0 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 0 843.39 0 0 0 0 0 0 0 0 0 0 0 0 0 843.39 0 0 1005086487 1760842579 36 Community mental health provider AID DIAMOND I 999999999 55 Kendall 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2131 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2131 0 0 37024.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141327.59 0 0 178352.39 0 0 1005086632 1780837922 10 Physicians CHOWDHRY SAEED A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 4844.45 0 0 0 0 0 0 4844.45 0 0 1005086745 1851734040 10 Physicians REID JOHN 999999999 53 Kane 0 0 Internal Medicine 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 0 157 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 3674.13 0 0 0 0 0 0 3674.13 0 0 1005086925 1396030094 10 Physicians LAMBA NEERAV N 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 4 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.6 0 28551.87 0 0 0 0 0 0 28593.47 0 0 1005087316 1972878288 10 Physicians LAURSEN LAURA E 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 27 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852.99 0 440838.82 0 0 0 0 0 0 441691.81 0 0 1005087333 1215480587 16 Nurse Practitioners BRANDT ASHLEY 999999999 63 Macon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 181.22 0 0 0 0 0 0 0 0 1783.09 0 0 0 0 0 0 1964.31 0 0 1005087343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17351.3 0 0 0 0 0 0 0 0 0 0 0 0 0 17351.3 0 0 1005087368 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21701.19 0 0 0 0 0 0 0 0 0 0 0 0 0 21701.19 0 0 1005087383 1336481779 10 Physicians MEHTA GAUTAM R 999999999 200 Cook 0 0 Internal Medicine 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2502.96 0 0 0 0 0 0 2502.96 0 0 1005087439 1699166892 16 Nurse Practitioners KOUZOUKAS BRENNA K. 999999999 200 Cook 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 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 2012.77 0 0 0 0 0 0 2012.77 0 0 1005087466 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13866.49 0 0 0 0 0 0 0 0 0 0 0 0 0 13866.49 0 0 1005087502 1407309982 16 Nurse Practitioners GREEN DANIEL R 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 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 1052.47 0 0 0 0 0 0 1052.47 0 0 1005087529 1275947756 65 Independent Diagnostic Testing Facility (IDTF) BELLEVILLE DIAGNOSTIC CENTER L 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1287.05 0 0 0 0 0 0 0 0 1287.05 0 0 1005087866 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20919.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20919.8 0 0 1005088108 1518263714 16 Nurse Practitioners THOMPSON MARY 999999999 70 McDonough 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2862.53 0 0 0 0 0 0 2862.53 0 0 1005088304 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18366.68 0 0 0 0 0 0 0 0 0 0 0 0 0 18366.68 0 0 1005088451 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4217.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4217.4 0 0 1005088579 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 1005088588 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7856.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7856.7 0 0 1005088737 10 Physicians 105 White 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1065.85 0 0 0 0 0 0 1065.85 0 0 1005088787 1255797825 16 Nurse Practitioners GRAZAITIS JOSEPH 999999999 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 827.7 0 0 0 0 0 0 827.7 0 0 1005089034 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40317.6 0 0 0 0 0 0 0 0 0 0 0 0 0 40317.6 0 0 1005089328 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 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 22649.29 0 0 0 0 0 0 0 0 0 0 0 0 0 22649.29 0 0 1005089429 1538611561 91 Waiver service provider--Adults (DHS/DDD) AMARO EVELYN 999999999 200 Cook 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12099.54 0 0 0 0 0 0 0 0 0 0 0 0 0 12099.54 0 0 1005089635 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31044.65 0 0 0 0 0 0 0 0 0 0 0 0 0 31044.65 0 0 1005089722 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5996.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5996.88 0 0 1005089825 4005089825 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 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 31239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2092542.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2092542.99 0 0 1005089908 1669767562 10 Physicians DIAL SAMANTHA J 999999999 91 Sangamon 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 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 16183.16 0 0 0 0 0 0 16183.16 0 0 1005089918 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6313.07 0 0 0 0 0 0 0 0 0 0 0 0 0 6313.07 0 0 1005090699 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10008.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10008.6 0 0 1005090709 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9316.23 0 0 0 0 0 0 0 0 0 0 0 0 0 9316.23 0 0 1005090850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4063.67 0 0 0 0 0 0 0 0 0 0 0 0 0 4063.67 0 0 1005090964 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17693.46 0 0 0 0 0 0 0 0 0 0 0 0 0 17693.46 0 0 1005091046 1750604963 36 Community mental health provider SPERO FAMILY SERVICES 999999999 49 Jefferson 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 326.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37943.39 0 0 38269.55 0 0 1005091184 1316398415 16 Nurse Practitioners KILZER AMANDA J 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 2898.61 0 0 0 0 0 0 2919.61 0 0 1005091305 1912457730 16 Nurse Practitioners WALSH OLIVIA K 999999999 200 Cook 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 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 0 354.25 0 0 0 0 0 0 354.25 0 0 1005091460 1184044174 10 Physicians KUMAR PRERNA 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2066.98 0 0 0 0 0 0 2066.98 0 0 1005091651 1891963641 10 Physicians PANDURANGADU ANANDA V 999999999 200 Cook 0 0 Emergency Medicine 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 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 1492.42 0 0 0 0 0 0 1492.42 0 0 1005091749 98 Waiver service provider--TBI (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39813.02 0 0 0 0 0 0 0 0 0 0 0 0 0 39813.02 0 0 1005091782 1851787865 60 Pharmacies WALGREENS #16093 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 1148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 51234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2353 0 0 115461.42 0 0 0 117814.42 0 0 1005091830 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.66 2127.66 0 0 1005091928 1053608208 10 Physicians PARULKAR SURAJ 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1207.5 0 0 0 0 0 0 1207.5 0 0 1005092780 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34565.74 0 0 0 0 0 0 0 0 0 0 0 0 0 34565.74 0 0 1005092886 98 Waiver service provider--TBI (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24893.9 0 0 0 0 0 0 0 0 0 0 0 0 0 24893.9 0 0 1005092927 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10815.28 0 0 0 0 0 0 0 0 0 0 0 0 0 10815.28 0 0 1005092999 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 142701.2 0 0 0 142701.2 0 0 1005093753 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23833.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23833.92 0 0 1005093758 1912263963 16 Nurse Practitioners REXROAD KRISTINA M 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 0 0 997.47 0 0 0 0 0 0 1089.37 0 0 1005093993 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33834.8 0 0 0 0 0 0 0 0 0 0 0 0 0 33834.8 0 0 1005094048 1154789964 16 Nurse Practitioners SAXSMA MARIE ARLENE J 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319.92 0 0 0 0 0 0 1319.92 0 0 1005094049 1568783991 10 Physicians LOWDEN ELIZABETH A 999999999 53 Kane 0 0 Internal Medicine 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 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 0 722.88 0 0 0 0 0 0 722.88 0 0 1005094077 1093702094 89 Physician Assistant Only(Encounter Only) HSIEH CHENG 999999999 200 Cook 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 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 2419.63 0 0 0 0 0 0 2419.63 0 0 1005094548 1932382652 89 Physician Assistant Only(Encounter Only) FINCHUM JENNICA M. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.11 0 0 0 0 0 0 1031.11 0 0 1005094619 1063862266 12 Optometrists BEYER EMILY M 999999999 91 Sangamon 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 91 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2788.97 0 132.8 0 0 0 0 2921.77 0 0 1005094749 91 Waiver service provider--Adults (DHS/DDD) 58 La Salle 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14800.06 0 0 0 0 0 0 0 0 0 0 0 0 0 14800.06 0 0 1005094795 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14962.57 0 0 0 0 0 0 0 0 0 0 0 0 0 14962.57 0 0 1005094826 1114994928 89 Physician Assistant Only(Encounter Only) REITEN SHELLY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 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 3301.67 0 0 0 0 0 0 3301.67 0 0 1005095205 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 832.08 0 0 0 0 0 0 0 0 0 0 0 0 0 832.08 0 0 1005095253 1487014627 16 Nurse Practitioners SWAYZE ROBERT M 999999999 22 Clay 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 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 80.4 0 0 0 0 0 0 80.4 0 0 1005095345 1093060584 10 Physicians HARDMAN JAMIE L 999999999 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2560.32 0 0 0 0 0 0 2560.32 0 0 1005095872 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 11591.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11591.36 0 0 1005095922 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 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 0 537.24 0 0 0 0 0 0 0 0 0 0 0 0 0 537.24 0 0 1005095987 1861869687 25 Audiologists JANSEN JACLYN N 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2626.96 2626.96 0 0 1005096171 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 82.7 0 0 0 0 0 0 0 0 0 0 0 0 0 82.7 0 0 1005096326 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 1005096333 1851714190 39 Hospice OASIS HOSPICE & PALLIATIVE CAR 999999999 107 Will 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47804.85 0 0 0 0 0 0 0 0 0 0 0 47804.85 0 0 1005096429 1114367778 10 Physicians OLEKSIAK MICHAEL 999999999 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4137.38 0 0 0 0 0 0 4137.38 0 0 1005096524 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 207.51 0 0 0 0 0 0 207.51 0 0 1005096573 89 Physician Assistant Only(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.6 0 0 0 0 0 0 243.6 0 0 1005096719 1255322764 16 Nurse Practitioners GOETZ CAROL 999999999 200 Cook 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3985.69 0 0 0 0 0 0 3985.69 0 0 1005097603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 142.45 0 0 0 0 0 0 0 0 0 0 0 0 0 142.45 0 0 1005097703 1891724597 10 Physicians BAUM MARGARET 999999999 96 St Clair 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458.16 0 179155.4 0 0 0 0 0 0 179613.56 0 0 1005097765 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005097859 1083899710 89 Physician Assistant Only(Encounter Only) FISK HOLLY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1041.42 0 0 0 0 0 0 1041.42 0 0 1005098076 10 Physicians 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.35 0 0 0 0 0 0 133.35 0 0 1005098378 1912456997 91 Waiver service provider--Adults (DHS/DDD) MEYER TRINA L 999999999 200 Cook 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77232.4 0 0 0 0 0 0 0 0 0 0 0 0 0 77232.4 0 0 1005098384 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 1005098653 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1539.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.18 0 0 1005098791 1558526574 10 Physicians SIYAM FADI F 999999999 826 Missouri 0 0 Internal Medicine 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 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 0 252.92 0 0 0 0 0 0 252.92 0 0 1005099082 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14407.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14407.8 0 0 1005099114 71 Medicar Provider 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1132.19 0 0 0 0 0 0 1132.19 0 0 1005099166 1114271905 89 Physician Assistant Only(Encounter Only) BEER DANIELLE E. 999999999 80 Peoria 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2165.22 0 0 0 0 0 0 2165.22 0 0 1005099186 1487012860 10 Physicians YOUSUF SAMINA 999999999 80 Peoria 0 0 Pediatrics 0 0 0 38 0 0 0 0 0 0 15 0 45 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 17 0 74 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 17 0 74 0 0 0 0 0 0 0 0 0 3505.07 0 0 0 0 0 0 153.42 0 3227.93 0 0 0 0 0 0 6886.42 0 0 1005099294 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22879.19 0 0 0 0 0 0 0 0 0 0 0 0 0 22879.19 0 0 1005099316 1811202146 89 Physician Assistant Only(Encounter Only) SMITH LAUREN 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 238.71 0 0 0 0 0 0 238.71 0 0 1005099427 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6595.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6595.76 0 0 1005099442 1972989838 16 Nurse Practitioners PRAY DANIELLE R. 999999999 80 Peoria 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.46 0 0 0 0 0 0 2710.46 0 0 1005099641 1619106242 10 Physicians UMSTEAD ERIC C 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.05 0 0 0 0 0 0 0 0 125.05 0 0 1005099692 1639519861 10 Physicians DEPTULA NICOLE C 999999999 200 Cook 0 0 Pediatrics 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12068.86 0 0 0 0 0 0 12068.86 0 0 1005099886 1720448848 30 General Hospitals FRESENIUS MEDICAL CARE LEMONT 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 860 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9691.97 0 0 0 0 0 9691.97 0 0 1005099944 1598216657 16 Nurse Practitioners GILE STEPHANIE M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 96.6 0 0 0 0 0 0 96.6 0 0 1005100257 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23158.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23158.7 0 0 1005100500 1366671091 10 Physicians NAVALKELE POURNIMA 999999999 89 Rock Island 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.15 0 0 0 0 0 0 1074.15 0 0 1005100558 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26121.37 0 0 0 0 0 0 0 0 0 0 0 0 0 26121.37 0 0 1005100569 1629524251 89 Physician Assistant Only(Encounter Only) COLLINS STEVEN M 999999999 200 Cook 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 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 0 441.86 0 0 0 0 0 0 441.86 0 0 1005100604 1952653438 16 Nurse Practitioners HEWITT MARY 999999999 200 Cook 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 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 0 105.54 0 0 0 0 0 0 105.54 0 0 1005100882 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 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 52531.74 0 0 0 0 0 0 0 0 0 0 0 0 0 52531.74 0 0 1005101251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.28 0 0 0 0 0 0 0 0 0 0 0 0 0 96.28 0 0 1005101336 1437466158 10 Physicians NANDA VISHAKHA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1781.44 0 0 0 0 0 0 1781.44 0 0 1005101397 1013300839 13 Podiatrists EL-CHAMI FAHED N 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 897.64 0 0 0 0 0 0 897.64 0 0 1005101410 1265412084 89 Physician Assistant Only(Encounter Only) TAYLOR SHANNON V 999999999 53 Kane 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1599.15 0 0 0 0 0 0 1599.15 0 0 1005101465 1134415805 10 Physicians LI PULSAR 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5717.59 0 0 0 0 0 0 5717.59 0 0 1005101596 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21355.43 0 0 0 0 0 0 0 0 0 0 0 0 0 21355.43 0 0 1005101656 1881089662 10 Physicians JOHNSON LAURA J 999999999 200 Cook 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 610.89 0 0 0 0 0 0 0 0 2291.16 0 0 0 0 0 0 2902.05 0 0 1005101940 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40131.67 0 0 0 0 0 0 0 0 0 0 0 0 0 40131.67 0 0 1005101969 1215383070 16 Nurse Practitioners HUGHES BRITTNEY N 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.06 0 0 0 0 0 0 457.06 0 0 1005102287 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21782.64 0 0 0 0 0 0 0 0 0 0 0 0 0 21782.64 0 0 1005102370 1649657024 16 Nurse Practitioners RODICH COURTNEY L 999999999 80 Peoria 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.4 0 0 0 0 0 0 405.4 0 0 1005102485 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9687.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9687.26 0 0 1005102575 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15028.36 0 0 0 0 0 0 0 0 0 0 0 0 0 15028.36 0 0 1005102790 1629140934 36 Community mental health provider HOLY CROSS HOSPITAL 999999999 200 Cook 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 466.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20843.01 0 0 21309.97 0 0 1005102806 1528513124 22 Physical Therapists HARTMAN REBECCA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 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 2595.36 2595.36 0 0 1005102947 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13788.18 0 0 0 0 0 0 0 0 0 0 0 0 0 13788.18 0 0 1005103090 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23969.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23969.5 0 0 1005103191 1164650248 10 Physicians KANJAMA THEODORA K 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.48 0 0 0 0 0 0 1948.48 0 0 1005103267 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 850.96 0 0 0 0 0 0 850.96 0 0 1005103545 1306161880 10 Physicians CHUI CECILIA 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 57 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3567.92 0 8477.2 0 0 0 0 0 0 12045.12 0 0 1005103648 1164875852 16 Nurse Practitioners KRAUSE BRYN 999999999 109 Winnebago 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042.64 0 0 0 0 0 0 1042.64 0 0 1005103710 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6332.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6332.92 0 0 1005103778 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14032.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14032.39 0 0 1005103877 1215240585 10 Physicians O'CONNOR SHAWN D 999999999 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 16.07 0 0 0 0 0 0 0 0 8129.38 0 0 0 0 0 0 8145.45 0 0 1005104000 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 9339.76 0 0 0 0 0 0 0 0 0 0 0 0 0 9339.76 0 0 1005104315 1124304407 16 Nurse Practitioners NORRIS MELISSA R 999999999 80 Peoria 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.92 0 0 0 0 0 0 25.92 0 0 1005104477 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432.43 0 0 0 0 0 0 0 0 0 0 0 0 0 432.43 0 0 1005104585 1760938583 16 Nurse Practitioners VOGEL MEGAN 999999999 19 Champaign 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 687 0 0 1005104751 1235199738 10 Physicians ELROD WALTER L 999999999 62 Logan 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550.03 0 0 0 0 0 0 550.03 0 0 1005104782 1295175487 10 Physicians PATEL PRAYAG 614553313 70 McDonough 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 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 1444.25 0 0 0 0 0 0 1444.25 0 0 1005104876 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 8941.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8941.65 0 0 1005104946 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16088.71 0 0 0 0 0 0 0 0 0 0 0 0 0 16088.71 0 0 1005104984 1205222197 30 General Hospitals FRESENIUS MEDICAL CARE WAUKEGA 999999999 57 Lake DIALYSIS Outpatient dialysis centers. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 2173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3024.06 0 0 0 0 0 3024.06 0 0 1005105232 1346537404 10 Physicians ORLOWSKI HILARY L 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 76 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4249.9 0 23.76 0 0 0 0 0 0 4273.66 0 0 1005105416 1972790889 48 Rural Health Clinics SPRINGFIELD CLINIC NEOGA RURAL 624471629 26 Cumberland 0 0 0 56 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4158.92 0 0 1005105418 89 Physician Assistant Only(Encounter Only) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005105787 1215273131 10 Physicians PEGG EDWARD W 999999999 80 Peoria 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3836.3 0 0 0 0 0 0 3836.3 0 0 1005105853 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36876.13 0 0 0 0 0 0 0 0 0 0 0 0 0 36876.13 0 0 1005106027 1538405931 89 Physician Assistant Only(Encounter Only) SOLUM STEPHEN M 999999999 200 Cook 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 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 0 177.77 0 0 0 0 0 0 177.77 0 0 1005106154 1225499825 16 Nurse Practitioners WAHOME ASHLEY F 999999999 108 Williamson 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 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 0 102.75 0 0 0 0 0 0 102.75 0 0 1005106180 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.89 0 0 1005106243 1659665263 10 Physicians GUPTA NISHA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.55 0 0 0 0 0 0 31.55 0 0 1005106378 1417247776 16 Nurse Practitioners LANE TERESA A 999999999 80 Peoria 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 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 0 829.69 0 0 0 0 0 0 829.69 0 0 1005106535 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 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 1901.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1901.22 0 0 1005106714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8318.57 0 0 0 0 0 0 0 0 0 0 0 0 0 8318.57 0 0 1005107042 1780799254 89 Physician Assistant Only(Encounter Only) MORRISON RACHEL 999999999 24 Coles 0 0 0 0 0 2 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 165.97 0 0 0 0 0 0 0 0 2610.28 0 0 0 0 0 0 2776.25 0 0 1005107215 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472.08 0 0 0 0 0 0 0 0 0 0 0 0 0 472.08 0 0 1005107494 1114303732 16 Nurse Practitioners JABER SARAH D. 999999999 10 Adams 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1536.2 0 0 0 0 0 0 1536.2 0 0 1005107675 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 588.7 0 0 0 0 0 0 0 0 0 0 0 0 0 588.7 0 0 1005107818 1053619676 10 Physicians RADOVIC ALEKSANDAR 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.44 0 471.96 0 0 0 0 0 0 534.4 0 0 1005107965 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.27 0 0 0 0 0 0 0 0 0 0 0 0 0 450.27 0 0 1005108167 1316351315 10 Physicians MIKSANEK ZACHARY A 999999999 88 Richland 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4976.55 0 0 0 0 0 0 4976.55 0 0 1005108688 1184089351 16 Nurse Practitioners DUERINCK ANDREA C 999999999 65 Madison 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 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 0 487.49 0 0 0 0 0 0 487.49 0 0 1005108757 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39486.06 0 0 0 0 0 0 0 0 0 0 0 0 0 39486.06 0 0 1005108822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.12 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.12 0 0 1005109793 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21325.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21325.85 0 0 1005109899 1467767855 10 Physicians ANDERSON MARTIN E 999999999 200 Cook 0 0 Otolaryngology 0 0 0 1 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 15.2 0 0 0 0 0 0 0 0 8140.78 0 0 0 0 0 0 8155.98 0 0 1005110001 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11045.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11045.25 0 0 1005110041 1528413945 60 Pharmacies EVANSTON HEALTHMART PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20829.4 0 0 0 20829.4 0 0 1005110151 1336507037 30 General Hospitals FRESENIUS MEDICAL CARE SUMMIT 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005110216 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10730.04 0 0 0 0 0 0 0 0 0 0 0 0 0 10730.04 0 0 1005110488 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.24 0 0 0 0 0 0 95.24 0 0 1005110582 1205243433 57 Home Nursing Agency "DYNAMIC HEALTHCARE SERVICES, I" 999999999 200 Cook 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 725 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229499.58 54972.97 0 0 0 0 0 0 0 0 0 0 0 0 284472.55 0 0 1005110597 1154587426 10 Physicians WILLIAMS KIM 999999999 200 Cook 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8911.37 0 0 0 0 0 0 8911.37 0 0 1005110638 1346694981 10 Physicians GURUNG SUBINA 999999999 200 Cook 0 0 Internal Medicine 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 0 147 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 3960.18 0 0 0 0 0 0 3960.18 0 0 1005110769 1356684070 10 Physicians HOSKINS JUSTIN T 999999999 200 Cook 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9322.22 0 0 0 0 0 0 9322.22 0 0 1005110846 1912457219 75 Department of Alcohol and Substance Abuse Provider ELITE TREATMENT CENTER 999999999 200 Cook 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12535.04 0 0 12535.04 0 0 1005111014 1437499803 16 Nurse Practitioners KENDRICK KRISTIN 999999999 80 Peoria 0 0 0 0 0 4 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 529.27 0 0 0 0 0 0 0 0 1266.91 0 0 0 0 0 0 1796.18 0 0 1005111107 60 Pharmacies 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6264.26 0 0 0 6264.26 0 0 1005111144 16 Nurse Practitioners 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216.96 0 0 0 0 0 0 216.96 0 0 1005111296 1922352939 10 Physicians BAINS SUKHVEER 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2503.91 0 0 0 0 0 0 2503.91 0 0 1005111405 1639478027 10 Physicians GOYAL SANDRA 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049.04 0 0 0 0 0 0 1049.04 0 0 1005111474 1639526015 16 Nurse Practitioners PUNO RACHELLE 999999999 200 Cook 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 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 0 386.31 0 0 0 0 0 0 386.31 0 0 1005111808 1194172932 55 Early Intervention Services DYSON EMILY S 999999999 57 Lake 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 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23802.06 0 0 0 0 0 0 23802.06 0 0 1005111834 4005111834 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3544838.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3544838.35 0 0 1005111918 92 Waiver service provider--Disability (DHS/DRS) 106 Whiteside 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6418.03 0 0 0 0 0 0 0 0 0 0 0 0 0 6418.03 0 0 1005112287 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.55 0 0 0 0 0 0 0 0 0 0 0 0 0 60.55 0 0 1005112340 1487855854 10 Physicians SALDANA CERVANTES SANDRA 999999999 53 Kane 0 0 Clinical Pathology 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1145.43 0 0 0 0 0 0 0 0 1145.43 0 0 1005112641 1821265182 10 Physicians SHAKIR NASEEM T 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 419 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6504.85 0 359.59 0 0 0 0 0 0 6864.44 0 0 1005112801 1336263201 10 Physicians CHAUDHRY KANWAL 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5382.25 0 0 0 0 0 0 5382.25 0 0 1005113238 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3176.3 0 0 0 0 0 0 3176.3 0 0 1005113380 94 Waiver service 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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 17770.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17770.57 0 0 1005120609 1619220589 10 Physicians RAPP HALEY M 999999999 826 Missouri 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1055.61 0 0 0 0 0 0 1055.61 0 0 1005120898 1831553908 16 Nurse Practitioners MCFADIN THERESA 999999999 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1466.27 0 0 0 0 0 0 1466.27 0 0 1005120907 1992259642 16 Nurse Practitioners HITESMAN HEATHER M 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244.75 0 0 0 0 0 0 244.75 0 0 1005120915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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0 0 0 0 0 0 0 0 0 0 0 3602.19 0 0 1005122702 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1953.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1953.36 0 0 1005122707 10 Physicians 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005122786 1043507866 10 Physicians FREDERICK LUKE R 999999999 109 Winnebago 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.34 0 2598.25 0 0 0 0 0 0 2610.59 0 0 1005122857 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20542.29 0 0 0 0 0 0 0 0 0 0 0 0 0 20542.29 0 0 1005122940 1831649029 89 Physician Assistant Only(Encounter Only) CARDEN JATAME 999999999 200 Cook 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 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 7.22 0 0 0 0 0 0 7.22 0 0 1005123044 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21615.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21615.85 0 0 1005123166 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18181.79 0 0 0 0 0 0 0 0 0 0 0 0 0 18181.79 0 0 1005123238 1144657503 16 Nurse Practitioners FRINK ELAINE M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 996.12 0 0 0 0 0 0 996.12 0 0 1005123245 1700128949 10 Physicians CHEATHAM CORY 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3499.18 0 0 0 0 0 0 3499.18 0 0 1005123434 94 Waiver service provider--Children's support (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5679.37 0 0 0 0 0 0 0 0 0 0 0 0 0 5679.37 0 0 1005123621 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3295.26 0 0 0 0 0 0 0 0 0 0 0 0 0 3295.26 0 0 1005123728 1679912687 10 Physicians VELASQUEZ GLADYS 999999999 63 Macon 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2636.45 0 0 0 0 0 0 2636.45 0 0 1005123740 1073969044 16 Nurse Practitioners SOPER NICOLE S. 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4083.32 0 0 0 0 0 0 4083.32 0 0 1005123793 1700230398 40 Federally Qualified Health Centers PRIMECARE WICKER PARK 999999999 200 Cook 0 0 0 340 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1368 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1368 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76487.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76487.67 0 0 1005123942 4005123942 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30817 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2288922.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2288922.89 0 0 1005124910 94 Waiver service provider--Children's support (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1523.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1523.34 0 0 1005124929 1578931051 63 Other Providers of Medical Equipment/Supplies (Non-registered) D & M MEDICAL SUPPLY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20192 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20192 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146639.89 0 15537.38 0 0 0 0 1162177.27 0 0 1005124941 1366573495 86 Clinical Social Worker(Encounter Only) HOLLAND JENNIFER 999999999 200 Cook 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2900.43 0 0 0 0 0 0 2900.43 0 0 1005125073 1972883254 10 Physicians BHAT GIFTY 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1670.99 0 0 0 0 0 0 1670.99 0 0 1005125278 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34888.8 0 0 0 0 0 0 0 0 0 0 0 0 0 34888.8 0 0 1005125384 1396000378 10 Physicians LIU JASON 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12254.99 0 0 0 0 0 0 12254.99 0 0 1005125499 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23815.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23815.69 0 0 1005125618 1114216413 10 Physicians ZHOU DELU 999999999 200 Cook 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 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 0 129.28 0 0 0 0 0 0 0 0 129.28 0 0 1005125833 1548429509 16 Nurse Practitioners DOSE AMI M 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 342.89 0 0 0 0 0 0 0 0 1504.56 0 0 0 0 0 0 1847.45 0 0 1005126072 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 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 38057.46 0 0 0 0 0 0 0 0 0 0 0 0 0 38057.46 0 0 1005126245 1467845479 16 Nurse Practitioners SHAH JESSICA D 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.51 0 0 0 0 0 0 35.51 0 0 1005126679 1528226941 10 Physicians RAYANI SHAYAN 999999999 200 Cook 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 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743.87 0 0 0 0 0 0 1743.87 0 0 1005126703 89 Physician Assistant Only(Encounter Only) 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.63 0 0 0 0 0 0 26.63 0 0 1005126763 1861652455 10 Physicians LINDGREN MICHELLE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 23 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.63 0 851.56 0 0 0 0 0 0 1107.19 0 0 1005126856 10 Physicians 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 213.9 0 0 0 0 0 0 213.9 0 0 1005126953 1245316199 10 Physicians HUSSAIN MAHA H.A. 999999999 200 Cook 0 0 Internal Medicine 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9548.92 0 0 0 0 0 0 9548.92 0 0 1005127001 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 7711.58 0 0 0 0 0 0 0 0 0 0 0 0 0 7711.58 0 0 1005127114 1578958435 30 General Hospitals FRESENIUS MEDICAL CARE ROUND L 999999999 57 Lake DIALYSIS Outpatient dialysis centers. 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19091.94 0 0 0 0 0 19091.94 0 0 1005127129 1841446473 10 Physicians MANEK MEGHA 999999999 91 Sangamon 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2562.04 0 0 0 0 0 0 2562.04 0 0 1005127176 16 Nurse Practitioners 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.19 0 0 0 0 0 0 7.19 0 0 1005127314 92 Waiver service provider--Disability (DHS/DRS) 71 McHenry 0 0 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 6494.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6494.53 0 0 1005127501 1538424098 10 Physicians MORGAN KRISTINA 999999999 61 Livingston 0 0 Emergency Medicine 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2146.95 0 0 0 0 0 0 2146.95 0 0 1005127549 1790988905 10 Physicians HOLT ROXANE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 40 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2019.5 0 1717.14 0 0 0 0 0 0 3736.64 0 0 1005127718 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15823.43 0 0 0 0 0 0 0 0 0 0 0 0 0 15823.43 0 0 1005127982 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2244.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2244.8 0 0 1005128247 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 0 878.85 0 0 0 0 0 0 0 0 0 0 0 0 0 878.85 0 0 1005128300 1427495241 10 Physicians SAGE ALISON 999999999 200 Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 857.48 0 0 0 0 0 0 0 0 764.28 0 0 0 0 0 0 1621.76 0 0 1005128422 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.1 0 0 0 0 0 0 49.1 0 0 1005128740 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25300.13 0 0 0 0 0 0 0 0 0 0 0 0 0 25300.13 0 0 1005128766 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2591.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2591.03 0 0 1005128788 1881613297 10 Physicians AHMAD SAAD 999999999 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.19 0 45670.07 0 0 0 0 0 0 45756.26 0 0 1005129202 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.1 0 0 0 0 0 0 92.1 0 0 1005129315 16 Nurse Practitioners 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 25.6 0 0 0 0 0 0 0 0 150.13 0 0 0 0 0 0 175.73 0 0 1005129316 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27191.89 0 0 0 0 0 0 0 0 0 0 0 0 0 27191.89 0 0 1005129354 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14460.71 0 0 0 0 0 0 0 0 0 0 0 0 0 14460.71 0 0 1005129779 1043669419 11 Dentists AL OBAIDI MUSTAFA 999999999 200 Cook 0 0 General Dentistry 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3855.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3855.97 0 0 1005129831 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21943.45 0 0 0 0 0 0 0 0 0 0 0 0 0 21943.45 0 0 1005129852 1861853517 16 Nurse Practitioners PARAMBEN LEKHA 999999999 200 Cook 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 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1956.34 0 0 0 0 0 0 1956.34 0 0 1005130143 1679925887 16 Nurse Practitioners STEWART THOMAS T 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7294.93 0 0 0 0 0 0 7294.93 0 0 1005130162 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.6 0 0 0 0 0 0 0 0 22.6 0 0 1005130223 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26365.99 0 0 0 0 0 0 0 0 0 0 0 0 0 26365.99 0 0 1005130878 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1005131005 1780950782 10 Physicians KRUEGER ERIC 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 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 6398.25 0 0 0 0 0 0 6398.25 0 0 1005131299 1023479417 16 Nurse Practitioners PATTON MICIAH B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 5117.04 0 0 0 0 0 0 5117.04 0 0 1005131720 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.22 0 0 0 0 0 0 67.22 0 0 1005131729 1801863469 10 Physicians LAVINE STEVEN J 999999999 53 Kane 0 0 Internal Medicine 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1223.46 0 0 0 0 0 0 1223.46 0 0 1005132083 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5891.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5891.52 0 0 1005132142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20725.17 0 0 0 0 0 0 0 0 0 0 0 0 0 20725.17 0 0 1005132198 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 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 4868.35 0 0 0 0 0 0 0 0 0 0 0 0 0 4868.35 0 0 1005132313 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5698.18 0 0 0 0 0 0 0 0 0 0 0 0 0 5698.18 0 0 1005132419 1811162704 10 Physicians MAZE JELICA 999999999 200 Cook 0 0 Internal Medicine 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 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 98.81 0 0 0 0 0 0 98.81 0 0 1005132447 70 Ambulance Service Providers 804 Arkansas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1410 0 0 0 0 0 0 1410 0 0 1005132462 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47160.2 0 0 0 0 0 0 0 0 0 0 0 0 0 47160.2 0 0 1005132514 1992258438 16 Nurse Practitioners DOTY KRYSTYNE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608.06 0 0 0 0 0 0 608.06 0 0 1005132588 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 954.78 0 0 0 0 0 0 0 0 0 0 0 0 0 954.78 0 0 1005132741 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1605.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1605.8 0 0 1005132790 1437434982 16 Nurse Practitioners CARR ABBI D 999999999 80 Peoria 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.52 0 0 0 0 0 0 450.52 0 0 1005132912 1922550300 16 Nurse Practitioners TATE SHAKIRA N 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.78 0 0 0 0 0 0 335.78 0 0 1005133670 10 Physicians 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.38 0 0 0 0 0 0 51.38 0 0 1005133805 10 Physicians 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 302.63 0 0 0 0 0 0 302.63 0 0 1005133939 1033422811 10 Physicians CHET ANDREW 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3575.02 0 0 0 0 0 0 3575.02 0 0 1005133950 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10358.82 0 0 0 0 0 0 0 0 0 0 0 0 0 10358.82 0 0 1005133961 1326060039 60 Pharmacies CVS PHARMACY #16999 606324010 200 Cook 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 0 758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27485 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26325.68 0 0 0 26325.68 0 0 1005134230 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26431.3 0 0 0 0 0 0 0 0 0 0 0 0 0 26431.3 0 0 1005134556 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39560.85 0 0 0 0 0 0 0 0 0 0 0 0 0 39560.85 0 0 1005135056 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1181.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1181.95 0 0 1005135169 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26213.14 0 0 0 0 0 0 0 0 0 0 0 0 0 26213.14 0 0 1005135311 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19274.9 0 0 0 0 0 0 0 0 0 0 0 0 0 19274.9 0 0 1005135528 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27952.03 0 0 0 0 0 0 0 0 0 0 0 0 0 27952.03 0 0 1005135541 1174977631 91 Waiver service provider--Adults (DHS/DDD) PALMER MELISSA 999999999 200 Cook 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 986 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14036.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14036.12 0 0 1005135644 1053622290 10 Physicians WALKER HOLLIS 999999999 200 Cook 0 0 Internal Medicine 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 0 110 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 1109.37 0 0 0 0 0 0 1109.37 0 0 1005135698 1013464031 16 Nurse Practitioners ENGELE CHRISTOPHER G 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 676.43 0 0 0 0 0 0 676.43 0 0 1005135707 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32897.57 0 0 0 0 0 0 0 0 0 0 0 0 0 32897.57 0 0 1005136010 4005136010 92 Waiver service provider--Disability (DHS/DRS) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4057437.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4057437.37 0 0 1005136197 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19347.25 0 0 0 0 0 0 0 0 0 0 0 0 0 19347.25 0 0 1005136230 1083062285 16 Nurse Practitioners BOORE HEATHER A. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 13533.08 0 0 0 0 0 0 13533.08 0 0 1005136314 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38972.15 0 0 0 0 0 0 0 0 0 0 0 0 0 38972.15 0 0 1005136315 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7759.92 0 0 0 0 0 0 0 0 0 0 0 0 0 7759.92 0 0 1005136429 10 Physicians 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 78.63 0 0 0 0 0 0 78.63 0 0 1005136503 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12798.09 0 0 0 0 0 0 0 0 0 0 0 0 0 12798.09 0 0 1005137143 1619264538 10 Physicians PITRODA SEAN P 999999999 30 DuPage 0 0 Radiation Oncology 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2332.4 0 0 0 0 0 0 2332.4 0 0 1005137180 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21120.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21120.44 0 0 1005137286 11 Dentists 200 Cook 0 0 Orthodontist 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 0 480 0 0 1005137339 75 Department of Alcohol and Substance Abuse Provider 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 190.2 0 0 190.2 0 0 1005137392 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 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 13713.86 0 0 0 0 0 0 0 0 0 0 0 0 0 13713.86 0 0 1005137543 10 Physicians 852 Wisconsin 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005137651 1861406431 89 Physician Assistant Only(Encounter Only) WILSON JENNIFER L 999999999 200 Cook 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.33 0 0 0 0 0 0 445.33 0 0 1005137816 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 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 0 585.9 0 0 0 0 0 0 0 0 0 0 0 0 0 585.9 0 0 1005137972 1801242631 23 Occupational Therapists CHEN SHU HUA 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7230.07 7230.07 0 0 1005138029 1811344096 16 Nurse Practitioners PISZCZEK MARGARET 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2149.49 0 0 0 0 0 0 2149.49 0 0 1005138296 1124482252 16 Nurse Practitioners DEUSHANE RYAN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1151.28 0 0 0 0 0 0 1151.28 0 0 1005138543 1003132549 10 Physicians DESAI VIKAS 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.14 0 3162.02 0 0 0 0 0 0 3171.16 0 0 1005138651 1407309941 16 Nurse Practitioners MACKE AMANDA L 999999999 200 Cook 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 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 0 886.47 0 0 0 0 0 0 886.47 0 0 1005138896 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3661.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3661.85 0 0 1005138926 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 62.02 0 0 0 0 0 0 62.02 0 0 1005139051 1740698562 89 Physician Assistant Only(Encounter Only) NILES SARA 999999999 200 Cook 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6815.78 0 0 0 0 0 0 6815.78 0 0 1005139055 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14057.79 0 0 0 0 0 0 0 0 0 0 0 0 0 14057.79 0 0 1005139247 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8184.66 0 0 0 0 0 0 0 0 0 0 0 0 0 8184.66 0 0 1005139550 1437435997 16 Nurse Practitioners MAY CARRIE 999999999 57 Lake 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632.46 0 0 0 0 0 0 632.46 0 0 1005139612 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21546.58 0 0 0 0 0 0 0 0 0 0 0 0 0 21546.58 0 0 1005139650 1255562146 10 Physicians BAZAVAN MUGUREL V. 999999999 200 Cook 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 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4665.22 0 0 0 0 0 0 4665.22 0 0 1005139714 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 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 13247.74 0 0 0 0 0 0 0 0 0 0 0 0 0 13247.74 0 0 1005139732 1649292434 60 Pharmacies CVS PHARMACY #16283 605109209 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3836 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3959.11 0 0 0 3959.11 0 0 1005140003 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25643.