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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 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KENKARE SONYA 999999999 200 Cook 0 0 Dermatology 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 0 129 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 2379.05 0 0 0 0 0 0 2379.05 0 0 1005809452 1750641692 13 Podiatrists TRIVEDI ASHKA 999999999 57 Lake 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 0 194 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 0 643.45 0 0 0 0 0 0 643.45 0 0 1005809488 1487181608 22 Physical Therapists THORSEN MITCHELL T 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 819.56 819.56 0 0 1005810461 1104169994 10 Physicians JEN ROBERT 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 0 290 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 4073.21 0 0 0 0 0 0 4073.21 0 0 1005810546 1053658237 89 Physician Assistant Only(Encounter Only) SEIBERT NATALIE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534.13 0 0 0 0 0 0 534.13 0 0 1005811434 1730507443 10 Physicians NGANSOP THIERRY N 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 0 243 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 2413.24 0 0 0 0 0 0 2413.24 0 0 1005811560 1265974604 16 Nurse Practitioners BORJON JULIE C. 627011034 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 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 0 516.16 0 0 0 0 0 0 516.16 0 0 1005811593 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 37.08 0 0 0 0 0 0 37.08 0 0 1005811651 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Physician Assistant Only(Encounter Only) AZARCON DOMINIQUE 999999999 200 Cook 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 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3839.93 0 0 0 0 0 0 3839.93 0 0 1005813601 80 Prepaid health plan--Health maintenance organization NEXTLEVEL HEALTH 60606 200 Cook 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400720.34 0 1005813816 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 0.19 0 0 0 0 0 0 0.19 0 0 1005814084 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 25.65 0 0 0 0 0 0 25.65 0 0 1005814302 91 Waiver service 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Psychologist(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 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 1195.23 0 0 0 0 0 0 1195.23 0 0 1005815555 1871682294 89 Physician Assistant Only(Encounter Only) AGUILAR JEFFREY 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 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 30.47 0 0 0 0 0 0 30.47 0 0 1005815914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22527.03 0 0 0 0 0 0 0 0 0 0 0 0 0 22527.03 0 0 1005815997 1417184078 10 Physicians RIAR RAVNEET 999999999 22 Clay 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 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 0 673.01 0 0 0 0 0 0 673.01 0 0 1005816174 1104113398 10 Physicians CHARBEK EDWARD 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 4183.74 0 0 0 0 0 0 4183.74 0 0 1005816371 1467626184 10 Physicians KOO NATHANIEL 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 9013.67 0 0 0 0 0 0 9013.67 0 0 1005816416 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24855.63 0 0 0 0 0 0 0 0 0 0 0 0 0 24855.63 0 0 1005816613 1508852245 89 Physician Assistant Only(Encounter Only) WENNINGER DEBORAH L 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.32 0 0 0 0 0 0 94.32 0 0 1005816816 1750803490 16 Nurse Practitioners CADAYONA JOSEPH 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 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 0 609.15 0 0 0 0 0 0 609.15 0 0 1005816930 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 2 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 3878.67 3878.67 0 0 1005817203 1023550688 16 Nurse Practitioners WOOD JENNIFER L 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 0 319.8 0 0 0 0 0 0 319.8 0 0 1005817446 1386194744 89 Physician Assistant Only(Encounter Only) WILCOX KAYLA M 999999999 101 Wabash 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 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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6227.56 0 0 1005818422 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 73.4 0 0 0 0 0 0 73.4 0 0 1005819850 1700954419 87 Psychologist(Encounter Only) ROGERS LESLIE S 999999999 53 Kane 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 0 114 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 2339.18 0 0 0 0 0 0 2339.18 0 0 1005820144 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 343.25 343.25 0 0 1005820387 1548519580 87 Psychologist(Encounter Only) WOOL LAURA 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 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 1375.21 0 0 0 0 0 0 1375.21 0 0 1005820391 63 Other Providers of Medical Equipment/Supplies (Non-registered) 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13111.32 0 0 0 0 13111.32 0 0 1005820808 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486.08 0 0 0 0 0 0 0 0 0 0 0 0 0 486.08 0 0 1005821120 1225355167 10 Physicians INDORKAR RAKSHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4497.93 0 0 0 0 0 0 4497.93 0 0 1005821247 1619396207 10 Physicians JACOB ANN 999999999 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 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 3416.48 0 0 0 0 0 0 3416.48 0 0 1005821577 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0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11131.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11131.4 0 0 1005822168 1164753281 86 Clinical Social Worker(Encounter Only) ADAMS LINDSEY M 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 4999.7 0 0 0 0 0 0 4999.7 0 0 1005822195 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 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 1613.39 0 0 0 0 0 0 1613.39 0 0 1005822251 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 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 14124.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14124.21 0 0 1005822743 1255863023 16 Nurse Practitioners LUETKENS JUDITH M 999999999 53 Kane 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.14 0 0 0 0 0 0 1.14 0 0 1005826913 1942616578 10 Physicians KANDULA MANASA 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 0 166 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 2675.19 0 0 0 0 0 0 2675.19 0 0 1005827387 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 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 0 114.69 114.69 0 0 1005827481 1770606634 10 Physicians SIMPSON DINEE C 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 0 114 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 0 485.02 0 0 0 0 0 0 485.02 0 0 1005827850 1811315682 10 Physicians ROSENBERG MICHAEL 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 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0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1005828715 1407260227 10 Physicians GIDAY GENET F 999999999 89 Rock Island 0 0 Pediatrics 0 0 0 75 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 0 6568.68 0 0 0 0 0 0 0 0 8160.24 0 0 0 0 0 0 14728.92 0 0 1005828781 1629127543 60 Pharmacies HARVEY HEALTH CENTER PHARMACY 604284047 200 Cook 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 0 601 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15118.63 0 0 0 15118.63 0 0 1005829047 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9401.36 0 0 0 0 0 0 0 0 0 0 0 0 0 9401.36 0 0 1005829153 1528580917 16 Nurse Practitioners ZIMMER NATALIE J 999999999 200 Cook 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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 8228.79 0 0 0 0 0 0 8228.79 0 0 1005840508 10 Physicians 91 Sangamon 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 480.84 0 0 0 0 0 0 480.84 0 0 1005840637 1659800316 11 Dentists DAMODARAN LOKESH K 999999999 71 McHenry 0 0 General Dentistry 0 0 349 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 2130 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 2130 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 51254.92 0 0 0 0 0 0 0 0 0 0 0 10161.45 0 0 0 0 61416.37 0 0 1005840816 22 Physical Therapists 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 485.68 485.68 0 0 1005840870 1679725097 89 Physician Assistant Only(Encounter Only) GROEZINGER TERRI L 999999999 97 Stephenson 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 0 127 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 1289.22 0 0 0 0 0 0 1289.22 0 0 1005840938 1922327535 10 Physicians SWOBODA APRIL 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 1391.85 0 0 0 0 0 0 1391.85 0 0 1005840981 1215487830 89 Physician Assistant Only(Encounter Only) DAVISSON RYAN 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 0 109 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 3990.38 0 0 0 0 0 0 3990.38 0 0 1005841042 86 Clinical Social Worker(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 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 0 184.76 0 0 0 0 0 0 184.76 0 0 1005841166 1932528114 10 Physicians ATHER NAZNEEN 999999999 30 DuPage 0 0 0 0 0 12 0 0 0 0 0 0 8 0 17 0 0 0 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1114380235 16 Nurse Practitioners FRANCIS ELIZABETH 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 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 0 619.38 0 0 0 0 0 0 619.38 0 0 1005842143 1821254830 10 Physicians YEH RICK 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 274 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3968.52 0 1124.27 0 0 0 0 0 0 5092.79 0 0 1005842179 10 Physicians 824 Minnesota 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 0 0 0 0 0 0 0 0 0 0 1005842217 1982142527 16 Nurse Practitioners JENKINS EDITH A 999999999 109 Winnebago 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 0 108 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 1243.3 0 0 0 0 0 0 1243.3 0 0 1005842385 1891015079 10 Physicians SOBINSKY JUSTIN DANIEL 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 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 1060.02 0 0 0 0 0 0 1060.02 0 0 1005842689 1215270178 10 Physicians CRUZ CELESTE GERALDINA 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 0 101 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 2280.97 0 0 0 0 0 0 2280.97 0 0 1005842920 1649697517 10 Physicians KIM CHLOE H 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 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 0 614.68 0 0 0 0 0 0 614.68 0 0 1005842931 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 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 0 944.24 0 0 0 0 0 0 0 0 0 0 0 0 0 944.24 0 0 1005842938 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10823.48 0 0 0 0 0 0 0 0 0 0 0 0 0 10823.48 0 0 1005843087 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11369.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11369.06 0 0 1005843177 1902160617 10 Physicians PEARSON CHAUHAN KRISTINE M 999999999 96 St Clair 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5412.92 0 0 0 0 0 0 5412.92 0 0 1005843399 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14650.22 0 0 0 0 0 0 0 0 0 0 0 0 0 14650.22 0 0 1005844131 1972848794 89 Physician Assistant Only(Encounter Only) CARUSO DANA M 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 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 0 515.82 0 0 0 0 0 0 515.82 0 0 1005844284 1427463801 10 Physicians ROGOWSKI LAUREN M 999999999 53 Kane 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 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 1592.87 0 0 0 0 0 0 1592.87 0 0 1005844419 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3199.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3199.92 0 0 1005844422 1144766817 16 Nurse Practitioners SLICK WENDY S. 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 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 0 757.6 0 0 0 0 0 0 757.6 0 0 1005844570 1306276597 63 Other Providers of Medical Equipment/Supplies (Non-registered) PRAIRIE CROSSING LIVING AND RE 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 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 1186.5 0 0 0 0 0 0 1186.5 0 0 1005844760 1578506168 87 Psychologist(Encounter Only) CAMPBELL THERESA 999999999 60 Lee 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1005844839 10 Physicians 31 Edgar 0 0 Obstetric-Gynecology 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 35.95 0 240.68 0 0 0 0 0 0 276.63 0 0 1005844954 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 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 43.54 0 0 0 0 0 0 43.54 0 0 1005845410 1689005977 89 Physician Assistant Only(Encounter Only) SANDS ERIN E 999999999 53 Kane 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 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 0 869.78 0 0 0 0 0 0 869.78 0 0 1005845434 1104111855 10 Physicians BATRA AYUSH 999999999 200 Cook 0 0 Neurology 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 0 105 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 8334.26 0 0 0 0 0 0 8334.26 0 0 1005845686 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 0 139 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 17031.08 0 0 0 0 0 0 0 0 0 0 0 0 0 17031.08 0 0 1005845687 1740695949 10 Physicians EWING ELIZABETH C 999999999 80 Peoria 0 0 Pediatrics 0 0 0 47 0 0 0 0 0 0 20 0 55 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 29 0 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18 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 12 0 22 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 12 0 22 0 0 0 0 0 0 0 0 0 1130.52 0 0 0 0 0 0 108.19 0 1043.67 0 0 0 0 0 0 2282.38 0 0 1005847776 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1005847908 1467478206 10 Physicians MURPHY ELIZABETH A 999999999 30 DuPage 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 0 155 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 2782.84 0 0 0 0 0 0 2782.84 0 0 1005847919 1750768685 10 Physicians ATALLAH RASHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.35 0 2269.7 0 0 0 0 0 0 2277.05 0 0 1005847957 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 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Practitioners ZIKE SARA H. 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 0 216 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 0 929.51 0 0 0 0 0 0 929.51 0 0 1005854542 1003268459 11 Dentists SALMA AMATUL 999999999 200 Cook 0 0 General Dentistry 0 0 43 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 8620.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8620.6 0 0 1005854551 1518371889 10 Physicians JONES SABRINA K 999999999 200 Cook 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 0 222 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 1406.61 0 0 0 0 0 0 1406.61 0 0 1005854678 1902288988 10 Physicians PANDEY ANSHUL L 999999999 91 Sangamon 0 0 Psychiatry 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6334.6 0 0 0 0 0 0 6334.6 0 0 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10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.22 0 0 0 0 0 0 108.22 0 0 1005872006 1740546589 10 Physicians BALTRUSHES-HUGHES 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 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 0 164.23 0 0 0 0 0 0 164.23 0 0 1005872273 1275825978 10 Physicians ALI AHMER M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.87 0 402.64 0 0 0 0 0 0 500.51 0 0 1005872299 1962952283 60 Pharmacies BASINGER'S WILL COUNTY PHARMAC 999999999 107 Will 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 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17902 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39646.21 0 0 0 39646.21 0 0 1005872507 1952733180 10 Physicians GARCIA BENJAMIN 999999999 30 DuPage 0 0 Emergency Medicine 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 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 2859.02 0 0 0 0 0 0 2859.02 0 0 1005873296 1003874652 60 Pharmacies GENOA HEALTHCARE LLC 622233809 96 St Clair 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 1412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46318.94 0 0 0 46318.94 0 0 1005873321 1437452612 87 Psychologist(Encounter Only) GREENE MICHELLE 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 1231.43 0 0 0 0 0 0 1231.43 0 0 1005873603 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 0 0 0 0 0 0 0 0 0 0 1005873609 1215324769 10 Physicians LANE TIMOTHY AUSTIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170 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 12474.07 0 0 0 0 0 0 12474.07 0 0 1005873743 10 Physicians 70 McDonough 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 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 1005873879 1598214512 60 Pharmacies WALGREENS #16501 999999999 200 Cook 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 0 384 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182250.11 0 0 0 182250.11 0 0 1005873971 1609009646 13 Podiatrists YAU SYDNEY 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 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 0 347.3 0 0 0 0 0 0 347.3 0 0 1005874111 1407083488 10 Physicians KIM THOMAS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 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BARNES SYLVESTER 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1188.03 0 0 0 0 0 0 1188.03 0 0 1005875717 1851675979 89 Physician Assistant Only(Encounter Only) MICHELSEN ASHLEY 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 36.11 0 0 0 0 0 0 36.11 0 0 1005876107 1982124566 16 Nurse Practitioners GIBSON DANA 999999999 89 Rock Island 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 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 0 596.43 0 0 0 0 0 0 596.43 0 0 1005876389 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17210.27 0 0 0 0 0 0 0 0 0 0 0 0 0 17210.27 0 0 1005876510 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14520.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14520.6 0 0 1005876714 1588075584 13 Podiatrists MIRKOVIC DIJANA 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 0 138 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 0 982.19 0 0 0 0 0 0 982.19 0 0 1005876771 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 1.95 0 0 0 0 0 0 1.95 0 0 1005877041 1790219459 16 Nurse Practitioners BOND LATOYA L 999999999 91 Sangamon 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 3305.44 0 0 0 0 0 0 3305.44 0 0 1005877201 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337.7 0 0 0 0 0 0 337.7 0 0 1005877301 1528471059 16 Nurse Practitioners EDWARDS CANDICE M 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 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 1563.44 0 0 0 0 0 0 1563.44 0 0 1005877337 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4331.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4331.22 0 0 1005877506 1447707229 10 Physicians MARRERO-RIVERA GABRIEL E 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 0 104 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 3170.97 0 0 0 0 0 0 3170.97 0 0 1005877704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17467.92 0 0 0 0 0 0 0 0 0 0 0 0 0 17467.92 0 0 1005877812 1295118610 16 Nurse Practitioners WYDRA MARIE 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 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 0 132.09 0 0 0 0 0 0 132.09 0 0 1005878073 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9559.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9559.2 0 0 1005878213 1275772766 89 Physician Assistant Only(Encounter Only) STANTON ELIZABETH M 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 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 0 687.44 0 0 0 0 0 0 687.44 0 0 1005878226 1811334691 10 Physicians BHATTACHARYA SHALINI 999999999 200 Cook 0 0 Internal Medicine 0 0 0 3 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 318.43 0 0 0 0 0 0 0 0 706.06 0 0 0 0 0 0 1024.49 0 0 1005878292 1699204883 10 Physicians ATTARWALA HAIDER 999999999 200 Cook 0 0 Family Practice 0 0 0 12 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 687.63 0 0 0 0 0 0 0 0 1623.71 0 0 0 0 0 0 2311.34 0 0 1005878329 1730573650 10 Physicians DAVIS BRADLEY 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 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 1897.25 0 0 0 0 0 0 1897.25 0 0 1005878364 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 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 0 148.15 0 0 0 0 0 0 148.15 0 0 1005878478 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4036.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4036.8 0 0 1005878728 1558819664 16 Nurse Practitioners IHLITSKAYA YULIYA 999999999 200 Cook 0 0 Child/Adolescent Psychiatry Residency 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 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4759.47 0 0 0 0 0 0 4759.47 0 0 1005879037 1316365950 10 Physicians REYNOLDS JONATHAN E 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 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 0 790.96 0 0 0 0 0 0 790.96 0 0 1005879087 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26197.