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25643.2 0 0 1005140077 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 557.9 0 0 0 0 0 0 0 0 0 0 0 0 0 557.9 0 0 1005140278 1710347406 89 Physician Assistant Only(Encounter Only) HATTAR ADINA 999999999 200 Cook 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1000.52 0 0 0 0 0 0 1000.52 0 0 1005140283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1266.17 0 0 0 0 0 0 0 0 0 0 0 0 0 1266.17 0 0 1005140345 92 Waiver service provider--Disability (DHS/DRS) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17064.53 0 0 0 0 0 0 0 0 0 0 0 0 0 17064.53 0 0 1005140381 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 3239.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3239.47 0 0 1005140427 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 382.08 0 0 0 0 0 0 0 0 0 0 0 0 0 382.08 0 0 1005140955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12676 0 0 0 0 0 0 0 0 0 0 0 0 0 12676 0 0 1005140975 1114360252 10 Physicians IVES LAUREN A 999999999 63 Macon 0 0 0 0 0 4 0 0 0 0 0 0 7 0 26 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 9 0 37 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 9 0 37 0 0 0 0 0 0 0 0 0 495.45 0 0 0 0 0 0 12.16 0 1323.16 0 0 0 0 0 0 1830.77 0 0 1005141097 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23385.59 0 0 0 0 0 0 0 0 0 0 0 0 0 23385.59 0 0 1005141285 1750749503 16 Nurse Practitioners PACEVICIUS LINA 999999999 80 Peoria 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 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866.63 0 0 0 0 0 0 866.63 0 0 1005141369 1417211780 10 Physicians DERANI LENA 999999999 200 Cook 0 0 Neurology 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696.66 0 0 0 0 0 0 696.66 0 0 1005141440 1225478027 10 Physicians SHAMS SHAHED M 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.76 0 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24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14944.52 0 0 0 0 0 0 0 0 0 0 0 0 0 14944.52 0 0 1005149939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2174.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2174.15 0 0 1005149989 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 14109.91 0 0 0 0 0 0 0 0 0 0 0 0 0 14109.91 0 0 1005149998 1932513934 10 Physicians VANDER ROEST DAPHNE LAMBROPOUL 999999999 200 Cook 0 0 0 0 0 8 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 776.64 0 0 0 0 0 0 0 0 4625.91 0 0 0 0 0 0 5402.55 0 0 1005150220 89 Physician Assistant Only(Encounter 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Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22590.65 0 0 0 0 0 0 0 0 0 0 0 0 0 22590.65 0 0 1005156939 1336534791 16 Nurse Practitioners DRUCK DENISE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1091.96 0 0 0 0 0 0 1091.96 0 0 1005156947 1326240102 10 Physicians LUDWIG OLIVIA J 999999999 109 Winnebago 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 189 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2728.1 0 35.37 0 0 0 0 0 0 2763.47 0 0 1005156985 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12733.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12733.57 0 0 1005157066 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30811.33 0 0 0 0 0 0 0 0 0 0 0 0 0 30811.33 0 0 1005157175 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4693.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4693.39 0 0 1005157229 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3994.57 0 0 0 0 0 0 0 0 0 0 0 0 0 3994.57 0 0 1005157275 1962761551 10 Physicians FEATHER RANDALL R. 999999999 47 Jackson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6514.52 0 0 0 0 0 0 6514.52 0 0 1005157403 1407858012 10 Physicians HEANEY MICHAEL L 999999999 49 Jefferson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 8798.6 0 0 0 0 0 0 8798.6 0 0 1005157418 1326598319 60 Pharmacies CVS PHARMACY #17686 999999999 841 Rhode Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4099.06 0 0 0 4099.06 0 0 1005157503 25 Audiologists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.22 256.22 0 0 1005157744 1588664940 65 Independent Diagnostic Testing Facility (IDTF) REACTDX 999999999 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 557.24 0 0 0 0 0 0 0 0 557.24 0 0 1005158065 1942596135 10 Physicians CHAWA VIKRAM S 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1538.06 0 0 0 0 0 0 1538.06 0 0 1005158140 1104835768 89 Physician Assistant Only(Encounter Only) YOUNG LEANN B 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 111.36 0 0 0 0 0 0 0 0 1266.77 0 0 0 0 0 0 1378.13 0 0 1005158526 1215391792 89 Physician Assistant Only(Encounter Only) URBANCZYK GRAZYNA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.55 0 0 0 0 0 0 146.55 0 0 1005158668 1619386836 50 Home Health Agencies - In Home OSF SAINT ANTHONYS HOME HEALTH 620025919 65 Madison 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 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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 0 414.97 0 0 0 0 0 0 414.97 0 0 1005160140 89 Physician Assistant Only(Encounter Only) 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.44 0 0 0 0 0 0 98.44 0 0 1005160280 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22414.52 0 0 0 0 0 0 0 0 0 0 0 0 0 22414.52 0 0 1005160298 1033131842 60 Pharmacies CVS PHARMACY # 16421 600472356 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1836.79 0 0 0 1836.79 0 0 1005160408 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 151.9 0 0 0 0 0 0 0 0 0 0 0 0 0 151.9 0 0 1005160625 1982913661 10 Physicians GEORGE MEENA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349.5 0 13050.69 0 0 0 0 0 0 13400.19 0 0 1005160660 1215481247 16 Nurse Practitioners SHARPE ROCHELL G 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12191.75 0 0 0 0 0 0 12191.75 0 0 1005160928 1427499441 10 Physicians SREEDHARAN MANOJ 999999999 80 Peoria 0 0 Family Practice 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 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 1576.02 0 0 0 0 0 0 1576.02 0 0 1005161092 1740630300 16 Nurse Practitioners WOODARD KAREN Z 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005161150 1902992050 89 Physician Assistant Only(Encounter Only) CRANICK SCOTT W 999999999 47 Jackson 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3258.64 0 0 0 0 0 0 3258.64 0 0 1005161261 1194183392 16 Nurse Practitioners ANHUT KATELYN 999999999 200 Cook 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6543.13 0 0 0 0 0 0 6543.13 0 0 1005161535 1699138990 16 Nurse Practitioners THORSTENSON RACHEL 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 659.4 0 0 0 0 0 0 659.4 0 0 1005161698 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24870.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24870.56 0 0 1005161701 10 Physicians 30 DuPage 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 948.54 0 0 0 0 0 0 980.69 0 0 1005161894 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 5980.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5980.32 0 0 1005161917 1578852836 10 Physicians AUH SOGYONG 999999999 70 McDonough 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866.8 0 0 0 0 0 0 866.8 0 0 1005162091 1912012626 87 Psychologist(Encounter Only) CONARD MARK W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622.76 0 0 0 0 0 0 1622.76 0 0 1005162136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10391.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10391.5 0 0 1005162162 1821433137 10 Physicians RODRIGUEZ ALEIDA A 999999999 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.88 0 1615.64 0 0 0 0 0 0 1623.52 0 0 1005162374 1467474254 60 Pharmacies CVS PHARMACY #16285 606295813 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17835.16 0 0 0 17835.16 0 0 1005162776 1578942686 16 Nurse Practitioners WEED AMANDA L. 999999999 80 Peoria 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358.75 0 0 0 0 0 0 358.75 0 0 1005162827 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22376.71 0 0 0 0 0 0 0 0 0 0 0 0 0 22376.71 0 0 1005162886 1992109755 16 Nurse Practitioners SMITH KATHLEEN W 999999999 91 Sangamon 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 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 0 396.5 0 0 0 0 0 0 396.5 0 0 1005163033 10 Physicians 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.77 0 0 0 0 0 0 47.77 0 0 1005163118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17184.98 0 0 0 0 0 0 0 0 0 0 0 0 0 17184.98 0 0 1005163196 86 Clinical Social Worker(Encounter Only) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.26 0 0 0 0 0 0 109.26 0 0 1005163257 1861871717 16 Nurse Practitioners ANDJELIC JAMES S 999999999 97 Stephenson 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 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 0 702.49 0 0 0 0 0 0 702.49 0 0 1005163545 1598077273 10 Physicians STOJANAC DANIJELA 999999999 200 Cook 0 0 Psychiatry 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15674.76 0 0 0 0 0 0 15674.76 0 0 1005163547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20206.14 0 0 0 0 0 0 0 0 0 0 0 0 0 20206.14 0 0 1005163647 1346551280 10 Physicians IVY ANDRE 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.69 0 1164.26 0 0 0 0 0 0 1205.95 0 0 1005163906 1285909382 10 Physicians BAIG ABDUL R 999999999 30 DuPage 0 0 Internal Medicine 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1964.5 0 0 0 0 0 0 1964.5 0 0 1005163925 1245593086 10 Physicians TYLER MATTHEW J 999999999 30 DuPage 0 0 Internal Medicine 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588.42 0 0 0 0 0 0 588.42 0 0 1005163949 1780947226 10 Physicians MALIK AAMIRA 999999999 91 Sangamon 0 0 General Practice 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 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 0 168.04 0 0 0 0 0 0 168.04 0 0 1005164131 1780133595 60 Pharmacies OSCO DRUG #3061 999999999 57 Lake 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1100.39 0 0 0 1100.39 0 0 1005164279 1265871750 10 Physicians HUTCHERSON BRETT L 999999999 96 St Clair 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 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 0 355.86 0 0 0 0 0 0 355.86 0 0 1005164649 1194195297 23 Occupational Therapists HEIEN ELLEN R. 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 408.28 408.28 0 0 1005164658 1235417627 10 Physicians ADELEKE IBUKUNOLUWA 999999999 200 Cook 0 0 Anesthesiology 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 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 2218.87 0 0 0 0 0 0 2218.87 0 0 1005164772 1275986051 86 Clinical Social Worker(Encounter Only) TOWNE TRAVIS E. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419.86 0 0 0 0 0 0 419.86 0 0 1005164889 1093158727 10 Physicians ZACHARIA ANNETTE 999999999 200 Cook 0 0 Internal Medicine 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 0 254 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 5663.11 0 0 0 0 0 0 5663.11 0 0 1005164983 10 Physicians 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 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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 78.09 0 0 0 0 0 0 78.09 0 0 1005166068 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25938.48 0 0 0 0 0 0 0 0 0 0 0 0 0 25938.48 0 0 1005166391 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.14 0 0 0 0 0 0 95.14 0 0 1005166506 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 1005166730 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14447.96 0 0 0 0 0 0 0 0 0 0 0 0 0 14447.96 0 0 1005166769 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21249.66 0 0 0 0 0 0 0 0 0 0 0 0 0 21249.66 0 0 1005166817 1639530298 16 Nurse Practitioners MITSDARFFER CHRISTINA M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 217.94 0 0 0 0 0 0 217.94 0 0 1005166885 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.15 0 0 0 0 0 0 22.15 0 0 1005166958 1306189790 10 Physicians HARRIS BHRANDON ALLISTER 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 361.08 0 0 0 0 0 0 0 0 5842.67 0 0 0 0 0 0 6203.75 0 0 1005167049 1982816237 10 Physicians VISHWANATH ANU 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 2 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.16 0 11996.77 0 0 0 0 0 0 12008.93 0 0 1005167055 1770525578 10 Physicians KORALNIK IGOR J 606118709 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453.12 0 0 0 0 0 0 453.12 0 0 1005167195 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8620.26 0 0 0 0 0 0 0 0 0 0 0 0 0 8620.26 0 0 1005167518 10 Physicians 91 Sangamon 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268.39 0 0 0 0 0 0 268.39 0 0 1005167555 1174887871 10 Physicians ZLATAROV NIKOLAY 999999999 200 Cook 0 0 Internal Medicine 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1778.03 0 0 0 0 0 0 1778.03 0 0 1005167775 1871878249 25 Audiologists RAGUSA JENNIFER 999999999 72 McLean 0 0 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 0 244 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 32956.85 32956.85 0 0 1005168100 1033571591 10 Physicians ZHANG ALICE 999999999 200 Cook 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 78.3 0 0 0 0 0 0 0 0 1438.88 0 0 0 0 0 0 1517.18 0 0 1005168116 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10451.34 0 0 0 0 0 0 0 0 0 0 0 0 0 10451.34 0 0 1005168131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15186.84 0 0 0 0 0 0 0 0 0 0 0 0 0 15186.84 0 0 1005168150 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10372.3 0 0 0 0 0 0 0 0 0 0 0 0 0 10372.3 0 0 1005168359 1093178576 16 Nurse Practitioners KRUSE MICHAEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2887.65 0 0 0 0 0 0 2887.65 0 0 1005168420 1235324450 89 Physician Assistant Only(Encounter Only) MURPHY LYLE A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2363.74 0 0 0 0 0 0 2363.74 0 0 1005168662 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.57 0 0 0 0 0 0 122.57 0 0 1005168672 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.96 0 0 0 0 0 0 0 0 0 0 0 0 0 113.96 0 0 1005169022 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 595.43 0 0 0 0 0 0 0 0 0 0 0 0 0 595.43 0 0 1005169048 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15771.25 0 0 0 0 0 0 0 0 0 0 0 0 0 15771.25 0 0 1005169053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4997.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4997.12 0 0 1005169081 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16242.62 0 0 0 0 0 0 0 0 0 0 0 0 0 16242.62 0 0 1005169169 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 1685.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1685.09 0 0 1005169413 1871643072 16 Nurse Practitioners HOGAN MICHELE L. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.33 0 0 0 0 0 0 1921.33 0 0 1005169815 1811296627 10 Physicians TANTOCO ANTHONY 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13106.95 0 0 0 0 0 0 13106.95 0 0 1005169882 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2057.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2057.16 0 0 1005170092 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 577.36 0 0 0 0 0 0 0 0 0 0 0 0 0 577.36 0 0 1005170187 1003088279 10 Physicians HOROWITZ PELEG M 999999999 30 DuPage 0 0 Neurology Surgery 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15073.57 0 0 0 0 0 0 15073.57 0 0 1005170262 1063434777 60 Pharmacies CVS PHARMACY #16664 601742424 53 Kane 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 77 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 2604.12 0 0 0 2604.12 0 0 1005170304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12303.11 0 0 0 0 0 0 0 0 0 0 0 0 0 12303.11 0 0 1005170546 1861824278 89 Physician Assistant Only(Encounter Only) NGUYEN LAURIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6618.02 0 0 0 0 0 0 6618.02 0 0 1005170664 1679937098 75 Department of Alcohol and Substance Abuse Provider MENTAL HEALTH CENTERS OF WESTE 999999999 83 Pike 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 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 1592.01 0 0 1592.01 0 0 1005170735 1407932114 16 Nurse Practitioners STOWE CATHERINE 999999999 200 Cook 0 0 0 0 0 28 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 2264.1 0 0 0 0 0 0 0 0 3703.54 0 0 0 0 0 0 5967.64 0 0 1005170746 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8565.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8565.88 0 0 1005170896 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15030.02 0 0 0 0 0 0 0 0 0 0 0 0 0 15030.02 0 0 1005171202 1457634693 16 Nurse Practitioners LANGLEY MEROPI I 999999999 80 Peoria 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 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299.03 0 0 0 0 0 0 299.03 0 0 1005171415 1821207978 10 Physicians MADDUR HARIPRIYA 999999999 200 Cook 0 0 Internal Medicine 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742.58 0 0 0 0 0 0 742.58 0 0 1005171694 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15802.93 0 0 0 0 0 0 0 0 0 0 0 0 0 15802.93 0 0 1005171712 1477985547 16 Nurse Practitioners FLINN LAURA E 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 363.99 0 0 0 0 0 0 363.99 0 0 1005171848 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 13972.62 0 0 0 0 0 0 0 0 0 0 0 0 0 13972.62 0 0 1005171906 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1444.3 0 0 0 0 0 0 1444.3 0 0 1005172046 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005172186 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33165.75 0 0 0 0 0 0 0 0 0 0 0 0 0 33165.75 0 0 1005172312 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17112.69 0 0 0 0 0 0 0 0 0 0 0 0 0 17112.69 0 0 1005172330 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 217.7 0 0 0 0 0 0 217.7 0 0 1005172361 1366612012 10 Physicians KLOVNING JASON J 999999999 109 Winnebago 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 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 4580.08 0 0 0 0 0 0 4580.08 0 0 1005172776 1558717280 22 Physical Therapists STEWARD ASHLEY A. 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530.01 530.01 0 0 1005172992 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 32 0 0 0 0 0 0 32 0 0 1005173017 1396063921 10 Physicians PALMER JEREMIAH 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.93 0 329.88 0 0 0 0 0 0 391.81 0 0 1005173277 1316349830 16 Nurse Practitioners TURNBULL CARA A 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 117.76 0 0 0 0 0 0 0 0 378.7 0 0 0 0 0 0 496.46 0 0 1005173335 1073064952 16 Nurse Practitioners SMITH MKENZEE B 999999999 80 Peoria 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 0 112 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 0 229.45 0 0 0 0 0 0 229.45 0 0 1005173613 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11383.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11383.62 0 0 1005173713 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 1183.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1183.86 0 0 1005173783 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32264.31 0 0 0 0 0 0 0 0 0 0 0 0 0 32264.31 0 0 1005173870 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34536.55 0 0 0 0 0 0 0 0 0 0 0 0 0 34536.55 0 0 1005173918 92 Waiver service provider--Disability (DHS/DRS) 23 Clinton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20842.73 0 0 0 0 0 0 0 0 0 0 0 0 0 20842.73 0 0 1005174252 1871047423 60 Pharmacies CVS PHARMACY 10660 999999999 53 Kane 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4983.94 0 0 0 4983.94 0 0 1005174282 1659325389 10 Physicians AHMAD JAMAL 999999999 200 Cook 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 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7890.42 0 0 0 0 0 0 7890.42 0 0 1005174619 1710172325 89 Physician Assistant Only(Encounter Only) WENDT DONALD 999999999 91 Sangamon 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400.42 0 0 0 0 0 0 400.42 0 0 1005174686 1548471204 10 Physicians MASOOD SYED A 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 4 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.7 0 3471.39 0 0 0 0 0 0 3616.09 0 0 1005174839 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 10849.48 0 0 0 0 0 0 0 0 0 0 0 0 0 10849.48 0 0 1005175001 1821492471 16 Nurse Practitioners LAPAZ LAUREN 999999999 30 DuPage 0 0 0 0 0 1 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 491.9 0 0 0 0 0 0 498.3 0 0 1005175046 1922398262 10 Physicians SANAN PRATEEK 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 442 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9009.85 0 153 0 0 0 0 0 0 9162.85 0 0 1005175157 1982050985 10 Physicians CHANG TIFFANY DIANA 999999999 200 Cook 0 0 Family Practice 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 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 0 565.17 0 0 0 0 0 0 565.17 0 0 1005175618 1629361829 10 Physicians MERRICK MARIA C 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2371.42 0 0 0 0 0 0 2371.42 0 0 1005175625 1962827881 16 Nurse Practitioners BURDA JANET E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 853.6 0 0 0 0 0 0 853.6 0 0 1005175965 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 1097.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1097.22 0 0 1005175968 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24437.01 0 0 0 0 0 0 0 0 0 0 0 0 0 24437.01 0 0 1005175973 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2898.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2898.01 0 0 1005175990 1235479783 10 Physicians IRRINKI KRISHNA M 999999999 19 Champaign 0 0 Clinical Pathology 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 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2532.43 0 0 0 0 0 0 0 0 2532.43 0 0 1005176112 1356782288 30 General Hospitals HOME DIALYSIS SERVICES OLYMPIA 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7484.46 0 0 0 0 0 7484.46 0 0 1005176446 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23964.93 0 0 0 0 0 0 0 0 0 0 0 0 0 23964.93 0 0 1005176586 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23092.53 0 0 0 0 0 0 0 0 0 0 0 0 0 23092.53 0 0 1005176658 1073985727 61 Independent Laboratories "TOXUSA LABS, LLC" 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467.74 0 0 0 0 0 0 0 0 467.74 0 0 1005176960 1467895128 10 Physicians HUANG FELIX Y 999999999 200 Cook 0 0 Emergency Medicine 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4154.59 0 0 0 0 0 0 4154.59 0 0 1005177061 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21782.64 0 0 0 0 0 0 0 0 0 0 0 0 0 21782.64 0 0 1005177113 1639532609 16 Nurse Practitioners LONG ANGELA L 999999999 66 Marion 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 782.75 0 0 0 0 0 0 782.75 0 0 1005177131 91 Waiver service provider--Adults (DHS/DDD) 94 Shelby 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6300.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6300.53 0 0 1005177275 1386002145 60 Pharmacies MARIANOS PHARMACY #8536 999999999 30 DuPage 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 796.94 0 0 0 796.94 0 0 1005177438 1558598102 86 Clinical Social Worker(Encounter Only) HEMANN AMY L 999999999 65 Madison 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1244.59 0 0 0 0 0 0 1244.59 0 0 1005177498 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10816.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10816.18 0 0 1005177645 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19221.94 0 0 0 0 0 0 0 0 0 0 0 0 0 19221.94 0 0 1005177648 1093071680 10 Physicians JOHNSON JESSICA D 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.9 0 5991.71 0 0 0 0 0 0 6015.61 0 0 1005177683 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27134.42 0 0 0 0 0 0 0 0 0 0 0 0 0 27134.42 0 0 1005177765 1730528944 10 Physicians WADLINGTON ADAM R 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1265.27 0 0 0 0 0 0 1265.27 0 0 1005178125 1215062419 87 Psychologist(Encounter Only) SMITH MICHAEL C 999999999 200 Cook 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 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 0 735.72 0 0 0 0 0 0 735.72 0 0 1005178330 1588091425 63 Other Providers of Medical Equipment/Supplies (Non-registered) MED RESOURCES 620024319 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11806.88 0 2822.79 0 0 0 0 14629.67 0 0 1005178341 1912196544 89 Physician Assistant Only(Encounter Only) SALAZAR RAQUEL 999999999 30 DuPage 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 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 0 476.8 0 0 0 0 0 0 476.8 0 0 1005178363 1124492012 16 Nurse Practitioners BOZADA THOMAS J. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351.6 0 0 0 0 0 0 351.6 0 0 1005178375 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 1933.12 0 0 0 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1005178897 1730319336 10 Physicians YANG WAYNE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3536.13 0 0 0 0 0 0 3536.13 0 0 1005179004 1962873919 30 General Hospitals "RENVIVA, LLC" 999999999 109 Winnebago DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166389.16 0 0 0 0 0 166389.16 0 0 1005179195 1710270376 11 Dentists CHANG YONG 999999999 71 McHenry 0 0 General Dentistry 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1272.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1272.3 0 0 1005179258 1619422870 22 Physical Therapists COOK JILL 999999999 83 Pike 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.14 0 2384.39 0 0 0 0 0 0 2390.53 0 0 1005180764 1821541582 16 Nurse Practitioners SPURLOCK ADAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3099.48 0 0 0 0 0 0 3099.48 0 0 1005180779 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.98 0 0 0 0 0 0 12.98 0 0 1005180860 1023167327 10 Physicians RANGALA SANGITA 999999999 30 DuPage 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 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 1603.65 0 0 0 0 0 0 1603.65 0 0 1005181090 1659820280 16 Nurse Practitioners GEBHARDT KATIE L 999999999 200 Cook 0 0 0 0 0 42 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.67 0 394.83 0 0 0 0 0 0 408.5 0 0 1005181458 1134438740 16 Nurse Practitioners KAMP SANDRA J 999999999 200 Cook 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 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 0 415.05 0 0 0 0 0 0 415.05 0 0 1005181520 1285077024 10 Physicians ELGAR CALLINA N 999999999 97 Stephenson 0 1 Family Practice 0 0 0 2 0 0 0 0 0 0 5 0 59 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 148 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 148 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 61.1 0 3105.93 0 0 0 0 0 0 3251.65 0 0 1005181538 1982153425 29 ICF/MR MARKLUND WASMOND CENTER 601209218 200 Cook 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 1243 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 0 0 0 0 0 0 0 0 0 0 0 0 9318179.33 0 0 0 0 0 0 0 0 0 0 9318179.33 0 0 1005182222 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 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 0 160 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 906.98 0 0 0 0 0 0 0 0 3557.83 0 0 0 0 0 0 4464.81 0 0 1005183051 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14033.36 0 0 0 0 0 0 0 0 0 0 0 0 0 14033.36 0 0 1005183231 1053856260 11 Dentists VENUGOPAL SHWETA 999999999 200 Cook 0 0 General Dentistry 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9548.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9548.81 0 0 1005183441 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1005183914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5081.02 0 0 0 0 0 0 0 0 0 0 0 0 0 5081.02 0 0 1005184369 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005184381 1437414695 10 Physicians HUSSAIN SYED B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 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 4436.25 0 0 0 0 0 0 4436.25 0 0 1005184420 1083042766 89 Physician Assistant Only(Encounter Only) WHITE KARA M 999999999 200 Cook 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717.57 0 0 0 0 0 0 717.57 0 0 1005184518 1538617402 16 Nurse Practitioners MONTEIRO BETHANY L 999999999 98 Tazewell 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 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 0 670.85 0 0 0 0 0 0 670.85 0 0 1005184542 1093844169 63 Other Providers of Medical Equipment/Supplies (Non-registered) INTERACTIVE PHYSICIANS LTD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6019.41 0 915.64 0 0 0 0 6935.05 0 0 1005184565 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 2.88 0 0 0 0 0 0 2.88 0 0 1005184623 10 Physicians 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.3 0 0 0 0 0 0 15.3 0 0 1005184952 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1295.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.68 0 0 1005185018 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22530.33 0 0 0 0 0 0 0 0 0 0 0 0 0 22530.33 0 0 1005185161 1720461858 16 Nurse Practitioners LOSIK STEFANIE J 999999999 200 Cook 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.24 0 0 0 0 0 0 1370.24 0 0 1005185171 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19773.53 0 0 0 0 0 0 0 0 0 0 0 0 0 19773.53 0 0 1005185364 1447610027 29 ICF/MR ROSEMARY HOME 606601017 200 Cook 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 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501549.44 0 0 0 0 0 0 0 0 0 0 1501549.44 0 0 1005185504 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1505.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1505.58 0 0 1005185672 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1833.08 0 0 1005185721 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21277.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21277.32 0 0 1005185843 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20804.73 0 0 0 0 0 0 0 0 0 0 0 0 0 20804.73 0 0 1005186210 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3808.86 0 0 0 0 0 0 0 0 0 0 0 0 0 3808.86 0 0 1005186248 91 Waiver service provider--Adults (DHS/DDD) 66 Marion 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13989.42 0 0 0 0 0 0 0 0 0 0 0 0 0 13989.42 0 0 1005186327 1801141569 10 Physicians ZAHARIA ALEXANDRE 999999999 200 Cook 0 0 Internal Medicine 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 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7063.81 0 0 0 0 0 0 7063.81 0 0 1005186864 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21732.07 0 0 0 0 0 0 0 0 0 0 0 0 0 21732.07 0 0 1005187038 1578645537 16 Nurse Practitioners DESHON DANA J 999999999 110 Woodford 0 0 0 0 0 34 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 2231.98 0 0 0 0 0 0 0 0 2375.05 0 0 0 0 0 0 4607.03 0 0 1005187180 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24763.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24763.81 0 0 1005187483 1114374139 16 Nurse Practitioners CALDWELL TESHICA 999999999 200 Cook 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 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8443.47 0 0 0 0 0 0 8443.47 0 0 1005188259 1407223183 63 Other Providers of Medical Equipment/Supplies (Non-registered) CENTRAL NURSING HOME 999999999 200 Cook 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 0 110 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 18397 0 0 0 0 0 0 18397 0 0 1005188389 1174672026 10 Physicians IKEZUAGU OJAKU B 999999999 200 Cook 0 0 Family Practice 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609.65 0 0 0 0 0 0 609.65 0 0 1005188592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1349.13 0 0 0 0 0 0 0 0 0 0 0 0 0 1349.13 0 0 1005188802 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242.45 0 0 0 0 0 0 242.45 0 0 1005188851 1376622092 10 Physicians KALRA SANDEEP 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 1 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1497 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1497 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 3080.32 0 0 0 0 0 0 3185.28 0 0 1005188921 1659617561 89 Physician Assistant Only(Encounter Only) BARTELS LARA B 999999999 19 Champaign 0 0 0 0 0 50 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 4051.49 0 0 0 0 0 0 0 0 2662.5 0 0 0 0 0 0 6713.99 0 0 1005189059 1427508233 89 Physician Assistant Only(Encounter Only) LEONARD TRISHA D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.9 0 0 0 0 0 0 10.9 0 0 1005189177 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9725.94 0 0 0 0 0 0 0 0 0 0 0 0 0 9725.94 0 0 1005189299 1285929414 10 Physicians KOWALCZYK JAMES 731279742 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10156.37 0 0 0 0 0 0 10156.37 0 0 1005189541 1609139393 10 Physicians SIMON JULIA C 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.78 0 5275.49 0 0 0 0 0 0 5332.27 0 0 1005189867 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16007.58 0 0 0 0 0 0 0 0 0 0 0 0 0 16007.58 0 0 1005189960 1346533866 10 Physicians LUTTIG CHRISTOPHER T 999999999 200 Cook 0 0 Emergency Medicine 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 0 171 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 5748.21 0 0 0 0 0 0 5748.21 0 0 1005189973 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15953.06 0 0 0 0 0 0 0 0 0 0 0 0 0 15953.06 0 0 1005189985 1629301890 10 Physicians SAHAY MANISHA 999999999 57 Lake 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.33 0 69.05 0 0 0 0 0 0 160.38 0 0 1005190017 1669824983 91 Waiver service provider--Adults (DHS/DDD) RANGEL DALINA 999999999 200 Cook 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 1032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92938.8 0 0 0 0 0 0 0 0 0 0 0 0 0 92938.8 0 0 1005190101 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.99 0 0 0 0 0 0 35.99 0 0 1005190187 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15626.45 0 0 0 0 0 0 0 0 0 0 0 0 0 15626.45 0 0 1005190288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6999.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6999.58 0 0 1005190345 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 16768.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16768.4 0 0 1005190483 1578585360 60 Pharmacies CVS PHARMACY #16278 601235525 53 Kane 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4881.89 0 0 0 4881.89 0 0 1005190757 46 Ambulatory Surgical Treatment Centers 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 240.46 0 0 0 0 0 240.46 0 0 1005190781 1265660534 10 Physicians BISWAS DEBDUT 999999999 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 37 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758.61 0 6327.21 0 0 0 0 0 0 7085.82 0 0 1005191569 16 Nurse Practitioners 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352.01 0 0 0 0 0 0 352.01 0 0 1005191593 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18699.66 0 0 0 0 0 0 0 0 0 0 0 0 0 18699.66 0 0 1005191965 91 Waiver service provider--Adults (DHS/DDD) 10 Adams 0 0 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 12874.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12874.42 0 0 1005191976 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1005192041 1891163200 23 Occupational Therapists ELMORE JILLIAN M 999999999 91 Sangamon 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9535.63 9535.63 0 0 1005192229 10 Physicians 109 Winnebago 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.38 0 0 0 0 0 0 173.38 0 0 1005192283 1528514411 16 Nurse Practitioners RICHRATH DENNIS A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 879.93 0 0 0 0 0 0 879.93 0 0 1005192539 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 15802.29 0 0 0 0 0 0 0 0 0 0 0 0 0 15802.29 0 0 1005192583 1518118140 89 Physician Assistant Only(Encounter Only) MEJORADO TERESA D 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3850.7 0 0 0 0 0 0 3850.7 0 0 1005192613 22 Physical Therapists 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 78.48 78.48 0 0 1005192931 1770036436 70 Ambulance Service Providers AIR EVAC EMS INC 999999999 90 Saline 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33042.71 0 0 0 0 0 0 33042.71 0 0 1005193059 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.48 0 0 0 0 0 0 21.48 0 0 1005193265 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39577.07 0 0 0 0 0 0 0 0 0 0 0 0 0 39577.07 0 0 1005193570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 967.94 0 0 0 0 0 0 0 0 0 0 0 0 0 967.94 0 0 1005193664 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 1005193983 1346403961 10 Physicians CHANG JONATHAN S 999999999 80 Peoria 0 0 Ophthalmology 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 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 2890.55 0 0 0 0 0 0 2890.55 0 0 1005194055 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 712.43 0 0 0 0 0 0 0 0 0 0 0 0 0 712.43 0 0 1005194094 1154610681 10 Physicians SHAH SANKET C 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 350 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6502.85 0 658.78 0 0 0 0 0 0 7161.63 0 0 1005194197 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6427.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6427.09 0 0 1005194259 1962780155 10 Physicians SCHWETYE KATHERINE 999999999 200 Cook 0 0 0 0 0 0 0 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 0 652.11 0 0 0 0 0 0 0 0 652.11 0 0 1005194861 1760866784 16 Nurse Practitioners JOSEPH JANAIES 999999999 200 Cook 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 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 0 549.55 0 0 0 0 0 0 549.55 0 0 1005195133 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44527.18 0 0 0 0 0 0 0 0 0 0 0 0 0 44527.18 0 0 1005195440 1518352772 89 Physician Assistant Only(Encounter Only) LUEKING RYAN E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.53 0 0 0 0 0 0 431.53 0 0 1005195676 1629364708 10 Physicians ROHR ASHLEY A 999999999 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 8 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.37 0 14324.94 0 0 0 0 0 0 14422.31 0 0 1005195742 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13921.67 0 0 0 0 0 0 0 0 0 0 0 0 0 13921.67 0 0 1005195907 1306172754 89 Physician Assistant Only(Encounter Only) FONTANA KATE 999999999 109 Winnebago 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 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 0 169.87 0 0 0 0 0 0 169.87 0 0 1005196060 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3110.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3110.22 0 0 1005196260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17649.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17649.43 0 0 1005196277 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2026.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2026.2 0 0 1005196440 1164886669 52 Certified local public health department KENDALL COUNTY HEALTH DEPARTME 999999999 55 Kendall 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.2 0 89.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.8 0 0 1005196449 1821448077 16 Nurse Practitioners GLEESON ERIKA ETHEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 3467.26 0 0 0 0 0 0 3467.26 0 0 1005196984 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 263.86 0 0 0 0 0 0 263.86 0 0 1005197069 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 1682.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1682.24 0 0 1005197282 16 Nurse Practitioners 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.46 0 0 0 0 0 0 2.46 0 0 1005197428 10 Physicians 108 Williamson 0 0 Internal Medicine 0 0 0 0 0 0 0 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 78.88 0 0 0 0 0 0 78.88 0 0 1005197561 1346612561 11 Dentists QADRI SUBUHI 999999999 200 Cook 0 0 General Dentistry 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13560.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13560.61 0 0 1005197744 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 30289.39 0 0 0 0 0 0 0 0 0 0 0 0 0 30289.39 0 0 1005197966 1548621121 16 Nurse Practitioners GERVASI KRISTEN M 999999999 200 Cook 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1657.86 0 0 0 0 0 0 1657.86 0 0 1005198182 10 Physicians 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154.9 0 0 0 0 0 0 154.9 0 0 1005198208 24 Speech Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.88 155.88 0 0 1005198495 1306292248 36 Community mental health provider THRESHOLDS 999999999 57 Lake 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785 0 0 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785 0 0 118792.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200055.39 0 0 318847.83 0 0 1005198496 1083974885 10 Physicians GLASER LAURA M 999999999 200 Cook 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 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 1322.48 0 0 0 0 0 0 1322.48 0 0 1005198681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 415.89 0 0 0 0 0 0 0 0 0 0 0 0 0 415.89 0 0 1005198773 1073952396 10 Physicians SULLIVAN STEPHANIE L 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1966.77 0 0 0 0 0 0 1966.77 0 0 1005198818 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.86 0 0 0 0 0 0 41.86 0 0 1005198844 1194064279 10 Physicians VENNAVARAM SWETHA 999999999 80 Peoria 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 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 1207.83 0 0 0 0 0 0 1207.83 0 0 1005199549 1457588071 10 Physicians ZABOLI DAVID 999999999 200 Cook 0 0 Otolaryngology 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 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 4337.94 0 0 0 0 0 0 4337.94 0 0 1005199557 92 Waiver service provider--Disability (DHS/DRS) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19105.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19105.91 0 0 1005199727 10 Physicians 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.01 0 0 0 0 0 0 8.01 0 0 1005199892 10 Physicians 80 Peoria 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005199949 1891920120 10 Physicians RAJJOUB SAMER R 999999999 200 Cook 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4350.91 0 0 0 0 0 0 4350.91 0 0 1005200101 1932519766 13 Podiatrists BASSI CHADWICK A 999999999 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.21 0 0 0 0 0 0 109.21 0 0 1005200259 1679877674 16 Nurse Practitioners SCHWARTZ BETH 999999999 200 Cook 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 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 0 892.84 0 0 0 0 0 0 892.84 0 0 1005200275 1205924099 89 Physician Assistant Only(Encounter Only) HEEREN SARAH THERICA 999999999 106 Whiteside 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 0 169 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 0 532.17 0 0 0 0 0 0 532.17 0 0 1005200409 25 Audiologists 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 17.46 17.46 0 0 1005200572 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24297.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24297.68 0 0 1005200785 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 78.09 0 0 1005200829 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.65 0 0 0 0 0 0 144.65 0 0 1005201017 1952496564 89 Physician Assistant Only(Encounter Only) MCKINNEY DALE T 999999999 91 Sangamon 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 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 24.04 0 0 0 0 0 0 24.04 0 0 1005201077 1194036210 10 Physicians FULLER ERIC B 999999999 200 Cook 0 0 Orthopedic Surgery 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6535.07 0 0 0 0 0 0 6535.07 0 0 1005201379 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26778.77 0 0 0 0 0 0 0 0 0 0 0 0 0 26778.77 0 0 1005201408 1760828842 10 Physicians JASTI SRAVAN K 999999999 31 Edgar 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4600.49 0 0 0 0 0 0 4600.49 0 0 1005201459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13196.61 0 0 0 0 0 0 0 0 0 0 0 0 0 13196.61 0 0 1005201470 1710036892 10 Physicians OBEIUS MARCUS 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 235.11 0 0 0 0 0 0 235.11 0 0 1005201649 1265583694 16 Nurse Practitioners BAILEY SHERRY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349.25 0 0 0 0 0 0 349.25 0 0 1005201862 1669823068 16 Nurse Practitioners JACKSON KORY 999999999 30 DuPage 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 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 54.34 0 0 0 0 0 0 54.34 0 0 1005201968 1548719610 33 Nursing Facilities "WATERFORD CARE CENTER, THE" 606261818 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1549956.16 0 0 0 0 0 0 0 1549956.16 0 0 1005202019 1134576804 60 Pharmacies CVS PHARMACY #10677 999999999 30 DuPage 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3928 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4136.63 0 0 0 4136.63 0 0 1005202077 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 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 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 10228.61 0 0 0 0 0 0 0 0 0 0 0 0 0 10228.61 0 0 1005202262 1245688209 16 Nurse Practitioners CONNOR LINDSAY 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 748.78 0 0 0 0 0 0 755.18 0 0 1005202311 1467455998 10 Physicians MCCONNELL KEVIN W 999999999 200 Cook 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 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 1261.53 0 0 0 0 0 0 1261.53 0 0 1005202473 1881141125 16 Nurse Practitioners BUTLER TRACY L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4571.68 0 0 0 0 0 0 4571.68 0 0 1005202567 1245606276 16 Nurse Practitioners MEINERT ALICIA 999999999 80 Peoria 0 0 0 0 0 4 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 327.58 0 0 0 0 0 0 0 0 578.99 0 0 0 0 0 0 906.57 0 0 1005202649 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 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 0 110.44 0 0 0 0 0 0 110.44 0 0 1005202895 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27598.53 0 0 0 0 0 0 0 0 0 0 0 0 0 27598.53 0 0 1005202943 1083076871 16 Nurse Practitioners DANIELS ASANTEWAH F 999999999 200 Cook 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 0 222 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 3409.24 0 0 0 0 0 0 3409.24 0 0 1005203027 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7641.21 0 0 0 0 0 0 0 0 0 0 0 0 0 7641.21 0 0 1005203061 1326338948 11 Dentists HAN MICHAEL DAVID 999999999 200 Cook 0 0 Maxillofacial Surgery 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15906.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15906.64 0 0 1005203170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1275.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1275.33 0 0 1005203215 1982980421 89 Physician Assistant Only(Encounter Only) KAWA ANNA 999999999 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461.96 0 0 0 0 0 0 461.96 0 0 1005203250 1225469752 16 Nurse Practitioners SANDLER HEATHER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.78 0 0 0 0 0 0 867.78 0 0 1005203854 1235151945 60 Pharmacies CVS PHARMACY #17001 604048845 107 Will 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4126.46 0 0 0 4126.46 0 0 1005203928 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30230.74 0 0 0 0 0 0 0 0 0 0 0 0 0 30230.74 0 0 1005203970 1053620930 89 Physician Assistant Only(Encounter Only) KISTENFEGER CAMI J 999999999 63 Macon 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 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 0 289.91 0 0 0 0 0 0 289.91 0 0 1005204268 1316139793 10 Physicians OSBUN JOSHUA W 999999999 96 St Clair 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 8 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.55 0 4214.82 0 0 0 0 0 0 4251.37 0 0 1005204314 1295104487 16 Nurse Practitioners SWEENEY DENNIS P 999999999 89 Rock Island 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 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 3922.34 0 0 0 0 0 0 3922.34 0 0 1005204380 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460.5 0 0 0 0 0 0 460.5 0 0 1005204583 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4482.88 0 0 0 0 0 0 0 0 0 0 0 0 0 4482.88 0 0 1005204821 1942755574 16 Nurse Practitioners NAVO KATHERINE ANNE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005204862 1477795607 10 Physicians MEHTA-SHAH NEHA 999999999 49 Jefferson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2457.23 0 0 0 0 0 0 2457.23 0 0 1005205222 16 Nurse Practitioners 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.92 0 0 0 0 0 0 86.92 0 0 1005205349 4005205349 90 Waiver service provider--Elderly (DOA) VIETNAMESE ASSOCIATION OF ILL 999999999 200 Cook 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 3939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286704.6 0 0 0 0 0 0 0 0 0 0 0 0 0 286704.6 0 0 1005205454 1932185154 10 Physicians BRINSER SHERI E 999999999 200 Cook 0 0 Anesthesiology 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 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 2370.55 0 0 0 0 0 0 2370.55 0 0 1005205620 1851495899 30 General Hospitals RUSH UNIVERSITY MEDICAL CENTER 606123833 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331664.91 0 0 0 0 0 0 0 0 0 331664.91 0 0 1005205657 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6691.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6691.08 0 0 1005205674 1912347329 10 Physicians JESWANI SARINA G 999999999 53 Kane 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1695.38 0 0 0 0 0 0 1695.38 0 0 1005205678 87 Psychologist(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005205688 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33122.06 0 0 0 0 0 0 0 0 0 0 0 0 0 33122.06 0 0 1005205729 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17409.07 0 0 0 0 0 0 0 0 0 0 0 0 0 17409.07 0 0 1005205756 1891717500 60 Pharmacies CVS PHARMACY # 16527 600148016 71 McHenry 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1405.1 0 0 0 1405.1 0 0 1005205788 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7895.24 0 0 0 0 0 0 0 0 0 0 0 0 0 7895.24 0 0 1005205961 1174775803 11 Dentists SHARMA TRIPTY 999999999 30 DuPage 0 0 General Dentistry 0 0 13 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3036.35 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 3412.7 0 0 1005206068 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23228.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23228.36 0 0 1005206251 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 25020.1 0 0 0 0 0 0 0 0 0 0 0 0 0 25020.1 0 0 1005206318 4005206318 92 Waiver service provider--Disability (DHS/DRS) PRUDENTIAL HOME HEALTH SVCS 999999999 200 Cook 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82070.8 0 0 0 0 0 0 0 0 0 0 0 0 0 82070.8 0 0 1005206487 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13198.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13198.37 0 0 1005206600 1063724664 10 Physicians KOCHAR KUNAL 999999999 200 Cook 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.36 0 0 0 0 0 0 2127.36 0 0 1005206748 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.75 0 0 0 0 0 0 3.75 0 0 1005206804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19832.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19832.38 0 0 1005207171 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5040.4 5040.4 0 0 1005207451 1336161041 60 Pharmacies CVS PHARMACY #16741 605438333 55 Kendall 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 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6067.14 0 0 0 6067.14 0 0 1005207512 1447498563 89 Physician Assistant Only(Encounter Only) SEE ANITA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612.84 0 0 0 0 0 0 612.84 0 0 1005207770 92 Waiver service provider--Disability (DHS/DRS) 836 Ohio 0 0 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 16402.43 0 0 0 0 0 0 0 0 0 0 0 0 0 16402.43 0 0 1005207975 1659710218 11 Dentists JOHNSON JAROD W 999999999 65 Madison 0 0 Pedodontics 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5126.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5126.14 0 0 1005208024 1386059624 10 Physicians AVILA CARLOS 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 14 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.56 0 2807.22 0 0 0 0 0 0 2923.78 0 0 1005208249 1144563594 10 Physicians SIDDIQI RAYYAN M 999999999 30 DuPage 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 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1057.94 0 0 0 0 0 0 1057.94 0 0 1005208726 1013319623 16 Nurse Practitioners LORD NICOLE M 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 598.6 0 0 0 0 0 0 683.22 0 0 1005208860 1841501434 10 Physicians MUNNS JUSTIN J 999999999 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 65 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1362.6 0 6715.94 0 0 0 0 0 0 8078.54 0 0 1005209062 1033425145 89 Physician Assistant Only(Encounter Only) JOHNSON TIMOTHY W 999999999 56 Knox 0 0 0 0 0 1 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 4651.57 0 0 0 0 0 0 4657.97 0 0 1005209091 1881034478 10 Physicians NAVARRETE THERESA A 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4996.72 0 0 0 0 0 0 4996.72 0 0 1005209488 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48234.19 0 0 0 0 0 0 0 0 0 0 0 0 0 48234.19 0 0 1005209772 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 11673.07 0 0 0 0 0 0 0 0 0 0 0 0 0 11673.07 0 0 1005209997 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4814.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4814.9 0 0 1005210116 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8140.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8140.84 0 0 1005210264 1073966313 16 Nurse Practitioners WHARTON MICHELLE M 999999999 69 Massac 0 0 0 0 0 3 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 10.5 0 0 0 0 0 0 0 0 355.38 0 0 0 0 0 0 365.88 0 0 1005210272 4005210272 90 Waiver service provider--Elderly (DOA) "HELP AT HOME, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 746260.52 0 0 0 0 0 0 0 0 0 0 0 0 0 746260.52 0 0 1005210303 1922374842 10 Physicians SAHA KANTA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4536.2 0 0 0 0 0 0 4536.2 0 0 1005210334 89 Physician Assistant Only(Encounter Only) 105 White 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.54 0 0 0 0 0 0 9.54 0 0 1005210506 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 7048.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7048.45 0 0 1005210541 1437603719 16 Nurse Practitioners HAEFELI AMY N 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5397.62 0 0 0 0 0 0 5397.62 0 0 1005210639 1457749079 16 Nurse Practitioners MERCADO LLOYD 999999999 200 Cook 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 1600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10393.97 0 0 0 0 0 0 10393.97 0 0 1005210909 1255568986 10 Physicians MEINTS LAURA 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 81 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4832.09 0 2790.63 0 0 0 0 0 0 7622.72 0 0 1005211009 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.74 0 0 0 0 0 0 42.74 0 0 1005211066 1932551058 11 Dentists NAKIB RANDA 999999999 200 Cook 0 0 0 0 16 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 2650.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2650.82 0 0 1005211258 25 Audiologists 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 391.58 391.58 0 0 1005211348 1508145327 10 Physicians BUDDHARAJU VENKATA L.N.V.K 999999999 81 Perry 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 0 607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10346.34 0 0 0 0 0 0 10346.34 0 0 1005211355 1467611095 23 Occupational Therapists ANGELI JEANINE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1128.67 1128.67 0 0 1005211448 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10025.15 0 0 0 0 0 0 0 0 0 0 0 0 0 10025.15 0 0 1005211449 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.63 0 0 0 0 0 0 13.63 0 0 1005212005 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005212095 1235241530 10 Physicians SNOW SHARI G 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234.32 0 0 0 0 0 0 234.32 0 0 1005212155 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3936.38 0 0 0 0 0 0 0 0 0 0 0 0 0 3936.38 0 0 1005212288 1043522410 10 Physicians CHU CHRISTINE M 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.69 0 0 0 0 0 0 87.69 0 0 1005212356 1376862540 10 Physicians BAESHU ASHRAF 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43209.59 0 0 0 0 0 0 43209.59 0 0 1005212412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492.48 0 0 0 0 0 0 0 0 0 0 0 0 0 492.48 0 0 1005212520 1992904221 10 Physicians GARCIA OTANO ANGEL M 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.24 0 502.55 0 0 0 0 0 0 521.79 0 0 1005212616 1730580572 89 Physician Assistant Only(Encounter Only) ZUBER STEPHANIE 999999999 88 Richland 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 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2497.22 0 0 0 0 0 0 2497.22 0 0 1005212737 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9218.16 0 0 0 0 0 0 0 0 0 0 0 0 0 9218.16 0 0 1005212760 1285998088 10 Physicians SHIMAK MORTON CHRISTINA 999999999 89 Rock Island 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.19 0 0 0 0 0 0 2083.19 0 0 1005212979 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1025 0 0 0 0 0 0 0 0 0 0 0 0 0 1025 0 0 1005213337 1528409034 10 Physicians RAFAQUAT AYSHA 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5714.79 0 0 0 0 0 0 5714.79 0 0 1005214122 1083962500 16 Nurse Practitioners JOHANN JESSICA L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404.94 0 0 0 0 0 0 404.94 0 0 1005214223 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 4454.42 0 0 0 0 0 0 0 0 0 0 0 0 0 4454.42 0 0 1005214398 23 Occupational Therapists 19 Champaign 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 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 1954.11 1954.11 0 0 1005214486 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.88 0 0 0 0 0 0 0 0 0 0 0 0 0 138.88 0 0 1005214651 1457652208 89 Physician Assistant Only(Encounter Only) MCKINLEY MONICA 999999999 200 Cook 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 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 3025.43 0 0 0 0 0 0 3025.43 0 0 1005214687 1295865590 10 Physicians BOYCE WILLIAM 999999999 24 Coles 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 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 0 346.76 0 0 0 0 0 0 0 0 346.76 0 0 1005214742 1407200421 11 Dentists PATEL KRUPA 999999999 200 Cook 0 0 General Dentistry 0 0 28 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2842.45 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 3595.15 0 0 1005214747 92 Waiver service provider--Disability (DHS/DRS) 65 Madison 0 0 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 0 330.54 0 0 0 0 0 0 0 0 0 0 0 0 0 330.54 0 0 1005214795 1184009102 89 Physician Assistant Only(Encounter Only) TIONGSON NICOLE 999999999 58 La Salle 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2571 0 0 0 0 0 0 2571 0 0 1005214879 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28234.94 0 0 0 0 0 0 0 0 0 0 0 0 0 28234.94 0 0 1005214999 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.42 0 0 0 0 0 0 0 0 62.42 0 0 1005215237 1437109667 60 Pharmacies JOHNS PHARMACY LLLP 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 2004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.96 0 0 2990.22 0 0 0 3047.18 0 0 1005215602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2165.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2165.15 0 0 1005215632 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23002.73 0 0 0 0 0 0 0 0 0 0 0 0 0 23002.73 0 0 1005215730 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 1005215817 1083047401 10 Physicians MOOTS PAUL S 999999999 80 Peoria 0 0 Internal Medicine 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3799.24 0 0 0 0 0 0 3799.24 0 0 1005215876 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005216202 1881049781 36 Community mental health provider THRESHOLDS 999999999 200 Cook 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1199 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1199 0 0 6365.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81304.2 0 0 87669.32 0 0 1005216204 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35948.18 0 0 0 0 0 0 0 0 0 0 0 0 0 35948.18 0 0 1005216295 1922313238 89 Physician Assistant Only(Encounter Only) ELLIS STEPHANIE M 999999999 80 Peoria 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 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517.07 0 0 0 0 0 0 1517.07 0 0 1005216298 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16413.59 0 0 0 0 0 0 0 0 0 0 0 0 0 16413.59 0 0 1005216390 1114385705 89 Physician Assistant Only(Encounter Only) BALIKIAN JULIA K 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439.74 0 0 0 0 0 0 439.74 0 0 1005216461 1073894481 16 Nurse Practitioners MCDERMOTT NICOLE M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.94 0 0 0 0 0 0 328.94 0 0 1005216575 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15365.68 0 0 0 0 0 0 0 0 0 0 0 0 0 15365.68 0 0 1005217058 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6222.47 0 0 0 0 0 0 0 0 0 0 0 0 0 6222.47 0 0 1005217133 16 Nurse Practitioners 50 Jersey 0 0 0 0 0 0 0 0 0 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 0 177.07 0 0 0 0 0 0 177.07 0 0 1005217143 1881086304 16 Nurse Practitioners MELNIC NATALIA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9209.54 0 0 0 0 0 0 9209.54 0 0 1005217613 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 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 5006.97 0 0 0 0 0 0 0 0 0 0 0 0 0 5006.97 0 0 1005217705 86 Clinical Social Worker(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 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 0 151.12 0 0 0 0 0 0 151.12 0 0 1005217833 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14685.34 0 0 0 0 0 0 0 0 0 0 0 0 0 14685.34 0 0 1005217927 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22600.85 0 0 0 0 0 0 0 0 0 0 0 0 0 22600.85 0 0 1005217958 1780784611 16 Nurse Practitioners GUIDO BARBARA A 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.85 0 0 0 0 0 0 138.85 0 0 1005218028 1205272317 10 Physicians VIG KARA S. 999999999 200 Cook 0 1 Pediatrics 0 0 0 5 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 44.31 0 0 0 0 0 0 0 0 556.48 0 0 0 0 0 0 600.79 0 0 1005218340 1740619840 89 Physician Assistant Only(Encounter Only) HEISE MICHAEL 999999999 24 Coles 0 0 0 0 0 6 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 509.63 0 0 0 0 0 0 0 0 1466.98 0 0 0 0 0 0 1976.61 0 0 1005218520 1760809198 10 Physicians ARORA AVI 999999999 82 Piatt 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.46 0 0 0 0 0 0 649.46 0 0 1005218891 1881080596 30 General Hospitals ILLINI INPATIENT BEHAVIORAL 623631350 83 Pike DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 37 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3687.81 0 0 0 0 0 0 0 0 0 3687.81 0 0 1005219050 1962838862 16 Nurse Practitioners HERMOSILLO CHRISTINE E 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.77 0 0 0 0 0 0 6.77 0 0 1005219132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13303.01 0 0 0 0 0 0 0 0 0 0 0 0 0 13303.01 0 0 1005219320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6289.62 0 0 0 0 0 0 0 0 0 0 0 0 0 6289.62 0 0 1005219555 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20569.78 0 0 0 0 0 0 0 0 0 0 0 0 0 20569.78 0 0 1005219604 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 568.45 0 0 0 0 0 0 568.45 0 0 1005219689 1881030963 10 Physicians DYER SEAN P 999999999 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3755.33 0 0 0 0 0 0 3755.33 0 0 1005219724 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20382.68 0 0 0 0 0 0 0 0 0 0 0 0 0 20382.68 0 0 1005219755 1285921429 10 Physicians SAMEE IRFAN 999999999 71 McHenry 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4992.17 0 0 0 0 0 0 4992.17 0 0 1005219862 1598008278 10 Physicians HENSCHEN ELIZABETH 999999999 200 Cook 0 0 Pediatrics 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4415.84 0 0 0 0 0 0 4415.84 0 0 1005220182 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11904.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11904.3 0 0 1005220380 1194042242 10 Physicians SHAH SUBIR B 999999999 200 Cook 0 0 Internal Medicine 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 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6501.72 0 0 0 0 0 0 6501.72 0 0 1005220381 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12748.16 0 0 0 0 0 0 0 0 0 0 0 0 0 12748.16 0 0 1005220486 1811281843 10 Physicians VEALEY RYAN J 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622.95 0 0 0 0 0 0 1622.95 0 0 1005220600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 29745.08 0 0 0 0 0 0 0 0 0 0 0 0 0 29745.08 0 0 1005220653 1508215823 10 Physicians JUNG JOSEPHINE M 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581.39 0 0 0 0 0 0 581.39 0 0 1005220792 1538508148 10 Physicians WOO JOYCE LEYI 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.26 0 1696.46 0 0 0 0 0 0 1750.72 0 0 1005220980 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15352.92 0 0 0 0 0 0 0 0 0 0 0 0 0 15352.92 0 0 1005221015 1275500530 10 Physicians ZHU XI 999999999 49 Jefferson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.96 0 0 0 0 0 0 295.96 0 0 1005221069 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24752.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24752.53 0 0 1005221101 1770809444 10 Physicians MADANI SYEDA W. 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1095.04 0 0 0 0 0 0 1095.04 0 0 1005221276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15472.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15472.85 0 0 1005221371 1356700744 60 Pharmacies OAK LAWN HEALTH MART PHARMACY 999999999 200 Cook 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 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8782.52 0 0 0 8782.52 0 0 1005221440 91 Waiver service provider--Adults (DHS/DDD) 62 Logan 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12201.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12201.56 0 0 1005221441 1023270279 10 Physicians GANGOPADHYAY NOOPUR 999999999 200 Cook 0 0 Plastic Surgery 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians REHMAN NADIA Q 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 49 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2483.6 0 138647.53 0 0 0 0 0 0 141131.13 0 0 1005222249 1235293622 10 Physicians FUNG JOHN 999999999 200 Cook 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 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 0 162.93 0 0 0 0 0 0 162.93 0 0 1005222634 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14361.11 0 0 0 0 0 0 0 0 0 0 0 0 0 14361.11 0 0 1005222665 1942632567 89 Physician Assistant Only(Encounter Only) BAILEY DEBORAH L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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SERVICES 631145825 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97191.54 0 0 0 0 0 0 97191.54 0 0 1005252305 1568802734 13 Podiatrists COHN KELLEN A. 999999999 57 Lake 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.51 0 0 0 0 0 0 193.51 0 0 1005252320 10 Physicians 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 0 162.9 0 0 0 0 0 0 162.9 0 0 1005252539 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13883.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13883.63 0 0 1005252992 91 Waiver service provider--Adults (DHS/DDD) 91 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(DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5517.7 0 0 0 0 0 0 0 0 0 0 0 0 0 5517.7 0 0 1005254068 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7608.96 0 0 0 0 0 0 0 0 0 0 0 0 0 7608.96 0 0 1005254321 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005254667 1124441340 30 General Hospitals FRESENIUS MEDICAL CARE NORMAL 617616195 72 McLean DIALYSIS Outpatient dialysis centers. 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 838 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.27 0 0 0 0 0 117.27 0 0 1005254855 1265753867 10 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S 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781.82 0 0 0 0 0 0 781.82 0 0 1005258808 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20290.88 0 0 0 0 0 0 0 0 0 0 0 0 0 20290.88 0 0 1005258809 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10989.34 0 0 0 0 0 0 0 0 0 0 0 0 0 10989.34 0 0 1005258862 1194179705 16 Nurse Practitioners PARK BOBBI J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.66 0 0 0 0 0 0 147.66 0 0 1005258920 94 Waiver service 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0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2723.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2723.2 0 0 1005261794 1912450941 16 Nurse Practitioners CAVETT JENNIFER L 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757.28 0 0 0 0 0 0 757.28 0 0 1005261833 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9216.71 0 0 0 0 0 0 0 0 0 0 0 0 0 9216.71 0 0 1005261985 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33199.3 0 0 0 0 0 0 0 0 0 0 0 0 0 33199.3 0 0 1005262754 92 Waiver service provider--Disability (DHS/DRS) 10 Adams 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27746.12 0 0 0 0 0 0 0 0 0 0 0 0 0 27746.12 0 0 1005262919 92 Waiver service provider--Disability (DHS/DRS) 56 Knox 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27125.13 0 0 0 0 0 0 0 0 0 0 0 0 0 27125.13 0 0 1005263011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5701.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5701.69 0 0 1005263214 1063891646 75 Department of Alcohol and Substance Abuse Provider ROSECRANCE LAKE VIEW OUTPATIEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 13663.2 0 0 13663.2 0 0 1005263521 1902185564 87 Psychologist(Encounter Only) SIKORA ZACHARY J 601228942 53 Kane 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 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 1411.59 0 0 0 0 0 0 1411.59 0 0 1005263580 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.47 0 0 0 0 0 0 30.47 0 0 1005263748 1447638887 16 Nurse Practitioners ALTGILBERS ANN 999999999 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1005263818 1073816013 16 Nurse Practitioners WINTERBAUER SUSAN C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 288.56 0 0 0 0 0 0 288.56 0 0 1005264249 1558639609 10 Physicians BASSI SHRUTI 999999999 823 Michigan 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13977.87 0 0 0 0 0 0 13977.87 0 0 1005264460 1124494711 10 Physicians KHAN OSAAMA H 999999999 53 Kane 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4576.96 0 0 0 0 0 0 4576.96 0 0 1005264468 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18982.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18982.8 0 0 1005264530 1194773374 10 Physicians BARROW FIRAS 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.85 0 4025.69 0 0 0 0 0 0 4042.54 0 0 1005264556 1437492493 10 Physicians MULVIHILL ASHLEY A 999999999 200 Cook 0 0 Psychiatry 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 0 184 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 20117.32 0 0 0 0 0 0 20117.32 0 0 1005264752 1124488945 36 Community mental health provider AID EAST TAYLOR STREET 999999999 27 Dekalb 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 2909.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49510.61 0 0 52420.29 0 0 1005264762 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 19264.83 0 0 0 0 0 0 0 0 0 0 0 0 0 19264.83 0 0 1005264799 91 Waiver service provider--Adults (DHS/DDD) 39 Greene 0 0 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 5051.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5051.88 0 0 1005264993 1366702870 10 Physicians KONDOWE CRYSTAL V 999999999 30 DuPage 0 0 Internal Medicine 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3050.05 0 0 0 0 0 0 3050.05 0 0 1005265139 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22273.73 0 0 0 0 0 0 0 0 0 0 0 0 0 22273.73 0 0 1005265162 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26322.77 0 0 0 0 0 0 0 0 0 0 0 0 0 26322.77 0 0 1005265265 1013185842 10 Physicians DALENCOURT GREGORY 999999999 200 Cook 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2982.76 0 0 0 0 0 0 2982.76 0 0 1005265305 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 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 13879.34 0 0 0 0 0 0 0 0 0 0 0 0 0 13879.34 0 0 1005265395 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 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 52352.4 0 0 0 0 0 0 0 0 0 0 0 0 0 52352.4 0 0 1005265455 1043760416 16 Nurse Practitioners KONNEKER ASHLEY R 999999999 91 Sangamon 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 45 0 0 0 0 0 0 0 0 0 1 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 1126.17 0 0 0 0 0 0 1126.17 0 0 1005265515 1215235007 89 Physician Assistant Only(Encounter Only) VANDERVEEN DANIELLE 999999999 80 Peoria 0 0 0 0 0 9 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 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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 0 190 0 0 0 0 0 0 190 0 0 1005266609 1992256218 36 Community mental health provider CTSHEALTH 999999999 200 Cook 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2499 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2499 0 0 125209.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442216.29 0 0 567425.44 0 0 1005266646 10 Physicians 89 Rock Island 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005266971 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4736.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4736.02 0 0 1005267128 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005267172 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.23 0 0 0 0 0 0 1.23 0 0 1005267541 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1005267563 1639522873 16 Nurse Practitioners BRUMMELL MANDY J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 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 1737.59 0 0 0 0 0 0 1737.59 0 0 1005267777 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 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 12096.04 0 0 0 0 0 0 0 0 0 0 0 0 0 12096.04 0 0 1005267884 1871740506 16 Nurse Practitioners GOLDEN AMY L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 862.03 0 0 0 0 0 0 862.03 0 0 1005267953 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11717.53 0 0 0 0 0 0 0 0 0 0 0 0 0 11717.53 0 0 1005268184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1088.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1088.71 0 0 1005268283 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 12207.3 0 0 0 0 0 0 0 0 0 0 0 0 0 12207.3 0 0 1005268312 1811298045 10 Physicians MALHOTRA GAUTAM 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12164.13 0 0 0 0 0 0 12164.13 0 0 1005268454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20195.55 0 0 0 0 0 0 0 0 0 0 0 0 0 20195.55 0 0 1005268496 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21678.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21678.85 0 0 1005268689 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3355.37 3355.37 0 0 1005268884 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 6044.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6044.58 0 0 1005269035 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 523.66 0 0 0 0 0 0 0 0 0 0 0 0 0 523.66 0 0 1005269054 1023244522 10 Physicians KELLY BRIAN 999999999 200 Cook 0 0 Orthopedic Surgery 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 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 3121.26 0 0 0 0 0 0 3121.26 0 0 1005269176 1407259559 16 Nurse Practitioners GORHAM CARISSA R 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14256.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14256.9 0 0 1005270617 1033562558 16 Nurse Practitioners LOGAN JESSICA L 999999999 70 McDonough 0 0 0 0 0 3 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 269.43 0 0 0 0 0 0 0 0 1480.84 0 0 0 0 0 0 1750.27 0 0 1005270816 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.45 0 0 0 0 0 0 43.45 0 0 1005270931 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 5856.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5856.14 0 0 1005271017 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5367.09 0 0 0 0 0 0 0 0 0 0 0 0 0 5367.09 0 0 1005271037 1134432479 10 Physicians REDDY REDDY SUPRAJA R 999999999 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.27 0 245.21 0 0 0 0 0 0 321.48 0 0 1005271107 1497764526 30 General Hospitals CENTEGRA HOSPITAL MCHENRY 600508409 71 McHenry DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83662.36 0 0 0 0 0 0 0 0 0 83662.36 0 0 1005271734 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 4608.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4608.59 0 0 1005271814 1073973095 89 Physician Assistant Only(Encounter Only) FLEMING ERYN L 999999999 80 Peoria 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 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 2182.95 0 0 0 0 0 0 2182.95 0 0 1005272428 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19326.29 0 0 0 0 0 0 0 0 0 0 0 0 0 19326.29 0 0 1005272953 1871962183 16 Nurse Practitioners AFARIN JESSICA 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9276.9 0 0 0 0 0 0 9276.9 0 0 1005273007 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9171.11 0 0 0 0 0 0 0 0 0 0 0 0 0 9171.11 0 0 1005273038 10 Physicians 200 Cook 0 0 Psychiatry 0 0 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Sangamon 0 0 0 0 0 3 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 36.95 0 0 0 0 0 0 0 0 747.19 0 0 0 0 0 0 784.14 0 0 1005273334 1942543178 10 Physicians WAWRZYNIAK MICHAEL 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6442.79 0 0 0 0 0 0 6442.79 0 0 1005273335 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10040.59 0 0 0 0 0 0 0 0 0 0 0 0 0 10040.59 0 0 1005273449 1033132311 60 Pharmacies CVS PHARMACY #16326 604351166 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 2823 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631.17 0 0 0 2631.17 0 0 1005273458 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20096.37 0 0 0 0 0 0 0 0 0 0 0 0 0 20096.37 0 0 1005273490 89 Physician Assistant Only(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.72 0 0 0 0 0 0 130.72 0 0 1005273492 1326200536 10 Physicians BAHUVA RUBIN D 999999999 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1965 0 0 0 0 0 0 1965 0 0 1005274064 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17368.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17368.43 0 0 1005274134 98 Waiver service 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0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25676.15 0 0 0 0 0 0 0 0 0 0 0 0 0 25676.15 0 0 1005274544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21157.22 0 0 0 0 0 0 0 0 0 0 0 0 0 21157.22 0 0 1005274560 1720393945 89 Physician Assistant Only(Encounter Only) TERRAZAS CHRISTINA 999999999 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1369.38 0 0 0 0 0 0 1369.38 0 0 1005274578 1720434608 89 Physician Assistant Only(Encounter Only) CONRAN MICHAEL T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1365.65 0 0 0 0 0 0 1365.65 0 0 1005275015 1376983882 10 Physicians SHAH HARSHIT 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1294.01 0 0 0 0 0 0 1294.01 0 0 1005275198 12 Optometrists 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 140.37 0 0 0 0 0 0 140.37 0 0 1005275248 1992164883 63 Other Providers of Medical Equipment/Supplies (Non-registered) LEHAN'S MEDICAL EQUIPMENT 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2332 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2332 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53902.2 0 747.83 0 0 0 0 54650.03 0 0 1005275572 1922446186 10 Physicians KHAN SARAH M 999999999 53 Kane 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359.47 0 0 0 0 0 0 359.47 0 0 1005275574 1184006272 16 Nurse Practitioners SCOTT DARCIE M 999999999 53 Kane 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.31 0 0 0 0 0 0 686.31 0 0 1005275941 1316978992 16 Nurse Practitioners BROADSTREET MARIA B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756.14 0 0 0 0 0 0 756.14 0 0 1005275972 1740223031 60 Pharmacies CVS PHARMACY #17042 607072312 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22882.58 0 0 0 22882.58 0 0 1005276042 1326064361 60 Pharmacies COUNTY MARKET PHARMACY 224 626292018 91 Sangamon 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2105.72 0 0 0 2105.72 0 0 1005276173 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 976.8 0 0 0 0 0 0 0 0 0 0 0 0 0 976.8 0 0 1005276269 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.72 0 0 0 0 0 0 6.72 0 0 1005276599 1194166595 10 Physicians RENGARAJAN DINESH KUMAR 999999999 200 Cook 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 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12008.98 0 0 0 0 0 0 12008.98 0 0 1005276613 1942662291 10 Physicians DELCONTE ADAM C 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 37 0 111 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 68 0 443 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 68 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1725.47 0 9337.57 0 0 0 0 0 0 11063.04 0 0 1005276706 1083845945 10 Physicians PATEL NIRAL B 999999999 109 Winnebago 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 14 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418.19 0 1471.34 0 0 0 0 0 0 1889.53 0 0 1005276839 1447647201 16 Nurse Practitioners PRESTON SARAH 999999999 200 Cook 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 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 0 200.58 0 0 0 0 0 0 200.58 0 0 1005276906 1083073977 36 Community mental health provider HOYLETON YOUTH AND FAMILY SERV 999999999 96 St Clair 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 1792.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19556.28 0 0 21348.72 0 0 1005276948 1659741312 89 Physician Assistant Only(Encounter Only) ECHOLS MORGAN L 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3701.94 0 0 0 0 0 0 3701.94 0 0 1005277017 98 Waiver service provider--TBI (DHS/DRS) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15081.27 0 0 0 0 0 0 0 0 0 0 0 0 0 15081.27 0 0 1005277078 1871856377 13 Podiatrists CHOI GENE Y 999999999 200 Cook 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 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2660.57 0 0 0 0 0 0 2660.57 0 0 1005277086 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 580.5 0 0 0 0 0 0 0 0 0 0 0 0 0 580.5 0 0 1005277265 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 45654.51 0 0 0 0 0 0 0 0 0 0 0 0 0 45654.51 0 0 1005277307 1578921532 16 Nurse Practitioners RAASCH CHRISTOPHER 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 216.32 0 0 0 0 0 0 0 0 322.85 0 0 0 0 0 0 539.17 0 0 1005277524 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6458.21 0 0 0 0 0 0 0 0 0 0 0 0 0 6458.21 0 0 1005277686 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22705.96 0 0 0 0 0 0 0 0 0 0 0 0 0 22705.96 0 0 1005277817 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.65 0 0 0 0 0 0 201.65 0 0 1005277889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33411.58 0 0 0 0 0 0 0 0 0 0 0 0 0 33411.58 0 0 1005278046 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4578.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4578.69 0 0 1005278206 1871961813 16 Nurse Practitioners MOORE LESLIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78438.1 0 0 0 0 0 0 78438.1 0 0 1005278493 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.36 0 0 0 0 0 0 0 0 0 0 0 0 0 113.36 0 0 1005278776 10 Physicians 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1005278940 92 Waiver service provider--Disability (DHS/DRS) 99 Union 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14775.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14775.77 0 0 1005279116 1437541125 89 Physician Assistant Only(Encounter Only) KIM CHRISTOPHER H 999999999 200 Cook 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462.48 0 0 0 0 0 0 462.48 0 0 1005279432 10 Physicians 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 4 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 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0 0 0 0 0 0 19293.9 0 0 1005280545 1689029993 16 Nurse Practitioners BROWN ASHLEY L 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2730.61 0 0 0 0 0 0 2730.61 0 0 1005280554 1659581262 10 Physicians JOHNSTON DOUGLAS R 999999999 200 Cook 0 0 Otolaryngology 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 0 184 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 11373.1 0 0 0 0 0 0 11373.1 0 0 1005281114 1649579939 10 Physicians AARDSMA NATHAN 999999999 200 Cook 0 0 Clinical Pathology 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919.64 0 0 0 0 0 0 0 0 919.64 0 0 1005281293 10 Physicians 815 Indiana 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005281490 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23996.72 0 0 0 0 0 0 0 0 0 0 0 0 0 23996.72 0 0 1005281505 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005281853 1629521109 16 Nurse Practitioners PARKER LYNN A 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 39 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 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 739.43 0 0 0 0 0 0 771.58 0 0 1005281880 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8108.82 0 0 0 0 0 0 0 0 0 0 0 0 0 8108.82 0 0 1005282116 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22151.18 0 0 0 0 0 0 0 0 0 0 0 0 0 22151.18 0 0 1005282180 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 136.76 0 0 0 0 0 0 136.76 0 0 1005282522 1073836706 10 Physicians GONG CHAO 999999999 53 Kane 0 0 Neurology 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 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 1903.87 0 0 0 0 0 0 1903.87 0 0 1005282527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2604.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2604.17 0 0 1005282678 1922448018 10 Physicians GEORGE THOMAS C 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1411.97 0 0 0 0 0 0 1411.97 0 0 1005283159 1346569563 10 Physicians KRUCZEK KIMBERLY R 999999999 30 DuPage 0 0 Internal Medicine 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 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4704.83 0 0 0 0 0 0 4704.83 0 0 1005283366 1407119779 10 Physicians WALLACE LAURA 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.96 0 1345.58 0 0 0 0 0 0 1404.54 0 0 1005283428 1588004246 11 Dentists GOLAM ISRAA 999999999 53 Kane 0 0 General Dentistry 0 0 106 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 13377.31 0 0 0 0 0 0 0 0 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0 32 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 722.97 0 0 0 0 0 0 799.81 0 0 1005284441 91 Waiver service provider--Adults (DHS/DDD) 71 McHenry 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1747.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1747.93 0 0 1005284501 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16774.92 0 0 0 0 0 0 0 0 0 0 0 0 0 16774.92 0 0 1005284504 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569.32 0 0 0 0 0 0 0 0 0 0 0 0 0 569.32 0 0 1005284768 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 906.4 0 0 0 0 0 0 906.4 0 0 1005285398 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 13415.67 0 0 0 0 0 0 0 0 0 0 0 0 0 13415.67 0 0 1005285479 1801108279 10 Physicians MANTHA SUPARNA 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191 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 2438.84 0 0 0 0 0 0 2438.84 0 0 1005285511 1760936090 16 Nurse Practitioners MANCO GENTI 999999999 30 DuPage 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 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 0 675.26 0 0 0 0 0 0 675.26 0 0 1005285652 36 Community mental health provider 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 2435.