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 1005879093 1962638130 89 Physician Assistant Only(Encounter Only) SHULL AMANDA L 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 353.67 0 0 0 0 0 0 385.82 0 0 1005879295 1245591924 10 Physicians BAHU RAMEZ 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 0 162 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 2240.07 0 0 0 0 0 0 2240.07 0 0 1005879360 1538368204 10 Physicians ENDALE BRUK 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 868 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1357 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1357 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17231.26 0 160.64 0 0 0 0 0 0 17391.9 0 0 1005879471 1518409259 16 Nurse Practitioners DECKER MARY B 999999999 10 Adams 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 0 199 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 8815.38 0 0 0 0 0 0 8815.38 0 0 1005879941 1295146421 10 Physicians ALI ARFAA 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 0 107 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 1213.15 0 0 0 0 0 0 1213.15 0 0 1005879953 1952729915 10 Physicians KHAN SHADAB 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 358 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3236.7 0 2590.32 0 0 0 0 0 0 5827.02 0 0 1005880084 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 112.52 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 143.53 0 0 1005880127 1043566094 86 Clinical Social Worker(Encounter Only) ONSGARD ERIC 999999999 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0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.84 0 177.33 0 0 0 0 0 0 181.17 0 0 1005883088 70 Ambulance Service Providers 826 Missouri 0 0 0 0 0 0 0 0 0 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 7050 0 0 0 0 0 0 7050 0 0 1005883264 1245556547 10 Physicians HARYANI ASHISH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 379 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2362.01 0 0 0 0 0 0 2362.01 0 0 1005883462 1003340753 22 Physical Therapists FRANK BRENDEN M 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 0 152 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 1896.7 1896.7 0 0 1005883475 1720320526 10 Physicians SIDDIQUI AMIR B 999999999 30 DuPage 0 0 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Cook 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 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4492.33 0 0 0 0 0 0 4492.33 0 0 1005884230 1265968713 16 Nurse Practitioners ERNST KATHERYN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 146.63 0 0 0 0 0 0 146.63 0 0 1005884280 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14462.69 0 0 0 0 0 0 0 0 0 0 0 0 0 14462.69 0 0 1005884384 1922026780 10 Physicians SECCOMBE JOHN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 3.82 0 2875.81 0 0 0 0 0 0 2879.63 0 0 1005884549 4005884549 10 Physicians YUEN ROBERT 999999999 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0 0 0 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1970.01 1970.01 0 0 1005885893 1265775571 10 Physicians FORRESTER KATHERINE R 999999999 826 Missouri 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 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 3250.4 0 0 0 0 0 0 3250.4 0 0 1005885963 10 Physicians 51 Jo Daviess 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 45.82 0 0 0 0 0 0 45.82 0 0 1005886040 10 Physicians 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 83.23 0 0 0 0 0 0 83.23 0 0 1005886256 1184058240 60 Pharmacies CVS PHARMACY #02376 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 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 1053 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 11566.94 0 0 1005886779 10 Physicians 30 DuPage 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 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 53.37 0 0 0 0 0 0 53.37 0 0 1005886832 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1120.55 0 0 0 0 0 0 1120.55 0 0 1005886952 1861856247 10 Physicians KHAN ASFAHAN 999999999 200 Cook 0 0 Family Practice 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 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4986.52 0 0 0 0 0 0 4986.52 0 0 1005887375 30 General Hospitals 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 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 1364.22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 513.17 0 0 1005889256 1871849331 10 Physicians TAILOR URVI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 26 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323.05 0 946.78 0 0 0 0 0 0 1269.83 0 0 1005889828 1457881765 10 Physicians VU JOHN 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 0 218 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 1833.92 0 0 0 0 0 0 1833.92 0 0 1005890173 1447512868 10 Physicians SIPE ADAM L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 283 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449.14 0 0 0 0 0 0 0 0 1449.14 0 0 1005890237 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23414.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23414.29 0 0 1005890368 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 0 0 0 0 0 0 0 0 0 0 1005890477 1003105511 10 Physicians TOBIN VEALEY 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 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 0 364.15 0 0 0 0 0 0 364.15 0 0 1005890505 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 0 111.65 111.65 0 0 1005890808 1487746939 89 Physician Assistant Only(Encounter Only) PITTMAN THOMAS L 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 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 67.22 0 0 0 0 0 0 67.22 0 0 1005891204 94 Waiver service 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305.75 0 0 0 0 0 0 305.75 0 0 1005894835 1992004162 10 Physicians TAUCHEN ALEXANDER J 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 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 2860.74 0 0 0 0 0 0 2860.74 0 0 1005894885 86 Clinical Social Worker(Encounter Only) 109 Winnebago 0 0 0 0 0 0 0 0 0 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 1395.28 0 0 0 0 0 0 1395.28 0 0 1005894915 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 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 0 247.7 247.7 0 0 1005895113 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 0 144 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 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0 0 0 0 0 0 0 0 0 0 0 3324.71 0 0 1005896885 1073856498 10 Physicians LEE KRISTIN 999999999 200 Cook 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.52 0 310.2 0 0 0 0 0 0 426.72 0 0 1005897066 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 48.2 0 0 0 0 0 0 48.2 0 0 1005897156 1235431974 86 Clinical Social Worker(Encounter Only) HANSEN JEANNE 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 0 101 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 0 898.08 0 0 0 0 0 0 898.08 0 0 1005897166 1295257285 89 Physician Assistant Only(Encounter Only) AUSTIN KATELYNN E 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 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 73.45 0 0 0 0 0 0 73.45 0 0 1005897659 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 0 165.91 0 0 0 0 0 0 165.91 0 0 1005897875 1053846816 16 Nurse Practitioners VOYDA BRITTNEY S 999999999 107 Will 0 0 0 0 0 1 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 28 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 531.67 0 0 0 0 0 0 700.91 0 0 1005897993 1215292933 10 Physicians GERDELMAN GRANT 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 0 145 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 5603.2 0 0 0 0 0 0 5603.2 0 0 1005897994 1659668804 10 Physicians GUPTA RAGHAV 999999999 106 Whiteside 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 163 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 6275 0 0 0 0 0 0 6275 0 0 1005900023 1164783619 10 Physicians NEWMAN JAMES P 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 79 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 0 0 6645.78 0 0 0 0 0 0 6645.78 0 0 1005900368 1245775147 16 Nurse Practitioners ORJI JULIET 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 1930.63 0 0 0 0 0 0 1930.63 0 0 1005900704 1871023341 16 Nurse Practitioners SHEAHAN THERESA M 999999999 109 Winnebago 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 0 529 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 5635.87 0 0 0 0 0 0 5635.87 0 0 1005900802 1114448578 11 Dentists MAGALLANES JACQUELINE 999999999 200 Cook 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842.36 0 0 0 0 0 0 842.36 0 0 1005902627 1215371810 10 Physicians TAN AINAH 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.27 0 359.47 0 0 0 0 0 0 400.74 0 0 1005902666 1588079966 10 Physicians KENNEDY MICHAEL R 999999999 200 Cook 0 0 Emergency 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 0 109 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 4070.57 0 0 0 0 0 0 4070.57 0 0 1005903084 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 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 0 984 0 0 0 0 0 0 0 0 0 0 0 0 0 984 0 0 1005903158 1891006276 10 Physicians VAN STRATEN MARTA M 999999999 60 Lee 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 0 122 0 0 0 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10 Physicians ARSHAD KHALID 999999999 54 Kankakee 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28229.09 0 0 0 0 0 0 28229.09 0 0 1005914916 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 38168.22 0 0 0 0 0 0 0 0 0 0 0 0 0 38168.22 0 0 1005915204 1861491599 10 Physicians SMITH MICHAEL J 999999999 82 Piatt 0 0 Emergency Medicine 0 0 0 42 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 249.6 0 0 0 0 0 0 0 0 4944.6 0 0 0 0 0 0 5194.2 0 0 1005915427 1174947204 30 General Hospitals WEST SIDE DIALYSIS 999999999 200 Cook 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1438.55 0 0 0 0 0 0 1438.55 0 0 1005916901 1366767766 10 Physicians SAPPINGTON JOSHUA 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 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 0 278.2 0 0 0 0 0 0 278.2 0 0 1005917425 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 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 5.31 0 0 0 0 0 0 5.31 0 0 1005917784 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13085.04 0 0 0 0 0 0 0 0 0 0 0 0 0 13085.04 0 0 1005917792 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4004.88 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Internal Medicine 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 0 453 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 6099.26 0 0 0 0 0 0 6099.26 0 0 1005924149 1780971523 13 Podiatrists SIDDIQUI BILAL 999999999 57 Lake 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 0 362 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 1738.76 0 0 0 0 0 0 1738.76 0 0 1005924230 1255673364 10 Physicians DIKOPF MARK 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 10 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.72 0 8957.27 0 0 0 0 0 0 8999.99 0 0 1005924384 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 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 0 0 0 0 0 0 0 0 0 0 1005924427 1174816797 21 Licensed Practical Nurses BENN JO A 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0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 57.75 0 0 0 0 0 0 0 0 429.28 0 0 0 0 0 0 487.03 0 0 1005936633 86 Clinical Social Worker(Encounter Only) 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1938.49 0 0 0 0 0 0 1938.49 0 0 1005936645 1063938413 16 Nurse Practitioners WASHO AUDRA D 999999999 60 Lee 0 0 0 0 0 0 0 0 0 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 0 666.5 0 0 0 0 0 0 666.5 0 0 1005936943 1598950883 89 Physician Assistant Only(Encounter Only) GUARDIA ANDREW K 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 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 1415.33 0 0 0 0 0 0 1415.33 0 0 1005936946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.95 0 204.24 0 0 0 0 0 0 303.19 0 0 1005938342 1568993962 16 Nurse Practitioners YUNKER KRISTEN N 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 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 3022.32 0 0 0 0 0 0 3022.32 0 0 1005938381 1467999821 89 Physician Assistant Only(Encounter Only) LITTRELL DANIELLE 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 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 0 547.33 0 0 0 0 0 0 547.33 0 0 1005938397 1902142037 16 Nurse Practitioners GARCIA KYLE 999999999 200 Cook 0 0 0 0 0 11 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 1072.36 0 0 0 0 0 0 0 0 414.87 0 0 0 0 0 0 1487.23 0 0 1005938433 1023371499 10 Physicians DRYLEWICZ MONICA R 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 319.29 0 0 0 0 0 0 0 0 319.29 0 0 1005938477 10 Physicians 89 Rock Island 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1005938523 1467992974 16 Nurse Practitioners VROMAN SHELLY S 999999999 57 Lake 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 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1928.43 0 0 0 0 0 0 1928.43 0 0 1005938706 1073599767 10 Physicians BADEJO ERHIME T 999999999 47 Jackson 0 0 Family Practice 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 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 0 996.82 0 0 0 0 0 0 996.82 0 0 1005938896 1275950354 10 Physicians ROBERTS CHAD ALAN 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 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 1024.9 0 0 0 0 0 0 1024.9 0 0 1005938966 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.8 0 0 1005939059 1659809440 89 Physician Assistant Only(Encounter Only) ATKINSON TAYLOR RAE 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 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 0 260.29 0 0 0 0 0 0 260.29 0 0 1005939214 1437142197 16 Nurse Practitioners JANNISCH ERICA C 999999999 30 DuPage 0 0 0 0 0 12 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 987.6 0 0 0 0 0 0 0 0 749.26 0 0 0 0 0 0 1736.86 0 0 1005939664 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24517.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24517.68 0 0 1005939950 1336427863 10 Physicians NACHEF ZAHI 999999999 63 Macon 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 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7639.17 0 0 0 0 0 0 7639.17 0 0 1005940105 1467985853 88 Other behavior health professional SWIONTEK PATRICIA 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 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 0 644.31 0 0 0 0 0 0 644.31 0 0 1005940297 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 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 1005940337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24259.07 0 0 0 0 0 0 0 0 0 0 0 0 0 24259.07 0 0 1005940357 1073983789 16 Nurse Practitioners SCHEMBRI ELODIE 999999999 107 Will 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 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 2515.1 0 0 0 0 0 0 2515.1 0 0 1005940405 1508158239 10 Physicians REYFMAN PAUL A 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 0 281.7 0 0 0 0 0 0 281.7 0 0 1005940716 1558800813 16 Nurse Practitioners POIROT SARAH 999999999 91 Sangamon 0 0 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 0 100 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 14.6 0 0 0 0 0 0 0 0 2700.97 0 0 0 0 0 0 2715.57 0 0 1005940888 1326271743 10 Physicians RIZVI SYED M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 5 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.16 0 2028.79 0 0 0 0 0 0 2040.95 0 0 1005941365 1730440116 10 Physicians WODZIAK MATTHEW 999999999 200 Cook 0 0 Neurology 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 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 1006.07 0 0 0 0 0 0 1006.07 0 0 1005941368 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 1157.77 0 0 0 0 0 0 0 0 0 0 0 0 0 1157.77 0 0 1005941590 1114337805 10 Physicians PARIKH RONAK AMRISH 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 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 0 828.06 0 0 0 0 0 0 828.06 0 0 1005941751 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25170.72 0 0 0 0 0 0 0 0 0 0 0 0 0 25170.72 0 0 1005942183 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4807.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4807.22 0 0 1005942284 1639584733 10 Physicians IBAZEBO EBEHIREME E. 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 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 78.23 0 0 0 0 0 0 78.23 0 0 1005942316 1245606946 16 Nurse Practitioners DONALD KIMBERLEY 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 98.51 0 0 0 0 0 0 98.51 0 0 1005942397 89 Physician Assistant Only(Encounter Only) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1005942600 1801200837 10 Physicians ROYAL NICHOLAS J 999999999 19 Champaign 0 0 Family Practice 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 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 1415.23 0 0 0 0 0 0 1415.23 0 0 1005942725 1932465259 10 Physicians DETWILER KATHLEEN E 999999999 30 DuPage 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 0 271 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 2529.64 0 0 0 0 0 0 2529.64 0 0 1005942813 1023433745 16 Nurse Practitioners LEWIS MAGGIE D 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 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 0 217.84 0 0 0 0 0 0 217.84 0 0 1005942904 1437508371 10 Physicians KALAFUT KEVIN 999999999 107 Will 0 0 0 0 0 18 0 0 0 0 0 0 6 0 60 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 7 0 92 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 7 0 92 0 0 0 0 0 0 0 0 0 696.32 0 0 0 0 0 0 21 0 3678.38 0 0 0 0 0 0 4395.7 0 0 1005943092 4005943092 71 Medicar Provider CRIS RURAL MASS TRANSIT DISTRI 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1682.32 0 0 0 0 0 0 1682.32 0 0 1005943160 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1005943191 1497140917 16 Nurse Practitioners TUCKER SARAH R 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 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 0 104.96 0 0 0 0 0 0 0 0 2730.35 0 0 0 0 0 0 2835.31 0 0 1005943245 1396277406 10 Physicians PATEL CHIRAG 999999999 200 Cook 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 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.63 0 2254.11 0 0 0 0 0 0 2260.74 0 0 1005943285 1013154327 10 Physicians HUMAYUN WASAY 999999999 200 Cook 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 0 953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 953 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7952.73 0 0 0 0 0 0 7952.73 0 0 1005943930 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 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 1005944859 87 Psychologist(Encounter Only) 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 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 0 123.29 0 0 0 0 0 0 123.29 0 0 1005944901 1992051262 89 Physician Assistant Only(Encounter Only) SAINE MARK 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 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 1005944953 1952832891 10 Physicians HAEMER ZOE ELIZABETH 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 0 102 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 3745.36 0 0 0 0 0 0 3745.36 0 0 1005945154 1548581341 10 Physicians OVADIA AARON E 999999999 200 Cook 0 0 Urology 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.78 0 880.2 0 0 0 0 0 0 884.98 0 0 1005945253 1841581220 10 Physicians BLANK ALAN 999999999 200 Cook 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 75 0 0 0 0 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 0 0 6656.11 0 0 0 0 0 0 6656.11 0 0 1005945317 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10101.24 0 0 0 0 0 0 0 0 0 0 0 0 0 10101.24 0 0 1005945712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15468.76 0 0 0 0 0 0 0 0 0 0 0 0 0 15468.76 0 0 1005945728 1932136389 46 Ambulatory Surgical Treatment Centers THE 900 N MICHIGAN SURGICAL CE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 106.87 0 0 0 0 0 106.87 0 0 1005946076 1699943308 87 Psychologist(Encounter Only) LARSON ERIC B 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 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 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0 0 0 0 0 0 0 0 11162.37 0 0 1005983960 1194278929 16 Nurse Practitioners HASHIM MOHAMMED H 999999999 200 Cook 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 0 151 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 6127.06 0 0 0 0 0 0 6127.06 0 0 1005984216 1851812507 25 Audiologists BOYCE AMY L 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 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 0 274.02 274.02 0 0 1005984377 1477099646 60 Pharmacies ATHENS PHARMACY 626137665 73 Menard 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 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9328.47 0 0 0 9328.47 0 0 1005985134 1467993444 16 Nurse Practitioners WILLIAMS AISHAH F 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 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FRANCIS HOSP PROF BLDG PHA 602023450 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 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5646 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13913.09 0 0 0 13913.09 0 0 1005986037 1972845287 10 Physicians ZAHID SARWAR 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 5 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321.96 0 8842.19 0 0 0 0 0 0 9164.15 0 0 1005986106 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 0 0 0 0 0 0 0 0 0 0 1005986162 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7434.42 0 0 0 0 0 0 0 0 0 0 0 0 0 7434.42 0 0 1005986293 1487902847 10 Physicians RYBAK SABINA 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General Hospitals BELVIDERE DIALYSIS 999999999 13 Boone 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 78 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 11909.52 0 0 0 0 0 11909.52 0 0 1005987617 1861849721 29 ICF/MR WALSH HOME 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 14 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 9965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251045.31 0 0 0 0 0 0 0 0 0 0 1251045.31 0 0 1005987657 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4789.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4789.72 0 0 1005987851 1346781879 20 Registered nurse VAIDYA KELLIE 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 0 158 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 1689.37 0 0 0 0 0 0 1689.37 0 0 1005988039 1053847186 10 Physicians CARLSON-DEXTER PHILIP 999999999 109 Winnebago 0 0 0 0 0 12 0 0 0 0 0 0 11 0 52 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 17 0 151 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 17 0 151 0 0 0 0 0 0 0 0 0 2134.42 0 0 0 0 0 0 47.69 0 4214.52 0 0 0 0 0 0 6396.63 0 0 1005988602 1225424575 10 Physicians WESSEL SEAN ROBERT 999999999 200 Cook 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 0 130 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 3093.99 0 0 0 0 0 0 3093.99 0 0 1005988795 10 Physicians 200 Cook 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 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 0 972.45 0 0 0 0 0 0 972.45 0 0 1005988865 1104277607 10 Physicians CORKERY ANDREW 999999999 91 Sangamon 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9426.06 0 0 0 0 0 0 9426.06 0 0 1005989235 1851708408 10 Physicians RIZVI HIRA F 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 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 0 237.91 0 0 0 0 0 0 237.91 0 0 1005989282 1295286045 48 Rural Health Clinics MIDWEST HEALTH CLINIC OF ELIZA 999999999 51 Jo Daviess 0 0 0 59 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3810.