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11748.91 0 0 14184.43 0 0 1005285703 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31427 0 0 0 0 0 0 0 0 0 0 0 0 0 31427 0 0 1005285732 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005285816 1154343861 60 Pharmacies CVS PHARMACY #16792 604302007 200 Cook 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 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9716.39 0 0 0 9716.39 0 0 1005285878 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 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 0 491.23 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0 0 1005286663 1396017877 16 Nurse Practitioners CURTIS BENJAMIN 999999999 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1660.65 0 0 0 0 0 0 1660.65 0 0 1005286706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16157.34 0 0 0 0 0 0 0 0 0 0 0 0 0 16157.34 0 0 1005286774 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1005286902 1265660393 10 Physicians BALDEA KRISTIN G 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.14 0 2790.13 0 0 0 0 0 0 2790.27 0 0 1005286916 1669790697 10 Physicians KENNELL KELLY A 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 457 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145.49 0 577.41 0 0 0 0 0 0 5722.9 0 0 1005287035 94 Waiver service provider--Children's support (DHS/DDD) 100 Vermilion 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10253.14 0 0 0 0 0 0 0 0 0 0 0 0 0 10253.14 0 0 1005287044 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20036.03 0 0 0 0 0 0 0 0 0 0 0 0 0 20036.03 0 0 1005287075 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24249.09 0 0 0 0 0 0 0 0 0 0 0 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General Hospitals 836 Ohio ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234.61 0 0 1005287949 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24713.04 0 0 0 0 0 0 0 0 0 0 0 0 0 24713.04 0 0 1005287974 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14772.08 0 0 0 0 0 0 0 0 0 0 0 0 0 14772.08 0 0 1005288034 1538181342 60 Pharmacies CVS PHARMACY #16303 600314591 57 Lake 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18853.53 0 0 0 18853.53 0 0 1005288402 10 Physicians 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.24 0 0 0 0 0 0 95.24 0 0 1005289201 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6774.74 0 0 0 0 0 0 0 0 0 0 0 0 0 6774.74 0 0 1005289392 1023465408 28 Waiver service provider--Supportive living facility (HFS) RIVER VALLEY SL RESIDENCE 999999999 54 Kankakee 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 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512609.78 0 0 0 0 0 0 0 0 0 0 0 0 0 512609.78 0 0 1005289537 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34410.8 0 0 0 0 0 0 0 0 0 0 0 0 0 34410.8 0 0 1005289617 1316223746 89 Physician Assistant Only(Encounter Only) WALLON REBECCA C 999999999 19 Champaign 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 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 1485.14 0 0 0 0 0 0 1485.14 0 0 1005289623 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17435.88 0 0 0 0 0 0 0 0 0 0 0 0 0 17435.88 0 0 1005289716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3883.93 0 0 0 0 0 0 0 0 0 0 0 0 0 3883.93 0 0 1005290019 63 Other Providers of Medical Equipment/Supplies (Non-registered) 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 948.61 0 0 0 0 0 0 948.61 0 0 1005290028 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11789.63 0 0 0 0 0 0 0 0 0 0 0 0 0 11789.63 0 0 1005290329 1629207477 10 Physicians ABO-SALEM ELSAYED 999999999 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4977.6 0 0 0 0 0 0 4977.6 0 0 1005290439 1689024036 60 Pharmacies FORUM EXTENDED CARE SERVICES O 999999999 91 Sangamon 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 0 834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8462.63 0 0 0 8462.63 0 0 1005290776 1619297264 10 Physicians DESHMUKH SWATI 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 109 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1802 0 0 0 0 0 0 0 0 1802 0 0 1005290822 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17728.2 0 0 0 0 0 0 0 0 0 0 0 0 0 17728.2 0 0 1005290901 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30322.4 0 0 0 0 0 0 0 0 0 0 0 0 0 30322.4 0 0 1005290963 1851680037 10 Physicians RUSIECKI JENNIFER M 999999999 30 DuPage 0 0 Internal Medicine 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3073.11 0 0 0 0 0 0 3073.11 0 0 1005291018 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9913.76 0 0 0 0 0 0 0 0 0 0 0 0 0 9913.76 0 0 1005291534 1174976286 16 Nurse Practitioners PANOZZO NEELIE M 999999999 54 Kankakee 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 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 54.34 0 0 0 0 0 0 54.34 0 0 1005291545 1700176450 10 Physicians SHARIEFF AMIN O 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.64 0 3652.22 0 0 0 0 0 0 3659.86 0 0 1005291774 1306189261 10 Physicians VAN GENDEREN KRISTIN 999999999 200 Cook 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 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 1665.87 0 0 0 0 0 0 1665.87 0 0 1005291978 10 Physicians 92 Schuyler 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.06 0 0 0 0 0 0 141.06 0 0 1005292156 1225394018 10 Physicians LYONS PATRICK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1899.38 0 0 0 0 0 0 1899.38 0 0 1005292185 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 181.24 0 0 0 0 0 0 181.24 0 0 1005292281 1770839987 10 Physicians CHOKSI TATVAM 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3602.88 0 0 0 0 0 0 3602.88 0 0 1005292311 1053764365 16 Nurse Practitioners STEPHENS MICHELLE M 999999999 80 Peoria 0 0 0 0 0 7 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 491.81 0 0 0 0 0 0 0 0 1379.86 0 0 0 0 0 0 1871.67 0 0 1005292391 1700131182 10 Physicians ATIENZA MATTHEW C 999999999 200 Cook 0 0 Psychiatry 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6702.68 0 0 0 0 0 0 6702.68 0 0 1005292542 1528323979 10 Physicians CATON REBECCA 999999999 36 Franklin 0 0 Emergency Medicine 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1928.72 0 0 0 0 0 0 1928.72 0 0 1005292767 1770030801 16 Nurse Practitioners MARSHALL MARY L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 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 0 277.77 0 0 0 0 0 0 277.77 0 0 1005292992 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47929.86 0 0 0 0 0 0 0 0 0 0 0 0 0 47929.86 0 0 1005293034 1437501723 11 Dentists FAHMY YUSUF 999999999 200 Cook 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1898.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1898.95 0 0 1005293235 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8426.64 0 0 0 0 0 0 0 0 0 0 0 0 0 8426.64 0 0 1005293683 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47124.44 0 0 0 0 0 0 0 0 0 0 0 0 0 47124.44 0 0 1005294009 1063408417 89 Physician Assistant Only(Encounter Only) CAPINA ELMER 999999999 200 Cook 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 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 0 106.28 0 0 0 0 0 0 106.28 0 0 1005294076 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9526.28 0 0 0 0 0 0 0 0 0 0 0 0 0 9526.28 0 0 1005294180 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46759.56 0 0 0 0 0 0 0 0 0 0 0 0 0 46759.56 0 0 1005294469 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.97 0 0 0 0 0 0 107.97 0 0 1005294766 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27335 0 0 0 0 0 0 0 0 0 0 0 0 0 27335 0 0 1005294977 1619130697 10 Physicians MARINESCU VICTOR 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2301.31 0 0 0 0 0 0 2301.31 0 0 1005295028 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14962.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14962.14 0 0 1005295090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16858.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16858.4 0 0 1005295453 93 Waiver service provider--HIV/AIDS (DHS/DRS) 200 Cook 0 0 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 1582.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1582.98 0 0 1005295697 1972056109 16 Nurse Practitioners WILSON NICOLE 999999999 55 Kendall 0 0 0 0 0 21 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 1805.33 0 0 0 0 0 0 0 0 3047.6 0 0 0 0 0 0 4852.93 0 0 1005295879 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6694.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6694.1 0 0 1005295942 1255716205 86 Clinical Social Worker(Encounter Only) JOHNSON NISA B 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 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 1086.79 0 0 0 0 0 0 1086.79 0 0 1005296058 1235502246 16 Nurse Practitioners BLACK CANDACE 999999999 200 Cook 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 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 1230.78 0 0 0 0 0 0 1230.78 0 0 1005296110 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20048.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20048.86 0 0 1005296421 1275973620 10 Physicians FIGURA ROBERT M. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376.3 0 0 0 0 0 0 376.3 0 0 1005296469 1164856704 13 Podiatrists GONZALEZ GRANT W 999999999 82 Piatt 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 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3245.31 0 0 0 0 0 0 3245.31 0 0 1005296485 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005296565 1619278074 89 Physician Assistant Only(Encounter Only) ZWIEFEL WESLEY 999999999 91 Sangamon 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 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 0 285.24 0 0 0 0 0 0 285.24 0 0 1005296620 1285787226 60 Pharmacies AXLINE PHARMACY 614221353 70 McDonough 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 0 653 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21635.38 0 0 0 21635.38 0 0 1005296646 1730443334 10 Physicians MARTIN JONGJIN 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 2 0 0 0 0 0 0 2 0 73 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 141 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 141 0 0 0 0 0 0 0 0 0 111.36 0 0 0 0 0 0 10.86 0 25733.91 0 0 0 0 0 0 25856.13 0 0 1005296736 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6191.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6191.86 0 0 1005296970 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3339.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3339.3 0 0 1005296974 1497075774 10 Physicians WARD GREGORY 999999999 19 Champaign 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1625.88 0 0 0 0 0 0 1625.88 0 0 1005297525 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455.84 0 0 0 0 0 0 0 0 0 0 0 0 0 455.84 0 0 1005297930 1871943472 97 Waiver service provider--Children's residential (DHS/DDD) WOOD THOMAS 999999999 109 Winnebago 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 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15033.04 0 0 0 0 0 0 0 0 0 0 0 0 0 15033.04 0 0 1005298214 1013250661 60 Pharmacies GENOA HEALTHCARE LLC 616033802 80 Peoria 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 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42201.27 0 0 0 42201.27 0 0 1005298284 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9526.48 0 0 0 0 0 0 0 0 0 0 0 0 0 9526.48 0 0 1005298444 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25537.61 0 0 0 0 0 0 0 0 0 0 0 0 0 25537.61 0 0 1005298490 1497203434 16 Nurse Practitioners SAYI MARIA P 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9585.56 0 0 0 0 0 0 9585.56 0 0 1005298593 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 331.35 0 0 0 0 0 0 0 0 0 0 0 0 0 331.35 0 0 1005298626 89 Physician Assistant Only(Encounter Only) 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 293.6 0 0 0 0 0 0 293.6 0 0 1005298653 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5311.35 0 0 0 0 0 0 0 0 0 0 0 0 0 5311.35 0 0 1005298699 16 Nurse Practitioners 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005298896 1215295613 10 Physicians MICK PAUL B 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1622.94 0 0 0 0 0 0 1622.94 0 0 1005298974 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005299096 1811393564 39 Hospice LOVING PEACE HOSPICE INC 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132727.25 0 0 0 0 0 0 0 0 0 0 0 132727.25 0 0 1005299128 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7830.29 0 0 0 0 0 0 0 0 0 0 0 0 0 7830.29 0 0 1005299134 1669807798 30 General Hospitals NXSTAGE KIDNEY CARE OAK BROOK 999999999 30 DuPage DIALYSIS Outpatient dialysis centers. 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 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1033 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2339.65 0 0 0 0 0 2339.65 0 0 1005299159 22 Physical Therapists 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 303.83 303.83 0 0 1005299394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26468.09 0 0 0 0 0 0 0 0 0 0 0 0 0 26468.09 0 0 1005299448 92 Waiver service provider--Disability (DHS/DRS) 107 Will 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24418.19 0 0 0 0 0 0 0 0 0 0 0 0 0 24418.19 0 0 1005299526 1154615656 10 Physicians WALDINGER RACHEL 999999999 200 Cook 0 0 Anesthesiology 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 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 24271.08 0 0 0 0 0 0 24271.08 0 0 1005299527 1487837027 10 Physicians BOOKER TIMBERLY E 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 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 4853.02 0 0 0 0 0 0 4853.02 0 0 1005299578 1447610472 48 Rural Health Clinics IMH MULTI-SPECIALTY PHYSICIANS 609701644 46 Iroquois 0 0 0 376 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2342 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2342 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22635.33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22635.33 0 0 1005299579 1164814000 16 Nurse Practitioners FALCONE THOMAS 999999999 104 Wayne 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883.77 0 0 0 0 0 0 883.77 0 0 1005299788 1265883490 16 Nurse Practitioners WILLIAMS JANELL 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.44 0 0 0 0 0 0 98.44 0 0 1005299836 91 Waiver service provider--Adults (DHS/DDD) 53 Kane 0 0 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 0 301.18 0 0 0 0 0 0 0 0 0 0 0 0 0 301.18 0 0 1005299948 89 Physician Assistant Only(Encounter Only) 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 0 0 0 0 106.72 0 0 1005299962 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 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 19396.31 0 0 0 0 0 0 0 0 0 0 0 0 0 19396.31 0 0 1005300076 10 Physicians 19 Champaign 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.97 0 0 0 0 0 0 121.97 0 0 1005300307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18492.67 0 0 0 0 0 0 0 0 0 0 0 0 0 18492.67 0 0 1005300525 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6928.31 0 0 0 0 0 0 0 0 0 0 0 0 0 6928.31 0 0 1005301031 10 Physicians 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.95 0 0 0 0 0 0 33.95 0 0 1005301084 1891241022 28 Waiver service provider--Supportive living facility (HFS) GATEWAY AT RIVER CITY 616052301 80 Peoria 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414009.56 0 0 0 0 0 0 0 0 0 0 0 0 0 414009.56 0 0 1005301140 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 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 2190.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2190.67 0 0 1005301430 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23962.24 0 0 0 0 0 0 0 0 0 0 0 0 0 23962.24 0 0 1005301580 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4782.13 0 0 0 0 0 0 0 0 0 0 0 0 0 4782.13 0 0 1005301644 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14737.47 0 0 0 0 0 0 0 0 0 0 0 0 0 14737.47 0 0 1005301738 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4640.55 0 0 0 0 0 0 0 0 0 0 0 0 0 4640.55 0 0 1005301773 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 528.88 0 0 0 0 0 0 0 0 0 0 0 0 0 528.88 0 0 1005301813 1922433440 10 Physicians AHMED SEEMA S 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.42 0 0 0 0 0 0 1316.42 0 0 1005301833 1235686759 16 Nurse Practitioners DAVIS BROOKE L 999999999 49 Jefferson 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 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 1819.74 0 0 0 0 0 0 1819.74 0 0 1005302024 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18672.96 0 0 0 0 0 0 0 0 0 0 0 0 0 18672.96 0 0 1005302048 1417242314 10 Physicians KING MICHAEL 999999999 200 Cook 0 0 Anesthesiology 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12533.1 0 0 0 0 0 0 12533.1 0 0 1005302431 4005302431 93 Waiver service provider--HIV/AIDS (DHS/DRS) "HELP AT HOME, LLC" 999999999 200 Cook 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 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 161857.65 0 0 0 0 0 0 0 0 0 0 0 0 0 161857.65 0 0 1005302740 1598879884 89 Physician Assistant Only(Encounter Only) WILLIS MICHELLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4956.26 0 0 0 0 0 0 4956.26 0 0 1005302851 1770804312 10 Physicians ARPS DAVID P 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.59 0 0 0 0 0 0 0 0 47.59 0 0 1005303156 30 General Hospitals 57 Lake DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6704.66 0 0 0 0 0 6704.66 0 0 1005303174 1790238707 11 Dentists AHN EUN JEONG 999999999 57 Lake 0 0 Maxillofacial Surgery 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.3 0 0 1005303426 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25040.39 0 0 0 0 0 0 0 0 0 0 0 0 0 25040.39 0 0 1005303457 1750595112 10 Physicians CHERENFANT JOVENEL 999999999 823 Michigan 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 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 0 283.56 0 0 0 0 0 0 283.56 0 0 1005303654 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21741.94 0 0 0 0 0 0 0 0 0 0 0 0 0 21741.94 0 0 1005303725 1528356292 10 Physicians ARAUZ VERONICA 604332548 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6527.2 0 0 0 0 0 0 6527.2 0 0 1005303911 10 Physicians 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 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 77.1 0 0 0 0 0 0 0 0 77.1 0 0 1005305358 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 1830.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1830.88 0 0 1005305442 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26187.15 0 0 0 0 0 0 0 0 0 0 0 0 0 26187.15 0 0 1005305716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30844.85 0 0 0 0 0 0 0 0 0 0 0 0 0 30844.85 0 0 1005305925 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26190.45 0 0 0 0 0 0 0 0 0 0 0 0 0 26190.45 0 0 1005305931 1992067094 10 Physicians LOPES PERDIGAO JOANA R 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 18 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1303.36 0 4783.92 0 0 0 0 0 0 6087.28 0 0 1005306009 1851755276 75 Department of Alcohol and Substance Abuse Provider MENTAL HEALTH CENTERS OF WESTE 999999999 42 Hancock 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1526.34 0 0 1526.34 0 0 1005306018 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5692.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5692.16 0 0 1005306300 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8095.54 0 0 0 0 0 0 0 0 0 0 0 0 0 8095.54 0 0 1005306406 16 Nurse Practitioners 102 Warren 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005306910 1629461694 16 Nurse Practitioners KUBIELEWICZ KRISTA L 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415.68 0 0 0 0 0 0 415.68 0 0 1005306934 1568811487 36 Community mental health provider IROQUOIS MENTAL HEALTH CENTER 999999999 107 Will 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 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 1846.4 0 0 1846.4 0 0 1005307172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15616.64 0 0 0 0 0 0 0 0 0 0 0 0 0 15616.64 0 0 1005307205 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 3372.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3372.87 0 0 1005307321 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.66 0 0 0 0 0 0 147.66 0 0 1005307330 1053460634 87 Psychologist(Encounter Only) MITCHELL KIRSTEN 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1227.45 0 0 0 0 0 0 1227.45 0 0 1005307335 1346390689 60 Pharmacies CVS PHARMACY #17175 604532675 200 Cook 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4092 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6709.79 0 0 0 6709.79 0 0 1005307405 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26571.33 0 0 0 0 0 0 0 0 0 0 0 0 0 26571.33 0 0 1005307894 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12078.22 0 0 0 0 0 0 0 0 0 0 0 0 0 12078.22 0 0 1005307947 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7114.82 0 0 0 0 0 0 0 0 0 0 0 0 0 7114.82 0 0 1005307994 98 Waiver service provider--TBI (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30760.82 0 0 0 0 0 0 0 0 0 0 0 0 0 30760.82 0 0 1005308019 1578750469 16 Nurse Practitioners TRAVIS CYNTHIA 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.67 0 0 0 0 0 0 202.67 0 0 1005308031 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 594.22 0 0 0 0 0 0 0 0 0 0 0 0 0 594.22 0 0 1005308085 1568628865 10 Physicians BALACH TESSA 999999999 30 DuPage 0 0 Orthopedic Surgery 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 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 9485.79 0 0 0 0 0 0 9485.79 0 0 1005308281 10 Physicians 10 Adams 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 188.22 0 0 0 0 0 0 188.22 0 0 1005308618 16 Nurse Practitioners 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381.93 0 0 0 0 0 0 381.93 0 0 1005308625 1780060517 16 Nurse Practitioners SMITH DANAE A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 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0 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 39.86 0 0 0 0 0 0 39.86 0 0 1005309748 1750669354 10 Physicians EL BITAR YOUSSEF 999999999 64 Macoupin 0 0 Orthopedic Surgery 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 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10441.79 0 0 0 0 0 0 10441.79 0 0 1005309907 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 200.3 0 0 0 0 0 0 200.3 0 0 1005309948 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 6301.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6301.53 0 0 1005310064 1902355316 40 Federally Qualified Health Centers LEGACY MEDICAL CARE INC 999999999 30 DuPage 0 0 0 230 0 149 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2481.75 0 0 0 0 0 0 2481.75 0 0 1005312625 1861790362 10 Physicians MINCA EUGEN C 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169 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 1259.9 0 0 0 0 0 0 0 0 1259.9 0 0 1005312683 1558722835 16 Nurse Practitioners LANGELLIER TODD E 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.33 0 0 0 0 0 0 522.33 0 0 1005312722 1255880647 40 Federally Qualified Health Centers ILLINI FAMILY MEDICINE 999999999 96 St Clair 0 0 0 117 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22093.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22093.11 0 0 1005312946 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 0 836.14 0 0 0 0 0 0 0 0 0 0 0 0 0 836.14 0 0 1005312953 1558720888 16 Nurse Practitioners CABRERA FLOR D 999999999 200 Cook 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 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 0 798.22 0 0 0 0 0 0 798.22 0 0 1005313189 1487000964 16 Nurse Practitioners AGUBE WERUCHE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.38 0 0 0 0 0 0 185.38 0 0 1005313240 1235687989 16 Nurse Practitioners GOSNELL JODY 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2108.95 0 0 0 0 0 0 2108.95 0 0 1005313899 1356790141 89 Physician Assistant Only(Encounter Only) MULROW JAMIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 0 0 0 0 0 0 0 0 0 1005314049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22433.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22433.4 0 0 1005314173 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23155 0 0 0 0 0 0 0 0 0 0 0 0 0 23155 0 0 1005314174 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.28 0 0 0 0 0 0 84.28 0 0 1005314202 91 Waiver service provider--Adults (DHS/DDD) 97 Stephenson 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42746.49 0 0 0 0 0 0 0 0 0 0 0 0 0 42746.49 0 0 1005314293 1962757286 10 Physicians BABU MATHURA 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.27 0 0 0 0 0 0 526.27 0 0 1005314304 1194934554 10 Physicians ARGHAVANI TRACY S 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.54 0 5576.4 0 0 0 0 0 0 5591.94 0 0 1005314379 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2621.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2621.52 0 0 1005314428 1740573427 10 Physicians JAMISON JUSTIN 999999999 200 Cook 0 0 Psychiatry 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3182.11 0 0 0 0 0 0 3182.11 0 0 1005314560 1770036584 16 Nurse Practitioners CULLICK CARRIE 999999999 80 Peoria 0 0 0 0 0 9 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 756.31 0 0 0 0 0 0 0 0 2127.63 0 0 0 0 0 0 2883.94 0 0 1005314655 1497150486 89 Physician Assistant Only(Encounter Only) LESS DIANE M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.4 0 0 0 0 0 0 55.4 0 0 1005314933 12 Optometrists 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.7 0 0 0 0 0 0 16.7 0 0 1005314983 1225376288 10 Physicians IQBAL SUMAIRA 999999999 109 Winnebago 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 5 0 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 6 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 6 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.16 0 519.03 0 0 0 0 0 0 531.19 0 0 1005315372 1467995407 91 Waiver service provider--Adults (DHS/DDD) GALL BRIAN M 999999999 200 Cook 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 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110514.03 0 0 0 0 0 0 0 0 0 0 0 0 0 110514.03 0 0 1005315455 89 Physician Assistant Only(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005315495 1891084927 10 Physicians MARK LAURIE 999999999 63 Macon 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 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 1014.54 0 0 0 0 0 0 1014.54 0 0 1005315506 1457664047 10 Physicians AJMAL SAAD 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383.03 0 0 0 0 0 0 383.03 0 0 1005316365 1699020800 10 Physicians DZAKA-DIZDAREVIC EMA 999999999 200 Cook 0 0 Internal Medicine 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 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 0 341.62 0 0 0 0 0 0 341.62 0 0 1005316531 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.57 0 0 0 0 0 0 22.57 0 0 1005316540 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1041.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1041.6 0 0 1005316906 1598119596 16 Nurse Practitioners LOMBARDO THERESA A. 999999999 200 Cook 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 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 1850.59 0 0 0 0 0 0 1850.59 0 0 1005317021 1780969634 89 Physician Assistant Only(Encounter Only) BOUFERRACHE KARIM H 999999999 54 Kankakee 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702.93 0 0 0 0 0 0 702.93 0 0 1005317188 91 Waiver service provider--Adults (DHS/DDD) 72 McLean 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6764.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6764.34 0 0 1005317490 1104272962 16 Nurse Practitioners WALTERS JAMIE L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3018.57 0 0 0 0 0 0 3018.57 0 0 1005317918 1497054944 10 Physicians HILKERT SARAH M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.82 0 7076.44 0 0 0 0 0 0 7089.26 0 0 1005318300 1649620352 89 Physician Assistant Only(Encounter Only) ROTH BENJAMIN J 999999999 106 Whiteside 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 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 26.74 0 0 0 0 0 0 26.74 0 0 1005318411 89 Physician Assistant Only(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005318512 1518310531 16 Nurse Practitioners AUGUST ANNA 999999999 109 Winnebago 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1574.88 0 0 0 0 0 0 1574.88 0 0 1005318689 1093006181 10 Physicians CHU ANDREW 999999999 200 Cook 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 2010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9609.05 0 0 0 0 0 0 0 0 9609.05 0 0 1005318781 1932653516 16 Nurse Practitioners DOLAN TIMOTHY M. 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1234.78 0 0 0 0 0 0 1234.78 0 0 1005318834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26256.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26256.27 0 0 1005318905 94 Waiver service provider--Children's support (DHS/DDD) 53 Kane 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14582.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14582.4 0 0 1005318909 1871946681 24 Speech Therapists BOUMA ALLISON 999999999 200 Cook 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 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6444.03 6444.03 0 0 1005318999 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26716.96 0 0 0 0 0 0 0 0 0 0 0 0 0 26716.96 0 0 1005319193 1902200702 10 Physicians LUNDBERG NINA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468.53 0 0 0 0 0 0 468.53 0 0 1005319610 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004.1 0 0 0 0 0 0 1004.1 0 0 1005320553 1144345364 13 Podiatrists ABRAHAM BIJOY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1645.45 0 0 0 0 0 0 1645.45 0 0 1005320701 1679800866 89 Physician Assistant Only(Encounter Only) BRAMER ANDREW 999999999 30 DuPage 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.92 0 0 0 0 0 0 10.92 0 0 1005320738 89 Physician Assistant Only(Encounter Only) 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 42.14 0 0 1005320998 98 Waiver service provider--TBI (DHS/DRS) 200 Cook 0 0 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 0 334.87 0 0 0 0 0 0 0 0 0 0 0 0 0 334.87 0 0 1005321155 1639412745 10 Physicians ISSA RASHA N 999999999 30 DuPage 0 0 Internal Medicine 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 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4628.87 0 0 0 0 0 0 4628.87 0 0 1005321374 1023247236 10 Physicians JENKINS VOGEL MARY TILLEY 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788.18 0 0 0 0 0 0 788.18 0 0 1005321978 23 Occupational Therapists 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 38.51 38.51 0 0 1005321990 1770035636 60 Pharmacies CVS PHARMACY #18092 999999999 80 Peoria 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4249.26 0 0 0 0 0 0 4249.26 0 0 1005324259 1275821225 89 Physician Assistant Only(Encounter Only) SHEERS SARAH E 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1976.53 0 0 0 0 0 0 1976.53 0 0 1005324379 1386987238 10 Physicians CABUGASON ELAINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3173.95 0 0 0 0 0 0 3173.95 0 0 1005324407 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23850.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23850.2 0 0 1005324462 1295022002 10 Physicians BOU STEVEN 999999999 30 DuPage 0 0 Physical 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200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18610.52 0 0 0 0 0 0 0 0 0 0 0 0 0 18610.52 0 0 1005325066 1588972749 89 Physician Assistant Only(Encounter Only) BELL NATHAN H 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.87 0 0 0 0 0 0 169.87 0 0 1005325132 1942657390 36 Community mental health provider ROSECRANCE CHAMPAIGN/URBANA 999999999 19 Champaign 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1057 0 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1057 0 0 4556.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51026.21 0 0 55582.61 0 0 1005325229 1194900134 10 Physicians PETERSON LINDSAY L. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2073.91 0 0 0 0 0 0 2073.91 0 0 1005325281 92 Waiver service provider--Disability (DHS/DRS) 24 Coles 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9171.68 0 0 0 0 0 0 0 0 0 0 0 0 0 9171.68 0 0 1005325453 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7084.05 0 0 0 0 0 0 0 0 0 0 0 0 0 7084.05 0 0 1005325525 60 Pharmacies 817 Kansas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2673 0 0 0 2673 0 0 1005326034 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2765.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2765.53 0 0 1005326139 91 Waiver 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0 0 1005326884 1154676625 16 Nurse Practitioners POUPORE KATLYN 999999999 200 Cook 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 0 148.86 0 0 0 0 0 0 148.86 0 0 1005326895 1467442673 60 Pharmacies LOMBARD PHARMACY 601482678 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 16044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.51 0 0 29851.57 0 0 0 30147.08 0 0 1005327020 1871950550 48 Rural Health Clinics CLAY COUNTY HOSPITAL CLAY CITY 999999999 22 Clay 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005327027 1396000337 10 Physicians GIRARD ORIETTA 999999999 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 1005328807 1659717841 10 Physicians SMITH ABIGAIL L 999999999 200 Cook 0 0 General Practice 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3437.69 0 0 0 0 0 0 3437.69 0 0 1005328931 1467772376 10 Physicians WEBER NICHOLAS 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 5 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.48 0 1437.61 0 0 0 0 0 0 1463.09 0 0 1005329095 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.8 0 0 1005329184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 2637.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2637.32 0 0 1005330243 1114263738 60 Pharmacies CVS PHARMACY #17656 616112445 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2446.53 0 0 0 2446.53 0 0 1005330480 1902257587 11 Dentists ABOURASS TAREK 999999999 200 Cook 0 0 General Dentistry 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16446.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16446.14 0 0 1005330528 1164735403 10 Physicians JASINSKI GREGORY B 999999999 80 Peoria 0 0 Psychiatry 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2127.14 0 0 0 0 0 0 2127.14 0 0 1005330658 1609142520 10 Physicians KIRKWOOD MARK K 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4574.35 0 0 0 0 0 0 4574.35 0 0 1005330666 1518367556 89 Physician Assistant Only(Encounter Only) ALBIAN ALLISON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3763.88 0 0 0 0 0 0 3763.88 0 0 1005330695 1255789285 87 Psychologist(Encounter Only) MATYJA ANNA 999999999 57 Lake 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 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 1359.1 0 0 0 0 0 0 1359.1 0 0 1005330713 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005330801 1295280790 16 Nurse Practitioners BERG KRISTINA 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 6 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.06 0 4068.31 0 0 0 0 0 0 4077.37 0 0 1005331666 1023054533 60 Pharmacies HY-VEE PHARMACY 1075 999999999 816 Iowa 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2453.43 0 0 0 2453.43 0 0 1005331936 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973.75 0 0 0 0 0 0 973.75 0 0 1005331987 1154876217 89 Physician Assistant Only(Encounter Only) LUKOSE MERIAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301.09 0 0 0 0 0 0 301.09 0 0 1005332315 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 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0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.6 0 242.12 0 0 0 0 0 0 529.72 0 0 1005332754 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 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 4229.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4229.5 0 0 1005332831 1396150280 16 Nurse Practitioners MOOL JENNIFER 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 15 0 0 0 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 27 0 0 0 0 0 0 0 0 0 239.33 0 0 0 0 0 0 0 0 643.22 0 0 0 0 0 0 882.55 0 0 1005332907 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.28 0 0 0 0 0 0 84.28 0 0 1005333022 1083046403 10 Physicians ROSARIO JENNIFER M 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 45 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.74 0 0 0 0 0 0 119.74 0 0 1005333635 1497109284 75 Department of Alcohol and Substance Abuse Provider ABOVE AND BEYOND FAMILY RECOVE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21331.81 0 0 21331.81 0 0 1005333669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23760.66 0 0 0 0 0 0 0 0 0 0 0 0 0 23760.66 0 0 1005333799 75 Department of Alcohol and Substance Abuse Provider 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1196.31 0 0 1196.31 0 0 1005333800 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7377.39 0 0 0 0 0 0 0 0 0 0 0 0 0 7377.39 0 0 1005333818 1033651567 91 Waiver service provider--Adults (DHS/DDD) DIAZ HOLLY 999999999 30 DuPage 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 0 760 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115486.8 0 0 0 0 0 0 0 0 0 0 0 0 0 115486.8 0 0 1005334168 1164793311 10 Physicians BHATTARAI BIKASH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.35 0 3545.39 0 0 0 0 0 0 3556.74 0 0 1005334185 22 Physical Therapists 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709.65 709.65 0 0 1005334192 1306206545 16 Nurse Practitioners OCHON JOY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005334267 1205285855 16 Nurse Practitioners BAGROV DIMITRI 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436.78 0 0 0 0 0 0 436.78 0 0 1005334434 1689612608 89 Physician Assistant Only(Encounter Only) STRYCZEK SONYA R 999999999 200 Cook 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 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 1058.34 0 0 0 0 0 0 1058.34 0 0 1005334519 1396721189 89 Physician Assistant Only(Encounter Only) GRANT EMILYE J 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.81 0 0 0 0 0 0 246.81 0 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0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30252.65 0 0 0 0 0 0 0 0 0 0 0 0 0 30252.65 0 0 1005344613 1790782480 63 Other Providers of Medical Equipment/Supplies (Non-registered) HOME AIR JOLIET 999999999 107 Will 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 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4515.69 0 0 0 0 0 0 4515.69 0 0 1005344722 1366777856 10 Physicians ZAID UWAIS B 999999999 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 12 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.19 0 6432.73 0 0 0 0 0 0 6455.92 0 0 1005344874 1619256534 10 Physicians NOWAK WALDEMAR M 999999999 200 Cook 0 0 Neurology 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 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 0 761.49 0 0 0 0 0 0 761.49 0 0 1005345040 1598120719 16 Nurse Practitioners HOSKINS LANESIA D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.54 0 0 0 0 0 0 161.54 0 0 1005345196 1306236625 57 Home Nursing Agency SHILOH HEALTHCARE SERVICES INC 999999999 200 Cook 0 0 0 0 0 0 0 13 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3049 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3049 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1137754.46 7920 0 0 0 0 0 0 0 0 0 0 0 0 1145674.46 0 0 1005345580 1255790986 33 Nursing Facilities ABINGTON OF GLENVIEW NURSING & 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605709.05 0 0 0 0 0 0 0 605709.05 0 0 1005346197 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25379.97 0 0 0 0 0 0 0 0 0 0 0 0 0 25379.97 0 0 1005346199 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30333.27 0 0 0 0 0 0 0 0 0 0 0 0 0 30333.27 0 0 1005346237 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15392.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15392.49 0 0 1005346327 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23318.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23318.95 0 0 1005346339 1073889242 10 Physicians DOWNING JOHN T 999999999 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234.6 0 0 0 0 0 0 234.6 0 0 1005346468 1598128282 16 Nurse Practitioners WIEBEL MOLLY 999999999 89 Rock Island 0 0 0 0 0 11 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 729.18 0 0 0 0 0 0 0 0 3924.87 0 0 0 0 0 0 4654.05 0 0 1005346480 92 Waiver service provider--Disability (DHS/DRS) 80 Peoria 0 0 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 3346.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3346.08 0 0 1005346575 1710223433 89 Physician Assistant Only(Encounter Only) VRAGEL JUSTIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.42 0 0 0 0 0 0 109.42 0 0 1005346861 1558718650 16 Nurse Practitioners WOODALL BRIDGETTE A 999999999 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.7 0 0 0 0 0 0 1132.7 0 0 1005346984 1518219401 89 Physician Assistant Only(Encounter Only) EICHELBERGER KYLE S 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1375.87 0 0 0 0 0 0 1375.87 0 0 1005346992 1952754798 16 Nurse Practitioners DODD AMY 999999999 10 Adams 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33652.78 0 0 0 0 0 0 33652.78 0 0 1005347093 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.88 0 0 0 0 0 0 0 0 0 0 0 0 0 65.88 0 0 1005347342 1932593217 16 Nurse Practitioners VALENTINO KATIE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3420.33 0 0 0 0 0 0 3420.33 0 0 1005347470 20 Registered nurse 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.51 0 0 0 0 0 0 32.51 0 0 1005347479 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 123.08 0 0 0 0 0 0 129.48 0 0 1005347552 1497849749 91 Waiver service provider--Adults (DHS/DDD) DUNCAN CONNIE L 629662057 47 Jackson 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 1144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19168.16 0 0 0 0 0 0 0 0 0 0 0 0 0 19168.16 0 0 1005347749 1831548916 24 Speech Therapists LOFTUS MARGARET 999999999 200 Cook 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6271.52 6271.52 0 0 1005347865 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16311.44 0 0 0 0 0 0 0 0 0 0 0 0 0 16311.44 0 0 1005347960 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24090.77 0 0 0 0 0 0 0 0 0 0 0 0 0 24090.77 0 0 1005348169 1679837470 10 Physicians TOTTLEBEN JONATHAN M. 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.62 0 0 0 0 0 0 186.62 0 0 1005348197 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27306.57 0 0 0 0 0 0 0 0 0 0 0 0 0 27306.57 0 0 1005348204 1053544627 10 Physicians TELLAGORRY JAVIER A 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 10 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.8 0 3478.41 0 0 0 0 0 0 3487.21 0 0 1005348398 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27589.44 0 0 0 0 0 0 0 0 0 0 0 0 0 27589.44 0 0 1005348443 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.6 0 0 0 0 0 0 148.6 0 0 1005348695 1457648073 10 Physicians JAYABALAN PRAKASH S 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828.98 0 0 0 0 0 0 828.98 0 0 1005348741 1760793889 10 Physicians ALVI HASHAM M 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 42 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.95 0 3141.84 0 0 0 0 0 0 3192.79 0 0 1005349136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11611.22 0 0 0 0 0 0 0 0 0 0 0 0 0 11611.22 0 0 1005349381 1356705297 16 Nurse Practitioners PASTORAL LINDSEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105153.72 0 0 0 0 0 0 105153.72 0 0 1005349564 1043754310 10 Physicians MOHSIN SAAD 999999999 53 Kane 0 0 Family Practice 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 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4468.87 0 0 0 0 0 0 4468.87 0 0 1005349737 1518352467 30 General Hospitals FRESENIUS MEDICAL CARE GURNEE 999999999 57 Lake DIALYSIS Outpatient dialysis centers. 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 2982 0 0 0 0 0 44.89 0 0 0 0 0 0 0 0 0 0 0 0 36878.61 0 0 0 0 0 36923.5 0 0 1005350305 89 Physician Assistant Only(Encounter Only) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.31 0 0 0 0 0 0 51.31 0 0 1005350622 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17219.13 0 0 0 0 0 0 0 0 0 0 0 0 0 17219.13 0 0 1005351056 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2035 0 0 0 0 0 0 0 0 0 0 0 0 0 2035 0 0 1005351132 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13644.95 0 0 0 0 0 0 0 0 0 0 0 0 0 13644.95 0 0 1005351135 1699128082 11 Dentists KHAN HIDAYATHULLA 999999999 200 Cook 0 0 General Dentistry 0 0 131 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 21760.06 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 24394.51 0 0 1005351203 1811215064 10 Physicians MATRISCH MELISSA S 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.05 0 457.76 0 0 0 0 0 0 592.81 0 0 1005351210 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2902.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2902.3 0 0 1005351359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24251.52 0 0 0 0 0 0 0 0 0 0 0 0 0 24251.52 0 0 1005351456 1124041405 60 Pharmacies CVS PHARMACY #16306 604451458 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 5196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.44 0 0 5383.49 0 0 0 5515.93 0 0 1005351476 1891134151 10 Physicians BROWN KYLE F 999999999 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 4 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.83 0 6919.99 0 0 0 0 0 0 6981.82 0 0 1005351567 1760878656 30 General Hospitals FRESENIUS MEDICAL CARE MCHENRY 999999999 71 McHenry DIALYSIS Outpatient dialysis centers. 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618.91 0 0 0 0 0 618.91 0 0 1005351831 1912352089 16 Nurse Practitioners DUNLOP JENNIFER 999999999 30 DuPage 0 0 0 0 0 2 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 1727.38 0 0 0 0 0 0 1896.62 0 0 1005352120 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23397.97 0 0 0 0 0 0 0 0 0 0 0 0 0 23397.97 0 0 1005352713 1851656847 12 Optometrists COY ERIC D 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3305.26 0 1537.02 0 0 0 0 4842.28 0 0 1005352955 10 Physicians 104 Wayne 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.23 0 0 0 0 0 0 83.23 0 0 1005353079 16 Nurse Practitioners 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.73 0 0 0 0 0 0 43.73 0 0 1005353098 1437443884 10 Physicians CONWAY JASON A 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.75 0 600.36 0 0 0 0 0 0 606.11 0 0 1005353193 88 Other behavior health professional 200 Cook 0 0 0 0 0 0 0 0 0 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 0 144.55 0 0 0 0 0 0 144.55 0 0 1005353220 16 Nurse Practitioners 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005353543 1336403500 10 Physicians KRITS SEMEON I 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 360.24 0 0 0 0 0 0 360.24 0 0 1005353746 1770710287 10 Physicians SETLUR LAURA 999999999 200 Cook 0 0 Internal Medicine 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 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 0 485.96 0 0 0 0 0 0 485.96 0 0 1005353775 1629311220 10 Physicians OLORODE GBEMISOLA T 999999999 72 McLean 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 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 3729.66 0 0 0 0 0 0 3729.66 0 0 1005353864 1851496152 30 General Hospitals SSM HEALTH ST CLARE HOSPITAL F 630262394 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 23 0 0 0 0 25 0 0 0 37 0 0 0 0 0 0 0 0 0 25 0 0 0 0 25 0 0 0 67 0 0 0 0 0 0 0 0 0 25 0 0 0 0 194 0 0 0 80 0 0 0 0 0 0 0 0 0 2667.44 0 0 0 0 61627.61 0 0 0 3246.19 0 0 0 0 0 67541.24 0 0 1005353886 1851350318 10 Physicians ZIMMERMAN RENA B 999999999 30 DuPage 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 0 128 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 1681.55 0 0 0 0 0 0 1681.55 0 0 1005354054 1164786836 10 Physicians GILFILLAN REBECCA 999999999 200 Cook 0 0 Psychiatry 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 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4048.51 0 0 0 0 0 0 4048.51 0 0 1005354415 92 Waiver service provider--Disability (DHS/DRS) 91 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0 0 0 0 0 0 0 33.38 0 16.79 0 0 0 0 0 0 50.17 0 0 1005371230 36 Community mental health provider 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 416.2 0 0 416.2 0 0 1005371269 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.13 0 0 0 0 0 0 67.13 0 0 1005371389 1215318027 11 Dentists TIEN CHIEHLI 999999999 200 Cook 0 0 General Dentistry 0 0 39 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 8850.69 0 0 0 0 0 0 0 0 0 0 0 2258.1 0 0 0 0 11108.79 0 0 1005371670 16 Nurse Practitioners 65 Madison 0 0 0 0 0 0 0 0 0 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 51.03 0 0 0 0 0 0 51.03 0 0 1005371692 1770025868 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service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20002.2 0 0 0 0 0 0 0 0 0 0 0 0 0 20002.2 0 0 1005372246 1578820510 10 Physicians JOSEPH CINDY 999999999 57 Lake 0 0 Neurology 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 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 0 146.38 0 0 0 0 0 0 146.38 0 0 1005372494 1659811024 16 Nurse Practitioners TENNANT AMY 999999999 200 Cook 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 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 1654.47 0 0 0 0 0 0 1654.47 0 0 1005372818 1073051330 89 Physician Assistant Only(Encounter Only) SLODYCZKA EDYTA 999999999 200 Cook 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084.23 0 0 0 0 0 0 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Nurse Practitioners BOKUS ANDREW 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1931.45 0 0 0 0 0 0 1931.45 0 0 1005373499 1174069512 16 Nurse Practitioners ADICHITHARA MICHELLE 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2816.68 0 0 0 0 0 0 2816.68 0 0 1005373628 1104056654 10 Physicians ARMSTRONG CHAD 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 583.01 0 0 0 0 0 0 583.01 0 0 1005374109 1891943007 16 Nurse Practitioners CORRAL KATHI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 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 6324.86 0 0 0 0 0 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JANDURA DAVID MARK 999999999 80 Peoria 0 0 Internal Medicine 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957.53 0 0 0 0 0 0 957.53 0 0 1005374874 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005375101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3672.13 0 0 0 0 0 0 0 0 0 0 0 0 0 3672.13 0 0 1005375293 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12680.49 0 0 0 0 0 0 0 0 0 0 0 0 0 12680.49 0 0 1005375418 1568801512 10 Physicians ROY SHEILA 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 4 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 49 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 49 0 0 0 0 0 0 0 0 0 12.3 0 0 0 0 0 0 220.87 0 5054.36 0 0 0 0 0 0 5287.53 0 0 1005375858 1942542618 10 Physicians BROMBERG DAVID J 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3067.51 0 0 0 0 0 0 3067.51 0 0 1005376411 1477873693 10 Physicians HUNGERFORD OLENA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.72 0 3273.72 0 0 0 0 0 0 3304.44 0 0 1005376992 1447782446 16 Nurse Practitioners COUDRON KELLY E 999999999 30 DuPage 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 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 0 269.72 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16422.24 0 0 1005378093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22246.23 0 0 0 0 0 0 0 0 0 0 0 0 0 22246.23 0 0 1005378624 13 Podiatrists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005378772 1962556365 89 Physician Assistant Only(Encounter Only) ENGER RYAN M 999999999 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.26 0 0 0 0 0 0 319.26 0 0 1005379462 89 Physician Assistant Only(Encounter Only) 103 Washington 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005379534 1104230218 10 Physicians TALEB AMEEN 999999999 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818.03 0 0 0 0 0 0 818.03 0 0 1005380070 1528321551 10 Physicians PHILLIPS ELIZABETH F 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 144.61 0 0 0 0 0 0 221.45 0 0 1005380316 1639120967 89 Physician Assistant Only(Encounter Only) DURBIN THERESA M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2258.99 0 0 0 0 0 0 2258.99 0 0 1005380319 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15863.53 0 0 0 0 0 0 0 0 0 0 0 0 0 15863.53 0 0 1005380640 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11002.26 0 0 0 0 0 0 0 0 0 0 0 0 0 11002.26 0 0 1005380722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5346.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5346.8 0 0 1005380871 1588765820 16 Nurse Practitioners DANIELS CARLA J 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41754.86 0 0 0 0 0 0 41754.86 0 0 1005381024 1932490273 10 Physicians SALARI POORIA 999999999 53 Kane 0 0 Orthopedic Surgery 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 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 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0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1602.74 0 0 0 0 0 0 1602.74 0 0 1005381860 1326363656 10 Physicians BROWN KRISTAL M 999999999 200 Cook 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 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4223.18 0 0 0 0 0 0 4223.18 0 0 1005381939 1134576093 29 ICF/MR HARTEMAYER HOME 606601017 200 Cook 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1315328.52 0 0 0 0 0 0 0 0 0 0 1315328.52 0 0 1005382060 1982121521 24 Speech Therapists STEPANEK BRITTANY 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27977.56 27977.56 0 0 1005382417 1972850048 24 Speech Therapists DENNIE CANDICE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77483.14 77483.14 0 0 1005382554 1598170847 10 Physicians TETREAULT STEPHANIE M 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 217.64 0 0 0 0 0 0 0 0 1175.49 0 0 0 0 0 0 1393.13 0 0 1005382706 1417315144 60 Pharmacies DURAND TELEPHARMACY INC 999999999 109 Winnebago 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5872.96 0 0 0 5872.96 0 0 1005382847 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 15826.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15826.8 0 0 1005382916 1841692894 89 Physician Assistant Only(Encounter Only) BELNAP CORY B 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.42 0 0 0 0 0 0 62.42 0 0 1005383117 1982015079 10 Physicians QURESHI ABDULLAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 2475.01 0 0 0 0 0 0 2475.01 0 0 1005383273 1700185154 10 Physicians MAHYLIS JARED M 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080.86 0 0 0 0 0 0 1080.86 0 0 1005383345 1366855454 10 Physicians ROSS MICHAEL 999999999 107 Will 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 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 0 252.96 0 0 0 0 0 0 252.96 0 0 1005383383 86 Clinical Social Worker(Encounter Only) 60 Lee 0 0 0 0 0 0 0 0 0 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 0 371.47 0 0 0 0 0 0 371.47 0 0 1005383688 1003347915 10 Physicians GRAND JACOB ALLAN 999999999 200 Cook 0 0 Internal Medicine 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2709.81 0 0 0 0 0 0 2709.81 0 0 1005383703 1033660303 89 Physician Assistant Only(Encounter Only) MCCALEB MEGAN L 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.22 0 0 0 0 0 0 656.22 0 0 1005383766 1396077970 89 Physician Assistant Only(Encounter Only) BLOWERS DIANE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 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 0 267.31 0 0 0 0 0 0 267.31 0 0 1005383896 1831540228 55 Early Intervention Services HALL CHRISTINE 999999999 71 McHenry 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6296 0 0 0 0 0 0 6296 0 0 1005384003 1780941013 10 Physicians CHEVALIER ALEXANDER K 999999999 47 Jackson 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258.34 0 0 0 0 0 0 258.34 0 0 1005384199 1417011529 10 Physicians MORGANS ALICIA K 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9196.71 0 0 0 0 0 0 9196.71 0 0 1005384331 1063778413 10 Physicians KARAS VASILI 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 115 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 335 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 901 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9040.04 0 184.55 0 0 0 0 0 0 9224.59 0 0 1005385838 1215469069 10 Physicians BYRNE MICHELLE 999999999 200 Cook 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 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 5249.34 0 0 0 0 0 0 5249.34 0 0 1005386035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005386105 1497206551 89 Physician Assistant Only(Encounter Only) MENENDEZ JENNIFER V. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256 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 5665.77 0 0 0 0 0 0 5665.77 0 0 1005386170 1659824928 87 Psychologist(Encounter Only) CRISANTI LAUREN K 999999999 30 DuPage 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 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 1086.56 0 0 0 0 0 0 1086.56 0 0 1005386254 1558812800 16 Nurse Practitioners MISZCZYSZYN LISA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738.62 0 0 0 0 0 0 738.62 0 0 1005386317 1508902941 86 Clinical Social Worker(Encounter Only) EGIZIO JILL M. 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232.71 0 0 0 0 0 0 232.71 0 0 1005386529 1427344258 10 Physicians VAN BEEK DARREN B 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 285 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1293.48 0 2900.68 0 0 0 0 0 0 4194.16 0 0 1005386614 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4733.41 0 0 0 0 0 0 0 0 0 0 0 0 0 4733.41 0 0 1005386637 1194808451 13 Podiatrists DUNN BRIAN H 999999999 200 Cook 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 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528.97 0 0 0 0 0 0 528.97 0 0 1005386852 1346668217 10 Physicians TAHERI SEAN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 23 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1053.6 0 1488.35 0 0 0 0 0 0 2541.95 0 0 1005386889 1871931790 10 Physicians SHAIKH BILAL 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.67 0 0 0 0 0 0 13.67 0 0 1005386989 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.43 0 0 0 0 0 0 49.43 0 0 1005387404 1194882548 89 Physician Assistant Only(Encounter Only) HIXSON ETHAN R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.02 0 0 0 0 0 0 62.02 0 0 1005387430 1114456183 24 Speech Therapists HATFILL BAILEY 999999999 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20141.79 20141.79 0 0 1005387842 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.58 0 0 0 0 0 0 146.58 0 0 1005388729 89 Physician Assistant Only(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.28 0 0 0 0 0 0 24.28 0 0 1005388872 1811940893 61 Independent Laboratories ASSOCIATED PHYSICIANS GROUP LT 622691848 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1299.15 0 0 0 0 0 0 0 0 1299.15 0 0 1005388985 1740733658 16 Nurse Practitioners WILLIAMS TAMRA 999999999 107 Will 0 0 0 0 0 3 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 205.66 0 0 0 0 0 0 0 0 382.44 0 0 0 0 0 0 588.1 0 0 1005389173 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.76 0 0 0 0 0 0 131.76 0 0 1005389274 1477644656 16 Nurse Practitioners ESSLINGER CONSTANCE L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570.43 0 0 0 0 0 0 570.43 0 0 1005389304 10 Physicians 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361.8 0 0 0 0 0 0 361.8 0 0 1005389445 1043599152 10 Physicians MENDELSON SCOTT J 999999999 200 Cook 0 0 Neurology 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 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2852.81 0 0 0 0 0 0 2852.81 0 0 1005389679 22 Physical Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.72 74.72 0 0 1005389720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7049.24 0 0 0 0 0 0 0 0 0 0 0 0 0 7049.24 0 0 1005389818 1881951630 10 Physicians UPPULURI SREEKANTH 999999999 30 DuPage 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 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3704.27 0 0 0 0 0 0 3704.27 0 0 1005389876 1356788285 10 Physicians DOBITSCH DENNIS M 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3450.57 0 0 0 0 0 0 3450.57 0 0 1005390614 1871854307 10 Physicians YOU ALEX 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212 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 5606.67 0 0 0 0 0 0 5606.67 0 0 1005390895 1023422797 10 Physicians WANG ANDREW 999999999 80 Peoria 0 0 Psychiatry 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 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4353.93 0 0 0 0 0 0 4353.93 0 0 1005391004 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1788.77 0 0 0 0 0 0 1788.77 0 0 1005391023 1134432594 11 Dentists SANKU PRASADA 999999999 91 Sangamon 0 0 General Dentistry 0 0 47 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 10468.27 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 11220.97 0 0 1005391133 1841589165 10 Physicians NOVAK JOSHUA A 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 1 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.97 0 4139.78 0 0 0 0 0 0 4228.75 0 0 1005391189 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1341.71 0 0 0 0 0 0 1341.71 0 0 1005391540 1336565134 16 Nurse Practitioners TODD ANGELA 999999999 40 Grundy 0 0 0 0 0 6 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 435.05 0 0 0 0 0 0 0 0 3128.62 0 0 0 0 0 0 3563.67 0 0 1005391664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10365.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10365.18 0 0 1005392123 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459.17 0 0 0 0 0 0 459.17 0 0 1005392187 10 Physicians 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.15 0 0 0 0 0 0 237.15 0 0 1005392328 1982041471 10 Physicians NORMAN LAURA 604405125 107 Will 0 0 Family Practice 0 0 0 8 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 828.22 0 0 0 0 0 0 8.48 0 532.74 0 0 0 0 0 0 1369.44 0 0 1005392352 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22810.01 0 0 0 0 0 0 0 0 0 0 0 0 0 22810.01 0 0 1005392434 1073554739 60 Pharmacies EVANSTON HOSPITAL OUTPATIENT P 602011718 200 Cook 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 0 333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153021.06 0 0 0 153021.06 0 0 1005392815 14 Chiropractors 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005392985 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 221.83 0 0 0 0 0 0 233.83 0 0 1005392990 4005392990 16 Nurse Practitioners CLUSKEY JACLYN 999999999 80 Peoria 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.97 0 0 0 0 0 0 328.97 0 0 1005393027 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 1073 0 0 0 0 0 0 0 0 0 0 0 0 0 1073 0 0 1005393029 1285168120 16 Nurse Practitioners DEROSE DONNA L 999999999 71 McHenry 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 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1163.16 0 0 0 0 0 0 1163.16 0 0 1005393242 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 480.58 0 0 0 0 0 0 480.58 0 0 1005393906 1992223895 16 Nurse Practitioners REED CASSANDRA K 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 741.15 0 0 0 0 0 0 741.15 0 0 1005394007 1255399481 10 Physicians RAO ANUPAMA K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 9 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.9 0 3300.2 0 0 0 0 0 0 3391.1 0 0 1005394142 1609954668 90 Waiver service provider--Elderly (DOA) MJM HEALTH AGENCY INC 604358113 107 Will 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88551.06 0 0 0 0 0 0 0 0 0 0 0 0 0 88551.06 0 0 1005394154 1578904892 10 Physicians LAKE EDEN LOUISE 999999999 200 Cook 0 0 Dermatology 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 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2026.76 0 0 0 0 0 0 2026.76 0 0 1005394791 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24119.89 0 0 0 0 0 0 0 0 0 0 0 0 0 24119.89 0 0 1005394889 1871945725 16 Nurse Practitioners HILLERTZ ASHLEY R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 513.59 0 0 0 0 0 0 513.59 0 0 1005394928 1902126097 10 Physicians PELLENBERG ROD 999999999 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3036.25 0 0 0 0 0 0 3036.25 0 0 1005395084 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.62 0 0 0 0 0 0 134.62 0 0 1005395215 1093233173 16 Nurse Practitioners NIERHOFF BRANDON N 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 103.82 0 0 0 0 0 0 0 0 1187.22 0 0 0 0 0 0 1291.04 0 0 1005395635 1144531666 10 Physicians AJDINOVICH JOSEPH M 999999999 33 Effingham 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268 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 8033.59 0 0 0 0 0 0 8033.59 0 0 1005395735 1417213257 10 Physicians KEROLUS JULIA LYNN 999999999 54 Kankakee 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1437.63 0 0 0 0 0 0 1437.63 0 0 1005395756 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27136.9 0 0 0 0 0 0 0 0 0 0 0 0 0 27136.9 0 0 1005396111 1689125700 89 Physician Assistant Only(Encounter Only) BEDI PRIYA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 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 0 266.3 0 0 0 0 0 0 266.3 0 0 1005396755 1326376443 89 Physician Assistant Only(Encounter Only) SHEAHAN WILLIAM P 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6767.97 0 0 0 0 0 0 6767.97 0 0 1005396988 80 Prepaid health plan--Health maintenance organization MERIDIAN TOTAL 60604 200 Cook 0 0 "795,266" 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3509461024 0 1005397221 1205125598 10 Physicians STULCE CASEY W 999999999 30 DuPage 0 0 Pediatrics 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13463.58 0 0 0 0 0 0 13463.58 0 0 1005398224 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20740.72 0 0 0 0 0 0 0 0 0 0 0 0 0 20740.72 0 0 1005398535 1144583287 10 Physicians COOPER JAC 999999999 91 Sangamon 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3062.48 0 0 0 0 0 0 3062.48 0 0 1005398558 1386768992 89 Physician Assistant Only(Encounter Only) OWENS KELLY A 999999999 200 Cook 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548.02 0 0 0 0 0 0 548.02 0 0 1005398775 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005398845 1467974196 16 Nurse Practitioners MCLEOD ELIZABETH A 999999999 80 Peoria 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 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 0 489.99 0 0 0 0 0 0 489.99 0 0 1005398945 1598179491 10 Physicians TORRIJOS MARDEN E 999999999 109 Winnebago 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 6 0 36 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 6 0 70 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 6 0 70 0 0 0 0 0 0 0 0 0 482.86 0 0 0 0 0 0 4.66 0 1249.14 0 0 0 0 0 0 1736.66 0 0 1005399301 1699030551 10 Physicians KIMPLE DANIEL 999999999 92 Schuyler 0 0 Neurology 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 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7005.55 0 0 0 0 0 0 7005.55 0 0 1005399314 1922557370 16 Nurse Practitioners ESTRELLA ROCHIE V 999999999 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322.2 0 0 0 0 0 0 322.2 0 0 1005399381 1902916851 89 Physician Assistant Only(Encounter Only) CLOIN TINA A 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1005399658 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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0 0 0 0 0 0 0 0 0 0 0 0 4333.01 0 0 0 0 0 0 0 0 0 0 0 0 0 4333.01 0 0 1005412062 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.92 0 126.25 0 0 0 0 0 0 136.17 0 0 1005412346 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702.06 0 0 0 0 0 0 702.06 0 0 1005412424 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44784.95 0 0 0 0 0 0 0 0 0 0 0 0 0 44784.95 0 0 1005412540 1699049874 16 Nurse Practitioners BOEHLER GINGER P 999999999 91 Sangamon 0 0 0 0 0 3 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 213.87 0 0 0 0 0 0 0 0 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0 0 0 0 2223.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2223.05 0 0 1005413427 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13556.72 0 0 0 0 0 0 0 0 0 0 0 0 0 13556.72 0 0 1005413493 1285016915 10 Physicians BAUK SOLMAZ 999999999 91 Sangamon 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 304.52 0 0 0 0 0 0 0 0 1674.09 0 0 0 0 0 0 1978.61 0 0 1005413516 89 Physician Assistant Only(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 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 88.03 0 0 0 0 0 0 88.03 0 0 1005413648 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350.29 0 0 0 0 0 0 350.29 0 0 1005413802 1902219611 10 Physicians YANG CHANG 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3778.36 0 0 0 0 0 0 3778.36 0 0 1005414250 1316304637 16 Nurse Practitioners THOMAS SHENELL E 999999999 80 Peoria 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1363.44 0 0 0 0 0 0 1363.44 0 0 1005414325 1497280671 23 Occupational Therapists NARINEDHAT NAVITA 999999999 91 Sangamon 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 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 1927.14 1927.14 0 0 1005414473 1275828394 10 Physicians BARRIOS CHRISTOPHER 999999999 200 Cook 0 0 Internal Medicine 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4199 0 0 0 0 0 0 4199 0 0 1005414724 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6183.36 0 0 0 0 0 0 0 0 0 0 0 0 0 6183.36 0 0 1005414820 1356786214 10 Physicians IMMEN STEVEN W 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564.54 0 0 0 0 0 0 564.54 0 0 1005414992 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3504.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3504.71 0 0 1005415059 1710434832 22 Physical Therapists BAN NELLI A 999999999 57 Lake 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 2780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24332.79 24332.79 0 0 1005415116 1679930457 10 Physicians ALPERT LINDSAY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1699.95 0 0 0 0 0 0 0 0 1699.95 0 0 1005415282 1447783915 60 Pharmacies BIENESTAR PHARMACY III 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63846.79 0 0 0 63846.79 0 0 1005415614 1356639942 10 Physicians BAIG HUMERA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 487 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9050.64 0 238.33 0 0 0 0 0 0 9288.97 0 0 1005415716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1.66 0 0 1005415728 1265665855 10 Physicians CHIWANE SAURABH 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2510.68 0 0 0 0 0 0 2510.68 0 0 1005415836 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 0 503.32 0 0 0 0 0 0 0 0 0 0 0 0 0 503.32 0 0 1005415867 1154731107 10 Physicians FRITZ ADAM 999999999 30 DuPage 0 0 Internal Medicine 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 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 1377.5 0 0 0 0 0 0 1377.5 0 0 1005415885 1346560448 10 Physicians BENNETT MICHAEL C 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 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Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1246.95 0 0 0 0 0 0 1246.95 0 0 1005416777 1083966790 10 Physicians ORIAIFO IRENE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2712.06 0 0 0 0 0 0 2712.06 0 0 1005416817 10 Physicians 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005417043 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299.71 0 0 0 0 0 0 0 0 0 0 0 0 0 299.71 0 0 1005417101 1275822090 10 Physicians GRANT TERRANCE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 461 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10649.51 0 998.47 0 0 0 0 0 0 11647.98 0 0 1005417155 1184052516 16 Nurse Practitioners SWANSON DINA 999999999 30 DuPage 0 0 0 0 0 1 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 984.03 0 0 0 0 0 0 1088.99 0 0 1005417236 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11696.38 0 0 0 0 0 0 0 0 0 0 0 0 0 11696.38 0 0 1005417339 1588194419 16 Nurse Practitioners MONKS COLLEEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5693.11 0 0 0 0 0 0 5693.11 0 0 1005417354 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25964.4 0 0 0 0 0 0 0 0 0 0 0 0 0 25964.4 0 0 1005417481 1992092639 25 Audiologists JIANG YAWEN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.82 138.82 0 0 1005417982 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 610.21 0 0 0 0 0 0 0 0 0 0 0 0 0 610.21 0 0 1005418175 1437514601 16 Nurse Practitioners STORTZ DANIELLE N 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.07 0 0 0 0 0 0 186.07 0 0 1005418641 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 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 64451.24 0 0 0 0 0 0 64451.24 0 0 1005423059 1801101720 10 Physicians NARTATEZ SERAG EVELYN GRACE 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 2 0 71 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 7 0 182 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 7 0 182 0 0 0 0 0 0 0 0 0 682.89 0 0 0 0 0 0 22.45 0 3801.89 0 0 0 0 0 0 4507.23 0 0 1005423320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15227.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15227.96 0 0 1005423419 1407384423 16 Nurse Practitioners REED AMANDA S. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351.48 0 0 0 0 0 0 351.48 0 0 1005423522 1043638042 10 Physicians CANTU-MANLEY HAYDEE 999999999 71 McHenry 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 16.42 0 731.83 0 0 0 0 0 0 833.9 0 0 1005423589 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 1290.2 0 0 0 0 0 0 1290.2 0 0 1005423710 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1005423983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8442.95 0 0 0 0 0 0 0 0 0 0 0 0 0 8442.95 0 0 1005423993 1326573155 60 Pharmacies PRIMERXPHARMACY 999999999 200 Cook 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 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10451.53 0 0 0 10451.53 0 0 1005424459 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13925.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13925.35 0 0 1005425313 1376937599 10 Physicians BROWN LISA ANN 999999999 200 Cook 0 0 Otolaryngology 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2618.47 0 0 0 0 0 0 2618.47 0 0 1005425329 1720491343 10 Physicians HOPE KATINA R 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 5 0 109 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 228 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 0 228 0 0 0 0 0 0 0 0 0 105.23 0 0 0 0 0 0 19.43 0 3818.7 0 0 0 0 0 0 3943.36 0 0 1005425560 1922261742 10 Physicians BANDT SARAH K 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330.47 0 0 0 0 0 0 330.47 0 0 1005425639 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9352.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9352.69 0 0 1005425640 1003234386 10 Physicians SRIVASTAVA VIDHI 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2963.59 0 0 0 0 0 0 2963.59 0 0 1005426330 1902331184 16 Nurse Practitioners BOLSER BRYAN A 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1161.56 0 0 0 0 0 0 1161.56 0 0 1005426425 1598185811 10 Physicians HSU SEAN I 999999999 19 Champaign 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1435.1 0 0 0 0 0 0 1435.1 0 0 1005426541 1104111772 10 Physicians DENISON SHALAKO 999999999 49 Jefferson 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 252.93 0 0 0 0 0 0 252.93 0 0 1005426787 1235492281 10 Physicians FRAUM TYLER J 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 68 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1488.88 0 535.48 0 0 0 0 0 0 2024.36 0 0 1005427073 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 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 7403.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7403.45 0 0 1005427111 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16155.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16155.35 0 0 1005427514 1568550804 89 Physician Assistant Only(Encounter Only) LUTZ KYLE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005427917 1417372772 89 Physician Assistant Only(Encounter Only) STUART MARY K 999999999 200 Cook 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1085.6 0 0 0 0 0 0 1085.6 0 0 1005428174 1659329845 10 Physicians LUFT THOMAS 999999999 200 Cook 0 0 Internal Medicine 0 0 0 1 0 0 0 0 0 0 1 0 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 148 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.51 0 2600.56 0 0 0 0 0 0 2605.07 0 0 1005428261 4005428261 16 Nurse Practitioners GARDNER CHRISTINE C 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 154.81 0 0 0 0 0 0 154.81 0 0 1005428312 1992238810 16 Nurse Practitioners MCCORMICK ANGELA 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 1808.79 0 0 0 0 0 0 1894.44 0 0 1005428396 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2490.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2490.84 0 0 1005428639 1336501550 16 Nurse Practitioners CHAPPELL DANIEL 999999999 200 Cook 0 0 Child/Adolescent Psychiatry Residency 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 0 169 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 6288.08 0 0 0 0 0 0 6288.08 0 0 1005428738 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4869.07 0 0 0 0 0 0 0 0 0 0 0 0 0 4869.07 0 0 1005428751 1023563335 16 Nurse Practitioners MENDOZA MAE G 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5036.89 0 0 0 0 0 0 5036.89 0 0 1005428825 1851591044 10 Physicians RIVAS ERICK 999999999 200 Cook 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 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10580.93 0 0 0 0 0 0 10580.93 0 0 1005428989 1700839651 89 Physician Assistant Only(Encounter Only) YUNG SILVIA 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005429201 1083076798 16 Nurse Practitioners PHU KYLA R 999999999 200 Cook 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 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 0 561.44 0 0 0 0 0 0 561.44 0 0 1005429557 1437310455 10 Physicians RAIJI MANISH T 999999999 30 DuPage 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7534.89 0 0 0 0 0 0 7534.89 0 0 1005429709 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 590.66 0 0 0 0 0 0 590.66 0 0 1005429834 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22850.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22850.1 0 0 1005429865 1770901852 10 Physicians EVANS KALEIGH L 999999999 53 Kane 0 0 Internal Medicine 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 0 233 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 1244.95 0 0 0 0 0 0 1244.95 0 0 1005430307 1043667900 29 ICF/MR KAPERL HOME 999999999 200 Cook 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1297442.3 0 0 0 0 0 0 0 0 0 0 1297442.3 0 0 1005430555 1639618085 89 Physician Assistant Only(Encounter Only) SLINGO HILLARY K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.78 0 0 0 0 0 0 66.78 0 0 1005430636 1336568450 10 Physicians EGGEMAN DANIEL R 999999999 53 Kane 0 0 Emergency Medicine 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 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 0 646.9 0 0 0 0 0 0 646.9 0 0 1005430641 1043756489 16 Nurse Practitioners SCHRADER ELIZABETH R. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1211.16 0 0 0 0 0 0 1211.16 0 0 1005430919 1114331402 10 Physicians YEE DEREK 999999999 47 Jackson 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 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 0 467.68 0 0 0 0 0 0 467.68 0 0 1005431269 1447240171 10 Physicians DAVIS CHARLES 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 98 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.81 0 0 0 0 0 0 0 0 204.81 0 0 1005431326 1508315516 30 General Hospitals ADVOCATE CHILDRENS HOSPITAL 999999999 200 Cook 0 0 0 0 0 0 1370 0 0 0 0 1458 0 0 0 726 0 0 0 0 0 0 0 0 0 1630 0 0 0 0 389 0 0 0 1239 0 0 0 0 0 0 0 0 0 1630 0 0 0 0 3879 0 0 0 1239 0 0 0 0 0 0 0 0 0 384159.18 0 0 0 0 14025841.5 0 0 0 476434.67 0 0 0 0 0 14886435.35 0 57716.54 1005431329 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15420.51 0 0 0 0 0 0 0 0 0 0 0 0 0 15420.51 0 0 1005431420 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005431451 1780926527 10 Physicians SELESKI NILI 999999999 200 Cook 0 0 Internal Medicine 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2785.82 0 0 0 0 0 0 2785.82 0 0 1005431473 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7380.01 0 0 0 0 0 0 0 0 0 0 0 0 0 7380.01 0 0 1005431827 1891086146 10 Physicians FORD CATHERINE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.73 0 8870.46 0 0 0 0 0 0 8946.19 0 0 1005432343 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005432642 1326458332 10 Physicians PATEL MOSAM B 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 13 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.48 0 225.29 0 0 0 0 0 0 416.77 0 0 1005432727 1295259901 16 Nurse Practitioners THIES LAINE K 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1219.87 0 0 0 0 0 0 1252.02 0 0 1005432860 1245765296 16 Nurse Practitioners THACKER KELSEY M 999999999 82 Piatt 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 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 0 405.31 0 0 0 0 0 0 405.31 0 0 1005433009 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 125.62 0 0 0 0 0 0 125.62 0 0 1005433071 1104848332 10 Physicians SANDERS MICHAEL 999999999 200 Cook 0 0 Pediatrics 0 0 0 40 0 0 0 0 0 0 12 0 32 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 17 0 43 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 17 0 43 0 0 0 0 0 0 0 0 0 2589.47 0 0 0 0 0 0 129.82 0 1998.34 0 0 0 0 0 0 4717.63 0 0 1005433137 1770011397 16 Nurse Practitioners BLOUGH ASHLEY G 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.65 0 0 0 0 0 0 119.65 0 0 1005433419 1770932204 10 Physicians FATOOREHCHI SAM 999999999 200 Cook 0 0 Family Practice 0 0 0 7 0 0 0 0 0 0 2 0 70 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 212.1 0 0 0 0 0 0 7.35 0 2835.69 0 0 0 0 0 0 3055.14 0 0 1005433479 86 Clinical Social Worker(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005433550 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.84 0 0 0 0 0 0 133.84 0 0 1005434106 1477828085 10 Physicians CANTRELL DONALD R 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 10 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501.91 0 3599.98 0 0 0 0 0 0 4101.89 0 0 1005434672 1215347125 10 Physicians HUSSAINI KAMRAN 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5269.22 0 0 0 0 0 0 5269.22 0 0 1005435119 1558735274 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDSERV EQUIPMENT CORP 618012709 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868.12 0 0 0 0 0 0 868.12 0 0 1005435267 1316497332 89 Physician Assistant Only(Encounter Only) O'DONNELL MARY E 999999999 53 Kane 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 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 0 598.54 0 0 0 0 0 0 598.54 0 0 1005435399 1336554658 10 Physicians BERG 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1005462034 1154743805 89 Physician Assistant Only(Encounter Only) SCOPP LAUREN R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486.31 0 0 0 0 0 0 486.31 0 0 1005462357 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.57 0 0 0 0 0 0 222.57 0 0 1005462518 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22992.81 0 0 0 0 0 0 0 0 0 0 0 0 0 22992.81 0 0 1005462812 1316461957 11 Dentists HYKER JESSICA 999999999 200 Cook 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1010 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1010 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17664.72 0 0 0 0 0 0 0 0 0 0 0 0 0 17664.72 0 0 1005473750 10 Physicians 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.9 0 0 0 0 0 0 52.9 0 0 1005473921 10 Physicians 92 Schuyler 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3759.93 0 0 0 0 0 0 3759.93 0 0 1005474011 1548689870 10 Physicians KUMAR ANUP 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1882.22 0 0 0 0 0 0 1882.22 0 0 1005474032 1598791527 89 Physician Assistant Only(Encounter Only) SCHERTZ JILL 999999999 80 Peoria 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 0 502.62 0 0 0 0 0 0 502.62 0 0 1005474048 1346770914 16 Nurse Practitioners GUIAB MARK P 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13175.99 0 0 0 0 0 0 13175.99 0 0 1005474128 1841501962 10 Physicians HO BRYANT 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 16 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.2 0 1818.59 0 0 0 0 0 0 1868.79 0 0 1005474288 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2023.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2023.53 0 0 1005474838 16 Nurse Practitioners 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1005474936 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.22 0 0 0 0 0 0 126.22 0 0 1005475003 10 Physicians 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 0 113.26 0 0 0 0 0 0 113.26 0 0 1005475127 30 General Hospitals 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778.36 0 0 0 0 0 778.36 0 0 1005475134 10 Physicians 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.85 0 0 0 0 0 0 159.85 0 0 1005475250 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.87 0 0 0 0 0 0 16.87 0 0 1005475524 1891057568 10 Physicians ALNIEMI SABA 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 2 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.73 0 7186.61 0 0 0 0 0 0 7231.34 0 0 1005476018 1275995722 10 Physicians GOODMAN COLIN DOUGLAS 999999999 200 Cook 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 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6319.57 0 0 0 0 0 0 6319.57 0 0 1005476394 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23850.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23850.2 0 0 1005477372 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22893.5 0 0 1005477387 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005477615 1467763599 10 Physicians GARCIA-SOSA REBECCA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7401.61 0 0 0 0 0 0 7401.61 0 0 1005477660 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6672.61 0 0 0 0 0 0 0 0 0 0 0 0 0 6672.61 0 0 1005477924 1063860187 16 Nurse Practitioners ATCHLEY ROBERT 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6268.71 0 0 0 0 0 0 6268.71 0 0 1005478123 1518379239 10 Physicians RAHMANI SOLMAZ 999999999 47 Jackson 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 0 0 1249.7 0 0 0 0 0 0 1341.6 0 0 1005478262 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19968.7 0 0 0 0 0 0 0 0 0 0 0 0 0 19968.7 0 0 1005478354 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25134.36 0 0 0 0 0 0 0 0 0 0 0 0 0 25134.36 0 0 1005478381 87 Psychologist(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332.18 0 0 0 0 0 0 332.18 0 0 1005478582 30 General Hospitals 844 Tennessee ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.35 0 0 1005478675 1386646032 89 Physician Assistant Only(Encounter Only) BROOKS DAVID ETHAN 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 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 2209.58 0 0 0 0 0 0 2209.58 0 0 1005478809 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17435.88 0 0 0 0 0 0 0 0 0 0 0 0 0 17435.88 0 0 1005478825 1366880908 10 Physicians BROWN STACY S 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.07 0 4695.42 0 0 0 0 0 0 4772.49 0 0 1005479265 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 144.88 0 0 0 0 0 0 144.88 0 0 1005479341 1407080575 10 Physicians WOO VINCENT K 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.63 0 5396.81 0 0 0 0 0 0 5460.44 0 0 1005479773 1811447139 89 Physician Assistant Only(Encounter Only) MCCORMICK COLE A 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 71.65 0 0 0 0 0 0 71.65 0 0 1005479868 1720427859 10 Physicians SCHMIDT MAGDALENA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2847.39 0 0 0 0 0 0 2847.39 0 0 1005480091 1093264756 16 Nurse Practitioners KUNZ DAWN 999999999 200 Cook 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 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 0 290.18 0 0 0 0 0 0 290.18 0 0 1005480220 1902249105 13 Podiatrists AHMED SYED 999999999 200 Cook 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 0 239 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 1493.18 0 0 0 0 0 0 1493.18 0 0 1005480271 1558806539 16 Nurse Practitioners ARIAS GIOCONDA C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1608.9 0 0 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10955.5 0 0 0 0 0 0 10955.5 0 0 1005481850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2100.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2100.64 0 0 1005482315 1053842039 10 Physicians KHAN ADIBA NASEEM 999999999 200 Cook 0 0 Family Practice 0 0 0 19 0 0 0 0 0 0 5 0 70 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 5 0 121 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 5 0 121 0 0 0 0 0 0 0 0 0 591.05 0 0 0 0 0 0 19.27 0 3464.7 0 0 0 0 0 0 4075.02 0 0 1005482789 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.58 0 0 0 0 0 0 111.58 0 0 1005482919 1285909481 10 Physicians SALAH AHMAD M 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 292.41 0 0 0 0 0 0 292.41 0 0 1005483435 1487059192 10 Physicians RAHBAR ATA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678.41 0 0 0 0 0 0 678.41 0 0 1005483648 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238.09 238.09 0 0 1005483661 1437681970 10 Physicians MARTIN JEROME JAMEEL 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.7 0 4622.06 0 0 0 0 0 0 4636.76 0 0 1005483678 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17628.01 0 0 0 0 0 0 0 0 0 0 0 0 0 17628.01 0 0 1005483728 1356861942 10 Physicians HUNTINGTON BRIAN THOMAS 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 78.76 0 0 0 0 0 0 78.76 0 0 1005483935 1689081861 10 Physicians DIEBOLD TODD 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 11 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.11 0 4150.34 0 0 0 0 0 0 4518.45 0 0 1005484008 1366521296 30 General Hospitals PRESENCE SAINT JOSEPH CHICAGO 606575640 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103421.67 0 0 0 0 0 0 0 0 0 103421.67 0 0 1005484428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3044.18 0 0 0 0 0 0 3044.18 0 0 1005499051 1730566837 63 Other Providers of Medical Equipment/Supplies (Non-registered) "SCHECK AND SIRESS PROSTHETICS," 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.63 0 5524.17 0 0 0 0 5686.8 0 0 1005499581 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 122.87 0 0 0 0 0 0 122.87 0 0 1005500497 1639693617 16 Nurse Practitioners LONGNECKER MONICA L 999999999 109 Winnebago 0 0 0 0 0 2 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 175.29 0 0 0 0 0 0 0 0 633.08 0 0 0 0 0 0 808.37 0 0 1005500590 1588670996 60 Pharmacies WALGREENS #21147 999999999 803 Arizona 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 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0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.19 0 1529.25 0 0 0 0 0 0 1550.44 0 0 1005501573 1013330760 28 Waiver service provider--Supportive living facility (HFS) "VISTAS FOX VALLEY, THE" 999999999 53 Kane 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477165.71 0 0 0 0 0 0 0 0 0 0 0 0 0 477165.71 0 0 1005501715 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85.3 0 0 0 0 0 0 85.3 0 0 1005501868 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22661.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22661.76 0 0 1005502297 1619316304 10 Physicians PEACOCK NICHOLAS J 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4103.61 0 0 0 0 0 0 4103.61 0 0 1005502565 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722.6 0 0 0 0 0 0 0 0 0 0 0 0 0 722.6 0 0 1005502639 1417240102 10 Physicians HANIF SAMEUL O 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 431 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8087.39 0 1249.92 0 0 0 0 0 0 9337.31 0 0 1005502704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24457.47 0 0 0 0 0 0 0 0 0 0 0 0 0 24457.47 0 0 1005502705 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 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 23.76 0 0 0 0 0 0 23.76 0 0 1005502925 1942683800 16 Nurse Practitioners OLES JENNIFER L. 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4296.06 0 0 0 0 0 0 4296.06 0 0 1005503113 1386941508 10 Physicians BRUME EDIRI J 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6754.83 0 0 0 0 0 0 6754.83 0 0 1005503518 1750716726 89 Physician Assistant Only(Encounter Only) SIEVERS LYNDSI K 999999999 53 Kane 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357.9 0 0 0 0 0 0 357.9 0 0 1005503854 1689853111 89 Physician Assistant Only(Encounter Only) PATEL SONAL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 983.64 0 0 0 0 0 0 983.64 0 0 1005503953 1700266848 16 Nurse Practitioners PALOMO CHERRY 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859.16 0 0 0 0 0 0 859.16 0 0 1005504027 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 975.86 0 0 0 0 0 0 975.86 0 0 1005504056 89 Physician Assistant Only(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 91.5 0 0 0 0 0 0 91.5 0 0 1005504135 1033210166 30 General Hospitals PRESENCE SAINT FRANCIS HOSP 602023328 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 755.1 0 0 0 0 0 755.1 0 0 1005504317 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25247.24 0 0 0 0 0 0 0 0 0 0 0 0 0 25247.24 0 0 1005504474 1922533397 16 Nurse Practitioners OLSZEWSKI KRISTEN J 999999999 53 Kane 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845.05 0 0 0 0 0 0 845.05 0 0 1005504703 1932391687 89 Physician Assistant Only(Encounter Only) SWINIGAN SHAWNA R 999999999 19 Champaign 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476.28 0 0 0 0 0 0 476.28 0 0 1005504899 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4875.