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3810.04 0 0 1005989536 1225476302 10 Physicians WALSH JACLYN A 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 819.07 0 0 0 0 0 0 819.07 0 0 1005989735 1316986292 89 Physician Assistant Only(Encounter Only) SINGH NISHA 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 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 0 204.59 0 0 0 0 0 0 204.59 0 0 1005989746 1275991606 16 Nurse Practitioners HAMILTON NICOLE 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 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 1.93 0 0 0 0 0 0 1.93 0 0 1005989828 10 Physicians 89 Rock Island 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1005989833 1346228822 89 Physician Assistant Only(Encounter Only) WILLIAMS REGINA 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 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 0 539.73 0 0 0 0 0 0 539.73 0 0 1005990730 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18520.95 0 0 0 0 0 0 0 0 0 0 0 0 0 18520.95 0 0 1005990839 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 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 17947.11 0 0 0 0 0 0 0 0 0 0 0 0 0 17947.11 0 0 1005991064 1629070933 16 Nurse Practitioners RAHN SUSAN K 999999999 97 Stephenson 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 0 331 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 1858.4 0 0 0 0 0 0 1858.4 0 0 1005991248 1609280502 10 Physicians MANIEV DIANA 999999999 200 Cook 0 0 Pediatrics 0 0 0 3 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 122.67 0 0 0 0 0 0 78.5 0 558.33 0 0 0 0 0 0 759.5 0 0 1005991293 1407827751 16 Nurse Practitioners ENRIGHT CHRISTY L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968.36 0 0 0 0 0 0 968.36 0 0 1005992084 1568725521 10 Physicians ALEXANDER-ANYAOGU NICOLE K 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.14 0 9057.61 0 0 0 0 0 0 9063.75 0 0 1005992162 1235471251 10 Physicians GRIFFITH ALEXANDER 999999999 200 Cook 0 0 Anesthesiology 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 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 7290.74 0 0 0 0 0 0 7290.74 0 0 1005992415 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 0 120 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 11346.89 0 0 0 0 0 0 0 0 0 0 0 0 0 11346.89 0 0 1005992591 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23191.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23191.48 0 0 1005992601 1033558283 10 Physicians RIZZO ANTHONY 999999999 53 Kane 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 4 0 150 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 11 0 249 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 11 0 249 0 0 0 0 0 0 0 0 0 305.98 0 0 0 0 0 0 131.57 0 3335.48 0 0 0 0 0 0 3773.03 0 0 1005992611 1851406870 89 Physician Assistant Only(Encounter Only) GILBERTSON MICHAEL 999999999 109 Winnebago 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 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 0 381.61 0 0 0 0 0 0 381.61 0 0 1005992651 1255747002 10 Physicians RUB FARIHA 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 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 0 743.07 0 0 0 0 0 0 743.07 0 0 1005992715 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 6 0 0 0 1598 0 0 0 0 1570 0 0 0 1317 0 0 0 0 0 6 0 0 0 2418 0 0 0 0 1022 0 0 0 2957 0 0 0 0 0 12 0 0 0 2418 0 0 0 0 5314 0 0 0 2958 0 0 0 0 0 19.03 0 0 0 281245.97 0 0 0 0 2919773.84 0 0 0 429175.87 0 0 0 0 0 3630214.71 0 22899.2 1005992861 1750814349 52 Certified local public health department MACOUPIN COUNTY PUBLIC HEALTH 999999999 64 Macoupin 0 0 0 31 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410.69 0 500.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911.17 0 0 1005992940 1235668781 87 Psychologist(Encounter Only) HARNER OLIVIA B 606118709 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 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 86.73 0 0 0 0 0 0 86.73 0 0 1005993046 1659521037 22 Physical Therapists ROUNTREE LISA B 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53020.49 53020.49 0 0 1005993118 1518315241 10 Physicians JIN KINSLEY 999999999 200 Cook 0 0 Family Practice 0 0 0 5 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 46 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 86.37 0 0 0 0 0 0 0 0 507.98 0 0 0 0 0 0 594.35 0 0 1005993206 1225471915 10 Physicians KIRKPATRICK JAMES 999999999 87 Randolph 0 0 General 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 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 0 542.98 0 0 0 0 0 0 542.98 0 0 1005993273 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3294.72 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 1005994512 1205033156 10 Physicians SINGH RAMAN P 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 11 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.67 0 1494.93 0 0 0 0 0 0 1738.6 0 0 1005994558 1366708471 10 Physicians CORCORAN AMY R 999999999 200 Cook 0 0 Psychiatry 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 0 265 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 8280.44 0 0 0 0 0 0 8280.44 0 0 1005995213 1316190028 10 Physicians RIVERA GUERRERO JOSE F 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1148.66 0 0 0 0 0 0 1148.66 0 0 1005995366 1932376092 10 Physicians FISHMAN FELICITY 999999999 19 Champaign 0 0 Orthopedic Surgery 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 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 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0 1005996479 1336673243 16 Nurse Practitioners BLEZIEN MONICA 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 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 1139.67 0 0 0 0 0 0 1139.67 0 0 1005996691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 634.92 0 0 0 0 0 0 0 0 0 0 0 0 0 634.92 0 0 1005996769 1255694170 10 Physicians KESSLER VEAR ALLISON B 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.95 0 6148.36 0 0 0 0 0 0 6165.31 0 0 1005997164 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 0 180 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 15042.72 0 0 0 0 0 0 0 0 0 0 0 0 0 15042.72 0 0 1005997319 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 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 2409.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2409.44 0 0 1005997390 1902350499 16 Nurse Practitioners SCHNEPPER KRISTINA M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 689.04 0 0 0 0 0 0 689.04 0 0 1005997397 1144452624 88 Other behavior health professional SULLIVAN STEVEN 999999999 89 Rock Island 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 0 182 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 2468.89 0 0 0 0 0 0 2468.89 0 0 1005997448 10 Physicians 96 St Clair 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 15 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 5217.78 0 0 1005998317 1912298571 10 Physicians PETKOVIC DJURO 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 42 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 410.98 0 526.44 0 0 0 0 0 0 937.42 0 0 1005998880 1760765887 10 Physicians PHILLIPS MOLLY KATHRYN 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 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 8397.19 0 0 0 0 0 0 8397.19 0 0 1005999053 1538470612 10 Physicians CHU AMANDA 999999999 97 Stephenson 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 112.56 0 0 0 0 0 0 0 0 112.56 0 0 1005999233 1427595156 16 Nurse Practitioners TASE FLORENTINA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 4271.4 0 0 0 0 0 0 4368 0 0 1005999237 1265886873 10 Physicians MCCORMACK MOLLY MARIE 999999999 200 Cook 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 0 158 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 6536.95 0 0 0 0 0 0 6536.95 0 0 1005999285 1205356821 10 Physicians JEBRAN ANWAR ANTOINE 999999999 200 Cook 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 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 0 580.83 0 0 0 0 0 0 580.83 0 0 1005999625 1164864625 10 Physicians LEE FRANCIS 999999999 19 Champaign 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 19 0 136 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 46 0 253 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 46 0 253 0 0 0 0 0 0 0 0 0 342.23 0 0 0 0 0 0 344.13 0 4522.05 0 0 0 0 0 0 5208.41 0 0 1006000135 1447692678 10 Physicians ROSAS EDWIN 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 0 305 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 3229.91 0 0 0 0 0 0 3229.91 0 0 1006000207 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 46.45 0 0 0 0 0 0 46.45 0 0 1006000556 86 Clinical Social Worker(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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1006000726 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 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 4344.29 0 0 0 0 0 0 0 0 0 0 0 0 0 4344.29 0 0 1006000928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 723.83 0 0 1006001140 16 Nurse Practitioners 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 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 0 673.09 0 0 0 0 0 0 673.09 0 0 1006001198 1316387947 10 Physicians RAW ALEXANDER 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 143 0 0 0 0 0 0 0 0 0 6.22 0 0 0 0 0 0 0 0 20581.02 0 0 0 0 0 0 20587.24 0 0 1006001206 1073784583 10 Physicians FARAH JAREER OTHAM BAKER 999999999 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 0 111 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 0 736.29 0 0 0 0 0 0 736.29 0 0 1006001522 1043304694 89 Physician Assistant Only(Encounter Only) WOLFINGER VICTORIA 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 4.81 0 0 0 0 0 0 4.81 0 0 1006001649 1780670141 89 Physician Assistant Only(Encounter Only) EVANS DIANA 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 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 0 453.04 0 0 0 0 0 0 453.04 0 0 1006001955 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 1006002124 1669910923 87 Psychologist(Encounter Only) WOLK-PHILLIPS GABRIELLE 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 0 108 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 0 0 0 0 0 0 0 0 0 0 1006002284 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2024.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2024.98 0 0 1006002524 1780022301 10 Physicians OVSEVITZ KATHERINE ELIZABETH 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 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 4867.52 0 0 0 0 0 0 4867.52 0 0 1006002587 1285952572 10 Physicians TEMIYAKARN LOYRIRK 999999999 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 91 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1569.83 0 2536.39 0 0 0 0 0 0 4106.22 0 0 1006002630 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 0 170.47 0 0 0 0 0 0 170.47 0 0 1006002728 1619325578 10 Physicians KOVARIK MADALYN 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 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 0 213.85 0 0 0 0 0 0 213.85 0 0 1006002880 1114011665 89 Physician Assistant Only(Encounter Only) HOLSTI SAMANTHA J 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 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 62.74 0 0 0 0 0 0 62.74 0 0 1006002935 1821309279 10 Physicians LAOHATHAI CHRISTOPHER 999999999 65 Madison 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1226.87 0 0 0 0 0 0 1226.87 0 0 1006003521 1790234045 10 Physicians ELKE DANIEL 999999999 92 Schuyler 0 0 Family Practice 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 0 131 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 2010.79 0 0 0 0 0 0 2010.79 0 0 1006003863 1518282797 10 Physicians GOODMAN BENJAMIN D 999999999 65 Madison 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 253.21 0 0 0 0 0 0 253.21 0 0 1006004044 1194741389 10 Physicians GRAY DANA A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 243 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5199.99 0 144.77 0 0 0 0 0 0 5344.76 0 0 1006004051 1841725611 86 Clinical Social Worker(Encounter Only) WERNER KATIE 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 0 128 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 6006.91 0 0 0 0 0 0 6006.91 0 0 1006004132 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 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 13540.8 0 0 0 0 0 0 0 0 0 0 0 0 0 13540.8 0 0 1006004306 1013163120 10 Physicians SINHA SWASTIK K 999999999 108 Williamson 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 7 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281.38 0 0 0 0 0 0 281.38 0 0 1006004693 1891180170 10 Physicians SABHAPATHY SURYA 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 0 164 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 8921.84 0 0 0 0 0 0 8921.84 0 0 1006004849 1134678048 16 Nurse Practitioners SWIGART LINDSEY 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 0 219.9 0 0 0 0 0 0 219.9 0 0 1006005250 10 Physicians 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 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 0 200 0 0 0 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MICHAEL 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 1 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 3292.56 0 0 0 0 0 0 3292.56 0 0 1006005954 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006005955 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 981.44 0 0 0 0 0 0 0 0 0 0 0 0 0 981.44 0 0 1006006089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23165.76 0 0 0 0 0 0 0 0 0 0 0 0 0 23165.76 0 0 1006006163 1386989549 89 Physician Assistant Only(Encounter Only) NEWGENT CASEY 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 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 0 431.09 0 0 0 0 0 0 431.09 0 0 1006006175 1649689282 10 Physicians WARREN ANDREW L 999999999 200 Cook 0 0 Radiology Diagnosis 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 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.08 0 66.41 0 0 0 0 0 0 127.49 0 0 1006006411 1427584259 16 Nurse Practitioners MESCHEWSKI MARIA 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 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 1798.16 0 0 0 0 0 0 1798.16 0 0 1006006431 86 Clinical Social Worker(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 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 0 150.6 0 0 0 0 0 0 150.6 0 0 1006006553 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.92 103.92 0 0 1006006857 1023363934 10 Physicians FERNANDES EDUARDO 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 3152.47 0 0 0 0 0 0 3152.47 0 0 1006006950 1811314792 10 Physicians SHAH ROHAN 999999999 200 Cook 0 0 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.3 0 2567.23 0 0 0 0 0 0 2657.53 0 0 1006006994 1548512262 10 Physicians KOU ANITA W 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 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 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42512.43 0 0 0 0 0 0 42512.43 0 0 1006007542 1013439777 16 Nurse Practitioners LIEFER KATHY L 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 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 0 180.7 0 0 0 0 0 0 180.7 0 0 1006008107 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 32.15 0 0 1006008123 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21196.56 0 0 0 0 0 0 0 0 0 0 0 0 0 21196.56 0 0 1006008171 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23114 0 0 0 0 0 0 0 0 0 0 0 0 0 23114 0 0 1006008306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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1006013056 1528508074 89 Physician Assistant Only(Encounter Only) HOWELL WESLEY R 999999999 47 Jackson 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 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2934.53 0 0 0 0 0 0 2934.53 0 0 1006013421 1083152359 75 Department of Alcohol and Substance Abuse Provider CORNERSTONE RECOVERING COMMUNI 999999999 200 Cook 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 0 182 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 14944.56 0 0 14944.56 0 0 1006013597 1043624760 10 Physicians QUINTANA PABLO N 999999999 200 Cook 0 0 Internal Medicine 0 0 0 2 0 0 0 0 0 0 2 0 60 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 134 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 134 0 0 0 0 0 0 0 0 0 171.3 0 0 0 0 0 0 11.47 0 5505.38 0 0 0 0 0 0 5688.15 0 0 1006013792 94 Waiver service provider--Children's support (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 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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 0 579.48 0 0 0 0 0 0 579.48 0 0 1006019368 1851818835 16 Nurse Practitioners GUEDE CYNTHIA I 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 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 0 341.95 0 0 0 0 0 0 341.95 0 0 1006019489 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4614.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4614.9 0 0 1006019547 1093268583 16 Nurse Practitioners BRASEL JULIE 999999999 49 Jefferson 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 0 101 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 9868.15 0 0 0 0 0 0 9868.15 0 0 1006019658 1720427230 10 Physicians CORONA CANDELARIO LAURA P 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 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0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6557.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6557.34 0 0 1006037571 1437470762 10 Physicians CASILLAS BERUMEN SERGIO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 7 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.17 0 2522.02 0 0 0 0 0 0 2537.19 0 0 1006038110 1568689511 86 Clinical Social Worker(Encounter Only) JENNINGS RUTH A 999999999 80 Peoria 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 0 119 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 6653.12 0 0 0 0 0 0 6653.12 0 0 1006038150 1154796902 16 Nurse Practitioners SLANA JEAN M. 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 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 2975.06 0 0 0 0 0 0 2975.06 0 0 1006038955 1699192690 10 Physicians CARVALHO PRISCILLA MEDEIROS 999999999 200 Cook 0 0 Pediatrics 0 0 0 17 0 0 0 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0 0 1006040200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15023.67 0 0 0 0 0 0 0 0 0 0 0 0 0 15023.67 0 0 1006040378 1629591854 11 Dentists TADAKAMALLA PRAMOD 999999999 72 McLean 0 0 General Dentistry 0 0 272 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 1323 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 36110.99 0 0 0 0 0 0 0 0 0 0 0 16935.75 0 0 0 0 53046.74 0 0 1006040443 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1117.81 0 0 0 0 0 0 1117.81 0 0 1006040509 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19895.13 0 0 0 0 0 0 0 0 0 0 0 0 0 19895.13 0 0 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TIMBERS KAY CHOW 999999999 54 Kankakee 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 4201.78 0 0 0 0 0 0 4201.78 0 0 1006045614 1679739866 10 Physicians NOWICKI SARA E 999999999 80 Peoria 0 0 Emergency 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 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 0 466.59 0 0 0 0 0 0 466.59 0 0 1006045740 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22865.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22865.26 0 0 1006045809 1164953352 16 Nurse Practitioners REED KELSEY L 999999999 91 Sangamon 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 0 108 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 2832.4 0 0 0 0 0 0 2832.4 0 0 1006046130 92 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0 0 0 0 0 0 6312.45 0 0 1006048647 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22603.92 0 0 0 0 0 0 0 0 0 0 0 0 0 22603.92 0 0 1006048690 1528516853 10 Physicians MOCAN MEHMET 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.2 0 10062.63 0 0 0 0 0 0 10081.83 0 0 1006048878 1073963344 10 Physicians TRAN ANN V 999999999 200 Cook 0 0 Family Practice 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 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5969.08 0 0 0 0 0 0 5969.08 0 0 1006049066 1538699558 10 Physicians HODGE DAVID 999999999 200 Cook 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 0 135 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 0 878.68 0 0 0 0 0 0 878.68 0 0 1006049448 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 25972.9 0 0 0 0 0 0 0 0 0 0 0 0 0 25972.9 0 0 1006050047 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 2306.89 0 0 0 0 0 0 2306.89 0 0 1006050130 1013303890 10 Physicians DAKIS KRISTINA EVELYN 999999999 80 Peoria 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 3 0 45 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 3 0 45 0 0 0 0 0 0 0 0 0 1248.09 0 0 0 0 0 0 2.58 0 1861.01 0 0 0 0 0 0 3111.68 0 0 1006050193 1124314349 10 Physicians GUJARATHI GAURANG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 638 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.02 0 4730.01 0 0 0 0 0 0 4797.03 0 0 1006050247 10 Physicians 80 Peoria 0 0 Family Practice 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 15.65 0 49.22 0 0 0 0 0 0 64.87 0 0 1006050275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8983.33 0 0 0 0 0 0 0 0 0 0 0 0 0 8983.33 0 0 1006050442 1770890162 89 Physician Assistant Only(Encounter Only) MUMBOWER BETHANY J 999999999 91 Sangamon 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 34 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 140.23 0 0 0 0 0 0 0 0 983.98 0 0 0 0 0 0 1124.21 0 0 1006050553 1174057269 16 Nurse Practitioners AL-KHENAIZI CHELSI E 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 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 2345.75 0 0 0 0 0 0 2345.75 0 0 1006050577 1679770069 10 Physicians MUZINICH MICHAEL C 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 682 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 862 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5359.48 0 289.29 0 0 0 0 0 0 5648.77 0 0 1006050689 1710115712 10 Physicians BROGAN DAVID M 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 16 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 4524.69 0 0 0 0 0 0 4524.69 0 0 1006050824 1548611296 10 Physicians FULKS TYLER 999999999 91 Sangamon 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 0 151 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 4033.09 0 0 0 0 0 0 4033.09 0 0 1006050995 1538166137 60 Pharmacies THE PHARMACIE SHOPPE 624201024 21 Clark 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 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0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49378.35 0 0 0 0 0 0 0 0 0 0 0 0 0 49378.35 0 0 1006054854 1457694481 13 Podiatrists JACOBY CORY 601234703 53 Kane 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 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 1796.31 0 0 0 0 0 0 1796.31 0 0 1006054959 1104196294 89 Physician Assistant Only(Encounter Only) GOOD JEREMY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 47.75 0 0 0 0 0 0 47.75 0 0 1006055307 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 1006055547 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 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 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IBEAWUCHI 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 0 106 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 0 944.17 0 0 0 0 0 0 944.17 0 0 1006065135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4169.46 0 0 0 0 0 0 0 0 0 0 0 0 0 4169.46 0 0 1006065199 1013356930 10 Physicians FORAY NATHALIE 999999999 91 Sangamon 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6183.76 0 0 0 0 0 0 6183.76 0 0 1006065320 1629285515 89 Physician Assistant Only(Encounter Only) HAM KAREN 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 0 130 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 63.03 0 0 0 0 0 0 63.03 0 0 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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 1637.08 0 0 0 0 0 0 1637.08 0 0 1006070025 1386716884 89 Physician Assistant Only(Encounter Only) PALMER JEREMY D 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 291.71 0 0 0 0 0 0 291.71 0 0 1006070055 10 Physicians 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 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 0 897.25 0 0 0 0 0 0 897.25 0 0 1006070111 1619320975 16 Nurse Practitioners AUSTIN GRACEANNA 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 67.3 0 0 0 0 0 0 67.3 0 0 1006070305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3777.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3777.99 0 0 1006079424 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.36 0 0 0 0 0 0 68.36 0 0 1006079545 1467652560 10 Physicians BALLARD DARREN 999999999 57 Lake 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4715.37 0 0 0 0 0 0 4715.37 0 0 1006079747 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12748.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12748.37 0 0 1006079783 89 Physician Assistant Only(Encounter Only) 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 1006079909 1104826361 89 Physician Assistant Only(Encounter Only) BARTZ CHRISTINA 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 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 62.47 0 0 0 0 0 0 62.47 0 0 1006079977 1134564651 89 Physician Assistant Only(Encounter Only) OHEATH ERIN K 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 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 0 159.48 0 0 0 0 0 0 159.48 0 0 1006080757 10 Physicians 107 Will 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 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 0 673.71 0 0 0 0 0 0 673.71 0 0 1006080817 1891225611 10 Physicians POTTS JOELLE 999999999 200 Cook 0 0 Family Practice 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 1057.51 0 0 0 0 0 0 1086.99 0 0 1006080889 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 0 222 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 48703.72 0 0 0 0 0 0 0 0 0 0 0 0 0 48703.72 0 0 1006081199 1568781177 86 Clinical Social Worker(Encounter Only) MILLER SEAN A 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 1456.68 0 0 0 0 0 0 1456.68 0 0 1006081436 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24961.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24961.42 0 0 1006081595 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 33.95 0 0 0 0 0 0 33.95 0 0 1006081812 1467871087 10 Physicians MULLEN C. MICHAEL 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 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 5591.57 0 0 0 0 0 0 5591.57 0 0 1006081917 1295001907 10 Physicians PARKER ELLEN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 12 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 1218.71 0 0 0 0 0 0 0 0 2237.33 0 0 0 0 0 0 3456.04 0 0 1006082415 1508833039 10 Physicians ARBONA JOSE A 999999999 80 Peoria 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 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 0 412.94 0 0 0 0 0 0 412.94 0 0 1006082499 1831506559 10 Physicians BROTON VERONICA 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 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 0 973.15 0 0 0 0 0 0 973.15 0 0 1006082586 1194999409 87 Psychologist(Encounter Only) GUSTAFSON KELLY 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 731.36 0 0 0 0 0 0 731.36 0 0 1006082696 1972919702 13 Podiatrists HOOK JONATHAN L 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 0 473 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 2620.75 0 0 0 0 0 0 2620.75 0 0 1006083072 1275086324 16 Nurse Practitioners SEATON SARAH A 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 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 99.86 0 0 0 0 0 0 99.86 0 0 1006083141 1811331374 10 Physicians KRISHNA HEMA 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 0 142 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 4332.41 0 0 0 0 0 0 4332.41 0 0 1006083427 1952759623 60 Pharmacies "MICHELLE'S PHARMACY, INC" 620141480 64 Macoupin 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 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7596.83 0 0 0 7596.83 0 0 1006083438 1801330717 16 Nurse Practitioners CREDEDIO KRISTY M 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 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 0 117.04 0 0 0 0 0 0 117.04 0 0 1006083465 1942372537 89 Physician Assistant Only(Encounter Only) GRAF JASON J 999999999 200 Cook 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 1227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3474.71 0 0 0 0 0 0 3474.71 0 0 1006083605 1285077453 10 Physicians DJONDO DANIEL P 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.54 0 5768.11 0 0 0 0 0 0 5779.65 0 0 1006083706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34070.52 0 0 0 0 0 0 0 0 0 0 0 0 0 34070.52 0 0 1006083754 1992149041 10 Physicians ZARZOUR AHMAD 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 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 1501.99 0 0 0 0 0 0 1501.99 0 0 1006083882 1871752394 10 Physicians MARTINEZ-SUAREZ HUMBERTO 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 10 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.76 0 1691.19 0 0 0 0 0 0 1704.95 0 0 1006084246 1619262474 10 Physicians DAGHFAL MEGAN 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 667 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15251.03 0 946.61 0 0 0 0 0 0 16197.64 0 0 1006084561 1255711370 10 Physicians TAPSCOTT DAVID C 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 25 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.63 0 2072.41 0 0 0 0 0 0 2459.04 0 0 1006084666 1235429085 10 Physicians OAKLEY FREDRICK D 999999999 80 Peoria 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 0 110 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 0 956.56 0 0 0 0 0 0 0 0 956.56 0 0 1006084709 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6918.75 0 0 0 0 0 0 0 0 0 0 0 0 0 6918.75 0 0 1006084719 1720425655 11 Dentists LIN CHAN 999999999 29 Douglas 0 0 General Dentistry 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68000.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68000.82 0 0 1006084733 1790120293 10 Physicians KILGORE KELLI M 999999999 57 Lake 0 0 Obstetric-Gynecology 0 0 0 2 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 171.3 0 0 0 0 0 0 0 0 353.09 0 0 0 0 0 0 524.39 0 0 1006084811 1396839031 16 Nurse Practitioners MARTINEK DONNA L 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 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 0 455.63 0 0 0 0 0 0 455.63 0 0 1006084893 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4973.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4973.74 0 0 1006084955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22509.37 0 0 0 0 0 0 0 0 0 0 0 0 0 22509.37 0 0 1006085184 1497096978 10 Physicians FULLMER RODNEY M 999999999 30 DuPage 0 0 Emergency Medicine 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 0 201 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 4474.13 0 0 0 0 0 0 4474.13 0 0 1006085625 1699207985 16 Nurse Practitioners WARDELL JULIE 999999999 106 Whiteside 0 0 0 0 0 2 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 44.95 0 0 0 0 0 0 0 0 996.85 0 0 0 0 0 0 1041.8 0 0 1006085974 1922543917 28 Waiver service provider--Supportive living facility (HFS) MONTCLARE SUPPORTIVE LIVING CO 606232327 200 Cook 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 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 486208.42 0 0 0 0 0 0 0 0 0 0 0 0 0 486208.42 0 0 1006086034 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7898.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7898.74 0 0 1006086197 1043741234 16 Nurse Practitioners SESTAK JESSICA M 999999999 91 Sangamon 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 0 102 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 1475.91 0 0 0 0 0 0 1475.91 0 0 1006086998 1063896819 10 Physicians CHAKRABARTY ARINDAM C 999999999 91 Sangamon 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 0 482 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 16067.8 0 0 0 0 0 0 16067.8 0 0 1006087093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23539.56 0 0 0 0 0 0 0 0 0 0 0 0 0 23539.56 0 0 1006087330 1114224391 10 Physicians SCHLANSER VICTORIA L 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 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 1313.68 0 0 0 0 0 0 1313.68 0 0 1006087540 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 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 2028.25 0 0 0 0 0 0 2028.25 0 0 1006087581 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10738.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10738.6 0 0 1006087621 1093772543 10 Physicians SEMIN MICHELE D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 46 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637.11 0 36.98 0 0 0 0 0 0 674.09 0 0 1006087998 87 Psychologist(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006088484 1609102631 89 Physician Assistant Only(Encounter Only) PEART MELISSA 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 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 1006088597 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 0 115 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 9602.18 0 0 0 0 0 0 0 0 0 0 0 0 0 9602.18 0 0 1006088703 1952852535 11 Dentists AHMED MOHAMMED 999999999 89 Rock Island 0 0 General Dentistry 0 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15784.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15784.15 0 0 1006088926 1205353786 16 Nurse Practitioners BECKER KRISTI 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 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 4105.91 0 0 0 0 0 0 4105.91 0 0 1006088976 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 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 1323.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1323.7 0 0 1006089495 1073677886 12 Optometrists BERRY BRIAN P 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 0 965.49 0 0 0 0 0 0 965.49 0 0 1006089591 1740570035 10 Physicians WU ALEX C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 487 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 884 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12181.78 0 130 0 0 0 0 0 0 12311.78 0 0 1006089774 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23023.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23023.7 0 0 1006090687 10 Physicians 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006090870 1013303221 16 Nurse Practitioners HOUSE AMANDA 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 0 182 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 1308.3 0 0 0 0 0 0 1308.3 0 0 1006090928 1942354642 30 General Hospitals PRESENCE SAINTS MARY & ELIZABE 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 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 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MIETELSKI MEGAN E 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440.01 0 4694.14 0 0 0 0 0 0 5134.15 0 0 1006103315 1821382946 10 Physicians JOONG ANNA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 19 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 6367.58 0 0 0 0 0 0 6367.58 0 0 1006103592 1477984656 89 Physician Assistant Only(Encounter Only) DUST THOMAS 999999999 24 Coles 0 0 0 0 0 1 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 289 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 5057.67 0 0 0 0 0 0 5069.67 0 0 1006103786 1639603814 16 Nurse Practitioners HOOLE DEANNA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.05 0 0 0 0 0 0 1074.05 0 0 1006104017 1073842993 89 Physician Assistant Only(Encounter Only) ROLAND AUTUMN R 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.12 0 0 0 0 0 0 81.12 0 0 1006104111 1598105827 89 Physician Assistant Only(Encounter Only) LIM JENNIFER S 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 71.87 0 0 0 0 0 0 71.87 0 0 1006104138 1619172947 10 Physicians PHILLIPS MATHEW 999999999 49 Jefferson 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 195 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4506.22 0 3319.77 0 0 0 0 0 0 7825.99 0 0 1006104319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16457.84 0 0 0 0 0 0 0 0 0 0 0 0 0 16457.84 0 0 1006104456 1407397284 16 Nurse Practitioners KIERBS AMANDA L 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 0 136 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 1541.61 0 0 0 0 0 0 1541.61 0 0 1006104503 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 0 153.96 0 0 0 0 0 0 153.96 0 0 1006104611 1821432261 10 Physicians WHITE MARTIN 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 0 188 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 1967.58 0 0 0 0 0 0 1967.58 0 0 1006104707 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2291.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.45 0 0 1006104720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9319.56 0 0 0 0 0 0 0 0 0 0 0 0 0 9319.56 0 0 1006104903 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 4151.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4151.25 0 0 1006104914 1619417979 60 Pharmacies THE NEW ROSELAND OUTPATIENT PH 999999999 200 Cook 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 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4581.05 0 0 0 4581.05 0 0 1006105048 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21733.04 0 0 0 0 0 0 0 0 0 0 0 0 0 21733.04 0 0 1006105079 1487010534 16 Nurse Practitioners HOMECGOY IMELDA 999999999 104 Wayne 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 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7396.07 0 0 0 0 0 0 7396.07 0 0 1006105186 1922462647 10 Physicians ABDUL-KAFI OWAIS 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 0 509.46 0 0 0 0 0 0 509.46 0 0 1006105189 1518407204 16 Nurse Practitioners MAGERL THOMAS S 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 10 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 202.21 0 0 0 0 0 0 0 0 1476.98 0 0 0 0 0 0 1679.19 0 0 1006105460 89 Physician Assistant Only(Encounter Only) 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006105984 1457582231 10 Physicians CHIOFFE MICHAEL A 999999999 24 Coles 0 0 Orthopedic Surgery 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 0 274 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 12213.38 0 0 0 0 0 0 12213.38 0 0 1006106015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 1006106304 1326345372 10 Physicians FALCO DANIEL ANTHONY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 181 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5138.31 0 2211.58 0 0 0 0 0 0 7349.89 0 0 1006106316 1174929335 89 Physician Assistant Only(Encounter Only) BAUMGART NORA 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 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 25.99 0 0 0 0 0 0 25.99 0 0 1006107106 1619400447 16 Nurse Practitioners DAUGHERTY KELLI A 999999999 80 Peoria 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 0 131 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 9838.77 0 0 0 0 0 0 9853.37 0 0 1006107298 1366994006 60 Pharmacies CAREPLUS DISCOUNT PHARMACY 999999999 200 Cook 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 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85667.54 0 0 0 85667.54 0 0 1006107471 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 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 0 204.59 0 0 0 0 0 0 204.59 0 0 1006107630 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 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 1006107978 1619352374 55 Early Intervention Services BART ANNA M 999999999 98 Tazewell 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 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33532.45 0 0 0 0 0 0 33532.45 0 0 1006107981 1386601185 10 Physicians CABELIN MARK A 999999999 35 Ford 0 0 Urology 0 0 0 0 0 0 0 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 0 920.36 0 0 0 0 0 0 920.36 0 0 1006108059 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 216.85 0 0 0 0 0 0 0 0 0 0 0 0 0 216.85 0 0 1006108074 1457446668 86 Clinical Social Worker(Encounter Only) KOSNICK CYNTHIA 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 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 2818.92 0 0 0 0 0 0 2818.92 0 0 1006108144 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 0 127.32 0 0 0 0 0 0 127.32 0 0 1006108150 1104844620 16 Nurse Practitioners BROWN KAREN S 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 71.28 0 0 0 0 0 0 71.28 0 0 1006108271 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 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 1249.44 0 0 0 0 0 0 1249.44 0 0 1006108281 1811282742 89 Physician Assistant Only(Encounter Only) BURRESS AMANDA M 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 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 0 484.31 0 0 0 0 0 0 484.31 0 0 1006108573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5511.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5511.75 0 0 1006108582 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 39.63 0 0 0 0 0 0 39.63 0 0 1006108602 1699297606 10 Physicians AUE MATTHEW G 999999999 109 Winnebago 0 0 Family Practice 0 0 0 13 0 0 0 0 0 0 4 0 42 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 4 0 55 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 4 0 55 0 0 0 0 0 0 0 0 0 727.7 0 0 0 0 0 0 23.84 0 1334.4 0 0 0 0 0 0 2085.94 0 0 1006108798 1811271935 89 Physician Assistant Only(Encounter Only) GALLOW KRISTINA K 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 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 0 258.71 0 0 0 0 0 0 258.71 0 0 1006108975 1194188383 89 Physician Assistant Only(Encounter Only) LEWIS RYAN G 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 229.72 0 0 0 0 0 0 229.72 0 0 1006108995 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006109245 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 0 229.01 0 0 0 0 0 0 229.01 0 0 1006109248 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 30.87 0 0 0 0 0 0 30.87 0 0 1006109617 1831486281 10 Physicians HOLBROOK CHRISTOPHER THOMAS 999999999 200 Cook 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 0 217 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 3215.47 0 0 0 0 0 0 3215.47 0 0 1006109675 16 Nurse Practitioners 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 1006110315 1205240538 10 Physicians BRANCHECK JOSEPH 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 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 0 230.7 0 0 0 0 0 0 230.7 0 0 1006110350 1750625562 16 Nurse Practitioners VENTURELLA VICTORIA M. 999999999 200 Cook 0 0 0 0 0 1 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 9 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 207.9 0 0 0 0 0 0 220.7 0 0 1006110364 1972056869 16 Nurse Practitioners FASIG SHANNON L 999999999 91 Sangamon 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 0 940.92 0 0 0 0 0 0 940.92 0 0 1006110402 1528384278 10 Physicians SRIVASTAVA ANAND NAND 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 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 0 156.28 0 0 0 0 0 0 156.28 0 0 1006110575 1144458126 10 Physicians MATHEW SHAKILA 999999999 30 DuPage 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 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 1348.02 0 0 0 0 0 0 1348.02 0 0 1006110854 80 Prepaid health plan--Health maintenance organization BLUE CROSS AND BLUE SHIELD OF 60601 200 Cook 0 0 "421,123" 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2280311299 0 1006110964 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 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 4564.38 0 0 0 0 0 0 0 0 0 0 0 0 0 4564.38 0 0 1006111145 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6108.48 0 0 0 0 0 0 0 0 0 0 0 0 0 6108.48 0 0 1006111619 1376846220 89 Physician Assistant Only(Encounter Only) HENDEE RACHEL 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 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 0 378.07 0 0 0 0 0 0 378.07 0 0 1006112074 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 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 1006112241 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24982.77 0 0 0 0 0 0 0 0 0 0 0 0 0 24982.77 0 0 1006112492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6815.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6815.09 0 0 1006112516 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006112595 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1006113109 1447538467 10 Physicians DALAL JANUSHI H 999999999 200 Cook 0 0 Radiology Diagnosis 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 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 208.08 0 0 0 0 0 0 0 0 208.08 0 0 1006113362 1083141493 36 Community mental health provider ST. MARY ST. ELIZABETH MEDICAL 999999999 200 Cook 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 1382.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4794.23 0 0 6177.01 0 0 1006113568 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1006113674 1548714041 16 Nurse Practitioners DEJAYNES JESSICA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497.99 0 0 0 0 0 0 497.99 0 0 1006113680 1962813907 10 Physicians AHSAN ALYA N. 