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4875.25 0 0 1005504930 1063803476 10 Physicians HYON KATHERINE S 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 9 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 16 0 61 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 16 0 61 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 277.03 0 2761.16 0 0 0 0 0 0 3070.34 0 0 1005505211 1386095594 23 Occupational Therapists DIRKS BROOKE ELIZABETH 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 419.03 419.03 0 0 1005505275 1891165809 89 Physician Assistant Only(Encounter Only) BRIDGES ASHLEY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 369.21 0 0 0 0 0 0 369.21 0 0 1005505430 1386697191 89 Physician Assistant Only(Encounter Only) SALTZMAN JINA A 999999999 30 DuPage 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 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2135.76 0 0 0 0 0 0 2135.76 0 0 1005505816 1386856961 89 Physician Assistant Only(Encounter Only) WALKO KIMBERLY 999999999 53 Kane 0 0 0 0 0 6 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 561.94 0 0 0 0 0 0 0 0 1241.99 0 0 0 0 0 0 1803.93 0 0 1005506012 1184035578 10 Physicians MANKUS MARGARITA 999999999 200 Cook 0 0 0 0 0 44 0 0 0 0 0 0 15 0 50 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 20 0 101 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 20 0 101 0 0 0 0 0 0 0 0 0 5713.04 0 0 0 0 0 0 162.65 0 4160.92 0 0 0 0 0 0 10036.61 0 0 1005506079 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8278.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8278.5 0 0 1005506421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15315.39 0 0 0 0 0 0 0 0 0 0 0 0 0 15315.39 0 0 1005506813 1528473311 10 Physicians STEFFENS ASHLEY 999999999 80 Peoria 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 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 0 120.28 0 0 0 0 0 0 120.28 0 0 1005506841 1801883129 12 Optometrists BROWN DANIEL J 999999999 88 Richland 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336.01 0 0 0 0 0 0 336.01 0 0 1005506882 1609181056 89 Physician Assistant Only(Encounter Only) SEDIVY AMANDA L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 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 1582.87 0 0 0 0 0 0 1582.87 0 0 1005506966 1447781224 16 Nurse Practitioners GROBENGIESER JENNIFER L 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1858.58 0 0 0 0 0 0 1858.58 0 0 1005507102 1275916918 10 Physicians SIDDIQUI SAUD 999999999 109 Winnebago 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 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1151.58 0 0 0 0 0 0 1151.58 0 0 1005507210 1629041710 10 Physicians ANANI ASHRAF 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9727.3 0 0 0 0 0 0 9727.3 0 0 1005507444 1346601895 86 Clinical Social Worker(Encounter Only) MARKOVITCH BROOKE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7292.34 0 0 0 0 0 0 7292.34 0 0 1005507453 1790947224 10 Physicians TRIKALINOS NIKOLAOS 999999999 200 Cook 0 0 Internal Medicine 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 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65950.86 0 0 0 0 0 0 65950.86 0 0 1005507728 1962816108 10 Physicians DESAI AALISHA VIPUL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 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 1697.16 0 0 0 0 0 0 1697.16 0 0 1005508106 1750798872 10 Physicians SMITH ELISA M 999999999 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.83 0 0 0 0 0 0 311.83 0 0 1005508223 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15836.37 0 0 0 0 0 0 0 0 0 0 0 0 0 15836.37 0 0 1005508310 1700308996 16 Nurse Practitioners MATTHEWS AMANDA S 999999999 80 Peoria 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 0 104 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 1127.69 0 0 0 0 0 0 1127.69 0 0 1005508383 1376961862 10 Physicians PINAWIN ASHLEY M 999999999 71 McHenry 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 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 4717.83 0 0 0 0 0 0 4717.83 0 0 1005508775 1407118318 10 Physicians MORITZ MICHAEL S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477.6 0 0 0 0 0 0 0 0 477.6 0 0 1005508918 86 Clinical Social Worker(Encounter Only) 89 Rock Island 0 0 0 0 0 0 0 0 0 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 85.03 0 0 0 0 0 0 85.03 0 0 1005509350 1417224098 10 Physicians PATEL MILAP 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 51 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559.77 0 3439.79 0 0 0 0 0 0 3999.56 0 0 1005509436 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 42.14 0 0 1005509555 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.66 0 0 0 0 0 0 248.66 0 0 1005510022 1336589480 10 Physicians TRILLO ALVAREZ LUDWIG 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433.5 0 0 0 0 0 0 433.5 0 0 1005510417 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 635.17 0 0 0 0 0 0 0 0 0 0 0 0 0 635.17 0 0 1005510852 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205.52 205.52 0 0 1005510881 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3147.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3147.56 0 0 1005511655 10 Physicians 65 Madison 0 0 0 0 0 0 0 0 0 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 0 135.66 0 0 0 0 0 0 135.66 0 0 1005511963 1154717569 89 Physician Assistant Only(Encounter Only) HORNADAY KRISTIN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005512202 1578013215 16 Nurse Practitioners WILLIAMS SONAL 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5496.54 0 0 0 0 0 0 5496.54 0 0 1005512258 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 307 0 0 0 0 0 0 307 0 0 1005512416 1710249610 10 Physicians BREWER ERIC 999999999 24 Coles 0 0 Orthopedic Surgery 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 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13068.85 0 0 0 0 0 0 13068.85 0 0 1005512447 1447515374 10 Physicians ADARAMOLA DORCAS 999999999 91 Sangamon 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 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9256.34 0 0 0 0 0 0 9256.34 0 0 1005512458 1285172643 16 Nurse Practitioners MO CAILIAN 999999999 200 Cook 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 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2035.55 0 0 0 0 0 0 2035.55 0 0 1005512572 1003216953 10 Physicians BANGASH IMTIAZ H 999999999 91 Sangamon 0 0 Internal 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Nurse Practitioners AICHER TRACY M. 999999999 200 Cook 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 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 0 488.66 0 0 0 0 0 0 488.66 0 0 1005526085 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 70 0 0 1005526147 1598122178 10 Physicians WILLIAMS JAMES R 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.7 0 0 0 0 0 0 601.7 0 0 1005526166 1063952000 16 Nurse Practitioners ANDERSON ALLYSON 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177.92 0 0 0 0 0 0 1177.92 0 0 1005526562 10 Physicians 106 Whiteside 0 0 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Physicians NARANG VIVEK 999999999 200 Cook 0 0 Internal Medicine 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9451.39 0 0 0 0 0 0 9451.39 0 0 1005528111 1912132580 10 Physicians SINGH MANMEET B 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2553.37 0 0 0 0 0 0 0 0 2553.37 0 0 1005528663 1689198335 91 Waiver service provider--Adults (DHS/DDD) KUCHAN COURTNEY 999999999 200 Cook 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 0 833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48337.42 0 0 0 0 0 0 0 0 0 0 0 0 0 48337.42 0 0 1005528874 1831646991 16 Nurse Practitioners SHELHORSE KRISTEN A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294.98 0 0 0 0 0 0 294.98 0 0 1005541422 1831487719 10 Physicians THEKKEMURIYIL DANY V 999999999 200 Cook 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 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 0 128.5 0 0 0 0 0 0 128.5 0 0 1005541768 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14799.36 0 0 0 0 0 0 0 0 0 0 0 0 0 14799.36 0 0 1005542041 1831480888 10 Physicians ARCOS VICENTE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.01 0 2304.6 0 0 0 0 0 0 2337.61 0 0 1005542281 1710185392 10 Physicians VRECENAK JESSE 999999999 200 Cook 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 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 7266.83 0 0 0 0 0 0 7266.83 0 0 1005542499 1710392428 10 Physicians HOSSLER ANDREW J 999999999 47 Jackson 0 0 Family Practice 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 0 119 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 1666.18 0 0 0 0 0 0 1666.18 0 0 1005542566 1023378767 10 Physicians BAJWA AJWAD SAEED 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 293 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5043.98 0 1032.29 0 0 0 0 0 0 6076.27 0 0 1005542734 1114455573 12 Optometrists BRENART ROBERT F 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1532.02 0 468.48 0 0 0 0 2000.5 0 0 1005542795 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1005542857 13 Podiatrists 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005542944 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14349.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14349.68 0 0 1005542945 1417241944 10 Physicians GENTILE NICOLE MARIE 999999999 200 Cook 0 0 Internal Medicine 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1343.89 0 0 0 0 0 0 1343.89 0 0 1005543070 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 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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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6146.12 0 0 0 0 0 0 6146.12 0 0 1005544155 1790190999 10 Physicians HAGENE MICHELLE L 999999999 60 Lee 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.55 0 0 0 0 0 0 506.55 0 0 1005544157 1306282561 10 Physicians HENSLEY LAUREN 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 33 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 48 0 51 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 48 0 51 0 0 0 0 0 0 0 0 0 190.61 0 0 0 0 0 0 1220.52 0 4880.83 0 0 0 0 0 0 6291.96 0 0 1005544159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 424.92 0 0 0 0 0 0 0 0 0 0 0 0 0 424.92 0 0 1005544171 1174842926 89 Physician Assistant Only(Encounter Only) PATEL ISHANI P 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 0 154.74 0 0 0 0 0 0 154.74 0 0 1005544184 1558897421 16 Nurse Practitioners MAYER DEANA M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239.4 0 0 0 0 0 0 239.4 0 0 1005544353 1417476375 24 Speech Therapists RIVERA MORGAN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 415.68 415.68 0 0 1005544524 24 Speech Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3781.04 3781.04 0 0 1005544542 1689009516 10 Physicians JAFRI MOHSIN 999999999 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8607.93 0 0 0 0 0 0 8607.93 0 0 1005544857 1902096928 10 Physicians KENTOSH JOSHUA B 999999999 80 Peoria 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 2 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.1 0 6160.98 0 0 0 0 0 0 6202.08 0 0 1005545074 1629499769 87 Psychologist(Encounter Only) FANK PATRICIA 999999999 200 Cook 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 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 0 977.52 0 0 0 0 0 0 977.52 0 0 1005545130 1972757557 89 Physician Assistant Only(Encounter Only) TURNER MEAGAN M 999999999 200 Cook 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 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 2194.79 0 0 0 0 0 0 2194.79 0 0 1005545251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9362.19 0 0 0 0 0 0 0 0 0 0 0 0 0 9362.19 0 0 1005545352 1013444934 16 Nurse Practitioners ANTICEVICH SHERYL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3325.29 0 0 0 0 0 0 3325.29 0 0 1005545354 1336541192 24 Speech Therapists SMITH ERIKA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.5 1948.5 0 0 1005545520 1023373198 10 Physicians GRIFFIN LINDSAY M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 237 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6831.11 0 1050.68 0 0 0 0 0 0 7881.79 0 0 1005545702 1558523464 10 Physicians TAYLOR MONTOYA 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2937.61 0 0 0 0 0 0 2937.61 0 0 1005545856 1699193490 10 Physicians THOMAS ANN 999999999 200 Cook 0 0 Pediatrics 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2835.23 0 0 0 0 0 0 2835.23 0 0 1005546525 1639600034 36 Community mental health provider "GATEWAY SERVICES, INC" 999999999 15 Bureau 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 1131.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32125.61 0 0 33257.01 0 0 1005546600 1982989687 89 Physician Assistant Only(Encounter Only) DECKER COURTNEY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 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LATORIA SARAH 999999999 200 Cook 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 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 0 834.95 0 0 0 0 0 0 834.95 0 0 1005548639 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3190.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3190.88 0 0 1005548648 89 Physician Assistant Only(Encounter Only) 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 251.4 0 0 0 0 0 0 251.4 0 0 1005548649 1457893661 16 Nurse Practitioners SANCHEZ ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8139.29 0 0 0 0 0 0 8139.29 0 0 1005548765 36 Community mental health provider 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 996.55 0 0 996.55 0 0 1005549636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1032.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1032.92 0 0 1005549696 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3108.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3108.9 0 0 1005549717 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.74 34.74 0 0 1005549849 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21900.7 0 0 0 0 0 0 0 0 0 0 0 0 0 21900.7 0 0 1005550204 1205205028 86 Clinical Social Worker(Encounter Only) DAVILA SHARONSLABA 999999999 200 Cook 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.4 0 0 0 0 0 0 328.4 0 0 1005550266 89 Physician Assistant Only(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 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 0 265.35 0 0 0 0 0 0 265.35 0 0 1005550309 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13496.12 0 0 0 0 0 0 0 0 0 0 0 0 0 13496.12 0 0 1005550479 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2044.13 0 0 0 0 0 0 0 0 0 0 0 0 0 2044.13 0 0 1005550515 1578911756 10 Physicians GOYAL ANITA VIJAY 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2651.8 0 0 0 0 0 0 2651.8 0 0 1005550651 1114449519 16 Nurse Practitioners SHIRO LYNDA A 999999999 97 Stephenson 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818.25 0 0 0 0 0 0 818.25 0 0 1005550680 1508283599 10 Physicians VIEN ALBERT C 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5140.92 0 0 0 0 0 0 5140.92 0 0 1005550691 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5099.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5099.01 0 0 1005550701 1417299330 10 Physicians TAYLOR RYAN J 999999999 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.52 0 1443.02 0 0 0 0 0 0 1465.54 0 0 1005550778 1245520410 10 Physicians HINZ ERICA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 16 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722.72 0 153857.81 0 0 0 0 0 0 154580.53 0 0 1005550967 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21862.84 0 0 0 0 0 0 0 0 0 0 0 0 0 21862.84 0 0 1005551028 1518007822 10 Physicians WOODS DUSTIN R 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.41 0 34.33 0 0 0 0 0 0 327.74 0 0 1005551460 10 Physicians 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1005551605 1902287956 10 Physicians PATEL NAEEM I 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6386.5 0 0 0 0 0 0 6386.5 0 0 1005551642 1629528443 16 Nurse Practitioners PATEL SEJALBEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17518.98 0 0 0 0 0 0 17518.98 0 0 1005551998 1477949204 10 Physicians DREIFUSS MIRIAM 999999999 200 Cook 0 0 Pediatrics 0 0 0 5 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 621.28 0 0 0 0 0 0 0 0 538.03 0 0 0 0 0 0 1159.31 0 0 1005552170 1316481898 60 Pharmacies PRIME PLUS PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22970 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38513.25 0 0 0 38513.25 0 0 1005552296 1629595749 24 Speech Therapists BUKSA KATARZYNA T 999999999 200 Cook 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 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16887.24 16887.24 0 0 1005552429 1598074353 10 Physicians GILLETTE NICKOLAS J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 23 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.87 0 1261.96 0 0 0 0 0 0 1458.83 0 0 1005552507 1407240708 10 Physicians PINKARD LAUREN A 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 17 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 25 0 22 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 25 0 22 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 180.7 0 1948.21 0 0 0 0 0 0 2135.31 0 0 1005552682 1780830703 10 Physicians BOULOS DANY 999999999 97 Stephenson 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 4 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 780.85 0 0 0 0 0 0 780.85 0 0 1005552775 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.8 0 0 0 0 0 0 146.8 0 0 1005553051 1982916466 10 Physicians AHMED AASMA 999999999 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.19 0 234.27 0 0 0 0 0 0 301.46 0 0 1005553088 1821348988 16 Nurse Practitioners EDWARDS ELLA 999999999 47 Jackson 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 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 0 457.7 0 0 0 0 0 0 457.7 0 0 1005553330 1598150393 10 Physicians MAYO ANDREW 999999999 49 Jefferson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 9 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784.48 0 1041.13 0 0 0 0 0 0 1825.61 0 0 1005553547 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18147.35 0 0 0 0 0 0 0 0 0 0 0 0 0 18147.35 0 0 1005553647 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1316.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.18 0 0 1005554246 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 5083.43 0 0 0 0 0 0 0 0 0 0 0 0 0 5083.43 0 0 1005554541 1992228365 16 Nurse Practitioners MADSEN BECKY L 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1082.19 0 0 0 0 0 0 1082.19 0 0 1005554591 1447788393 10 Physicians BOCK KATHLEEN 999999999 107 Will 0 0 0 0 0 4 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 147.8 0 0 0 0 0 0 11.59 0 870.76 0 0 0 0 0 0 1030.15 0 0 1005554744 22 Physical Therapists 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 15.61 15.61 0 0 1005554782 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253.52 0 0 0 0 0 0 253.52 0 0 1005554881 1801145891 10 Physicians OCONNELL JOSEPH M 999999999 30 DuPage 0 0 Pediatrics 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 0 245 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 38080.17 0 0 0 0 0 0 38080.17 0 0 1005555226 1518328624 16 Nurse Practitioners STONE CRYSTAL L 999999999 96 St Clair 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 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5505.05 0 0 0 0 0 0 5505.05 0 0 1005555397 1417210931 10 Physicians LAYNE MIA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.92 0 500.62 0 0 0 0 0 0 618.54 0 0 1005555473 1699967463 16 Nurse Practitioners DENNISON TONYA L 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.11 0 0 0 0 0 0 503.11 0 0 1005555726 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.51 0 0 0 0 0 0 151.51 0 0 1005555843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10029.22 0 0 0 0 0 0 0 0 0 0 0 0 0 10029.22 0 0 1005555858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21936.46 0 0 0 0 0 0 0 0 0 0 0 0 0 21936.46 0 0 1005555864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27418.41 0 0 0 0 0 0 0 0 0 0 0 0 0 27418.41 0 0 1005556007 1093000721 16 Nurse Practitioners WILLIS KATHRYN O 999999999 200 Cook 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 890.46 0 0 0 0 0 0 890.46 0 0 1005556129 1730224908 10 Physicians KELLY KENNETH J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.61 0 0 0 0 0 0 159.61 0 0 1005556349 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16511.04 0 0 0 0 0 0 0 0 0 0 0 0 0 16511.04 0 0 1005556615 1962781559 10 Physicians BHUPALI DEEPA 999999999 200 Cook 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 0 230 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 2789.1 0 0 0 0 0 0 2789.1 0 0 1005556947 1881134781 16 Nurse Practitioners FABIAN LETITIA 999999999 200 Cook 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 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.52 0 0 0 0 0 0 374.52 0 0 1005557294 1891241329 16 Nurse Practitioners NELSON JENNIFER B 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 3228.95 0 0 0 0 0 0 3313.57 0 0 1005557465 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20723.49 0 0 0 0 0 0 0 0 0 0 0 0 0 20723.49 0 0 1005558246 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.32 0 0 0 0 0 0 0 0 0 0 0 0 0 368.32 0 0 1005558333 1215348149 10 Physicians DINIOTIS BOBBY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 915.9 0 0 0 0 0 0 915.9 0 0 1005558734 1053795765 10 Physicians SHARMA VIJAY K 999999999 15 Bureau 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 176.67 0 0 0 0 0 0 0 0 1969.25 0 0 0 0 0 0 2145.92 0 0 1005559057 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.83 0 0 0 0 0 0 53.83 0 0 1005559123 1316259799 10 Physicians SINHA JYOTSANA 999999999 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 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 0 142.86 0 0 0 0 0 0 142.86 0 0 1005559264 1053850586 16 Nurse Practitioners PENAS ALGER 999999999 19 Champaign 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 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 1266.92 0 0 0 0 0 0 1266.92 0 0 1005559525 1699855007 16 Nurse Practitioners COLLOPY JANET L 999999999 80 Peoria 0 0 0 0 0 6 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 491.45 0 0 0 0 0 0 0 0 395.11 0 0 0 0 0 0 886.56 0 0 1005559759 1154857795 16 Nurse Practitioners MYERS LINDA 999999999 27 Dekalb 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 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 0 656.62 0 0 0 0 0 0 656.62 0 0 1005559787 89 Physician Assistant Only(Encounter Only) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005559888 1306366794 20 Registered nurse KOWALEWSKI CHRISTINE E 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 2770.71 0 0 0 0 0 0 2875.67 0 0 1005560065 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13475.16 0 0 0 0 0 0 0 0 0 0 0 0 0 13475.16 0 0 1005560200 1447659800 10 Physicians KOTECHA TULSI J 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5447.47 0 0 0 0 0 0 5447.47 0 0 1005560363 1811418718 10 Physicians THOMULKA JONATHAN 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 389.66 0 0 0 0 0 0 0 0 757.22 0 0 0 0 0 0 1146.88 0 0 1005560459 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.96 51.96 0 0 1005560607 1386969079 10 Physicians WALLACE ADAM D 999999999 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 692.13 0 0 0 0 0 0 692.13 0 0 1005560795 1609310960 16 Nurse Practitioners WIEZOREK EMILY A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 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Physicians PAINTER DANIEL C 999999999 109 Winnebago 0 0 Physical Medicine/Rehabilitation 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2962.34 0 0 0 0 0 0 2962.34 0 0 1005575936 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005576005 1598031205 10 Physicians MIHALCIK STEPHEN ANDREW 999999999 200 Cook 0 0 Radiation Oncology 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 0 128 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 2378.06 0 0 0 0 0 0 2378.06 0 0 1005576100 1790071199 10 Physicians PATWA TANMAY P 999999999 30 DuPage 0 0 Internal Medicine 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 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6136.54 0 0 0 0 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10 Physicians MCCOY KARA 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 5 0 0 0 0 0 0 27 0 49 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 62 0 113 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 62 0 113 0 0 0 0 0 0 0 0 0 189.47 0 0 0 0 0 0 1691.16 0 2911.1 0 0 0 0 0 0 4791.73 0 0 1005581137 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15549.22 0 0 0 0 0 0 0 0 0 0 0 0 0 15549.22 0 0 1005581224 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 24266.04 0 0 0 0 0 0 0 0 0 0 0 0 0 24266.04 0 0 1005581307 1689195778 10 Physicians MOHAMMED ASIYA S 999999999 91 Sangamon 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 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 0 0 0 0 0 0 0 0 0 0 1005581539 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 975.44 975.44 0 0 1005583969 1316280647 10 Physicians HORBERG JOHN V 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 47 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483.9 0 7458.12 0 0 0 0 0 0 7942.02 0 0 1005584116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30686.28 0 0 0 0 0 0 0 0 0 0 0 0 0 30686.28 0 0 1005584269 1245781079 75 Department of Alcohol and Substance Abuse Provider "CHESTNUT HEALTH SYSTEMS, INC." 617011429 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 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 33292.8 0 0 33292.8 0 0 1005584276 1427374891 10 Physicians CHRISTOPHER DERRICK A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 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Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877.2 0 0 0 0 0 0 877.2 0 0 1005585092 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.64 0 0 0 0 0 0 144.64 0 0 1005585242 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8465.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8465.6 0 0 1005585418 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8724.77 0 0 0 0 0 0 0 0 0 0 0 0 0 8724.77 0 0 1005585456 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361.72 0 0 0 0 0 0 361.72 0 0 1005586045 1871831495 89 Physician Assistant Only(Encounter Only) KNIPPEL KAITLIN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.45 0 0 0 0 0 0 454.45 0 0 1005586149 1104258144 10 Physicians ANDROSOV ALEKSEY 999999999 24 Coles 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.58 0 0 0 0 0 0 119.58 0 0 1005586356 1760909626 16 Nurse Practitioners CORLEY HANNAH K 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 2064.79 0 0 0 0 0 0 2096.94 0 0 1005586697 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.59 0 0 0 0 0 0 106.59 0 0 1005586824 1396008116 10 Physicians SULEIMAN LINDA I 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 58 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355.04 0 1654.8 0 0 0 0 0 0 2009.84 0 0 1005587041 1821493040 89 Physician Assistant Only(Encounter Only) BUTCHER MARISSA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4716.41 0 0 0 0 0 0 4716.41 0 0 1005587081 1033659081 16 Nurse Practitioners KNOCHEL RICK 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940.04 0 0 0 0 0 0 940.04 0 0 1005587159 1760913933 16 Nurse Practitioners SILVERMAN SAMANTHA K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 250.34 0 0 0 0 0 0 250.34 0 0 1005587375 1265895239 13 Podiatrists BELL RICHARD H 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4468.62 0 0 0 0 0 0 4468.62 0 0 1005587498 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8205.12 0 0 0 0 0 0 0 0 0 0 0 0 0 8205.12 0 0 1005587619 10 Physicians 106 Whiteside 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608.11 0 0 0 0 0 0 608.11 0 0 1005587791 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3890.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3890.92 0 0 1005587992 1194711838 89 Physician Assistant Only(Encounter Only) PERILLO KELLY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192.16 0 0 0 0 0 0 192.16 0 0 1005588139 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1005588413 1821414459 10 Physicians KUMAR ABHINEET 999999999 20 Christian 0 0 Family Practice 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1712.97 0 0 0 0 0 0 1712.97 0 0 1005588429 1053576579 10 Physicians MEHTA AVANI TUSHAR 999999999 200 Cook 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 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 1086.96 0 0 0 0 0 0 1086.96 0 0 1005588473 1992249585 16 Nurse Practitioners PANGANIBAN KAREN DIOMAMPO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2964.71 0 0 0 0 0 0 2964.71 0 0 1005588980 1568812279 12 Optometrists MCLAUGHLIN MALLORY J 999999999 91 Sangamon 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 120 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2962.18 0 1165.35 0 0 0 0 4127.53 0 0 1005589232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3220.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3220.87 0 0 1005589346 1063846467 16 Nurse Practitioners JOHNSON MIKA 999999999 80 Peoria 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 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 0 410.4 0 0 0 0 0 0 410.4 0 0 1005589432 1952539371 10 Physicians MARMA AMANDA 999999999 200 Cook 0 0 Pediatrics 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870.61 0 0 0 0 0 0 870.61 0 0 1005589911 1497208011 23 Occupational Therapists GARCIA LAMAREE C 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 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 15878 15878 0 0 1005590079 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.47 0 0 0 0 0 0 30.47 0 0 1005590292 1053632422 10 Physicians HARTUPEE JUSTIN C 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.89 0 775.31 0 0 0 0 0 0 782.2 0 0 1005590695 1689916785 10 Physicians KAPOOR VICTOR 999999999 53 Kane 0 0 Internal Medicine 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804.1 0 0 0 0 0 0 804.1 0 0 1005590748 1073060265 16 Nurse Practitioners ANGDERSON CHRISTIE M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764.61 0 0 0 0 0 0 764.61 0 0 1005590930 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 147.72 0 0 0 0 0 0 147.72 0 0 1005591067 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30370.07 0 0 0 0 0 0 0 0 0 0 0 0 0 30370.07 0 0 1005591081 30 General Hospitals 818 Kentucky ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Children Section 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.15 0 0 0 0 0 311.15 0 0 1005591180 1952753576 16 Nurse Practitioners HEICHER HEATHER 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1991.75 0 0 0 0 0 0 1991.75 0 0 1005591429 10 Physicians 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.23 0 0 0 0 0 0 14.23 0 0 1005591468 1205923539 30 General Hospitals PRESENCE RESURRECTION MED CTR 606313707 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 6 0 0 0 1148 0 0 0 0 839 0 0 0 1924 0 0 0 0 0 11 0 0 0 1423 0 0 0 0 948 0 0 0 4402 0 0 0 0 0 13 0 0 0 1423 0 0 0 0 5874 0 0 0 4405 0 0 0 0 0 137.3 0 0 0 202534.68 0 0 0 0 2816597.73 0 0 0 370605.89 0 0 0 0 0 3389875.6 0 0 1005591847 1639693237 11 Dentists PATEL HARSHIL V 999999999 71 McHenry 0 0 General Dentistry 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12603.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12603.27 0 0 1005591901 1013451681 23 Occupational Therapists TOTH JESSICA 999999999 200 Cook 0 0 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 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33343.48 33343.48 0 0 1005593047 1487197034 16 Nurse Practitioners MCLAIN AMY 999999999 24 Coles 0 0 0 0 0 1 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 3138.14 0 0 0 0 0 0 3170.29 0 0 1005593072 1770025603 16 Nurse Practitioners HENRY JOHN C 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498.89 0 0 0 0 0 0 1498.89 0 0 1005593091 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005593228 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.01 0 62.02 0 0 0 0 0 0 129.03 0 0 1005593784 1558746701 16 Nurse Practitioners COOPER ROBIN 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 1240.45 0 0 0 0 0 0 1253.25 0 0 1005593889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.62 0 0 0 0 0 0 0 0 0 0 0 0 0 431.62 0 0 1005594047 1699036574 10 Physicians GOODLOE JEAN 999999999 63 Macon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1867.97 0 0 0 0 0 0 1867.97 0 0 1005594163 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 732.6 0 0 0 0 0 0 0 0 0 0 0 0 0 732.6 0 0 1005594282 24 Speech Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1950.92 1950.92 0 0 1005594353 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005594401 1417302316 36 Community mental health provider THRESHOLDS 600772387 200 Cook 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1011 0 0 3519.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53783.3 0 0 57302.82 0 0 1005594590 1982973459 10 Physicians VASNANI RAJ 999999999 107 Will 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 268 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5097.1 0 3483.74 0 0 0 0 0 0 8580.84 0 0 1005594680 1629384573 86 Clinical Social Worker(Encounter Only) COOK PATTY L 999999999 30 DuPage 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254.19 0 0 0 0 0 0 254.19 0 0 1005595225 1942651781 10 Physicians TWEET MARIT 999999999 200 Cook 0 0 Emergency Medicine 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 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 0 532.09 0 0 0 0 0 0 532.09 0 0 1005595284 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 205.2 0 0 0 0 0 0 205.2 0 0 1005595428 1477091726 16 Nurse Practitioners IKENS TONI L 999999999 106 Whiteside 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2693.99 0 0 0 0 0 0 2693.99 0 0 1005595588 1922366632 10 Physicians BELIKOFF BRYAN G 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 687 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9226.75 0 79.85 0 0 0 0 0 0 9306.6 0 0 1005595767 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 23408.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.49 0 0 1005596045 1316465297 91 Waiver service provider--Adults (DHS/DDD) MOSER RACHEL 999999999 96 St Clair 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 1242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88773.09 0 0 0 0 0 0 0 0 0 0 0 0 0 88773.09 0 0 1005596181 1396832622 30 General Hospitals PRESENCE RESURRECTION MED CTR 606313707 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122597.66 0 0 0 0 0 0 0 0 0 122597.66 0 0 1005596204 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2723.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2723.35 0 0 1005596231 1649709668 10 Physicians GUILLOTTE KENNETH 999999999 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3748.67 0 0 0 0 0 0 3748.67 0 0 1005596423 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9768.39 0 0 0 0 0 0 0 0 0 0 0 0 0 9768.39 0 0 1005596696 1780948703 10 Physicians GUERRA RODAS DANIEL 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1786 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1786 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10714.87 0 0 0 0 0 0 10714.87 0 0 1005596856 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.99 0 0 0 0 0 0 89.99 0 0 1005597156 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5743.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5743.14 0 0 1005597286 1497172845 10 Physicians ABRAHAM IVY ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4171.26 0 0 0 0 0 0 4171.26 0 0 1005597449 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9347 0 0 0 0 0 0 0 0 0 0 0 0 0 9347 0 0 1005597499 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1159.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1159.76 0 0 1005598175 1609216399 10 Physicians GADDIKERI RAMYA S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1626 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2656 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2656 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14857.59 0 113.67 0 0 0 0 0 0 14971.26 0 0 1005598389 1164836722 10 Physicians SYED TAHA 999999999 19 Champaign 0 0 Family Practice 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3574.96 0 0 0 0 0 0 3574.96 0 0 1005598509 1700308913 10 Physicians SANCHEZ GOMEZ JOSE 999999999 109 Winnebago 0 0 0 0 0 2 0 0 0 0 0 0 8 0 58 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8 0 135 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8 0 135 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 45.93 0 2152.89 0 0 0 0 0 0 2211.62 0 0 1005598567 10 Physicians 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486.32 0 0 0 0 0 0 486.32 0 0 1005598845 1861745218 10 Physicians MARELLA SRIMANNARAYANA 620628501 65 Madison 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314.53 0 0 0 0 0 0 314.53 0 0 1005599616 1588607683 10 Physicians CHIDI ARATI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2318.44 0 0 0 0 0 0 2318.44 0 0 1005599741 89 Physician Assistant Only(Encounter Only) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 265.22 0 0 0 0 0 0 265.22 0 0 1005599935 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26642.84 0 0 0 0 0 0 0 0 0 0 0 0 0 26642.84 0 0 1005599937 1619311644 10 Physicians DALAL ANKITA 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 422.32 0 0 0 0 0 0 0 0 924.87 0 0 0 0 0 0 1347.19 0 0 1005600226 1942543665 10 Physicians MUNOZ JASMINE A 999999999 107 Will 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 39 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2338.03 0 4950.3 0 0 0 0 0 0 7288.33 0 0 1005600499 1558599175 10 Physicians HOOD KEITH C 999999999 200 Cook 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 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 8521.68 0 0 0 0 0 0 8521.68 0 0 1005600517 1609230887 16 Nurse Practitioners GLAVIN SUZANNE R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265.78 0 0 0 0 0 0 265.78 0 0 1005601431 1871502955 16 Nurse Practitioners KEANE JANICE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.15 0 0 0 0 0 0 172.15 0 0 1005601496 1619233277 10 Physicians GARG ANJALI R 999999999 53 Kane 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 234 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 4462.24 0 0 0 0 0 0 4462.24 0 0 1005601889 1295722296 89 Physician Assistant Only(Encounter Only) GNEZDA JOHN D 999999999 30 DuPage 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968.95 0 0 0 0 0 0 968.95 0 0 1005601922 1629336524 10 Physicians MANDAL RAKESH 999999999 91 Sangamon 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544.13 0 0 0 0 0 0 0 0 544.13 0 0 1005601978 1487819827 10 Physicians SHEIKH MARYAM 999999999 91 Sangamon 0 0 Internal Medicine 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.15 0 0 0 0 0 0 225.15 0 0 1005602458 1508131046 16 Nurse Practitioners HOLST LAURA 999999999 22 Clay 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 1363.18 0 0 0 0 0 0 1363.18 0 0 1005602730 1558733428 89 Physician Assistant Only(Encounter Only) RADEMACHER RACHEL A 999999999 80 Peoria 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 0 154 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 1012.73 0 0 0 0 0 0 1012.73 0 0 1005602761 1740725704 75 Department of Alcohol and Substance Abuse Provider GATEWAY FOUNDATION INC GURNEE 999999999 57 Lake 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10448.94 0 0 10448.94 0 0 1005603072 30 General Hospitals 815 Indiana 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.71 0 0 1005603167 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7907.39 0 0 0 0 0 0 0 0 0 0 0 0 0 7907.39 0 0 1005603384 1851740161 10 Physicians KINSLEY KAREN 999999999 107 Will 0 0 0 0 0 4 0 0 0 0 0 0 4 0 49 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 0 0 0 327.01 0 0 0 0 0 0 33.81 0 3451.35 0 0 0 0 0 0 3812.17 0 0 1005603498 1528359106 10 Physicians MILLER MARK D. 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 4 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.2 0 8961.47 0 0 0 0 0 0 8986.67 0 0 1005603569 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 1209.21 0 0 0 0 0 0 1209.21 0 0 1005603677 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501.46 0 0 0 0 0 0 0 0 0 0 0 0 0 501.46 0 0 1005603692 1972048528 16 Nurse Practitioners BUTTS CARRISSA A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1135.79 0 0 0 0 0 0 1135.79 0 0 1005604348 1306136668 10 Physicians MAYEKAR EMILY MEREDITH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 27 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.13 0 3267.34 0 0 0 0 0 0 3418.47 0 0 1005604362 10 Physicians 89 Rock Island 0 0 Family Practice 0 0 0 0 0 0 0 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 0.15 0 0 0 0 0 0 0.15 0 0 1005604422 1245590330 10 Physicians WEINBERG STACY L 999999999 200 Cook 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669.25 0 0 0 0 0 0 669.25 0 0 1005604730 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29552.97 0 0 0 0 0 0 0 0 0 0 0 0 0 29552.97 0 0 1005605001 1598106882 10 Physicians LOMBARDI PAMELA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 418 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 638 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 638 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2923.48 0 0.5 0 0 0 0 0 0 2923.98 0 0 1005605042 1528401395 10 Physicians KAPANGA EVAN 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1489.98 0 0 0 0 0 0 1489.98 0 0 1005605186 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.5 0 0 0 0 0 0 153.5 0 0 1005605259 1275820359 10 Physicians MALIAKKAL JOSEPH 999999999 53 Kane 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3940 0 0 0 0 0 0 3940 0 0 1005605390 16 Nurse Practitioners 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005605508 1043755044 16 Nurse Practitioners CRAIG MARJORIE 999999999 200 Cook 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 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 0 812.02 0 0 0 0 0 0 812.02 0 0 1005605770 1073963799 10 Physicians PAGANI RODRIGO 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.88 0 4042.08 0 0 0 0 0 0 4122.96 0 0 1005605856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16641.86 0 0 0 0 0 0 0 0 0 0 0 0 0 16641.86 0 0 1005606044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23949.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23949.2 0 0 1005606124 1518981752 10 Physicians ROONEY WALTER G 999999999 54 Kankakee 0 0 Otolaryngology 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 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4162.04 0 0 0 0 0 0 4162.04 0 0 1005606824 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131.45 0 0 0 0 0 0 131.45 0 0 1005607025 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 50.23 0 0 0 0 0 0 50.23 0 0 1005607117 10 Physicians 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 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 66.4 0 0 0 0 0 0 66.4 0 0 1005607199 1871736413 10 Physicians SUBOC TISHA MARIE B 999999999 200 Cook 0 0 Internal Medicine 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 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2743 0 0 0 0 0 0 2743 0 0 1005607472 89 Physician Assistant Only(Encounter Only) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.26 0 0 0 0 0 0 147.26 0 0 1005607495 1851849269 33 Nursing Facilities "ALDEN COURTS OF WATERFORD, LLC" 999999999 53 Kane 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331781.59 0 0 0 0 0 0 0 331781.59 0 0 1005607517 1356752679 10 Physicians CHEN MARGARET 999999999 91 Sangamon 0 0 0 0 0 7 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 795.11 0 0 0 0 0 0 0 0 3131.31 0 0 0 0 0 0 3926.42 0 0 1005607563 91 Waiver service provider--Adults (DHS/DDD) 19 Champaign 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25194.88 0 0 0 0 0 0 0 0 0 0 0 0 0 25194.88 0 0 1005607578 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 47025.36 0 0 0 0 0 0 0 0 0 0 0 0 0 47025.36 0 0 1005608848 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332.56 332.56 0 0 1005609179 1952643694 10 Physicians ARIALIS AMY E 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 145.44 0 0 0 0 0 0 0 0 2128.79 0 0 0 0 0 0 2274.23 0 0 1005609279 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9548.