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 0 185 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 2233.08 0 0 0 0 0 0 2233.08 0 0 1006113686 1083145262 16 Nurse Practitioners BROWNLEE MAURICE 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 0 116 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 8082.34 0 0 0 0 0 0 8082.34 0 0 1006114116 1194261479 16 Nurse Practitioners JOHNSON TARA 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 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 0 324.76 0 0 0 0 0 0 324.76 0 0 1006114426 1669739371 10 Physicians SLADE DAVID 999999999 200 Cook 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 0 186 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 2700.14 0 0 0 0 0 0 2700.14 0 0 1006114883 1194089334 10 Physicians WILLIAMS DOMINIQUE S 999999999 826 Missouri 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 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 0 196.58 0 0 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12486.55 0 0 0 0 0 0 0 0 0 0 0 0 0 12486.55 0 0 1006117135 1124381926 10 Physicians ROBINSON SYLVIA MARIE 999999999 200 Cook 0 0 Pediatrics 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 6 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.8 0 3382.39 0 0 0 0 0 0 3420.19 0 0 1006117286 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12860.25 0 0 0 0 0 0 0 0 0 0 0 0 0 12860.25 0 0 1006117462 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006117551 1073965729 60 Pharmacies PROPEL PHARMACY LLC 999999999 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 2994 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2317.13 0 0 0 2317.13 0 0 1006117746 1134448665 10 Physicians PEARSON ALEXANDER T 999999999 30 DuPage 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 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 0 356.16 0 0 0 0 0 0 356.16 0 0 1006117962 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 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 1591.64 1591.64 0 0 1006118441 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 49.22 0 0 0 0 0 0 49.22 0 0 1006118676 10 Physicians 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 0 107.74 0 0 0 0 0 0 107.74 0 0 1006119016 91 Waiver service 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10057.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10057.41 0 0 1006119779 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 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 1006119808 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37280.87 0 0 0 0 0 0 0 0 0 0 0 0 0 37280.87 0 0 1006119838 1174686893 10 Physicians KARCIOGLU AMANDA S. 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 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 1716.18 0 0 0 0 0 0 1716.18 0 0 1006119894 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27700.75 0 0 0 0 0 0 0 0 0 0 0 0 0 27700.75 0 0 1006119969 1508066192 10 Physicians BAQAI ATIF 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 11 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.2 0 4960.06 0 0 0 0 0 0 5006.26 0 0 1006120043 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3462.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3462.47 0 0 1006120068 1063660074 89 Physician Assistant Only(Encounter Only) CLARK NATHANIEL E 999999999 47 Jackson 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 0 190 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 0 961.48 0 0 0 0 0 0 961.48 0 0 1006120199 1144462797 10 Physicians DORROH COLBY P 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 377.17 0 0 0 0 0 0 377.17 0 0 1006120573 1427578319 16 Nurse Practitioners UZELAC LYNN 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 0 146 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 5865.8 0 0 0 0 0 0 5865.8 0 0 1006121155 1326321233 10 Physicians SADDLETON ELISE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 28 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500.96 0 847.62 0 0 0 0 0 0 1348.58 0 0 1006121656 1225365794 16 Nurse Practitioners CORRIGAN CAREN 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 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 0 262.09 0 0 0 0 0 0 262.09 0 0 1006122199 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10495.73 0 0 0 0 0 0 0 0 0 0 0 0 0 10495.73 0 0 1006122201 1073055885 16 Nurse Practitioners BARR LORING 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 19.32 0 0 0 0 0 0 19.32 0 0 1006122382 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26157.12 0 0 0 0 0 0 0 0 0 0 0 0 0 26157.12 0 0 1006122710 1124187232 16 Nurse Practitioners SHOTWELL JULIE 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 0 553.36 0 0 0 0 0 0 553.36 0 0 1006122790 1386061232 10 Physicians PENA CHAVEZ SAMANTHA R 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 5689.11 0 0 0 0 0 0 5718.59 0 0 1006122856 1710326038 10 Physicians RICHARDSON GREGORY D 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.01 0 7802.45 0 0 0 0 0 0 7844.46 0 0 1006122913 10 Physicians 90 Saline 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 1006122976 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 0 146 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 23225.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23225.29 0 0 1006123033 1275976094 10 Physicians SHIPP ZACHARY J 999999999 63 Macon 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 0 108 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 1628.78 0 0 0 0 0 0 1628.78 0 0 1006123046 1598059438 10 Physicians SOSNOWSKI CYNDI R 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 12 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355.88 0 9485.28 0 0 0 0 0 0 9841.16 0 0 1006123255 1588004881 10 Physicians AHMAD USMAN 999999999 106 Whiteside 0 0 Family Practice 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 0 153 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 2132.43 0 0 0 0 0 0 2132.43 0 0 1006123331 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 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 1352.48 1352.48 0 0 1006123645 1114479052 89 Physician Assistant Only(Encounter Only) CLARK JENNIFER E 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2283.77 0 0 0 0 0 0 2283.77 0 0 1006123862 1598168221 22 Physical Therapists LITVIN ANNA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1658 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1658 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14771.38 14771.38 0 0 1006123920 1609315407 33 Nursing Facilities STONEBRIDGE NURSING & REHABILI 628123413 36 Franklin 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 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306148.4 0 0 0 0 0 0 0 306148.4 0 0 1006123936 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 0 165.62 0 0 0 0 0 0 165.62 0 0 1006124365 1942649819 10 Physicians RUEBHAUSEN MICHAEL R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 2724.99 0 0 0 0 0 0 2724.99 0 0 1006124378 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 48.57 0 0 0 0 0 0 48.57 0 0 1006124604 1073045266 10 Physicians LEPAGE KATHRYN R 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 426.74 0 0 0 0 0 0 426.74 0 0 1006124949 1386069607 89 Physician Assistant Only(Encounter Only) BUSHEMI CARA A 999999999 200 Cook 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006125522 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 0 0 0 0 0 0 0 71.9 0 0 1006125673 91 Waiver service provider--Adults (DHS/DDD) 47 Jackson 0 0 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 5290.04 0 0 0 0 0 0 0 0 0 0 0 0 0 5290.04 0 0 1006125689 10 Physicians 80 Peoria 0 0 Vascular 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 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 0 103.17 0 0 0 0 0 0 103.17 0 0 1006125739 1659801629 11 Dentists GASS CODY 999999999 24 Coles 0 0 General Dentistry 0 0 235 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 0 0 0 0 0 0 0 0 0 0 0 0 1244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Only(Encounter Only) TERRILL RACHEL 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 336.9 0 0 0 0 0 0 336.9 0 0 1006128752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 44197.65 0 0 0 0 0 0 0 0 0 0 0 0 0 44197.65 0 0 1006129105 1205221587 16 Nurse Practitioners JOHNSON JENNIFER 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 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 0 142.56 0 0 0 0 0 0 142.56 0 0 1006129258 1174903793 10 Physicians RANGANATHAN MANJARI 999999999 30 DuPage 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 19.17 0 0 0 0 0 0 0 0 413.83 0 0 0 0 0 0 433 0 0 1006129278 10 Physicians 10 Adams 0 0 Neurology 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1458.92 0 0 0 0 0 0 1458.92 0 0 1006129407 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1006129633 1538540679 10 Physicians SMITH MATTHEW 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804.01 0 0 0 0 0 0 804.01 0 0 1006129934 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777.68 0 0 0 0 0 0 777.68 0 0 1006130070 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.8 0 0 0 0 0 0 0 0 0 0 0 0 0 86.8 0 0 1006130380 1164711081 10 Physicians SCHIRO ADAM J 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 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 1508.55 0 0 0 0 0 0 1508.55 0 0 1006130825 1760758353 10 Physicians CHERNAIK JONATHAN D. 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 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 3611.91 0 0 0 0 0 0 3611.91 0 0 1006130929 1134660590 16 Nurse Practitioners ZERRUSEN KENDRA L 999999999 96 St Clair 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 0 340.78 0 0 0 0 0 0 340.78 0 0 1006130999 86 Clinical Social Worker(Encounter Only) 64 Macoupin 0 0 0 0 0 0 0 0 0 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 0 965.77 0 0 0 0 0 0 965.77 0 0 1006131133 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 792.68 0 0 0 0 0 0 0 0 0 0 0 0 0 792.68 0 0 1006131363 1699059238 10 Physicians JONES APRIL D 999999999 30 DuPage 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 10966.18 0 0 0 0 0 0 10966.18 0 0 1006131617 1538461728 10 Physicians KHAN ASMA M 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 0 121 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 5929.6 0 0 0 0 0 0 5929.6 0 0 1006131689 1538599782 16 Nurse Practitioners RAGUSA MARIA A 999999999 53 Kane 0 0 0 0 0 36 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 3123.8 0 0 0 0 0 0 0 0 1700.42 0 0 0 0 0 0 4824.22 0 0 1006131732 1093123432 89 Physician Assistant Only(Encounter Only) WANEZEK EMILY 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 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 0 841.55 0 0 0 0 0 0 841.55 0 0 1006131799 1174866917 10 Physicians KARAM JOSEPH 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 0 128 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 4070.4 0 0 0 0 0 0 4070.4 0 0 1006132046 1245433416 10 Physicians GANG GYU I 999999999 53 Kane 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12067.82 0 0 0 0 0 0 12067.82 0 0 1006132056 1285073080 10 Physicians HOVLAND REBEKAH A 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 15 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 1351.79 0 0 0 0 0 0 19.5 0 1798.88 0 0 0 0 0 0 3170.17 0 0 1006132683 1235455619 10 Physicians IMAM SYED F 999999999 80 Peoria 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 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3196.97 0 0 0 0 0 0 3196.97 0 0 1006132789 1043750540 16 Nurse Practitioners FARGHER NATALIE J 999999999 80 Peoria 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 0 109 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 1561.46 0 0 0 0 0 0 1561.46 0 0 1006133097 10 Physicians 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006133263 1902217938 10 Physicians BRADY ALEXANDRA K. 999999999 200 Cook 0 0 0 0 0 14 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 881.09 0 0 0 0 0 0 300.96 0 983.15 0 0 0 0 0 0 2165.2 0 0 1006133379 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 446.64 0 0 0 0 0 0 0 0 0 0 0 0 0 446.64 0 0 1006133429 1467592840 10 Physicians KUNREUTHER ELIZABETH P 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.24 0 1976.9 0 0 0 0 0 0 1997.14 0 0 1006133505 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 0 108 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 8058.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8058.6 0 0 1006133511 1801329578 16 Nurse Practitioners TANDEZ JULIA 999999999 53 Kane 0 0 0 0 0 9 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 17 0 0 0 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 1006133854 1265960520 10 Physicians PATEL BIANCA YOGESH 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 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 0 942.71 0 0 0 0 0 0 942.71 0 0 1006133921 1912195058 89 Physician Assistant Only(Encounter Only) ARICO CHRISTOPHER 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 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 0 893.16 0 0 0 0 0 0 893.16 0 0 1006134497 1205383197 48 Rural Health Clinics OSF MEDICAL GROUP-WASHINGTON S 613421471 58 La Salle 0 0 0 102 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10095.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10095.55 0 0 1006134656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8033.98 0 0 0 0 0 0 0 0 0 0 0 0 0 8033.98 0 0 1006134946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30735.12 0 0 0 0 0 0 0 0 0 0 0 0 0 30735.12 0 0 1006135005 1649712373 16 Nurse Practitioners DAVIDOV RAFIE D 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 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 0 401.86 0 0 0 0 0 0 401.86 0 0 1006135037 1518244714 89 Physician Assistant Only(Encounter Only) BANGERT JODI L 999999999 91 Sangamon 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 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 0 432.06 0 0 0 0 0 0 432.06 0 0 1006135333 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17276.91 0 0 0 0 0 0 0 0 0 0 0 0 0 17276.91 0 0 1006135893 1437260064 89 Physician Assistant Only(Encounter Only) GRABOW AUBREY E 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 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 0 261.58 0 0 0 0 0 0 261.58 0 0 1006135993 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9192.12 0 0 0 0 0 0 0 0 0 0 0 0 0 9192.12 0 0 1006136234 1427391168 10 Physicians DUROWADE TAIWO F 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 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 0 295.18 0 0 0 0 0 0 295.18 0 0 1006136801 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7537.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7537.64 0 0 1006136811 1851773188 16 Nurse Practitioners TRAN KELLY Q 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1006137370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23829.12 0 0 0 0 0 0 0 0 0 0 0 0 0 23829.12 0 0 1006137425 1891237095 16 Nurse Practitioners BALBARIN GRANT T 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 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 1869.86 0 0 0 0 0 0 1869.86 0 0 1006138365 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22640.77 0 0 0 0 0 0 0 0 0 0 0 0 0 22640.77 0 0 1006138390 1336436435 10 Physicians GREGORY STACIE 999999999 91 Sangamon 0 0 Otolaryngology 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 0 148 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 19680.36 0 0 0 0 0 0 19680.36 0 0 1006138672 1427578251 94 Waiver service provider--Children's support (DHS/DDD) LAM AI LING AMANDA 602014447 200 Cook 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 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 13554.6 0 0 0 0 0 0 0 0 0 0 0 0 0 13554.6 0 0 1006138784 1205374808 16 Nurse Practitioners BECKER ALAINA 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 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 2106.93 0 0 0 0 0 0 2106.93 0 0 1006139066 1235679978 16 Nurse Practitioners TALBOTT CAROLYN 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 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 0 141.3 0 0 0 0 0 0 141.3 0 0 1006139264 1942751664 89 Physician Assistant Only(Encounter Only) HARTNETT MICHELLE 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 56.4 0 0 0 0 0 0 56.4 0 0 1006139515 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26197.05 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.05 0 0 1006139873 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 398.86 0 0 0 0 0 0 0 0 0 0 0 0 0 398.86 0 0 1006139964 1467975052 11 Dentists DUKANWALA SUHEL 999999999 200 Cook 0 0 General Dentistry 0 0 34 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 4710.31 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 5463.01 0 0 1006139976 1255530119 10 Physicians AL-JANABI HASAN 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 0 187 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 3024.54 0 0 0 0 0 0 3024.54 0 0 1006140233 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10869.62 0 0 0 0 0 0 0 0 0 0 0 0 0 10869.62 0 0 1006140405 1710111331 10 Physicians IVY TRACY L 999999999 10 Adams 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 1722.27 0 0 0 0 0 0 1722.27 0 0 1006140519 1669913349 16 Nurse Practitioners GRUBB LAURA J 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612.28 0 0 0 0 0 0 612.28 0 0 1006141329 1710241328 13 Podiatrists RUSH KATI K 999999999 47 Jackson 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 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2323.91 0 0 0 0 0 0 2323.91 0 0 1006141533 1093007221 10 Physicians FITZGERALD DANIEL J 999999999 30 DuPage 0 0 General Practice 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 0 251 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 2609.18 0 0 0 0 0 0 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0 1006143196 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24192.08 0 0 0 0 0 0 0 0 0 0 0 0 0 24192.08 0 0 1006143309 1326277526 10 Physicians KEMP JOANNA 999999999 71 McHenry 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 7147.8 0 0 0 0 0 0 7147.8 0 0 1006143321 12 Optometrists 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.23 0 0 0 0 0 0 193.23 0 0 1006143689 1205378460 16 Nurse Practitioners RODRIGUEZ CAROLINE 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 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 0 164.44 0 0 0 0 0 0 164.44 0 0 1006143805 1467991265 33 Nursing Facilities CARRIER MILLS NURSING & REHABI 999999999 90 Saline 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 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887751.97 0 0 0 0 0 0 0 887751.97 0 0 1006143850 1811167489 87 Psychologist(Encounter Only) TREZONA RICHARD R 999999999 53 Kane 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 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 2087.5 0 0 0 0 0 0 2087.5 0 0 1006143965 1801238449 10 Physicians MEHTA ARJUN DEV 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 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 1001.81 0 0 0 0 0 0 1001.81 0 0 1006144253 1750675187 10 Physicians NAM JOO YEON 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 22 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11817.92 0 0 0 11817.92 0 0 1006148556 1487071940 10 Physicians GRAHAM HANNAH E 999999999 200 Cook 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 273.74 0 0 0 0 0 0 0 0 768.44 0 0 0 0 0 0 1042.18 0 0 1006149064 1982052932 10 Physicians YANG HANNAH HAINA 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 103 0 0 0 0 0 0 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 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4197.09 0 0 0 0 0 0 4197.09 0 0 1006150067 1699068767 10 Physicians BAGHMANLI ZIYA 999999999 80 Peoria 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 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 1689.04 0 0 0 0 0 0 1689.04 0 0 1006150877 1891016515 10 Physicians MIKHALKOVA DEANA 999999999 200 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622741538 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 2552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258962.59 0 0 0 0 0 0 0 258962.59 0 0 1006154604 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006154650 1164841631 10 Physicians RYBALKO DANIL 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 22 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.93 0 6877.35 0 0 0 0 0 0 7323.28 0 0 1006154798 1497299689 16 Nurse Practitioners CHAN SUZANNE 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 214 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 652 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 652 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 7213.65 0 0 0 0 0 0 7318.61 0 0 1006155037 1912220864 10 Physicians HAMSAKUTTY HARIS 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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 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 0 364.82 0 0 0 0 0 0 364.82 0 0 1006156012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10461.25 0 0 0 0 0 0 0 0 0 0 0 0 0 10461.25 0 0 1006156036 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1006156250 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 53610.5 0 0 0 0 0 0 0 0 0 0 0 0 0 53610.5 0 0 1006156284 1760757959 10 Physicians BURGER MAJOR A 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006156465 1477099935 16 Nurse Practitioners RUDER STANLEY 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 0 317 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 0 619.51 0 0 0 0 0 0 619.51 0 0 1006156692 1245693589 10 Physicians MURPHY PATRICK WILLIAM 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 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 35.38 0 0 0 0 0 0 0 0 35.38 0 0 1006156832 1538548235 14 Chiropractors STEGMAIER JAMES T 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488.33 0 0 0 0 0 0 488.33 0 0 1006157192 1629310073 10 Physicians KOVACEVIC JELENA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 6564.07 0 0 0 0 0 0 6595.08 0 0 1006157345 1295279503 75 Department of Alcohol and Substance Abuse Provider "FAMILY GUIDANCE CENTERS, INC." 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 3765.65 0 0 3765.65 0 0 1006157386 1033540646 10 Physicians SHERWANI UBAID 999999999 80 Peoria 0 0 Internal Medicine 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 0 130 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 3863.05 0 0 0 0 0 0 3863.05 0 0 1006157493 1588100952 16 Nurse Practitioners GROTE CHRISTINA M 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 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 0 771.08 0 0 0 0 0 0 771.08 0 0 1006157707 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 0 190 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 14110 0 0 0 0 0 0 0 0 0 0 0 0 0 14110 0 0 1006157931 1265798110 10 Physicians LEAVITT OLGA 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5990.74 0 0 0 0 0 0 5990.74 0 0 1006158120 1700090982 87 Psychologist(Encounter Only) BECKER KIMBERLY 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 0 388.43 0 0 0 0 0 0 388.43 0 0 1006158337 1558812057 30 General Hospitals FRESENIUS MEDICAL CARE PLAINFI 999999999 107 Will 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 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7976.6 0 0 0 0 0 7976.6 0 0 1006158716 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 0 149.21 0 0 0 0 0 0 149.21 0 0 1006158950 1467983486 16 Nurse Practitioners ODOM APRIL 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 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5262.11 0 0 0 0 0 0 5262.11 0 0 1006159084 1154878510 16 Nurse Practitioners RAFACZ EWA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 79 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 6.4 0 0 0 0 0 0 0 0 3178.32 0 0 0 0 0 0 3184.72 0 0 1006159350 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 14106.37 0 0 0 0 0 0 0 0 0 0 0 0 0 14106.37 0 0 1006159400 1770028078 16 Nurse Practitioners BOMMARITO MELISSA 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 1406.14 0 0 0 0 0 0 1406.14 0 0 1006159655 1760938815 16 Nurse Practitioners SCHAPPE ELIZABETH 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 0 192.76 0 0 0 0 0 0 192.76 0 0 1006159669 1205376720 89 Physician Assistant Only(Encounter Only) CARLSEN KATHLEEN 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 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 0 549.2 0 0 0 0 0 0 549.2 0 0 1006159725 1538248786 16 Nurse Practitioners KENNEDY HELEN B 999999999 91 Sangamon 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 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Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 887 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 8068.82 0 0 0 0 0 0 8071 0 0 1006160149 1396939559 16 Nurse Practitioners HEAD ELIZABETH 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 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 2005.08 0 0 0 0 0 0 2005.08 0 0 1006160199 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11667.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11667.78 0 0 1006160306 1770876161 10 Physicians SHIANG ELAINE Y 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 18 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 468.52 0 189.63 0 0 0 0 0 0 658.15 0 0 1006160392 1306220793 16 Nurse Practitioners ORTEGA KELLY 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 0 247 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 7938.31 0 0 0 0 0 0 7938.31 0 0 1006160667 89 Physician Assistant Only(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 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 53.17 0 0 0 0 0 0 53.17 0 0 1006160854 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19459.39 0 0 0 0 0 0 0 0 0 0 0 0 0 19459.39 0 0 1006161162 1225571920 16 Nurse Practitioners LUKE KRISTY 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 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 0 324.15 0 0 0 0 0 0 324.15 0 0 1006161413 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 0 1006161537 1184672628 16 Nurse Practitioners WILDEMAN JACKI 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 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 0 341.33 0 0 0 0 0 0 341.33 0 0 1006161745 1295946473 10 Physicians BAUER KIMBERLY A 999999999 53 Kane 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1549.55 0 0 0 0 0 0 1549.55 0 0 1006161748 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006161840 10 Physicians 200 Cook 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 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 15.8 0 0 0 0 0 0 45.28 0 0 1006161899 1356583413 10 Physicians BEAN JONATHAN F 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 1 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36254.24 0 0 0 0 0 0 36254.24 0 0 1006161946 89 Physician Assistant Only(Encounter Only) 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.2 0 0 0 0 0 0 13.2 0 0 1006162248 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 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 2.08 0 0 0 0 0 0 2.08 0 0 1006162290 1457430027 16 Nurse Practitioners VILLANUEVA MARIE ELIZABETH N 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 0 111 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 4366.2 0 0 0 0 0 0 4366.2 0 0 1006162449 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 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 0 564.3 0 0 0 0 0 0 0 0 0 0 0 0 0 564.3 0 0 1006162911 1215316278 10 Physicians MOIZ MOHAMMAD A 999999999 82 Piatt 0 0 General Practice 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 0 292 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 3656.58 0 0 0 0 0 0 3656.58 0 0 1006163503 1669770947 10 Physicians TOMKO STUART 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 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 0 740.26 0 0 0 0 0 0 740.26 0 0 1006163948 1124451810 16 Nurse Practitioners HOFMAN SIMONA 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 0 112 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 2558.18 0 0 0 0 0 0 2558.18 0 0 1006164115 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 1006164133 63 Other Providers of Medical Equipment/Supplies (Non-registered) 810 Florida 0 0 0 0 0 0 0 0 0 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 5658.15 0 0 0 0 0 0 5658.15 0 0 1006164254 1396117867 16 Nurse Practitioners CHENEY ELIZABETH K 999999999 64 Macoupin 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 0 215 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 5062.22 0 0 0 0 0 0 5062.22 0 0 1006164305 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 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0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20888.42 0 0 0 0 0 0 0 0 0 0 0 0 0 20888.42 0 0 1006186192 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 0 219.18 0 0 0 0 0 0 219.18 0 0 1006186503 1356634612 10 Physicians MOHSENI MAHSHID 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 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 0 888.51 0 0 0 0 0 0 888.51 0 0 1006186593 1326276528 10 Physicians PATEL NISHA A 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 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 0 299.92 0 0 0 0 0 0 299.92 0 0 1006186606 1285049536 10 Physicians PATEL MIRAL MILAN 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 12 0 0 0 0 0 0 0 0 0 0 0 0 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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 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 14974.17 0 0 0 0 0 0 0 0 0 0 0 0 0 14974.17 0 0 1006200098 1255878518 89 Physician Assistant Only(Encounter Only) MANNING SARAH 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 0 119.2 0 0 0 0 0 0 119.2 0 0 1006200126 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 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 10546.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10546.2 0 0 1006200128 1114364106 10 Physicians SHETH RAVI M 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 597 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10989.58 0 892.23 0 0 0 0 0 0 11881.81 0 0 1006200216 1437659570 11 Dentists FORD JOHN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1485.4 0 0 1006200296 1407264187 16 Nurse Practitioners BOWMAN MARY KATHARINE 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 0 152 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 21090.96 0 0 0 0 0 0 21090.96 0 0 1006200510 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 17110.28 0 0 0 0 0 0 0 0 0 0 0 0 0 17110.28 0 0 1006200968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16707.35 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 3083.85 0 0 1006201890 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38522.04 0 0 0 0 0 0 0 0 0 0 0 0 0 38522.04 0 0 1006201907 1407360308 16 Nurse Practitioners READLE AMY M 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 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 0 461.76 0 0 0 0 0 0 461.76 0 0 1006201928 1669732970 10 Physicians BOGALE SAIVIVEK R 999999999 88 Richland 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 990 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12247.53 0 826.06 0 0 0 0 0 0 13073.59 0 0 1006202140 1336438456 10 Physicians SHOKOOHI SUSANNE 999999999 200 Cook 0 0 Internal Medicine 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 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 1506.94 0 0 0 0 0 0 1506.94 0 0 1006202890 1134624240 12 Optometrists KUROSE MINAMI 999999999 30 DuPage 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 255.64 0 58.56 0 0 0 0 314.2 0 0 1006203205 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22230.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22230.54 0 0 1006203566 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22985.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22985.6 0 0 1006204296 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3325.13 0 0 0 0 0 0 0 0 0 0 0 0 0 3325.13 0 0 1006204360 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 0 274.97 0 0 0 0 0 0 274.97 0 0 1006205073 1932155041 89 Physician Assistant Only(Encounter Only) CORWIN JULIA 999999999 101 Wabash 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 3093.41 0 0 0 0 0 0 3093.41 0 0 1006205139 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 0 145.31 0 0 0 0 0 0 145.31 0 0 1006205277 1558802843 10 Physicians EVANS NEIL R 999999999 80 Peoria 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 0 241 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 2006.72 0 0 0 0 0 0 2006.72 0 0 1006205281 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 930.29 0 0 0 0 0 0 0 0 0 0 0 0 0 930.29 0 0 1006205761 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 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 3649.15 0 0 0 0 0 0 0 0 0 0 0 0 0 3649.15 0 0 1006205789 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1647.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1647.21 0 0 1006205879 1336401355 89 Physician Assistant Only(Encounter Only) MUELLER JOSHUA 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 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 40.47 0 0 0 0 0 0 40.47 0 0 1006206246 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.67 0 0 0 0 0 0 189.67 0 0 1006206304 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 0 153 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 14086.57 0 0 0 0 0 0 0 0 0 0 0 0 0 14086.57 0 0 1006206326 1376830745 10 Physicians HASSANEEN MOSTAFA WAEL A 999999999 19 Champaign 0 0 Neurology 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 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 10918.47 0 0 0 0 0 0 10918.47 0 0 1006206716 11 Dentists 200 Cook 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 24.25 0 0 1006206772 10 Physicians 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 0 199.55 0 0 0 0 0 0 199.55 0 0 1006207206 1255697249 10 Physicians MURPHY VERONICA 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 14.95 0 0 0 0 0 0 0 0 24.25 0 0 0 0 0 0 39.2 0 0 1006207445 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20936 0 0 0 0 0 0 0 0 0 0 0 0 0 20936 0 0 1006207720 1285996116 10 Physicians BADR ABDUL 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 3428.96 0 0 0 0 0 0 3428.96 0 0 1006207770 1629487640 16 Nurse Practitioners GETHERS MARVA 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 98.44 0 0 0 0 0 0 98.44 0 0 1006207832 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 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 4.15 0 0 0 0 0 0 4.15 0 0 1006207908 1679941819 16 Nurse Practitioners TELISZCZAK ALLISON A 999999999 53 Kane 0 0 0 0 0 2 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 170.27 0 0 0 0 0 0 0 0 3433.77 0 0 0 0 0 0 3604.04 0 0 1006208134 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2551.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2551.89 0 0 1006208447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1914.37 0 0 0 0 0 0 0 0 0 0 0 0 0 1914.37 0 0 1006208798 1336653716 16 Nurse Practitioners WARGELIN LINDSAY J 999999999 200 Cook 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 65 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 144.96 0 0 0 0 0 0 0 0 3184 0 0 0 0 0 0 3328.96 0 0 1006208818 1972942035 10 Physicians HADEN TYLER 999999999 97 Stephenson 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1656.61 0 0 0 0 0 0 1656.61 0 0 1006209024 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24489.19 0 0 0 0 0 0 0 0 0 0 0 0 0 24489.19 0 0 1006209094 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 18246.68 0 0 0 0 0 0 0 0 0 0 0 0 0 18246.68 0 0 1006209587 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 0 135 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 21027.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21027.3 0 0 1006209665 1043537871 10 Physicians LABEDI MOHAMED 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 1336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.43 0 13887 0 0 0 0 0 0 13891.43 0 0 1006209755 1518443225 16 Nurse Practitioners PATTEN KEITH 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 0 537.93 0 0 0 0 0 0 537.93 0 0 1006209926 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 87.45 0 0 0 0 0 0 87.45 0 0 1006210025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13339.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13339.93 0 0 1006210166 1144753237 10 Physicians SAUER MEGAN 999999999 89 Rock Island 0 0 0 0 0 1 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 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 6 0 7 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 160.46 0 1236.15 0 0 0 0 0 0 1501.57 0 0 1006210534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22515.24 0 0 0 0 0 0 0 0 0 0 0 0 0 22515.24 0 0 1006210933 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 3 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 14426.7 0 0 14426.7 0 0 1006211142 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 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 0 400.78 0 0 0 0 0 0 400.78 0 0 1006211506 1093298127 16 Nurse Practitioners NGUYEN LOAN T. 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 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 0 165.78 0 0 0 0 0 0 165.78 0 0 1006211584 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24452.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24452.56 0 0 1006211618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10207.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10207.56 0 0 1006211982 1114306396 10 Physicians BAO LIHUA 999999999 30 DuPage 0 0 Internal Medicine 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 0 324 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 3256.78 0 0 0 0 0 0 3256.78 0 0 1006212241 30 General Hospitals 815 Indiana 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 0 286.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286.89 0 0 1006212290 1629464318 10 Physicians BALL JULIEANNE P 999999999 200 Cook 0 0 Emergency Medicine 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 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 5556.73 0 0 0 0 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1006213473 1811335953 10 Physicians CONNORS PAUL CHRISTIAN 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 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 0 760.42 0 0 0 0 0 0 760.42 0 0 1006213641 10 Physicians 96 St Clair 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 1006213904 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2414.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2414.54 0 0 1006214519 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14861.09 0 0 0 0 0 0 0 0 0 0 0 0 0 14861.09 0 0 1006214976 1487693131 89 Physician Assistant Only(Encounter Only) JESKE JOHN 600162359 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 1006214990 1760764153 10 Physicians MASON BENJAMIN D 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 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 0 333.46 0 0 0 0 0 0 333.46 0 0 1006215216 1821580523 10 Physicians SENIUTKIN OLESKII 999999999 200 Cook 0 0 General 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 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 1088.6 0 0 0 0 0 0 1088.6 0 0 1006215443 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 18080.59 0 0 0 0 0 0 0 0 0 0 0 0 0 18080.59 0 0 1006215628 1467746529 10 Physicians ALTAMIMI SARAH A 999999999 47 Jackson 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 0 135 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 3633.77 0 0 0 0 0 0 3633.77 0 0 1006215877 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10879.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10879.41 0 0 1006215903 1801383211 16 Nurse Practitioners SCHWARZ MARLA J 999999999 60 Lee 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 0 150 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 4574.51 0 0 0 0 0 0 4574.51 0 0 1006216051 4006216051 90 Waiver service provider--Elderly (DOA) ACTIVE HOME HEALTHCARE SERVICE 999999999 200 Cook 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 6752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698354.28 0 0 0 0 0 0 0 0 0 0 0 0 0 698354.28 0 0 1006216083 1043790306 16 Nurse Practitioners BLAND LORI 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 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 1409.01 0 0 0 0 0 0 1409.01 0 0 1006216215 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 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 0 558.57 558.57 0 0 1006216292 1992782247 87 Psychologist(Encounter Only) BERNARD BRYAN 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 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 1384.18 0 0 0 0 0 0 1384.18 0 0 1006216443 1407348345 10 Physicians BIANCHETTA CODY Z 999999999 109 Winnebago 0 0 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 18 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 12.16 0 814.89 0 0 0 0 0 0 859.2 0 0 1006216546 87 Psychologist(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 18.86 0 0 0 0 0 0 18.86 0 0 1006216673 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502.03 0 0 0 0 0 0 0 0 0 0 0 0 0 502.03 0 0 1006217966 16 Nurse Practitioners 64 Macoupin 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 174.94 0 0 0 0 0 0 0 0 127.31 0 0 0 0 0 0 302.25 0 0 1006218226 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 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 0 499.93 0 0 0 0 0 0 0 0 0 0 0 0 0 499.93 0 0 1006218567 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1904.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1904.25 0 0 1006219116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.64 0 0 0 0 0 0 0 0 0 0 0 0 0 26.64 0 0 1006219700 1346786803 16 Nurse Practitioners MORSE SHERI 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 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 2405.15 0 0 0 0 0 0 2405.15 0 0 1006219781 1164975892 12 Optometrists IVANOVA DIYANA 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 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 0 271.05 0 0 0 0 0 0 271.05 0 0 1006219803 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 0 167 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 34360.88 0 0 0 0 0 0 0 0 0 0 0 0 0 34360.88 0 0 1006219915 1033603956 16 Nurse Practitioners MONARREZ LIZEHT 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 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9233.71 0 0 0 0 0 0 9233.71 0 0 1006220064 1013414226 24 Speech Therapists HODSON JULIE K 999999999 30 DuPage 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 0 118 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 8331.8 8331.8 0 0 1006220647 1871071431 16 Nurse Practitioners PATEL HITEKSHA 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 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 83.65 0 0 0 0 0 0 83.65 0 0 1006221090 1184136996 89 Physician Assistant Only(Encounter Only) SMALLEY DEBRA R 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 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 1118.49 0 0 0 0 0 0 1118.49 0 0 1006221192 1376800284 10 Physicians MOTL JILL R 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 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 6822.9 0 0 0 0 0 0 6822.9 0 0 1006221371 86 Clinical Social Worker(Encounter Only) 35 Ford 0 0 0 0 0 0 0 0 0 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 0 232.46 0 0 0 0 0 0 232.46 0 0 1006221381 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10958.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10958.5 0 0 1006221627 1558751560 10 Physicians CARABALLO THOMAS F 999999999 91 Sangamon 0 0 Emergency 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 0 242 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 9021.7 0 0 0 0 0 0 9021.7 0 0 1006221682 1073818878 89 Physician Assistant Only(Encounter Only) WAGNER COURTNEY A 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 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 0 321.6 0 0 0 0 0 0 321.6 0 0 1006221716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 618.22 0 0 0 0 0 0 0 0 0 0 0 0 0 618.22 0 0 1006221720 1003105792 13 Podiatrists KHAYYAL USAMA 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 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 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0 0 202.33 0 0 0 0 0 0 202.33 0 0 1006222406 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 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 1006222461 1285828681 16 Nurse Practitioners CAVINDER BETH 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 0 143 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 0 468.66 0 0 0 0 0 0 468.66 0 0 1006222765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23408.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.49 0 0 1006223049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25017.54 0 0 0 0 0 0 0 0 0 0 0 0 0 25017.54 0 0 1006223176 1629485735 12 Optometrists RIX GEORGE R 999999999 100 Vermilion 0 0 Diagnostic Pharmaceutical Agents 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 0 148 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 3052.54 0 0 0 0 0 0 3052.54 0 0 1006223258 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24526.