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9548.78 0 0 1005609725 86 Clinical Social Worker(Encounter Only) 107 Will 0 0 0 0 0 0 0 0 0 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 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 0 150.6 0 0 0 0 0 0 150.6 0 0 1005609969 10 Physicians 89 Rock Island 0 0 Internal 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DWAYNE C 999999999 200 Cook 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 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 1090.12 0 0 0 0 0 0 1090.12 0 0 1005610756 1588001275 10 Physicians CAVANAUGH ERIN 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2590.06 0 0 0 0 0 0 2590.06 0 0 1005610777 1063772572 10 Physicians JONAS EMILY K 999999999 200 Cook 0 0 Emergency Medicine 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4821.84 0 0 0 0 0 0 4821.84 0 0 1005610785 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.42 0 0 0 0 0 0 126.42 0 0 1005611183 1528367836 10 Physicians MILLER JOHN R 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SADOWSKI DANIEL J 999999999 109 Winnebago 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.24 0 12702.68 0 0 0 0 0 0 12705.92 0 0 1005621924 86 Clinical Social Worker(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005622118 1366671802 89 Physician Assistant Only(Encounter Only) BROWN DERRICK M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.62 0 0 0 0 0 0 522.62 0 0 1005622181 1225479280 10 Physicians CHAN EDWIN Y 999999999 80 Peoria 0 0 Anesthesiology 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 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 1048.45 0 0 0 0 0 0 1048.45 0 0 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0 1005623700 1922426931 10 Physicians BIESIADA IZABELA 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.23 0 0 0 0 0 0 95.23 0 0 1005624062 1023088655 89 Physician Assistant Only(Encounter Only) LANE LANCE 999999999 53 Kane 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1026.4 0 0 0 0 0 0 1026.4 0 0 1005624238 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25790.4 0 0 0 0 0 0 0 0 0 0 0 0 0 25790.4 0 0 1005624504 1952720377 10 Physicians ZARLENGO DOMINIC J 999999999 200 Cook 0 0 Pediatrics 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3586.28 0 0 0 0 0 0 3586.28 0 0 1005624690 1750794178 10 Physicians GOLDMAN JULIE 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244.19 0 0 0 0 0 0 244.19 0 0 1005624902 1063660611 10 Physicians HAN SEUNGHYE 999999999 200 Cook 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3181.3 0 0 0 0 0 0 3181.3 0 0 1005624909 1770027369 55 Early Intervention Services JARMAN JESSICA M 999999999 91 Sangamon 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 0 848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51311.34 0 0 0 0 0 0 51311.34 0 0 1005625000 1205386711 16 Nurse Practitioners GUTIERREZ HEATHER 999999999 200 Cook 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 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 0 665.35 0 0 0 0 0 0 665.35 0 0 1005625484 86 Clinical Social Worker(Encounter Only) 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.05 0 0 0 0 0 0 45.05 0 0 1005625497 1518213537 10 Physicians ATRI GAURIKA M 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19051.33 0 0 0 0 0 0 19051.33 0 0 1005625601 1811412885 16 Nurse Practitioners ARING MISCHAELA N 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631.36 0 0 0 0 0 0 2631.36 0 0 1005625903 1891099776 16 Nurse Practitioners ABASOLO ROWENA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108.36 0 0 0 0 0 0 1108.36 0 0 1005625976 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4363.04 0 0 0 0 0 0 0 0 0 0 0 0 0 4363.04 0 0 1005626127 1548702954 16 Nurse Practitioners FOTI VICKI H 999999999 109 Winnebago 0 0 0 0 0 10 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 607.16 0 0 0 0 0 0 0 0 3310.21 0 0 0 0 0 0 3917.37 0 0 1005626403 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 26789.96 0 0 0 0 0 0 0 0 0 0 0 0 0 26789.96 0 0 1005626636 1215229935 10 Physicians ALIKHAN MIR B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.86 0 38.84 0 0 0 0 0 0 126.7 0 0 1005626774 1316482557 16 Nurse Practitioners DELLAS CHRISTINE T 999999999 200 Cook 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 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 2858.33 0 0 0 0 0 0 2858.33 0 0 1005627047 1588682330 87 Psychologist(Encounter Only) DROSSOS TINA N 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625.53 0 0 0 0 0 0 625.53 0 0 1005627582 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1458.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1458.73 0 0 1005627766 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 1005627887 1477968832 10 Physicians BURKOVA MARINA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 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 0 151.93 0 0 0 0 0 0 151.93 0 0 1005628054 1255673570 10 Physicians KHAN YASMEEN JAMAL 999999999 200 Cook 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 3 0 54 0 0 0 0 0 0 0 0 0 374.5 0 0 0 0 0 0 6.68 0 1973.85 0 0 0 0 0 0 2355.03 0 0 1005628530 1770917288 65 Independent Diagnostic Testing Facility (IDTF) XCEL DIAGNOSTICS LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4879 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8771.62 0 0 0 0 0 0 0 0 8771.62 0 0 1005628705 1902038094 10 Physicians O'SULLIVAN KATIE L 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.99 0 2378.79 0 0 0 0 0 0 2396.78 0 0 1005628832 1124546122 24 Speech Therapists AMALIA RAMIREZ 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10563.83 10563.83 0 0 1005629034 1225471824 10 Physicians GARIBASHVILI KONSTANTIN Y 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1674.49 0 0 0 0 0 0 1674.49 0 0 1005629114 10 Physicians 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1005629115 92 Waiver service 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1005630091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22228.71 0 0 0 0 0 0 0 0 0 0 0 0 0 22228.71 0 0 1005630160 1073913356 23 Occupational Therapists MCGAUGHY ASHLEY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 8735.18 8735.18 0 0 1005630489 16 Nurse Practitioners 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005630821 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22151.36 0 0 0 0 0 0 0 0 0 0 0 0 0 22151.36 0 0 1005631288 1912430703 16 Nurse Practitioners SINHA RAHUL 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 441.7 0 0 0 0 0 0 441.7 0 0 1005631443 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461.33 0 0 0 0 0 0 461.33 0 0 1005631641 1477973691 10 Physicians NAUGHTON MARY BRENNAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4503.8 0 0 0 0 0 0 4503.8 0 0 1005631814 1861758849 10 Physicians BURJEK NICHOLAS 999999999 200 Cook 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 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 6467.95 0 0 0 0 0 0 6467.95 0 0 1005631881 1760899090 16 Nurse Practitioners ONWUEKWE OBIAJULU 999999999 19 Champaign 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 785.74 0 0 0 0 0 0 785.74 0 0 1005631976 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 238.7 0 0 0 0 0 0 0 0 0 0 0 0 0 238.7 0 0 1005632091 10 Physicians 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 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 26.63 0 0 0 0 0 0 26.63 0 0 1005632350 1255539789 10 Physicians CHAHIN SALIM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 122.94 0 0 0 0 0 0 122.94 0 0 1005632473 1285999334 10 Physicians GOTH STEPHEN 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 588 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 781 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7839.11 0 243.5 0 0 0 0 0 0 8082.61 0 0 1005632475 1295049377 10 Physicians JAWAD AHMED 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1723.23 0 0 0 0 0 0 1723.23 0 0 1005632738 94 Waiver service provider--Children's support (DHS/DDD) 89 Rock Island 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1092.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1092.8 0 0 1005632824 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 311.39 0 0 0 0 0 0 0 0 0 0 0 0 0 311.39 0 0 1005633002 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 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0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 12141.94 0 0 0 0 0 0 0 0 0 0 0 0 0 12141.94 0 0 1005634318 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 845.76 0 0 0 0 0 0 0 0 0 0 0 0 0 845.76 0 0 1005634388 1518215318 11 Dentists LABLONDE BRIAN 999999999 200 Cook 0 0 Orthodontist 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40630.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40630.2 0 0 1005634619 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24998.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24998.4 0 0 1005634775 1609267095 10 Physicians TOLENTINO JOCELYN 999999999 200 Cook 0 0 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Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.37 0 0 0 0 0 0 44.37 0 0 1005636023 1699177030 10 Physicians LEMOINE CAROLINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.3 0 2996.72 0 0 0 0 0 0 3020.02 0 0 1005636225 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.07 0 0 0 0 0 0 202.07 0 0 1005636489 1689110850 16 Nurse Practitioners MORALES DENISE J 999999999 70 McDonough 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 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 14.96 0 0 0 0 0 0 14.96 0 0 1005636520 1790981298 11 Dentists ROTH ELISA 999999999 72 McLean 0 0 Pedodontics 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4915.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4915.39 0 0 1005636623 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 878.74 0 0 0 0 0 0 0 0 0 0 0 0 0 878.74 0 0 1005636738 1508194663 86 Clinical Social Worker(Encounter Only) INGRAM DORDANA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1553.67 0 0 0 0 0 0 1553.67 0 0 1005636962 1518282938 10 Physicians GRENNAN DARA B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.81 0 0 0 0 0 0 246.81 0 0 1005637304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21255.61 0 0 0 0 0 0 0 0 0 0 0 0 0 21255.61 0 0 1005637350 10 Physicians 109 Winnebago 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1459.48 0 0 0 0 0 0 1459.48 0 0 1005637491 1043670417 30 General Hospitals FRESENIUS MEDICAL CARE ROCK IS 999999999 89 Rock Island DIALYSIS Outpatient dialysis centers. 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6992 0 0 0 0 0 6992 0 0 1005637501 1891175576 10 Physicians MONNEY KARISSA 999999999 107 Will 0 0 0 0 0 12 0 0 0 0 0 0 5 0 66 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 6 0 154 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 6 0 154 0 0 0 0 0 0 0 0 0 1136.64 0 0 0 0 0 0 20.6 0 3204.32 0 0 0 0 0 0 4361.56 0 0 1005637625 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19741.55 0 0 0 0 0 0 0 0 0 0 0 0 0 19741.55 0 0 1005637989 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 1005638101 1083145940 10 Physicians GILLENWATER LANE ANNE 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 4 0 63 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 110 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 110 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 14.18 0 2880.08 0 0 0 0 0 0 2926.41 0 0 1005638133 1588088470 16 Nurse Practitioners SCHAGEMANN CARA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 1040.65 0 0 0 0 0 0 1040.65 0 0 1005638213 1346551561 10 Physicians BARBER EMMA L 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14533.08 0 0 0 0 0 0 14533.08 0 0 1005638336 86 Clinical Social Worker(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1005638869 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18786.96 0 0 0 0 0 0 0 0 0 0 0 0 0 18786.96 0 0 1005639010 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.71 189.71 0 0 1005639027 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 0 0 0 0 73.4 0 0 1005639367 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1005639582 1306292412 10 Physicians JOSHI NEERJA SHAILESH 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.54 0 0 0 0 0 0 94.54 0 0 1005639634 1164427498 10 Physicians ROUBEIN DANIEL R 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 336 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4819.42 0 596.39 0 0 0 0 0 0 5415.81 0 0 1005639758 24 Speech Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448.49 448.49 0 0 1005639859 1699299776 11 Dentists PATEL CHAITALI 999999999 53 Kane 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 605 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 605 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 20238.05 0 0 0 0 0 0 0 0 0 0 0 2493.3 0 0 0 0 22731.35 0 0 1005639913 1811425085 11 Dentists ABDELRAHIM SAMI M 999999999 200 Cook 0 0 General Dentistry 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7463.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7463.46 0 0 1005640019 24 Speech Therapists 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200.74 1200.74 0 0 1005640411 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1065.17 0 0 0 0 0 0 0 0 0 0 0 0 0 1065.17 0 0 1005640493 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15065.16 0 0 0 0 0 0 0 0 0 0 0 0 0 15065.16 0 0 1005640709 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19120.73 0 0 0 0 0 0 0 0 0 0 0 0 0 19120.73 0 0 1005640865 10 Physicians 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005640975 1710250444 60 Pharmacies GENOA HEALTHCARE LLC 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 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1275069296 89 Physician Assistant Only(Encounter Only) KOCEN LAWRENCE C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.63 0 0 0 0 0 0 1921.63 0 0 1005641715 1982053294 10 Physicians KULACH EMANUELA 999999999 30 DuPage 0 0 Family Practice 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 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4957.32 0 0 0 0 0 0 4957.32 0 0 1005641717 1982043097 10 Physicians KOOPERMAN RYAN S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 7 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790.9 0 2764.2 0 0 0 0 0 0 3555.1 0 0 1005641733 24 Speech Therapists 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1467.87 1467.87 0 0 1005641765 1295140143 10 Physicians CHANDRA SIDHARTH 999999999 36 Franklin 0 0 Psychiatry 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6058 0 0 0 0 0 0 6058 0 0 1005642165 1255620282 10 Physicians GOETZ CELINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2021.9 0 0 0 0 0 0 2021.9 0 0 1005642975 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23321.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23321.1 0 0 1005643027 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.66 0 0 0 0 0 0 326.66 0 0 1005643420 1851720304 16 Nurse Practitioners BOHLING TIFFANY R 999999999 200 Cook 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 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 1046.46 0 0 0 0 0 0 1046.46 0 0 1005643488 1326574666 16 Nurse Practitioners TVRTKOVIC ZORAN 999999999 200 Cook 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 950.72 0 0 0 0 0 0 950.72 0 0 1005643795 1245651009 10 Physicians GUO HUAZHANG 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 36 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1322.49 0 49.8 0 0 0 0 0 0 1372.29 0 0 1005644155 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3833.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3833.5 0 0 1005644359 91 Waiver 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0 0 0 0 0 0 0 2996.73 0 0 0 0 0 0 6841.38 0 0 1005645939 1700218799 10 Physicians KHAN MOHAMMED F 999999999 109 Winnebago 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 9 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.09 0 2238.26 0 0 0 0 0 0 2339.35 0 0 1005646959 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.6 0 0 0 0 0 0 178.6 0 0 1005647089 1053653634 10 Physicians ZIMMERMAN JOSHUA D 999999999 88 Richland 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5338.52 0 0 0 0 0 0 5338.52 0 0 1005647104 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1005647112 1306131974 10 Physicians KAO JEROME L 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 5 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.9 0 1025.22 0 0 0 0 0 0 1087.12 0 0 1005647184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22707.99 0 0 0 0 0 0 0 0 0 0 0 0 0 22707.99 0 0 1005647371 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19015.37 0 0 0 0 0 0 0 0 0 0 0 0 0 19015.37 0 0 1005647953 1881127991 16 Nurse Practitioners GUNSTEEN CYNTHIA 999999999 200 Cook 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 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 0 159.12 0 0 0 0 0 0 159.12 0 0 1005648505 10 Physicians 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.93 0 0 0 0 0 0 80.93 0 0 1005648526 1942376694 11 Dentists TOURLOUKIS VASILIKI 999999999 200 Cook 0 0 0 0 9 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 1247.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.54 0 0 1005648551 1225397219 10 Physicians HAFIZ ABDUL 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8191.91 0 0 0 0 0 0 8191.91 0 0 1005648898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23848.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23848.28 0 0 1005648983 1578849097 16 Nurse Practitioners SOLOMON STEPHANIE A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.68 0 0 0 0 0 0 303.68 0 0 1005649081 1841630142 10 Physicians YANGER SHERYL 999999999 200 Cook 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 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7173.34 0 0 0 0 0 0 7173.34 0 0 1005649145 87 Psychologist(Encounter Only) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005649158 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 230.71 0 0 0 0 0 0 230.71 0 0 1005649269 1154697274 10 Physicians MOIOLI EDUARDO K 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695.44 0 0 0 0 0 0 695.44 0 0 1005649271 10 Physicians 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005649362 1588924328 10 Physicians SLADE JAMIE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 113 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2112.77 0 81.23 0 0 0 0 0 0 2194 0 0 1005649589 1386063782 10 Physicians PATEL KUSHAL R 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743.36 0 0 0 0 0 0 1743.36 0 0 1005649976 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21310.52 0 0 0 0 0 0 0 0 0 0 0 0 0 21310.52 0 0 1005650047 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23020.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23020.94 0 0 1005650445 1881009637 10 Physicians HAIDER BAQER A 999999999 19 Champaign 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5010.16 0 0 0 0 0 0 5010.16 0 0 1005650453 1629212725 10 Physicians WIGGINS ANDREW C 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.6 0 0 0 0 0 0 656.6 0 0 1005650481 1407304397 16 Nurse Practitioners JOHNSON MAGGIE E 999999999 80 Peoria 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 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4694.21 0 0 0 0 0 0 4694.21 0 0 1005650727 1245587401 89 Physician Assistant Only(Encounter Only) CASTALDI MAUREEN A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683.17 0 0 0 0 0 0 683.17 0 0 1005650776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26808.55 0 0 0 0 0 0 0 0 0 0 0 0 0 26808.55 0 0 1005650790 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19926.72 0 0 0 0 0 0 0 0 0 0 0 0 0 19926.72 0 0 1005651791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14829.04 0 0 0 0 0 0 0 0 0 0 0 0 0 14829.04 0 0 1005652136 4005652136 10 Physicians BECK MICHELLE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 9 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.88 0 5103.43 0 0 0 0 0 0 5439.31 0 0 1005652806 1700290921 13 Podiatrists THAKRAR AMEET 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496.21 0 0 0 0 0 0 496.21 0 0 1005653063 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22169.29 0 0 0 0 0 0 0 0 0 0 0 0 0 22169.29 0 0 1005653083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3101.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3101.34 0 0 1005653120 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 381.58 0 0 0 0 0 0 381.58 0 0 1005653276 1508892126 10 Physicians RAHMAN TAHIR 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 734.05 0 0 0 0 0 0 734.05 0 0 1005653290 16 Nurse Practitioners 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.73 0 0 0 0 0 0 87.73 0 0 1005653340 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14875.46 0 0 0 0 0 0 0 0 0 0 0 0 0 14875.46 0 0 1005653663 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34097.09 0 0 0 0 0 0 0 0 0 0 0 0 0 34097.09 0 0 1005653838 1235563271 16 Nurse Practitioners WILKS SARAH L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363.88 0 0 0 0 0 0 363.88 0 0 1005653990 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24955 0 0 0 0 0 0 0 0 0 0 0 0 0 24955 0 0 1005654227 1588906168 10 Physicians KONDRAGUNTA VINOD 999999999 200 Cook 0 0 Internal Medicine 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472.45 0 0 0 0 0 0 472.45 0 0 1005654375 1114281920 10 Physicians THOMAS JACOB A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 558.15 0 0 0 0 0 0 558.15 0 0 1005654505 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.45 0 0 0 0 0 0 0 0 110.45 0 0 1005654620 1538456363 10 Physicians MAUER KURTIS B. 999999999 50 Jersey 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.08 0 146.2 0 0 0 0 0 0 157.28 0 0 1005654689 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 46.45 0 0 0 0 0 0 46.45 0 0 1005655196 1891176830 10 Physicians GAW JODIE 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1082.09 0 0 0 0 0 0 1082.09 0 0 1005655372 1255348694 10 Physicians HAMPTON DAVID A 999999999 30 DuPage 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 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25049.64 0 0 0 0 0 0 25049.64 0 0 1005655598 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.53 0 0 0 0 0 0 222.53 0 0 1005655603 1871889303 10 Physicians HAYDEN TASSY N 999999999 826 Missouri 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.99 0 0 0 0 0 0 67.99 0 0 1005655754 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005656136 1548447113 10 Physicians SUMOZA ILIA R 999999999 200 Cook 0 0 Internal Medicine 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 0 104 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 1569.98 0 0 0 0 0 0 1569.98 0 0 1005656203 1992259410 16 Nurse Practitioners VALENCIA CINDY E 999999999 200 Cook 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 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 0 285.95 0 0 0 0 0 0 285.95 0 0 1005656297 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25063.06 0 0 0 0 0 0 0 0 0 0 0 0 0 25063.06 0 0 1005656459 1386184307 16 Nurse Practitioners OGDEN SHANNON E 999999999 91 Sangamon 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 0 111.4 0 0 0 0 0 0 111.4 0 0 1005656462 1043469471 10 Physicians PENUMETSA MARUTHI SRIKANTH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1594.25 0 0 0 0 0 0 1594.25 0 0 1005656684 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17765.72 0 0 0 0 0 0 0 0 0 0 0 0 0 17765.72 0 0 1005656720 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112.34 0 0 0 0 0 0 112.34 0 0 1005656792 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26177.16 0 0 0 0 0 0 0 0 0 0 0 0 0 26177.16 0 0 1005657308 1346569480 10 Physicians BLACKWELL ROBERT 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 11 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.27 0 6696.61 0 0 0 0 0 0 6712.88 0 0 1005657355 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40653.99 0 0 0 0 0 0 0 0 0 0 0 0 0 40653.99 0 0 1005657467 1356637177 10 Physicians MCGORISK TIMOTHY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7384.26 0 0 0 0 0 0 7384.26 0 0 1005657526 1720317910 10 Physicians SPITZ JAMIE A 999999999 200 Cook 0 0 Plastic Surgery 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7714.36 0 0 0 0 0 0 7714.36 0 0 1005657592 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 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 10119.55 0 0 0 0 0 0 0 0 0 0 0 0 0 10119.55 0 0 1005658101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21365.92 0 0 0 0 0 0 0 0 0 0 0 0 0 21365.92 0 0 1005658129 1699209528 16 Nurse Practitioners STREICHER BRENDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.63 0 0 0 0 0 0 54.63 0 0 1005658157 1013274349 10 Physicians ANIS MARIAM 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733.24 0 0 0 0 0 0 733.24 0 0 1005658331 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 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 90.04 0 0 0 0 0 0 90.04 0 0 1005658550 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24082.19 0 0 0 0 0 0 0 0 0 0 0 0 0 24082.19 0 0 1005658621 10 Physicians 25 Crawford 0 0 Neurology 0 0 0 0 0 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1076.45 0 0 0 0 0 0 1076.45 0 0 1005674084 1023472883 10 Physicians FOSSEN ERIK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6977.02 0 0 0 0 0 0 6977.02 0 0 1005674982 1639516313 10 Physicians BRADLEY LAURENCE M 999999999 80 Peoria 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4062.12 0 0 0 0 0 0 4062.12 0 0 1005675180 1518184324 89 Physician Assistant Only(Encounter Only) TAYFEL TRACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.42 0 0 0 0 0 0 167.42 0 0 1005675183 1396026506 10 Physicians ALI ABDULMONAM 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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Assistant Only(Encounter Only) LAGRANGE CHELSEA N 999999999 19 Champaign 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1414.97 0 0 0 0 0 0 1414.97 0 0 1005677617 1952705188 24 Speech Therapists CERVANTEZ WHITNEY 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18217.62 18217.62 0 0 1005677634 1992234934 24 Speech Therapists HOFFMIRE BRITTANY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7031.88 7031.88 0 0 1005677789 1265775365 10 Physicians BINDER ASHLEY KAYE 999999999 200 Cook 0 0 Emergency Medicine 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 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 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MARK G 999999999 200 Cook 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 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 0 431.05 0 0 0 0 0 0 431.05 0 0 1005678986 1396752531 16 Nurse Practitioners HARRIGER LAURA 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2511.88 0 0 0 0 0 0 2511.88 0 0 1005679122 1215488697 16 Nurse Practitioners TOAL JACQUELINE J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5899.45 0 0 0 0 0 0 5899.45 0 0 1005679207 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1420.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1420.18 0 0 1005679702 1366822918 10 Physicians DRURY BERTRAM E 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208.42 0 377.17 0 0 0 0 0 0 585.59 0 0 1005679807 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 536.4 0 0 0 0 0 0 536.4 0 0 1005679827 86 Clinical Social Worker(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 464.39 0 0 0 0 0 0 464.39 0 0 1005680055 1497021497 10 Physicians HARPER GLORILEE B 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2585.15 0 0 0 0 0 0 2585.15 0 0 1005680148 1992792345 60 Pharmacies FAMILY DRUG STORE 999999999 94 Shelby 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 0 971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32748.77 0 0 0 32748.77 0 0 1005680229 1982801908 10 Physicians GUAN HUI 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 71 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.89 0 34.89 0 0 0 0 0 0 440.78 0 0 1005680239 1417307430 11 Dentists JOSHUA RAMYA R 999999999 30 DuPage 0 0 General Dentistry 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10780.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10780.8 0 0 1005680285 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.68 0 0 0 0 0 0 215.68 0 0 1005680344 1568487346 10 Physicians KRISHNAMURTHY RAJLAKSHMI 999999999 200 Cook 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 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 0 162.93 0 0 0 0 0 0 162.93 0 0 1005680366 1316365869 10 Physicians MORRISON THOMAS A 999999999 200 Cook 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1236.15 0 0 0 0 0 0 1236.15 0 0 1005680503 1780106997 10 Physicians VERMA NUPUR 999999999 91 Sangamon 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 3 0 27 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 0 48 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 0 48 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 47.93 0 782.81 0 0 0 0 0 0 895.04 0 0 1005680588 1417947847 10 Physicians KORN STEPHEN 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1531.35 0 0 0 0 0 0 1531.35 0 0 1005680632 1093111544 60 Pharmacies GENOA HEALTHCARE LLC 601873977 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41774 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82996.35 0 0 0 82996.35 0 0 1005681017 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 20061.65 0 0 0 0 0 0 0 0 0 0 0 0 0 20061.65 0 0 1005681081 1669789327 10 Physicians SHIMA MARK T 999999999 19 Champaign 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8884.29 0 0 0 0 0 0 8884.29 0 0 1005681097 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 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 13148.58 0 0 0 0 0 0 0 0 0 0 0 0 0 13148.58 0 0 1005681969 1952797110 10 Physicians LOZA JULIE 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 4 0 76 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 4 0 163 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 4 0 163 0 0 0 0 0 0 0 0 0 174.26 0 0 0 0 0 0 2.78 0 7722.41 0 0 0 0 0 0 7899.45 0 0 1005682586 75 Department of Alcohol and Substance Abuse Provider 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1328.44 0 0 1328.44 0 0 1005682606 1104087014 10 Physicians CHENG GEORGINA 999999999 19 Champaign 0 0 Obstetric-Gynecology 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 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 1404.78 0 0 0 0 0 0 1404.78 0 0 1005682678 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7956.33 0 0 0 0 0 0 0 0 0 0 0 0 0 7956.33 0 0 1005682705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18476.98 0 0 0 0 0 0 0 0 0 0 0 0 0 18476.98 0 0 1005682830 1356874093 60 Pharmacies CANCER CARE SPECIALISTS OF ILL 625265858 63 Macon 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582535.4 0 0 0 582535.4 0 0 1005683007 1609302900 10 Physicians GONZALEZ CLEMEN O 999999999 200 Cook 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 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 1520.44 0 0 0 0 0 0 1520.44 0 0 1005683008 1417943523 10 Physicians STIVERS MARK R 999999999 200 Cook 0 0 Internal Medicine 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 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1840.41 0 0 0 0 0 0 1840.41 0 0 1005683043 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8766.7 0 0 0 0 0 0 0 0 0 0 0 0 0 8766.7 0 0 1005683523 1396173753 13 Podiatrists THOUVENOT MIA C 999999999 200 Cook 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 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1391.05 0 0 0 0 0 0 1391.05 0 0 1005683596 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24282.35 0 0 0 0 0 0 0 0 0 0 0 0 0 24282.35 0 0 1005683652 1659890267 23 Occupational Therapists MATHEWS MARGARET A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21814.38 0 0 0 0 0 0 0 0 0 0 0 0 0 21814.38 0 0 1005684315 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 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 14.75 14.75 0 0 1005684577 1164650859 10 Physicians MAHALINGAM DEVALINGAM 999999999 200 Cook 0 0 Internal Medicine 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 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24455.4 0 0 0 0 0 0 24455.4 0 0 1005684645 1588083257 10 Physicians SHANKAR SHILPA 999999999 200 Cook 0 0 0 0 0 9 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 1050.24 0 0 0 0 0 0 0 0 526.01 0 0 0 0 0 0 1576.25 0 0 1005684769 1487969432 57 Home Nursing Agency BRIGHTSTAR CARE - NW CHICAGO 999999999 200 Cook 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 437 0 0 0 0 0 0 0 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Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 10.35 0 0 0 0 0 0 10.35 0 0 1005700784 1427598903 16 Nurse Practitioners CROSS JAMIE L 999999999 63 Macon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 2130.82 0 0 0 0 0 0 2195.12 0 0 1005700934 1720354806 10 Physicians LAWRIE CHARLES 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911.1 0 0 0 0 0 0 911.1 0 0 1005701052 1043553571 10 Physicians MUGVE NEAL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7060.45 0 0 0 0 0 0 7060.45 0 0 1005701118 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13792.33 0 0 0 0 0 0 0 0 0 0 0 0 0 13792.33 0 0 1005701307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21884.97 0 0 0 0 0 0 0 0 0 0 0 0 0 21884.97 0 0 1005701334 1952699894 10 Physicians WORKMAN JONATHAN P 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 8 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.15 0 591.51 0 0 0 0 0 0 664.66 0 0 1005701487 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803.08 0 0 0 0 0 0 0 0 0 0 0 0 0 803.08 0 0 1005701586 1477096568 70 Ambulance Service 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0 0 0 0 0 0 1382.77 0 0 1005702485 1942405592 10 Physicians LO ALEXANDER S 999999999 200 Cook 0 0 Emergency Medicine 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4334.1 0 0 0 0 0 0 4334.1 0 0 1005703398 1831408889 89 Physician Assistant Only(Encounter Only) BALANEY RUCHI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429.3 0 0 0 0 0 0 429.3 0 0 1005703457 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16817.24 0 0 0 0 0 0 0 0 0 0 0 0 0 16817.24 0 0 1005703916 1336567478 10 Physicians ROS SARA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344.02 0 0 0 0 0 0 1344.02 0 0 1005703950 1821015652 10 Physicians BOONSWANG NARONGSAK G 999999999 19 Champaign 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11630.85 0 0 0 0 0 0 11630.85 0 0 1005704054 1730479932 10 Physicians JOHNSON DANE 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.3 0 0 0 0 0 0 79.3 0 0 1005704214 1215226865 10 Physicians EDEN CATHERINE L 999999999 109 Winnebago 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.38 0 884.73 0 0 0 0 0 0 900.11 0 0 1005704233 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25319.69 0 0 0 0 0 0 0 0 0 0 0 0 0 25319.69 0 0 1005704327 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12525.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12525.75 0 0 1005704438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22507.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22507.1 0 0 1005704511 1871922369 12 Optometrists GORE SARAH NICOLE 999999999 65 Madison 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.45 0 0 0 0 0 0 130.45 0 0 1005704828 1568908283 89 Physician Assistant Only(Encounter Only) MEYERS ROBERT S 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 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 0 115.3 0 0 0 0 0 0 115.3 0 0 1005704983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10223.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10223.7 0 0 1005705303 1255862157 10 Physicians WESLEY GIBBERT 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792.86 0 0 0 0 0 0 792.86 0 0 1005705455 1275058687 16 Nurse Practitioners STOFFEL CYNTHIA 999999999 200 Cook 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 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 6803.55 0 0 0 0 0 0 6803.55 0 0 1005705547 1093243339 16 Nurse Practitioners PEDERSON LINDSEY 999999999 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2274.4 0 0 0 0 0 0 2274.4 0 0 1005705613 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16973.9 0 0 0 0 0 0 0 0 0 0 0 0 0 16973.9 0 0 1005705833 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1005706070 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 190.21 0 0 0 0 0 0 0 0 0 0 0 0 0 190.21 0 0 1005706161 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24301.97 0 0 0 0 0 0 0 0 0 0 0 0 0 24301.97 0 0 1005706317 1053857912 16 Nurse Practitioners JENKS ASHLEY C 999999999 200 Cook 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 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 0 223.9 0 0 0 0 0 0 223.9 0 0 1005706790 1588983829 10 Physicians FARRAG SAFA E. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981.78 0 0 0 0 0 0 981.78 0 0 1005707238 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005707461 1235304551 10 Physicians BENDIX PETER G 999999999 70 McDonough 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7867.8 0 0 0 0 0 0 7867.8 0 0 1005708390 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14544.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14544.5 0 0 1005709044 1376070102 10 Physicians DEGIOVANNI ALBERTO 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3379.32 0 0 0 0 0 0 3379.32 0 0 1005709288 1831115229 10 Physicians LUFT ULRICH C 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 969.44 0 0 0 0 0 0 969.44 0 0 1005709370 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 93.44 0 0 0 0 0 0 93.44 0 0 1005709382 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23316.37 0 0 0 0 0 0 0 0 0 0 0 0 0 23316.37 0 0 1005709615 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337.21 0 0 0 0 0 0 337.21 0 0 1005709662 1366857906 10 Physicians TOONE ERIC S 999999999 25 Crawford 0 0 Emergency Medicine 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 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9237.51 0 0 0 0 0 0 9237.51 0 0 1005709955 1831637040 16 Nurse Practitioners HELMUTH MARTHA 999999999 19 Champaign 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 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.27 0 0 0 0 0 0 1079.27 0 0 1005710356 10 Physicians 107 Will 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 111.36 0 0 0 0 0 0 0 0 163.74 0 0 0 0 0 0 275.1 0 0 1005710358 1669990396 11 Dentists GAUBA ARJUN 999999999 63 Macon 0 0 General Dentistry 0 0 206 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1232 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1232 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 35114.5 0 0 0 0 0 0 0 0 0 0 0 3387.15 0 0 0 0 38501.65 0 0 1005710426 1912265018 10 Physicians TAYLOR RENWICK 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 855.77 0 0 0 0 0 0 855.77 0 0 1005710880 24 Speech Therapists 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2578.1 2578.1 0 0 1005711189 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7089.37 0 0 0 0 0 0 0 0 0 0 0 0 0 7089.37 0 0 1005711472 1780099747 10 Physicians MAYFIELD ALLISON E 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.5 0 4044.79 0 0 0 0 0 0 4066.29 0 0 1005711487 1952609828 10 Physicians MODY NITESH S 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8559.33 0 0 0 0 0 0 8559.33 0 0 1005711626 1346534674 10 Physicians FOSTER KELLY D 999999999 200 Cook 0 0 Internal Medicine 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 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 0 569.23 0 0 0 0 0 0 569.23 0 0 1005711882 1982688669 89 Physician Assistant Only(Encounter Only) NIELSEN LISA K 999999999 98 Tazewell 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383.51 0 0 0 0 0 0 383.51 0 0 1005711991 1164712873 10 Physicians VAN STRATEN JOHN 999999999 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2188.14 0 0 0 0 0 0 2188.14 0 0 1005712401 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.28 0 0 0 0 0 0 71.28 0 0 1005712436 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2722.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2722.83 0 0 1005712660 1437247996 89 Physician Assistant Only(Encounter Only) VESPA SALLY A 999999999 91 Sangamon 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 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 0 166.27 0 0 0 0 0 0 166.27 0 0 1005712807 1508967837 16 Nurse Practitioners AMIDON LAURA J 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 518.26 0 0 0 0 0 0 518.26 0 0 1005713072 1417362542 10 Physicians REGAN ELIZABETH 999999999 200 Cook 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 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2707.31 0 0 0 0 0 0 2707.31 0 0 1005713223 1164970273 16 Nurse Practitioners VALJEVCIC ALMEDIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 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Neurology 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1005713846 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21990.78 0 0 0 0 0 0 0 0 0 0 0 0 0 21990.78 0 0 1005713989 1437444163 89 Physician Assistant Only(Encounter Only) SHAW EVERETT L 999999999 63 Macon 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398.67 0 0 0 0 0 0 398.67 0 0 1005714107 1740693449 10 Physicians AL-ABBOUD OMAR A 999999999 59 Lawrence 0 0 Internal Medicine 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2659.21 0 0 0 0 0 0 2659.21 0 0 1005714242 1306387774 10 Physicians HALEES WALID YOUSEF 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 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 2900.45 0 0 0 0 0 0 2900.45 0 0 1005714719 1902224058 10 Physicians HOLLOWAY-VERRILL AMANDA M 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604.7 0 0 0 0 0 0 604.7 0 0 1005714752 10 Physicians 108 Williamson 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 32 0 0 1005714807 16 Nurse Practitioners 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 848.8 0 0 0 0 0 0 848.8 0 0 1005714968 88 Other behavior health professional 53 Kane 0 0 0 0 0 0 0 0 0 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 0 650 0 0 0 0 0 0 650 0 0 1005715235 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23232.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23232.04 0 0 1005715263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 779.06 0 0 0 0 0 0 0 0 0 0 0 0 0 779.06 0 0 1005715641 1902339864 91 Waiver service provider--Adults (DHS/DDD) CHANCEY CHRISTINA 999999999 47 Jackson 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 1097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66695.48 0 0 0 0 0 0 0 0 0 0 0 0 0 66695.48 0 0 1005715705 1295149284 10 Physicians FLETCHER MICHELLE L 999999999 200 Cook 0 0 Internal Medicine 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 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1668.28 0 0 0 0 0 0 1668.28 0 0 1005715746 1588953897 10 Physicians MAREK STEVEN 999999999 200 Cook 0 0 Pediatrics 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 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3579.28 0 0 0 0 0 0 3579.28 0 0 1005715750 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005715804 1275853335 10 Physicians OGILVIE MICHAEL PATRICK 999999999 200 Cook 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 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 2023.63 0 0 0 0 0 0 2023.63 0 0 1005715992 1942524962 10 Physicians AHMED MOHAMMED S 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 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 2373.33 0 0 0 0 0 0 2373.33 0 0 1005716313 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23069.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23069.85 0 0 1005716693 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22295.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22295.58 0 0 1005717360 1174974661 16 Nurse Practitioners SVALINA GLADYS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.27 0 0 0 0 0 0 41.27 0 0 1005717403 1184714198 89 Physician Assistant Only(Encounter Only) FIELDS KRISTIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846.18 0 0 0 0 0 0 846.18 0 0 1005717676 1871033282 16 Nurse Practitioners ADINA CESYL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 1699.41 0 0 0 0 0 0 1699.41 0 0 1005717705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8625.06 0 0 0 0 0 0 0 0 0 0 0 0 0 8625.06 0 0 1005717732 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1005717810 1497200323 16 Nurse Practitioners SEEWALD NATALIE M. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.69 0 0 0 0 0 0 116.69 0 0 1005718347 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23695.76 0 0 0 0 0 0 0 0 0 0 0 0 0 23695.76 0 0 1005718349 1629367966 10 Physicians LODHI ATENA W 999999999 65 Madison 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3551.06 0 0 0 0 0 0 3551.06 0 0 1005718639 1174962732 10 Physicians EFAM TOLULOPE T 999999999 19 Champaign 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 5 0 28 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 8 0 41 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 8 0 41 0 0 0 0 0 0 0 0 0 314.88 0 0 0 0 0 0 28.85 0 1290.52 0 0 0 0 0 0 1634.25 0 0 1005719213 1679866842 10 Physicians DESAI DEVARSHI J 999999999 88 Richland 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 790 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14199.94 0 388.08 0 0 0 0 0 0 14588.02 0 0 1005719352 1437686821 16 Nurse Practitioners SANJUAN APRIL L 999999999 47 Jackson 0 0 0 0 0 1 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 823.74 0 0 0 0 0 0 836.54 0 0 1005719549 1720056229 89 Physician Assistant Only(Encounter Only) RUTHERFORD ANDREA I 999999999 200 Cook 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 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 0 591.37 0 0 0 0 0 0 591.37 0 0 1005720051 1235556333 10 Physicians RICHARDSON JESSICA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 806.1 0 0 0 0 0 0 806.1 0 0 1005720126 1497845283 10 Physicians VINCENT CHARLES R 999999999 53 Kane 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.72 0 0 0 0 0 0 9.72 0 0 1005720191 1043756083 16 Nurse Practitioners BATTISTA MELISSA K. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2001.63 0 0 0 0 0 0 2001.63 0 0 1005720803 1730622952 16 Nurse Practitioners BROWN PATRICIA 999999999 30 DuPage 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395.84 0 0 0 0 0 0 395.84 0 0 1005720984 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2286.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2286.11 0 0 1005721133 1275898744 10 Physicians PATTEN KELLEN 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.18 0 394.35 0 0 0 0 0 0 578.53 0 0 1005721151 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1005721248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4344.01 0 0 0 0 0 0 0 0 0 0 0 0 0 4344.01 0 0 1005721778 1306289046 10 Physicians ZEAL CARLEY J 999999999 109 Winnebago 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 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 5856.19 0 0 0 0 0 0 5856.19 0 0 1005721851 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21965.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21965.68 0 0 1005722159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19044.45 0 0 0 0 0 0 0 0 0 0 0 0 0 19044.45 0 0 1005722269 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005722276 1821228321 10 Physicians RAHMAN SOPHIA 999999999 200 Cook 0 0 Internal Medicine 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 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2562.24 0 0 0 0 0 0 2562.24 0 0 1005722619 1598172140 10 Physicians AZHAR WAQAS 999999999 91 Sangamon 0 0 Internal Medicine 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 0 104 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 1016.23 0 0 0 0 0 0 1016.23 0 0 1005722635 1235675091 16 Nurse Practitioners WARAMIT CASSANDRA 999999999 200 Cook 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 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2484.11 0 0 0 0 0 0 2484.11 0 0 1005723208 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21320.75 0 0 0 0 0 0 0 0 0 0 0 0 0 21320.75 0 0 1005723274 1881122844 10 Physicians GOLITKO AARON M 999999999 62 Logan 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3601.67 0 0 0 0 0 0 3601.67 0 0 1005723343 1013462969 24 Speech Therapists FLYNN KELLY 999999999 98 Tazewell 0 0 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 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34896.45 34896.45 0 0 1005723358 1902242373 10 Physicians GRAFF NICHOLAS 999999999 53 Kane 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10054.56 0 0 0 0 0 0 10054.56 0 0 1005723514 1306376496 10 Physicians SWALE LAURA 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 12.56 0 0 0 0 0 0 0 0 4387.32 0 0 0 0 0 0 4399.88 0 0 1005723539 1891244463 16 Nurse Practitioners PANELO LADY MAY O 999999999 54 Kankakee 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.49 0 0 0 0 0 0 162.49 0 0 1005723937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13072.84 0 0 0 0 0 0 0 0 0 0 0 0 0 13072.84 0 0 1005724220 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68919.11 0 0 0 0 0 0 0 0 0 0 0 0 0 68919.11 0 0 1005724233 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8044.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8044.2 0 0 1005724565 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.48 0 0 1005724676 1487034195 10 Physicians ALI FARAHNAZ 999999999 30 DuPage 0 0 Family Practice 0 0 0 18 0 0 0 0 0 0 1 0 82 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 1254.17 0 0 0 0 0 0 15.7 0 3885.33 0 0 0 0 0 0 5155.2 0 0 1005724798 1780604546 16 Nurse Practitioners KOTEK SARAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884.91 0 0 0 0 0 0 884.91 0 0 1005724880 16 Nurse Practitioners 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.05 0 0 0 0 0 0 36.05 0 0 1005724906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 972.76 0 0 0 0 0 0 0 0 0 0 0 0 0 972.76 0 0 1005724985 1750605788 10 Physicians KAN KRISTIN H 999999999 200 Cook 0 0 Pediatrics 0 0 0 23 0 0 0 0 0 0 4 0 36 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 5 0 57 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 5 0 57 0 0 0 0 0 0 0 0 0 2126.57 0 0 0 0 0 0 15.22 0 3089.9 0 0 0 0 0 0 5231.69 0 0 1005725143 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 486.76 0 0 0 0 0 0 0 0 0 0 0 0 0 486.76 0 0 1005725361 1215348545 10 Physicians HAMID MAHVISH 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 6.3 0 197.54 0 0 0 0 0 0 288.46 0 0 1005725399 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3349.96 0 0 0 0 0 0 0 0 0 0 0 0 0 3349.96 0 0 1005725495 1952432239 16 Nurse Practitioners GULINO THOMAS A 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1036.54 0 0 0 0 0 0 1036.54 0 0 1005725689 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 871.4 0 0 0 0 0 0 0 0 0 0 0 0 0 871.4 0 0 1005725798 23 Occupational Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 23.2 23.2 0 0 1005726014 1093151573 10 Physicians SHETH GOGAWALE PUJA R 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4601.12 0 0 0 0 0 0 4601.12 0 0 1005726246 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25653.21 0 0 0 0 0 0 0 0 0 0 0 0 0 25653.21 0 0 1005726337 1174510960 10 Physicians BENNETT PATRICK J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 518 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8581.96 0 143.2 0 0 0 0 0 0 8725.16 0 0 1005726351 1235675620 16 Nurse Practitioners BERGER KRISTEN 999999999 200 Cook 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 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428.75 0 0 0 0 0 0 428.75 0 0 1005726913 1013189281 10 Physicians SADAT KAMEL 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6122.32 0 0 0 0 0 0 6122.32 0 0 1005726991 1861455297 86 Clinical Social Worker(Encounter Only) BEAVERS VALERIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2360.54 0 0 0 0 0 0 2360.54 0 0 1005727026 1154735041 10 Physicians WONG NATALYN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12364.42 0 0 0 0 0 0 12364.42 0 0 1005727120 63 Other Providers of Medical Equipment/Supplies (Non-registered) 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 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 3473.74 0 0 0 0 3473.74 0 0 1005727322 1619354719 63 Other Providers of Medical Equipment/Supplies (Non-registered) "SCHECK AND SIRESS PROSTHETICS," 601427655 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13020.34 0 0 0 0 13020.34 0 0 1005727366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21973.39 0 0 0 0 0 0 0 0 0 0 0 0 0 21973.39 0 0 1005727435 90 Waiver service provider--Elderly (DOA) 30 DuPage 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7886.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7886.97 0 0 1005727483 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2927.25 0 0 0 0 0 0 2927.25 0 0 1005728032 10 Physicians 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 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 0.24 0 0 0 0 0 0 0.24 0 0 1005728183 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 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 0 680.08 0 0 0 0 0 0 680.08 0 0 1005728345 1063701241 10 Physicians SULLIVAN RYAN R 999999999 200 Cook 0 0 Orthopedic Surgery 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 487.2 0 0 0 0 0 0 487.2 0 0 1005729067 1548670623 10 Physicians SCAVONE ANTHONY 999999999 200 Cook 0 0 Internal Medicine 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 0 191 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 2228.11 0 0 0 0 0 0 2228.11 0 0 1005729127 16 Nurse Practitioners 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1005729147 16 Nurse Practitioners 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.76 0 0 0 0 0 0 2.76 0 0 1005729358 1679659585 30 General Hospitals PRESENCE SAINT JOSEPH CHICAGO 606575640 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 3 12 0 0 633 0 0 0 0 454 0 0 0 1098 0 0 0 0 0 3 109 0 0 861 0 0 0 0 511 0 0 0 2564 0 0 0 0 0 5 109 0 0 861 0 0 0 0 2296 0 0 0 2565 0 0 0 0 0 68.14 18459.89 0 0 89799.23 0 0 0 0 1953624.64 0 0 0 148634.94 0 0 0 0 0 2210586.84 0 0 1005729388 1942542519 10 Physicians THOMPSON ANDREW BLATT 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.1 0 0 0 0 0 0 87.1 0 0 1005729793 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 Sangamon 0 0 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 39704.66 0 0 0 0 0 0 0 0 0 0 0 0 0 39704.66 0 0 1005729856 1730578535 89 Physician Assistant Only(Encounter Only) CASTONGUAY DESIREE A 999999999 200 Cook 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 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 0 792 0 0 0 0 0 0 792 0 0 1005729889 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 334.32 0 0 0 0 0 0 0 0 0 0 0 0 0 334.32 0 0 1005729962 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13074.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13074.96 0 0 1005730193 1861797276 10 Physicians KHAN FAROOQ H 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3031.35 0 0 0 0 0 0 3031.35 0 0 1005730522 1962798652 10 Physicians MURPHY GREGORY 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 4 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.37 0 1334.91 0 0 0 0 0 0 1342.28 0 0 1005730824 1962761742 10 Physicians BURKE MICHAEL C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1077 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1448 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1448 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20938.4 0 570.5 0 0 0 0 0 0 21508.9 0 0 1005730975 1427378256 10 Physicians MCCRATE MARY E 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 403 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8022.63 0 187.71 0 0 0 0 0 0 8210.34 0 0 1005731214 1356797260 16 Nurse Practitioners ROSEN COLLEEN E. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.19 0 0 0 0 0 0 1187.19 0 0 1005731228 10 Physicians 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 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 0 470.02 0 0 0 0 0 0 470.02 0 0 1005731323 1194130302 10 Physicians CONCEPCION CARLOS D 999999999 200 Cook 0 0 Internal Medicine 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 0 222 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 2576.66 0 0 0 0 0 0 2576.66 0 0 1005731980 1790198976 10 Physicians SALLEN DAVID A 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 4 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.23 0 9386.71 0 0 0 0 0 0 9454.94 0 0 1005732127 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.54 0 0 0 0 0 0 60.54 0 0 1005732284 1285933549 10 Physicians ALFANO DANIELLE N 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 7306.21 0 0 0 0 0 0 7306.21 0 0 1005732363 1043440316 16 Nurse Practitioners TREPS VANESSA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1185.52 0 0 0 0 0 0 1185.52 0 0 1005732475 1538507561 10 Physicians THIBODEAU SETH 999999999 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8416.32 0 0 0 0 0 0 8416.32 0 0 1005733178 10 Physicians 101 Wabash 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.83 0 0 0 0 0 0 111.83 0 0 1005733291 1932356763 10 Physicians GULLAPALLI SRINIVAS 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3276.2 0 0 0 0 0 0 3276.2 0 0 1005734236 1760855274 48 Rural Health Clinics IVCH MEDICAL GROUP OGLESBY MED 999999999 58 La Salle 0 0 0 87 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5511.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5511.46 0 0 1005734476 10 Physicians 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 107.62 0 0 0 0 0 0 107.62 0 0 1005734588 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005734602 1003121310 10 Physicians ZIA HAMID M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 485 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2602 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2602 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15867.48 0 16414.88 0 0 0 0 0 0 32282.36 0 0 1005734671 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7783.14 0 0 0 0 0 0 0 0 0 0 0 0 0 7783.14 0 0 1005735132 1780883876 10 Physicians YOUSEF NIDA T 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.33 0 2578.39 0 0 0 0 0 0 2613.72 0 0 1005735184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4123.5 0 0 0 0 0 0 0 0 0 0 0 0 0 4123.5 0 0 1005735310 1316384886 10 Physicians CHEN TINA H 999999999 98 Tazewell 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1035.39 0 0 0 0 0 0 1035.39 0 0 1005735384 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24021.9 0 0 0 0 0 0 0 0 0 0 0 0 0 24021.9 0 0 1005735411 1356654735 10 Physicians DA SILVA IVAN ROCHA FERREIRA 999999999 200 Cook 0 0 Neurology 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7544.82 0 0 0 0 0 0 7544.82 0 0 1005735437 1730506718 10 Physicians SINHA JASMINE 999999999 200 Cook 0 0 Internal Medicine 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 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 0 633.09 0 0 0 0 0 0 633.09 0 0 1005735725 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005735734 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.14 0 0 0 0 0 0 6.14 0 0 1005735799 1962923201 60 Pharmacies EXCLUSIVE RX INC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6224.88 0 0 0 6224.88 0 0 1005736128 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31315.31 0 0 0 0 0 0 0 0 0 0 0 0 0 31315.31 0 0 1005736233 1104965565 87 Psychologist(Encounter Only) SEGAL EVELYN 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577.53 0 0 0 0 0 0 1577.53 0 0 1005736423 1336670181 10 Physicians KILLIAN BRYAN T 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940.26 0 0 0 0 0 0 940.26 0 0 1005736485 4005736485 10 Physicians JAFFERY ZEHRA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 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2459.51 0 0 1005748062 1508209750 10 Physicians TUN SANDY T 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744.12 0 0 0 0 0 0 744.12 0 0 1005748200 1437441672 10 Physicians AVVARI SUNIL 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.58 0 0 0 0 0 0 111.58 0 0 1005748272 1174940001 10 Physicians WOLFORD KATHRYN A 999999999 200 Cook 0 0 Emergency Medicine 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4901.45 0 0 0 0 0 0 4901.45 0 0 1005749080 1417244617 10 Physicians CLUKIES LINDSAY D 999999999 63 Macon 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171.72 0 0 0 0 0 0 1171.72 0 0 1005749117 1003067240 10 Physicians SMEDS MATTHEW 999999999 66 Marion 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.02 0 5903.88 0 0 0 0 0 0 5937.9 0 0 1005749219 1245612142 10 Physicians NAYEEMUDDIN FARAAZ 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5384.56 0 0 0 0 0 0 5384.56 0 0 1005749317 1043227689 16 Nurse Practitioners HINTON CATHY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372.89 0 0 0 0 0 0 372.89 0 0 1005749371 63 Other Providers of Medical Equipment/Supplies (Non-registered) 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1060.35 0 0 0 0 1060.35 0 0 1005749781 1144213117 30 General Hospitals REGIONAL ONE HEALTH 381032807 844 Tennessee ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 6 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 1 0 0 0 2 0 0 0 0 0 0 0 0 0 7 0 0 0 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 544.06 0 0 0 0 0 0 0 0 73.3 0 0 0 0 0 617.36 0 0 1005750228 1235513458 11 Dentists SHAH RACHIT 999999999 71 McHenry 0 0 General Dentistry 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15533.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15533.26 0 0 1005750403 1235557927 10 Physicians PATEL AKASH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2983.62 0 0 0 0 0 0 2983.62 0 0 1005750482 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 466.54 0 0 0 0 0 0 0 0 0 0 0 0 0 466.54 0 0 1005750529 1366869570 10 Physicians GALEANO XOCHIL 999999999 200 Cook 0 0 0 0 0 63 0 0 0 0 0 0 11 0 33 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 13 0 42 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 13 0 42 0 0 0 0 0 0 0 0 0 6782.62 0 0 0 0 0 0 68.14 0 1409.33 0 0 0 0 0 0 8260.09 0 0 1005750887 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34314.76 0 0 0 0 0 0 0 0 0 0 0 0 0 34314.76 0 0 1005751231 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1886.52 0 0 0 0 0 0 1886.52 0 0 1005751316 1669660874 89 Physician Assistant Only(Encounter Only) JOSEFOWICZ MEGAN 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.08 0 0 0 0 0 0 378.08 0 0 1005751489 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.97 0 0 0 0 0 0 54.97 0 0 1005751504 1336555911 10 Physicians WATT LAURA J 999999999 76 Montgomery 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2032.5 0 0 0 0 0 0 2032.5 0 0 1005751507 1619327061 16 Nurse Practitioners KRUPA BEATA A 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 0 0 1536.85 0 0 0 0 0 0 1549.73 0 0 1005751688 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22807.05 0 0 0 0 0 0 0 0 0 0 0 0 0 22807.05 0 0 1005751782 1629420229 16 Nurse Practitioners COUSINS DAWN M 999999999 42 Hancock 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670.93 0 0 0 0 0 0 670.93 0 0 1005751960 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16444.22 0 0 0 0 0 0 0 0 0 0 0 0 0 16444.22 0 0 1005752474 1457711301 16 Nurse Practitioners SPORAR MELISSA 999999999 200 Cook 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 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53170.9 0 0 0 0 0 0 53170.9 0 0 1005752487 1396757928 10 Physicians MALIK AAMIR I 999999999 80 Peoria 0 0 Internal Medicine 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1806.2 0 0 0 0 0 0 1806.2 0 0 1005752631 14 Chiropractors 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005752686 1124431895 10 Physicians MAALOUF MONICA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 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 2592.17 0 0 0 0 0 0 2592.17 0 0 1005752732 1700112521 89 Physician Assistant Only(Encounter Only) FRITCHER LISA 999999999 80 Peoria 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 0 230 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 3105.17 0 0 0 0 0 0 3105.17 0 0 1005752963 24 Speech Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4938 4938 0 0 1005753015 1023317450 10 Physicians KAY SETH T 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 7 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 272 0 3342.26 0 0 0 0 0 0 3614.26 0 0 1005753174 1184986135 10 Physicians TOAZ ERIN E 999999999 200 Cook 0 0 Anesthesiology 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 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 13146.3 0 0 0 0 0 0 13146.3 0 0 1005753204 1265718886 10 Physicians AHMED FAIZA 999999999 53 Kane 0 0 Internal Medicine 0 0 0 3 0 0 0 0 0 0 15 0 109 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 26 0 276 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 26 0 276 0 0 0 0 0 0 0 0 0 181.89 0 0 0 0 0 0 194.82 0 7688.83 0 0 0 0 0 0 8065.54 0 0 1005753351 30 General Hospitals 30 DuPage DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005753352 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26214.07 0 0 0 0 0 0 0 0 0 0 0 0 0 26214.07 0 0 1005753585 16 Nurse Practitioners 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005753588 1376870311 10 Physicians JOHN JOBIN 999999999 200 Cook 0 0 Family Practice 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 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7440.41 0 0 0 0 0 0 7440.41 0 0 1005753845 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17723 0 0 0 0 0 0 0 0 0 0 0 0 0 17723 0 0 1005753964 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005754017 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11476.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11476.12 0 0 1005754291 1942737606 36 Community mental health provider KENDALL COUNTY HEALTH DEPARTME 999999999 55 Kendall 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 0 1340.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16879.43 0 0 18219.78 0 0 1005754332 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2238.21 0 0 0 0 0 0 0 0 0 0 0 0 0 2238.21 0 0 1005754343 1669814349 89 Physician Assistant Only(Encounter Only) DEZOUTE MELISSA L 999999999 200 Cook 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263.83 0 0 0 0 0 0 263.83 0 0 1005754734 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 548.46 0 0 0 0 0 0 548.46 0 0 1005755101 1255874392 16 Nurse Practitioners RASTELLO ALITA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5148.63 0 0 0 0 0 0 5148.63 0 0 1005755213 1255646675 10 Physicians ZAIDI SYED JAVED H 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 16 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620.53 0 9023.19 0 0 0 0 0 0 9643.72 0 0 1005755378 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.41 48.41 0 0 1005755389 89 Physician Assistant Only(Encounter Only) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.56 0 0 0 0 0 0 2.56 0 0 1005755450 1114367356 10 Physicians IDANGODAGE HASITHA 999999999 63 Macon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2225.63 0 0 0 0 0 0 2225.63 0 0 1005755504 1114369170 10 Physicians ISMAIL IMTIAZ 999999999 10 Adams 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.44 0 292.31 0 0 0 0 0 0 322.75 0 0 1005755576 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2687.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2687.69 0 0 1005757246 1699020305 22 Physical Therapists GOSNELL MICHAEL 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5615.74 5615.74 0 0 1005757607 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084.42 1084.42 0 0 1005757805 1013394246 16 Nurse Practitioners ZEDNIK TERESA R 999999999 200 Cook 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 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 1327.51 0 0 0 0 0 0 1327.51 0 0 1005757808 1689123010 89 Physician Assistant Only(Encounter Only) MCCORMICK AMANDA N 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1910.45 0 0 0 0 0 0 1910.45 0 0 1005758038 1255883674 16 Nurse Practitioners MASSUTTI ANGELA 999999999 15 Bureau 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 991.4 0 0 0 0 0 0 991.4 0 0 1005758067 1841305877 60 Pharmacies PRESENCE NAZARETH FAMILY CTR 999999999 200 Cook 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13410.67 0 0 0 13410.67 0 0 1005758453 1083818561 10 Physicians SIMMONS ALAN J 999999999 200 Cook 0 0 Internal Medicine 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 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785.49 0 0 0 0 0 0 1785.49 0 0 1005758529 16 Nurse Practitioners 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1005759035 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9472.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9472.04 0 0 1005759114 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23175.62 0 0 0 0 0 0 0 0 0 0 0 0 0 23175.62 0 0 1005759319 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15155.28 0 0 0 0 0 0 0 0 0 0 0 0 0 15155.28 0 0 1005759369 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1549.28 0 0 0 0 0 0 1549.28 0 0 1005759434 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926.56 0 0 0 0 0 0 926.56 0 0 1005759439 1194156422 86 Clinical Social Worker(Encounter Only) BERNSTEIN BENJAMIN 999999999 19 Champaign 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 741.14 0 0 0 0 0 0 741.14 0 0 1005759499 1699095828 10 Physicians WHEATLEY CATHERINE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.14 0 7326.74 0 0 0 0 0 0 7332.88 0 0 1005759969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23728.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23728.1 0 0 1005760172 1073549028 89 Physician Assistant Only(Encounter Only) RIEGER MATTHEW 999999999 40 Grundy 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 737.71 0 0 0 0 0 0 737.71 0 0 1005760394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23453.22 0 0 0 0 0 0 0 0 0 0 0 0 0 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5836.02 0 0 0 0 0 0 0 0 0 0 0 0 0 5836.02 0 0 1005761865 1912424649 16 Nurse Practitioners COLLIER MEGAN J 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1005762132 1811289192 10 Physicians CERASALE MATTHEW T 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2147.38 0 0 0 0 0 0 2147.38 0 0 1005762268 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730.95 0 0 0 0 0 0 730.95 0 0 1005762336 87 Psychologist(Encounter Only) 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.25 0 0 0 0 0 0 58.25 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4254.61 0 127802.07 0 0 0 0 132056.68 0 0 1005775937 1770950107 89 Physician Assistant Only(Encounter Only) GENIN MICHAEL R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677.44 0 0 0 0 0 0 677.44 0 0 1005775966 1013233022 10 Physicians WEHRHEIM KARLA K 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 13 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843.31 0 6173.77 0 0 0 0 0 0 7017.08 0 0 1005776159 1194793711 16 Nurse Practitioners LAWRENCE ELAINE 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 167.86 0 0 0 0 0 0 0 0 1494.47 0 0 0 0 0 0 1662.33 0 0 1005776478 1104374727 16 Nurse 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0 3034.19 0 0 1005777746 1891945184 10 Physicians NYATSANZA IGNATIUS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 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 2666.07 0 0 0 0 0 0 2666.07 0 0 1005777852 16 Nurse Practitioners 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.8 0 0 0 0 0 0 45.8 0 0 1005778183 10 Physicians 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1498.25 0 0 0 0 0 0 1498.25 0 0 1005778365 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.15 0 0 1005779016 1811304066 10 Physicians PERVIN NAJWA 999999999 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0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1844.41 0 0 0 0 0 0 1844.41 0 0 1005781488 1760921167 33 Nursing Facilities MAYFIELD HEALTH CENTER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420219.16 0 0 0 0 0 0 0 420219.16 0 0 1005781510 1649700782 10 Physicians MATTSON CHRISTOPHER D 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1105.64 0 0 0 0 0 0 1105.64 0 0 1005781520 1275957334 10 Physicians GUASTALLI NICHOLAS 999999999 54 Kankakee 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 0 121 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 1453.88 0 0 0 0 0 0 1453.88 0 0 1005781527 1306281480 10 Physicians WRIGHT AISHA T 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 671.8 0 0 0 0 0 0 671.8 0 0 1005781736 1245677319 10 Physicians NAIR LEKSHMI T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722.01 0 0 0 0 0 0 722.01 0 0 1005781782 1043741192 10 Physicians MORENO JASMINE 999999999 200 Cook 0 0 Pediatrics 0 0 0 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 244.07 0 0 0 0 0 0 340.52 0 0 1005782146 1932531407 10 Physicians ZHOU MEI 999999999 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1192.17 0 0 0 0 0 0 1192.17 0 0 1005782301 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23959.43 0 0 0 0 0 0 0 0 0 0 0 0 0 23959.43 0 0 1005782453 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.58 0 0 0 0 0 0 88.58 0 0 1005782530 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22128.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22128.57 0 0 1005782691 1992090930 10 Physicians LARSON JILL E. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13726.53 0 0 0 0 0 0 13726.53 0 0 1005782778 30 General Hospitals 806 Colorado ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417.4 0 0 1005782971 1275829723 10 Physicians WALIULLAH KHALID I 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.12 0 1779.9 0 0 0 0 0 0 1827.02 0 0 1005783409 1205296456 55 Early Intervention Services ALBUS AMBER C 999999999 97 Stephenson 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13731.04 0 0 0 0 0 0 13731.04 0 0 1005783606 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 4 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 0 509.44 509.44 0 0 1005783751 10 Physicians 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005784057 1629426184 16 Nurse Practitioners ZEE CAROLINE 999999999 107 Will 0 0 0 0 0 81 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 7012.39 0 0 0 0 0 0 0 0 3707.21 0 0 0 0 0 0 10719.6 0 0 1005784108 1518499664 20 Registered nurse REED MONET 999999999 200 Cook 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 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 0 809.51 0 0 0 0 0 0 809.51 0 0 1005784660 1215458187 16 Nurse Practitioners DEDDO ELIZABETH L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1226.29 0 0 0 0 0 0 1226.29 0 0 1005784765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13842.07 0 0 0 0 0 0 0 0 0 0 0 0 0 13842.07 0 0 1005784843 1659786317 10 Physicians ABRAMS RACHEL F 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 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 2669.3 0 0 0 0 0 0 2669.3 0 0 1005785401 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 7860.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7860.64 0 0 1005785849 12 Optometrists 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.41 0 0 0 0 0 0 62.41 0 0 1005785864 1083969513 10 Physicians ALLIOWE NICKYLA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.95 0 3302.1 0 0 0 0 0 0 3335.05 0 0 1005785866 1912308727 89 Physician Assistant Only(Encounter Only) HERRERA KIMBERLY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.39 0 0 0 0 0 0 201.39 0 0 1005785884 1396278255 16 Nurse Practitioners HOWARD ALISSA 999999999 66 Marion 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 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2685.61 0 0 0 0 0 0 2685.61 0 0 1005785947 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 638.24 0 0 0 0 0 0 0 0 0 0 0 0 0 638.24 0 0 1005786153 1356880470 89 Physician Assistant Only(Encounter Only) PTACK MATTHEW ALLEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.85 0 0 0 0 0 0 224.85 0 0 1005786232 1104846633 16 Nurse Practitioners DANNER-KOPTIK KARINA E. 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 873.86 0 0 0 0 0 0 880.26 0 0 1005786449 1669784559 10 Physicians ALLAM HESHAM 999999999 63 Macon 0 0 Neurology 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 0 154 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 5306.12 0 0 0 0 0 0 5306.12 0 0 1005786554 1356876387 40 Federally Qualified Health Centers HOWARD BROWN HEALTH AT TPAN 999999999 200 Cook 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2058.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2058.38 0 0 1005786652 1356737308 10 Physicians MASKELL KENNETH LOGAN 999999999 200 Cook 0 0 Internal Medicine 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 0 191 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 2022.22 0 0 0 0 0 0 2022.22 0 0 1005786824 86 Clinical Social Worker(Encounter Only) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005786869 1154578870 10 Physicians MILLER MELISSA J 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 1155.63 0 0 0 0 0 0 1227.53 0 0 1005787054 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21994.28 0 0 0 0 0 0 0 0 0 0 0 0 0 21994.28 0 0 1005787268 1235671264 16 Nurse Practitioners SETTU KARPAGAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 0 216.56 0 0 0 0 0 0 216.56 0 0 1005787274 1205365129 11 Dentists AL MUFTI FAHAD 999999999 200 Cook 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 13711.56 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 14087.91 0 0 1005787305 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24511.79 0 0 0 0 0 0 0 0 0 0 0 0 0 24511.79 0 0 1005787413 24 Speech Therapists 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 900.8 900.8 0 0 1005787650 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5937.83 0 0 0 0 0 0 0 0 0 0 0 0 0 5937.83 0 0 1005787909 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.46 0 0 0 0 0 0 20.46 0 0 1005788172 1699189332 10 Physicians NORTH AMY 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 167.15 0 0 0 0 0 0 0 0 2749.72 0 0 0 0 0 0 2916.87 0 0 1005788815 1235579491 10 Physicians SAHRMANN JULIE M 999999999 89 Rock Island 0 0 Family Practice 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1911.76 0 0 0 0 0 0 1911.76 0 0 1005790528 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.62 0 0 0 0 0 0 169.62 0 0 1005791239 1073069381 10 Physicians ARGENTINE SARAH E 999999999 200 Cook 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 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 1233.17 0 0 0 0 0 0 1233.17 0 0 1005791325 1013464304 16 Nurse Practitioners SAVANI RUCHI 999999999 200 Cook 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 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875.78 0 0 0 0 0 0 875.78 0 0 1005791447 1598170458 10 Physicians SHAH SONAL DIVENDRA 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 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 2896.67 0 0 0 0 0 0 2896.67 0 0 1005791957 1891142758 21 Licensed Practical Nurses GEORGE ASHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 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 0 253.33 0 0 0 0 0 0 253.33 0 0 1005792271 1114478955 16 Nurse Practitioners JACOBS JENNIFER M. 999999999 200 Cook 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1587.76 0 0 0 0 0 0 1587.76 0 0 1005792583 1063941847 10 Physicians FOSSES VUONG MICHAELIA 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4366.29 0 0 0 0 0 0 4366.29 0 0 1005792603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24096.22 0 0 0 0 0 0 0 0 0 0 0 0 0 24096.22 0 0 1005792649 1841721180 12 Optometrists BANDSTRA ALAINA R 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3112.65 0 0 0 0 0 0 3112.65 0 0 1005793063 1730405812 10 Physicians HOLDEN SARA 999999999 200 Cook 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 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 1647.49 0 0 0 0 0 0 1647.49 0 0 1005793336 1407970395 89 Physician Assistant Only(Encounter Only) VANBEVERN PAMELA A 999999999 200 Cook 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.81 0 0 0 0 0 0 170.81 0 0 1005793368 1619267572 10 Physicians COLEMAN JOHNATHAN 999999999 200 Cook 0 0 Psychiatry 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 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7680.7 0 0 0 0 0 0 7680.7 0 0 1005793756 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 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 0 146.27 0 0 0 0 0 0 146.27 0 0 1005793774 1548554157 10 Physicians WATSON MARK 600165337 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2365.18 0 0 0 0 0 0 2365.18 0 0 1005793805 1780979302 10 Physicians NELSON KELLY KELLY 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48303.08 0 0 0 0 0 0 48303.08 0 0 1005793869 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 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Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 292.42 0 0 0 0 0 0 292.42 0 0 1005796064 1477088292 16 Nurse Practitioners PRIEBE JORDAN N. 999999999 200 Cook 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 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 0 107.72 0 0 0 0 0 0 107.72 0 0 1005796085 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23222.73 0 0 0 0 0 0 0 0 0 0 0 0 0 23222.73 0 0 1005796215 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570.18 0 0 0 0 0 0 570.18 0 0 1005796985 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 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0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 42.14 0 0 1005798388 1760904676 16 Nurse Practitioners CASAS TRACY A 999999999 89 Rock Island 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 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 0 767.16 0 0 0 0 0 0 767.16 0 0 1005798667 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005798877 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1844.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1844.7 0 0 1005798915 1740711803 91 Waiver service provider--Adults (DHS/DDD) RENZAGLIA-WEIR MARY JO 999999999 75 Monroe 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 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12598.51 0 0 0 0 0 0 0 0 0 0 0 0 0 12598.51 0 0 1005798983 1063826006 16 Nurse Practitioners CORSO MARGARET 999999999 24 Coles 0 0 0 0 0 1 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 209 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 4344.99 0 0 0 0 0 0 4377.14 0 0 1005799218 1417052325 89 Physician Assistant Only(Encounter Only) DUGGAL ABEER A 999999999 200 Cook 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 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 0 427.76 0 0 0 0 0 0 427.76 0 0 1005799316 1437573706 87 Psychologist(Encounter Only) DOYLE TODD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 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 0 227.58 0 0 0 0 0 0 227.58 0 0 1005799352 1285170746 16 Nurse Practitioners REYES MARION 999999999 49 Jefferson 0 0 0 0 0 1 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 10.46 0 0 0 0 0 0 0 0 20050.67 0 0 0 0 0 0 20061.13 0 0 1005799401 1083979181 10 Physicians KIRK CARTER N 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 238 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4589.29 0 0 0 0 0 0 4589.29 0 0 1005799465 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19269.6 0 0 0 0 0 0 0 0 0 0 0 0 0 19269.6 0 0 1005799685 1881123016 16 Nurse Practitioners HUGH SIGRID 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005799766 1578002853 91 Waiver service provider--Adults (DHS/DDD) COX HUNTER 999999999 200 Cook 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96911.61 0 0 0 0 0 0 0 0 0 0 0 0 0 96911.61 0 0 1005799820 16 Nurse Practitioners 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.4 0 0 0 0 0 0 1.4 0 0 1005799988 1386768232 86 Clinical Social Worker(Encounter Only) WATSON SUSAN C 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.53 0 0 0 0 0 0 1982.53 0 0 1005800024 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15766.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15766.52 0 0 1005800068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23815.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23815.7 0 0 1005800405 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 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 0 976.8 0 0 0 0 0 0 0 0 0 0 0 0 0 976.8 0 0 1005800477 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 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 2767.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2767.2 0 0 1005800496 1679514038 12 Optometrists WOLLENBERG LYNN A 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324.75 0 15.04 0 0 0 0 339.79 0 0 1005800531 1962821892 10 Physicians ZAHRAEE KEVIN A 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3109.46 0 0 0 0 0 0 3109.46 0 0 1005800689 16 Nurse Practitioners 59 Lawrence 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.76 0 0 0 0 0 0 61.76 0 0 1005800797 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24829.99 0 0 0 0 0 0 0 0 0 0 0 0 0 24829.99 0 0 1005801211 1861469132 10 Physicians KARIMPOUR SHERVIN E 999999999 30 DuPage 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1081.72 0 0 0 0 0 0 1081.72 0 0 1005801295 1629232087 10 Physicians DELACRUZ MICHAEL 999999999 22 Clay 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16907.91 0 0 0 0 0 0 16907.91 0 0 1005801407 1497271035 16 Nurse Practitioners WORKMAN ASHLEY N 999999999 80 Peoria 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544.01 0 0 0 0 0 0 544.01 0 0 1005801717 1801335914 16 Nurse Practitioners DAVENPORT CHRISTINA M 999999999 200 Cook 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 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 1010.46 0 0 0 0 0 0 1010.46 0 0 1005801771 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22623.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22623.28 0 0 1005801821 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23288.97 0 0 0 0 0 0 0 0 0 0 0 0 0 23288.97 0 0 1005802413 10 Physicians 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.18 0 0 0 0 0 0 45.18 0 0 1005802442 1114238276 10 Physicians ALNAJAR TAREK 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4936.04 0 0 0 0 0 0 4936.04 0 0 1005802780 1063831477 10 Physicians CARDOSO RUBEN 999999999 80 Peoria 0 0 Emergency Medicine 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 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7268.2 0 0 0 0 0 0 7268.2 0 0 1005802839 1396186300 10 Physicians KWAK HEEWON A 999999999 200 Cook 0 0 Clinical Pathology 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 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2537.5 0 0 0 0 0 0 0 0 2537.5 0 0 1005803212 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 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 58.98 58.98 0 0 1005803302 1851816482 33 Nursing Facilities APERION CARE FAIRFIELD 999999999 104 Wayne 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 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805913.98 0 0 0 0 0 0 0 805913.98 0 0 1005803308 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22878.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22878.22 0 0 1005803336 1336680925 16 Nurse Practitioners SMITH JAMIE R 999999999 49 Jefferson 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 0 946 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 11589.56 0 0 0 0 0 0 11589.56 0 0 1005803358 1003045097 10 Physicians KIM ELIJAH 999999999 91 Sangamon 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8941.13 0 0 0 0 0 0 8941.13 0 0 1005803437 1891085395 10 Physicians SCHIVONE GILLIAN B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27203.45 0 0 0 0 0 0 27203.45 0 0 1005803625 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 150.87 0 0 0 0 0 0 150.87 0 0 1005803929 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3945.02 0 0 0 0 0 0 0 0 0 0 0 0 0 3945.02 0 0 1005804336 1932524196 16 Nurse Practitioners KOPERDOWSKI ANNA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338.61 0 0 0 0 0 0 338.61 0 0 1005804584 1326429242 10 Physicians MANSURI KAIF M 999999999 47 Jackson 0 0 Family Practice 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 499.71 0 0 0 0 0 0 499.71 0 0 1005804750 1316983794 89 Physician Assistant Only(Encounter Only) WOELTJEN BONNIE LANE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005804993 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 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 22862.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22862.8 0 0 1005805225 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 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 0 508.67 0 0 0 0 0 0 508.67 0 0 1005805372 1285185173 40 Federally Qualified Health Centers SHAWNEE HEALTH CARE SAME DAY 629013547 47 Jackson 0 0 0 791 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2248 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2248 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127320.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127320.81 0 0 1005805601 1245691799 16 Nurse Practitioners CZERNECKI DOROTA 999999999 200 Cook 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 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 1003.86 0 0 0 0 0 0 1003.86 0 0 1005805893 12 Optometrists 91 Sangamon 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.32 0 0 0 0 0 0 102.32 0 0 1005806029 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35744.4 0 0 0 0 0 0 0 0 0 0 0 0 0 35744.4 0 0 1005806698 1770561417 10 Physicians VAN AMERONGEN ALEXANDER W 999999999 200 Cook 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 0 893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25048.58 0 0 0 0 0 0 0 0 25048.58 0 0 1005806824 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3091.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3091.09 0 0 1005806841 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371.08 0 0 0 0 0 0 0 0 371.08 0 0 1005806902 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18669.43 0 0 0 0 0 0 0 0 0 0 0 0 0 18669.43 0 0 1005807265 1871668418 86 Clinical Social Worker(Encounter Only) HENDERSON ALDRIDGE MARTRICE 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12632.88 0 0 0 0 0 0 12632.88 0 0 1005807727 1023479508 16 Nurse Practitioners BAKER MANISA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005807820 10 Physicians 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 32.72 0 0 0 0 0 0 32.72 0 0 1005808074 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24978.82 0 0 0 0 0 0 0 0 0 0 0 0 0 24978.82 0 0 1005808136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11678.49 0 0 0 0 0 0 0 0 0 0 0 0 0 11678.49 0 0 1005808308 1154334258 89 Physician Assistant Only(Encounter Only) FAIRFIELD ANNE E 999999999 47 Jackson 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 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 43.54 0 0 0 0 0 0 43.54 0 0 1005808598 1043508724 10 Physicians KENKARE SONYA 999999999 200 Cook 0 0 Derm