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24526.37 0 0 1006223308 1508221755 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 57 Lake 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 0 357 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 92541.54 0 0 92541.54 0 0 1006223353 1649614272 10 Physicians BENHARDT AMBER 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 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 0 924.9 0 0 0 0 0 0 924.9 0 0 1006223511 1346680766 10 Physicians OPARA CHIBUZOR N 999999999 200 Cook 0 0 Pediatrics 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 0 191 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 17631.76 0 0 0 0 0 0 17631.76 0 0 1006223884 1669761177 10 Physicians STETSON BETHANY T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 26 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 946.22 0 1357.38 0 0 0 0 0 0 2303.6 0 0 1006224097 1700024767 16 Nurse Practitioners WENGROFF NADINE Y 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 0 124 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 1875.9 0 0 0 0 0 0 1875.9 0 0 1006224396 1114218799 10 Physicians FLAHIVE MEGAN C 999999999 53 Kane 0 0 Obstetric-Gynecology 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 12 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.69 0 3081.81 0 0 0 0 0 0 3328.5 0 0 1006224826 1346746591 16 Nurse Practitioners CAGAS KRYS ELAN A 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 0 206 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 0 738.86 0 0 0 0 0 0 738.86 0 0 1006225034 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25709.76 0 0 0 0 0 0 0 0 0 0 0 0 0 25709.76 0 0 1006225060 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.06 0 0 0 0 0 0 3.06 0 0 1006225215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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KRISTEN L 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 0 269.3 0 0 0 0 0 0 269.3 0 0 1006233795 1114464088 57 Home Nursing Agency TREASURE HOME CARE INC. 999999999 53 Kane 0 0 0 0 0 0 0 4 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140422 29574.5 0 0 0 0 0 0 0 0 0 0 0 0 169996.5 0 0 1006234146 1033624648 16 Nurse Practitioners WADAS JAMIE 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 1162.96 0 0 0 0 0 0 1162.96 0 0 1006234239 1245626001 89 Physician Assistant Only(Encounter Only) CAMPBELL CHELSEA D 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 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 0 158.07 0 0 0 0 0 0 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0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.04 0 0 0 0 0 0 464.04 0 0 1006240579 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 0 510.67 0 0 0 0 0 0 510.67 0 0 1006241210 1831675545 89 Physician Assistant Only(Encounter Only) MCLAFFERTY KYLE P 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 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 8.81 0 0 0 0 0 0 8.81 0 0 1006241519 1134617764 16 Nurse Practitioners WARMBRODT RENEE 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 2685.79 0 0 0 0 0 0 2685.79 0 0 1006241657 1417312661 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 57 Lake 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 0 220 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 57028.4 0 0 57028.4 0 0 1006241963 1457732620 10 Physicians KOPYDLOWSKI AMANDA A 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 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 0 610.54 0 0 0 0 0 0 610.54 0 0 1006242233 1255832564 70 Ambulance Service Providers LIFEGUARD AMBULANCE SERVICE OF 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 585 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236327.39 0 0 0 0 0 0 236327.39 0 0 1006243933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518.82 0 0 0 0 0 0 0 0 0 0 0 0 0 518.82 0 0 1006244030 1245767185 91 Waiver service provider--Adults (DHS/DDD) SCOTT MEGAN R 999999999 91 Sangamon 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 7086.6 0 0 0 0 0 0 0 0 0 0 0 0 0 7086.6 0 0 1006244212 1760961775 16 Nurse Practitioners RADON ANETA KATARZYNA 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 64.4 0 0 0 0 0 0 0 0 1528.44 0 0 0 0 0 0 1592.84 0 0 1006244225 1366860884 10 Physicians TALASILA SREYA 999999999 200 Cook 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 60.93 0 0 0 0 0 0 60.93 0 0 1006244499 1659664753 10 Physicians SANZ ALEJANDRO F 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 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 3083.4 0 0 0 0 0 0 3083.4 0 0 1006244752 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 0 102.56 0 0 0 0 0 0 102.56 0 0 1006244838 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 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 31138.05 0 0 0 0 0 0 0 0 0 0 0 0 0 31138.05 0 0 1006245016 1831572619 10 Physicians BECKSVORT CODY 999999999 88 Richland 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 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 1378.04 0 0 0 0 0 0 1378.04 0 0 1006245527 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9246.91 0 0 0 0 0 0 0 0 0 0 0 0 0 9246.91 0 0 1006245748 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 1006245796 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 0 309.51 0 0 0 0 0 0 309.51 0 0 1006245988 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29011.11 0 0 0 0 0 0 0 0 0 0 0 0 0 29011.11 0 0 1006246039 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27023.62 0 0 0 0 0 0 0 0 0 0 0 0 0 27023.62 0 0 1006246163 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 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 0 346.11 0 0 0 0 0 0 346.11 0 0 1006246466 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 0 127 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 13631 0 0 0 0 0 0 0 0 0 0 0 0 0 13631 0 0 1006246830 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.62 38.62 0 0 1006247027 1730680380 16 Nurse Practitioners METJE ALLISON B 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 0 431.24 0 0 0 0 0 0 431.24 0 0 1006247055 1154702082 10 Physicians AKKARI LANA 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 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 1920.79 0 0 0 0 0 0 1920.79 0 0 1006247330 10 Physicians 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 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 14.15 0 0 0 0 0 0 14.15 0 0 1006247431 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15595.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15595.85 0 0 1006247661 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24171.09 0 0 0 0 0 0 0 0 0 0 0 0 0 24171.09 0 0 1006247790 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1006248205 1477862001 10 Physicians KINNO MENHEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 15 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.44 0 4926.72 0 0 0 0 0 0 5237.16 0 0 1006248251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11835.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11835.62 0 0 1006248314 1801273362 10 Physicians KHUDAI JAYDEEP 999999999 200 Cook 0 0 Family Practice 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 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.11 0 453.28 0 0 0 0 0 0 478.39 0 0 1006248343 1083055180 89 Physician Assistant Only(Encounter Only) KASSEBAUM AMY M 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 0 369.34 0 0 0 0 0 0 369.34 0 0 1006248526 1093186314 10 Physicians KHAN MUHAMMAD Y 999999999 80 Peoria 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 0 122 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 3768.48 0 0 0 0 0 0 3768.48 0 0 1006248601 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12323.96 0 0 0 0 0 0 0 0 0 0 0 0 0 12323.96 0 0 1006248851 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25361.58 0 0 0 0 0 0 0 0 0 0 0 0 0 25361.58 0 0 1006249217 1801312129 10 Physicians HUNTER NICHOLAS 999999999 70 McDonough 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 0 250 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 2398.71 0 0 0 0 0 0 0 0 2398.71 0 0 1006249322 39 Hospice 200 Cook 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3916.39 0 0 0 0 0 0 0 0 0 0 0 3916.39 0 0 1006249405 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 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 0 312.24 0 0 0 0 0 0 0 0 312.24 0 0 1006249966 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 23951.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 1006250068 1841796505 10 Physicians BORRA PHANI MADHURI 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 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 0 359.06 0 0 0 0 0 0 359.06 0 0 1006250174 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23929.26 0 0 0 0 0 0 0 0 0 0 0 0 0 23929.26 0 0 1006250478 1407147150 10 Physicians KLATT CROMWELL CRISTINE N 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 1058.68 0 0 0 0 0 0 1058.68 0 0 1006250656 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 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 36003.72 0 0 0 0 0 0 0 0 0 0 0 0 0 36003.72 0 0 1006250806 1861756652 10 Physicians FAHEY TIMOTHY 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 368 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3909.69 0 3012.36 0 0 0 0 0 0 6922.05 0 0 1006251112 1649215344 10 Physicians IDRIZI HANEME 999999999 91 Sangamon 0 0 Pediatrics 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 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 3765.99 0 0 0 0 0 0 3765.99 0 0 1006251276 1053801191 86 Clinical Social Worker(Encounter Only) MEACHUM JOY L. 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 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 1859.6 0 0 0 0 0 0 1859.6 0 0 1006251489 1912438623 16 Nurse Practitioners CUARESMA KRISTINE B 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 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 0 262.02 0 0 0 0 0 0 262.02 0 0 1006252102 1104251321 10 Physicians FAHEEM SHEIKH M 999999999 19 Champaign 0 0 Neurology 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 0 122 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 2206.83 0 0 0 0 0 0 2206.83 0 0 1006252202 1558885228 30 General Hospitals WASHINGTON HEIGHTS DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1797 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39824.37 0 0 0 0 0 39824.37 0 0 1006252330 1689967705 10 Physicians ALSARA OSAMA 999999999 19 Champaign 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 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7102.62 0 0 0 0 0 0 7102.62 0 0 1006252589 1710271341 10 Physicians ACEVEDO-ALVAREZ MARIAN 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 1420.92 0 0 0 0 0 0 1420.92 0 0 1006252593 1578749990 10 Physicians LYNN MATTHEW A 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 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 1080.73 0 0 0 0 0 0 0 0 1080.73 0 0 1006252975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11836.89 0 0 0 0 0 0 0 0 0 0 0 0 0 11836.89 0 0 1006253176 1043766538 10 Physicians ZHENG JIANBIN 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 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 0 316.26 0 0 0 0 0 0 316.26 0 0 1006253182 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 0 117.77 0 0 0 0 0 0 117.77 0 0 1006253217 10 Physicians 19 Champaign 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 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TRANSITIONS OF WESTERN ILLINOI 623055849 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 19263.97 0 0 19263.97 0 0 1006268867 1164913141 16 Nurse Practitioners SOTTA SARAH 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 1006269448 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 0 109.02 0 0 0 0 0 0 109.02 0 0 1006269523 1154852598 10 Physicians NOONAN ELIZABETH 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 8 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 64.3 0 0 0 0 0 0 0 0 780.81 0 0 0 0 0 0 845.11 0 0 1006269888 1124560727 89 Physician Assistant Only(Encounter Only) ROBINSON AMANDA L 999999999 80 Peoria 0 0 0 0 0 10 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 501.26 0 0 0 0 0 0 0 0 2019.94 0 0 0 0 0 0 2521.2 0 0 1006270151 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2239.26 0 0 0 0 0 0 0 0 0 0 0 0 0 2239.26 0 0 1006270321 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 4.88 0 0 0 0 0 0 4.88 0 0 1006270460 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 1.95 0 0 0 0 0 0 1.95 0 0 1006270561 1689988644 10 Physicians LETZING MICHAEL A 999999999 98 Tazewell 0 0 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0 0 0 0 0 0 0 0 180.11 0 0 0 0 0 180.11 0 0 1006271306 1912385998 10 Physicians SCHLEUNING ANDREW C 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 0 177 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 1051.29 0 0 0 0 0 0 1051.29 0 0 1006271530 1366702284 10 Physicians LODHI MAHAM W 999999999 200 Cook 0 0 Internal Medicine 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 0 229 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 5595.42 0 0 0 0 0 0 5595.42 0 0 1006271772 1972080687 89 Physician Assistant Only(Encounter Only) BRISARD ARNAUD 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 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 0 251.17 0 0 0 0 0 0 251.17 0 0 1006271850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1891.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1891.35 0 0 1006272275 1568759975 10 Physicians KIANIRAD YASAMAN 999999999 200 Cook 0 0 Neurology 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 0 119 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 5707.86 0 0 0 0 0 0 5707.86 0 0 1006272348 1134627201 16 Nurse Practitioners PATEL RESHA 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 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 1278.54 0 0 0 0 0 0 1278.54 0 0 1006272448 1982185450 16 Nurse Practitioners PARAN CHRISTINE-MARY C. 999999999 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 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 1206.43 0 0 0 0 0 0 1206.43 0 0 1006272482 1497100572 16 Nurse Practitioners ATEN KELLY 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 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 2278.22 0 0 0 0 0 0 2278.22 0 0 1006272599 1881103646 28 Waiver service provider--Supportive living facility (HFS) STONEBRIDGE OF GURNEE LLC 999999999 57 Lake 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 0 138 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 451541.68 0 0 0 0 0 0 0 0 0 0 0 0 0 451541.68 0 0 1006272791 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 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 0 140.41 140.41 0 0 1006272892 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21486.56 0 0 0 0 0 0 0 0 0 0 0 0 0 21486.56 0 0 1006273116 1396243317 60 Pharmacies GOLCONDA PHARMACY 999999999 84 Pope 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.89 0 0 0 0 0 0 79.89 0 0 1006274546 1841729589 16 Nurse Practitioners FOMA CARLSON 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788.98 0 0 0 0 0 0 788.98 0 0 1006274837 1760897623 10 Physicians KHANAL MAMATA 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 0 421.4 0 0 0 0 0 0 421.4 0 0 1006274962 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4339.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4339.6 0 0 1006275337 89 Physician Assistant Only(Encounter Only) 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 15.7 0 0 0 0 0 0 15.7 0 0 1006276169 1134603913 16 Nurse Practitioners ROSEN LAUREN E 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 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 1041.02 0 0 0 0 0 0 1053.9 0 0 1006276180 1073926929 10 Physicians MESSMER SARAH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 10 0 0 0 0 0 0 1 0 82 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 855.88 0 0 0 0 0 0 2.11 0 3820.16 0 0 0 0 0 0 4678.15 0 0 1006276302 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.91 0 0 220.65 0 0 0 346.56 0 0 1006276547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 4 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 252.44 0 0 0 0 0 0 0 0 1996.54 0 0 0 0 0 0 2248.98 0 0 1006279617 1407261217 10 Physicians ESFAHANI AMIN 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 86 0 0 0 0 0 0 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 0 0 1004.87 0 0 0 0 0 0 1004.87 0 0 1006279778 1093004772 10 Physicians LYNCH THOMAS 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 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 2640.5 0 0 0 0 0 0 2640.5 0 0 1006279954 1508126699 10 Physicians ABRAHAM MANJUSHA 999999999 65 Madison 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 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 5466.27 0 0 0 0 0 0 5466.27 0 0 1006280259 10 Physicians 200 Cook 0 0 Internal Medicine 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 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 1279.13 0 0 0 0 0 0 1279.13 0 0 1006286088 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16882.6 0 0 0 0 0 0 0 0 0 0 0 0 0 16882.6 0 0 1006286551 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8328.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8328.2 0 0 1006286624 1467718379 10 Physicians KIM HYUN 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 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 1104.81 0 0 0 0 0 0 1104.81 0 0 1006286871 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 7.37 0 0 0 0 0 0 7.37 0 0 1006287176 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 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 1006287211 1073995593 10 Physicians ORF ERIN E 999999999 10 Adams 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 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 0 454.38 0 0 0 0 0 0 454.38 0 0 1006287379 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10745.43 0 0 0 0 0 0 0 0 0 0 0 0 0 10745.43 0 0 1006287429 1184980716 10 Physicians JAMAL ALI A 999999999 70 McDonough 0 0 Neurology 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 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 3114.07 0 0 0 0 0 0 3114.07 0 0 1006287729 1275056418 89 Physician Assistant Only(Encounter Only) AGOMBAR WOLF LEIGH 999999999 30 DuPage 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 0 325 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 2125.54 0 0 0 0 0 0 2125.54 0 0 1006287862 10 Physicians 200 Cook 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006288248 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 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 4890.95 0 0 0 0 0 0 0 0 0 0 0 0 0 4890.95 0 0 1006288751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20164.69 0 0 0 0 0 0 0 0 0 0 0 0 0 20164.69 0 0 1006288859 1538434998 10 Physicians SUN JINGLU 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6626.77 0 0 0 0 0 0 6626.77 0 0 1006288928 1275046815 16 Nurse Practitioners OHEARN COLLEEN M 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 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 1960.22 0 0 0 0 0 0 1960.22 0 0 1006289018 1184113987 91 Waiver service provider--Adults (DHS/DDD) OHANA COMMUNITY SERVICES LLC 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 1784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452184.76 0 0 0 0 0 0 0 0 0 0 0 0 0 452184.76 0 0 1006289219 1407246697 10 Physicians NEZIROVA LILYANA 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 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 0 186.05 0 0 0 0 0 0 186.05 0 0 1006290014 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15189.41 0 0 0 0 0 0 0 0 0 0 0 0 0 15189.41 0 0 1006290017 1609354976 24 Speech Therapists STRANG JESSICA M 999999999 83 Pike 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 0 309 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 21065.89 21065.89 0 0 1006290785 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 0 0 0 0 0 0 0 0 0 0 1006290950 1578092441 16 Nurse Practitioners BARNEY KATHRYN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.96 0 0 0 0 0 0 129.96 0 0 1006291500 1104960517 10 Physicians DORSCH ANDREW K 999999999 200 Cook 0 0 Neurology 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 0 109 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 1478.5 0 0 0 0 0 0 1478.5 0 0 1006291785 1619456670 33 Nursing Facilities AVANTARA OF ELGIN 999999999 53 Kane 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 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842472.44 0 0 0 0 0 0 0 842472.44 0 0 1006291791 10 Physicians 200 Cook 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 53.69 0 0 0 0 0 0 0 0 53.69 0 0 1006292113 1801398813 16 Nurse Practitioners GUAN AMY 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 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 0 632.1 0 0 0 0 0 0 632.1 0 0 1006293160 1760779755 10 Physicians PATEL MANISH A. 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4969.09 0 0 0 0 0 0 4969.09 0 0 1006293250 1760618466 10 Physicians NARAN SANJAY 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 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 11226.9 0 0 0 0 0 0 11226.9 0 0 1006293721 1316327927 10 Physicians KRASIN BENJAMIN 999999999 30 DuPage 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 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 0 441.34 0 0 0 0 0 0 441.34 0 0 1006293812 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 25983.23 0 0 0 0 0 0 0 0 0 0 0 0 0 25983.23 0 0 1006294044 1588186084 16 Nurse Practitioners DESPAIN CAITLEN 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 6163.54 0 0 0 0 0 0 6268.5 0 0 1006294622 1396162756 10 Physicians SWEENEY BRYAN R. 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.51 0 1388.84 0 0 0 0 0 0 1404.35 0 0 1006295371 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 33024.47 0 0 0 0 0 0 0 0 0 0 0 0 0 33024.47 0 0 1006295521 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6835.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6835.5 0 0 1006295738 1881969921 60 Pharmacies ALIXA RX 999999999 815 Indiana 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 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3162.85 0 0 0 3162.85 0 0 1006295750 1669982427 16 Nurse Practitioners MUNOZ MARISOL 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 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 0 155.17 0 0 0 0 0 0 155.17 0 0 1006295898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14115.81 0 0 0 0 0 0 0 0 0 0 0 0 0 14115.81 0 0 1006296156 1467948034 11 Dentists HA CATHERINE 999999999 200 Cook 0 0 General Dentistry 0 0 33 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 3594.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3594.79 0 0 1006296805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2527.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2527.57 0 0 1006296943 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 21235.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21235.9 0 0 1006297127 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 1006297217 12 Optometrists 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.99 0 58.56 0 0 0 0 247.55 0 0 1006297295 1326526716 16 Nurse Practitioners MULASMAJIC MUAMER 999999999 79 Ogle 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 0 384 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 0 165.08 0 0 0 0 0 0 165.08 0 0 1006297340 1689158826 16 Nurse Practitioners ALLEN DOROTHY 999999999 53 Kane 0 0 0 0 0 8 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 12 0 0 0 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 1006297401 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15879.39 0 0 0 0 0 0 0 0 0 0 0 0 0 15879.39 0 0 1006297808 1821592726 23 Occupational Therapists GAETA ELENA 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 0 165 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 10227.2 10227.2 0 0 1006298077 1518476969 23 Occupational Therapists KONING ABIGAIL LEE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362 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 26193.2 26193.2 0 0 1006298109 1801389119 10 Physicians SIDDIQUI HARRIS 999999999 109 Winnebago 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 0 100 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 1837.73 0 0 0 0 0 0 1837.73 0 0 1006298260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23003.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23003.49 0 0 1006298346 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19198.03 0 0 0 0 0 0 0 0 0 0 0 0 0 19198.03 0 0 1006298426 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4379.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4379.32 0 0 1006298470 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 79.72 0 0 0 0 0 0 79.72 0 0 1006298517 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 0 0 0 0 0 0 0 0 0 0 1006298526 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 0 1604.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1604.84 0 0 1006299949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22812.3 0 0 0 0 0 0 0 0 0 0 0 0 0 22812.3 0 0 1006300071 1639339195 25 Audiologists TEUSCHER AMANDA B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 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 0 488.85 488.85 0 0 1006300479 1528440161 10 Physicians BALLARD WENNERS 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 0 248.74 0 0 0 0 0 0 248.74 0 0 1006300979 1932527132 10 Physicians PESANTES PAOLA A. 999999999 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 4659.18 0 0 0 0 0 0 4659.18 0 0 1006301486 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 17663.8 0 0 0 0 0 0 0 0 0 0 0 0 0 17663.8 0 0 1006301816 1366959041 55 Early Intervention Services BRYANT SCHAMAKI 604675237 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 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26035.8 0 0 0 0 0 0 26035.8 0 0 1006301916 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 0 205.59 0 0 0 0 0 0 205.59 0 0 1006301920 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8789.39 0 0 0 0 0 0 0 0 0 0 0 0 0 8789.39 0 0 1006301970 1841645066 86 Clinical Social Worker(Encounter Only) COLTON HEIDI L 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 0 112 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 3951.25 0 0 0 0 0 0 3951.25 0 0 1006302190 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33393.71 0 0 0 0 0 0 0 0 0 0 0 0 0 33393.71 0 0 1006302644 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.7 0 0 0 0 0 0 2.7 0 0 1006302646 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006302758 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24087 0 0 0 0 0 0 0 0 0 0 0 0 0 24087 0 0 1006303067 1003276866 16 Nurse Practitioners LONGO DOUG 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 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 1117 0 0 0 0 0 0 1117 0 0 1006303102 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35361.9 0 0 0 0 0 0 0 0 0 0 0 0 0 35361.9 0 0 1006303376 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 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 1851.4 1851.4 0 0 1006303698 1912250424 10 Physicians KHAN TALAT N 999999999 107 Will 0 0 Pediatrics 0 0 0 128 0 0 0 0 0 0 47 0 152 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 79 0 347 0 0 0 0 0 0 0 0 0 467 0 0 0 0 0 0 79 0 347 0 0 0 0 0 0 0 0 0 14187.27 0 0 0 0 0 0 513.58 0 18079.99 0 0 0 0 0 0 32780.84 0 0 1006304075 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24519.66 0 0 0 0 0 0 0 0 0 0 0 0 0 24519.66 0 0 1006304182 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 0 0 0 0 0 0 0 0 0 0 1006305018 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 231.14 0 0 0 0 0 0 231.14 0 0 1006305253 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 45.27 0 0 0 0 0 0 45.27 0 0 1006306121 10 Physicians 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.34 0 0 0 0 0 0 79.34 0 0 1006306370 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 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 0 976.8 0 0 0 0 0 0 0 0 0 0 0 0 0 976.8 0 0 1006306451 1548434780 10 Physicians ENGEN RACHEL 999999999 200 Cook 0 0 Pediatrics 0 0 0 1 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 0 126 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 4248.8 0 0 0 0 0 0 4261.6 0 0 1006306641 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.02 0 0 0 0 0 0 60.02 0 0 1006306779 1811486350 16 Nurse Practitioners STIVERS STEPHANIE 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 111.36 0 0 0 0 0 0 0 0 1983.12 0 0 0 0 0 0 2094.48 0 0 1006306798 1326435660 10 Physicians NARSINGHANI ARTI A. 999999999 200 Cook 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 0 166 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 2052.44 0 0 0 0 0 0 2052.44 0 0 1006306818 1295903110 36 Community mental health provider PILLARS COMMUNITY HEALTH 604023130 200 Cook 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 485 0 0 24088.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73377.02 0 0 97465.68 0 0 1006306821 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20223.83 0 0 0 0 0 0 0 0 0 0 0 0 0 20223.83 0 0 1006307249 1710414891 16 Nurse Practitioners STATKUS JENNIFER LOUISE 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 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 1403.44 0 0 0 0 0 0 1403.44 0 0 1006307424 1124412374 10 Physicians NICOL LARA K 999999999 200 Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 828.98 0 0 0 0 0 0 0 0 1898.98 0 0 0 0 0 0 2727.96 0 0 1006307437 1336686302 89 Physician Assistant Only(Encounter Only) JONES BENJAMEN 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 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 0 282.68 0 0 0 0 0 0 282.68 0 0 1006307503 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1603.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1603.58 0 0 1006307655 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 85.65 0 0 0 0 0 0 85.65 0 0 1006308093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 485.23 0 0 0 0 0 0 0 0 0 0 0 0 0 485.23 0 0 1006308152 1871931337 16 Nurse Practitioners VAN ASTEN SCOTT 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 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 0 676.82 0 0 0 0 0 0 676.82 0 0 1006308274 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2718.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2718.76 0 0 1006308317 1063932531 10 Physicians SAM SABRINA 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 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 0 103.39 0 0 0 0 0 0 103.39 0 0 1006308717 1528579901 89 Physician Assistant Only(Encounter Only) SAMES JULIA E 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 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 91.62 0 0 0 0 0 0 91.62 0 0 1006308812 1659465516 10 Physicians ALAM SHANAWAR 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 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 1763.51 0 0 0 0 0 0 1763.51 0 0 1006308836 1932613916 16 Nurse Practitioners PEOPLES PAMELA M 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 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 0 326.36 0 0 0 0 0 0 326.36 0 0 1006308869 1790277481 16 Nurse Practitioners VOIGTS KELSEY L 999999999 200 Cook 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 0 161 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 6036.35 0 0 0 0 0 0 6036.35 0 0 1006308920 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15804.34 0 0 0 0 0 0 0 0 0 0 0 0 0 15804.34 0 0 1006309319 1316306194 16 Nurse Practitioners SMITH KERRI ANN 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 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 0 211.18 0 0 0 0 0 0 211.18 0 0 1006309824 1083909956 10 Physicians KADOW TIFFANY 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 36 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876.24 0 5016.88 0 0 0 0 0 0 5893.12 0 0 1006310091 1205254828 10 Physicians OKELBERRY ERIC S 999999999 72 McLean 0 0 Emergency 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 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 0 817.05 0 0 0 0 0 0 817.05 0 0 1006310359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4332.47 0 0 0 0 0 0 0 0 0 0 0 0 0 4332.47 0 0 1006310397 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12140.08 0 0 0 0 0 0 0 0 0 0 0 0 0 12140.08 0 0 1006310570 1780073700 16 Nurse Practitioners MURPHY ZENY J 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 0 191.39 0 0 0 0 0 0 191.39 0 0 1006310575 1154681468 10 Physicians VASHI MONA T 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11199.96 0 0 0 0 0 0 11199.96 0 0 1006310765 1235641804 16 Nurse Practitioners RALSTON ELIZABETH M 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 0 240 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 0 0 0 0 0 0 0 0 0 0 1006311034 1962885095 10 Physicians KAMATAM SRAVANI 999999999 80 Peoria 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 0 218 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 1546.65 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.6 0 7998.56 0 0 0 0 0 0 8016.16 0 0 1006342944 91 Waiver service provider--Adults (DHS/DDD) 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 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 4974.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4974.85 0 0 1006343200 1740733708 61 Independent Laboratories TEMPUS LABS INC. 999999999 200 Cook 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 1350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90950.33 0 0 0 0 0 0 0 0 90950.33 0 0 1006343354 1700385077 16 Nurse Practitioners MURPHY GLENNA 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 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 0 115.52 0 0 0 0 0 0 115.52 0 0 1006343589 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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25.74 0 0 0 0 0 0 25.74 0 0 1006345178 1548735459 91 Waiver service provider--Adults (DHS/DDD) JOHNS TAYLOR M 999999999 30 DuPage 0 0 0 0 0 0 0 12 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 10566.4 0 0 0 0 0 0 0 0 0 0 0 0 0 10566.4 0 0 1006345412 1679963821 89 Physician Assistant Only(Encounter Only) MUSCAVITCH KELLY A 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 45.47 0 0 0 0 0 0 45.47 0 0 1006345523 10 Physicians 97 Stephenson 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 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 0 133.56 0 0 0 0 0 0 133.56 0 0 1006345652 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11908.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11908.96 0 0 1006345865 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 78.63 0 0 0 0 0 0 142.93 0 0 1006346160 1104324771 16 Nurse Practitioners SMITH AMBER H 999999999 91 Sangamon 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 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 1055.58 0 0 0 0 0 0 1055.58 0 0 1006346421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 398.85 0 0 0 0 0 0 0 0 0 0 0 0 0 398.85 0 0 1006346878 1013494152 55 Early Intervention Services RODERFELD KATIE E 999999999 65 Madison 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 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20457.04 0 0 0 0 0 0 20457.04 0 0 1006347472 1467951699 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCOLNLAND HOME MEDICAL EQUIP 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1300 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1300 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23606.18 0 3481.63 0 0 0 0 27087.81 0 0 1006347554 1871001644 16 Nurse Practitioners STONE CASSIE J 999999999 37 Fulton 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 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 0 501.96 0 0 0 0 0 0 501.96 0 0 1006347755 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 2604 0 0 0 0 0 0 0 0 0 0 0 0 0 2604 0 0 1006348745 1568752681 10 Physicians KUMAR PRERNA 999999999 80 Peoria 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 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 4901.79 0 0 0 0 0 0 4901.79 0 0 1006349145 1417486663 16 Nurse Practitioners STEVENS TRACY A 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 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 0 229.84 0 0 0 0 0 0 229.84 0 0 1006349162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8256.46 0 0 0 0 0 0 0 0 0 0 0 0 0 8256.46 0 0 1006349474 1780099572 10 Physicians DUGGAL SHWETA 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 293 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 1464.54 0 0 0 0 0 0 1464.54 0 0 1006349495 1730391509 10 Physicians PARK DERIC M 999999999 30 DuPage 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 0 100 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 1493.9 0 0 0 0 0 0 1493.9 0 0 1006349715 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 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 0 128.17 128.17 0 0 1006349724 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 11287 0 0 0 0 0 0 0 0 0 0 0 0 0 11287 0 0 1006349929 11 Dentists 200 Cook 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006350692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6475.3 0 0 0 0 0 0 0 0 0 0 0 0 0 6475.3 0 0 1006350771 1699171371 89 Physician Assistant Only(Encounter Only) SCHRAGE ANDREA 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 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 0 380.54 0 0 0 0 0 0 380.54 0 0 1006350835 1063910016 16 Nurse Practitioners DRAKE EKI 999999999 109 Winnebago 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 1714.82 0 0 0 0 0 0 1714.82 0 0 1006350915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4617.78 0 0 0 0 0 0 0 0 0 0 0 0 0 4617.78 0 0 1006351100 1386022432 10 Physicians BALDWIN JOHN 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11215.53 0 0 0 0 0 0 11215.53 0 0 1006351111 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28455.97 0 0 0 0 0 0 0 0 0 0 0 0 0 28455.97 0 0 1006351269 1124526652 16 Nurse Practitioners PEARSON DREW W 999999999 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 590.09 0 0 0 0 0 0 590.09 0 0 1006352052 1013490721 89 Physician Assistant Only(Encounter Only) FEDERICO BIANCA 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 31.01 0 0 0 0 0 0 31.01 0 0 1006352311 1265915474 16 Nurse Practitioners GALARDINI LAINE E 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 71 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 2008.04 0 0 0 0 0 0 2113 0 0 1006352469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5365.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5365.9 0 0 1006352512 1235447368 10 Physicians LAEEQ KULSOOM 999999999 19 Champaign 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 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 0 660.04 0 0 0 0 0 0 660.04 0 0 1006352837 1306365556 16 Nurse Practitioners TROWER LEAH M 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 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 0 383.15 0 0 0 0 0 0 383.15 0 0 1006353319 1326211327 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 4 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.08 0 2112.83 0 0 0 0 2249.91 0 0 1006353527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26377.65 0 0 0 0 0 0 0 0 0 0 0 0 0 26377.65 0 0 1006354011 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 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 0 111.44 111.44 0 0 1006354107 1457834723 11 Dentists NOUNA RIYAD 999999999 200 Cook 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27593.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27593.25 0 0 1006354428 1124555693 70 Ambulance Service Providers AIR EVAC EMS INC 999999999 24 Coles 0 0 0 0 0 0 0 0 0 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 11480.35 0 0 0 0 0 0 11480.35 0 0 1006354614 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14046.55 0 0 0 0 0 0 0 0 0 0 0 0 0 14046.55 0 0 1006354977 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.71 0 0 0 0 0 0 31.71 0 0 1006354992 1639628415 30 General Hospitals FRESENIUS MEDICAL CARE OF ILLI 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 454 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55520.14 0 0 0 0 0 55520.14 0 0 1006355043 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.15 0 0 0 0 0 0 0 0 0 0 0 0 0 16.15 0 0 1006355134 1255886073 40 Federally Qualified Health Centers AUNT MARTHA''S COMMUNITY HEALT 600674791 200 Cook 0 0 0 13 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13201.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13201.73 0 0 1006355310 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29097.76 0 0 0 0 0 0 0 0 0 0 0 0 0 29097.76 0 0 1006355429 16 Nurse Practitioners 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 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 91.93 0 0 0 0 0 0 91.93 0 0 1006355861 1174016992 11 Dentists BAZIRGAN KASSIM 999999999 200 Cook 0 0 0 0 61 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 7643.41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7643.41 0 0 1006356363 1336166347 63 Other Providers of Medical Equipment/Supplies (Non-registered) VIEMED 999999999 819 Louisiana 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 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176805.24 0 0 0 0 0 0 176805.24 0 0 1006356664 1619059300 30 General Hospitals MT SINAI HOSP MED CTR CHICAGO 606081704 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 2462 0 0 0 0 0 1853.31 0 0 0 0 0 0 0 0 0 0 0 0 255650.31 0 0 0 0 0 257503.62 0 0 1006356761 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6882.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6882.33 0 0 1006356766 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2474.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2474.56 0 0 1006356959 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 1446.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1446.84 0 0 1006356992 1720580467 22 Physical Therapists SYFERT QUINLAN D 999999999 63 Macon 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 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 0 164.8 164.8 0 0 1006357204 1851534176 10 Physicians LIN JENNIE J 999999999 200 Cook 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 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 0 153.68 0 0 0 0 0 0 153.68 0 0 1006357584 1184005670 10 Physicians COCKRUM RICHARD 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 3036.03 0 0 0 0 0 0 3036.03 0 0 1006357587 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3676.31 0 0 0 0 0 0 0 0 0 0 0 0 0 3676.31 0 0 1006358240 1760992739 10 Physicians DI COCCO PIERPAOLO 999999999 200 Cook 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 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23983.73 0 0 0 0 0 0 23983.73 0 0 1006358282 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 19906.5 0 0 0 0 0 0 0 0 0 0 0 0 0 19906.5 0 0 1006358416 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21082.6 0 0 0 0 0 0 0 0 0 0 0 0 0 21082.6 0 0 1006358516 4006358516 72 Taxicabs and Livery Companies SAFE CIRCLE TRANSPORTATION CO 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 412.44 0 0 0 0 0 0 412.44 0 0 1006358824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35103.21 0 0 0 0 0 0 0 0 0 0 0 0 0 35103.21 0 0 1006358898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 170.36 0 0 0 0 0 0 0 0 0 0 0 0 0 170.36 0 0 1006359741 1902060411 10 Physicians SCHAPIRO MELISSA 999999999 76 Montgomery 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 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 2589.6 0 0 0 0 0 0 2589.6 0 0 1006359744 89 Physician Assistant Only(Encounter Only) 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.98 0 0 0 0 0 0 219.98 0 0 1006359788 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 1.62 0 0 0 0 0 0 1.62 0 0 1006359974 1841729936 10 Physicians DEANGELIS GLENN M 999999999 200 Cook 0 0 0 0 0 44 0 0 0 0 0 0 7 0 49 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 8 0 60 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 8 0 60 0 0 0 0 0 0 0 0 0 2218.79 0 0 0 0 0 0 78.54 0 2138.88 0 0 0 0 0 0 4436.21 0 0 1006360148 1689938938 10 Physicians SHUJA ASIM 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 0 134 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 10503.68 0 0 0 0 0 0 10503.68 0 0 1006360374 1205190485 10 Physicians SONI MONA C. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 7 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.52 0 2983.45 0 0 0 0 0 0 3002.97 0 0 1006361246 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 14928.76 0 0 0 0 0 0 0 0 0 0 0 0 0 14928.76 0 0 1006361300 1447470935 87 Psychologist(Encounter Only) GROTE CHRISTOPHER 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 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 0 195.99 0 0 0 0 0 0 195.99 0 0 1006361639 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 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 1984.99 0 0 0 0 0 0 1984.99 0 0 1006361752 1154491884 60 Pharmacies CVS PHARMACY 10624 999999999 61 Livingston 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 0 584 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15582 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24975.16 0 0 0 24975.16 0 0 1006361761 1063921534 16 Nurse Practitioners FORSYTHE KRISTEN L 999999999 107 Will 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 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 83.49 0 0 0 0 0 0 83.49 0 0 1006361888 1578902409 10 Physicians GOLD JULIA 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 205.86 0 0 0 0 0 0 5.17 0 515.2 0 0 0 0 0 0 726.23 0 0 1006362013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4919.16 0 0 0 0 0 0 0 0 0 0 0 0 0 4919.16 0 0 1006362487 1407019946 12 Optometrists WILTZ SHARNA A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2906.51 0 15.92 0 0 0 0 2922.43 0 0 1006362635 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 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 23730.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23730.3 0 0 1006362663 1316448939 89 Physician Assistant Only(Encounter Only) PRICE TOVA C. 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 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 0 643.88 0 0 0 0 0 0 643.88 0 0 1006362969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26192.26 0 0 0 0 0 0 0 0 0 0 0 0 0 26192.26 0 0 1006362974 1386127660 16 Nurse Practitioners ELDRIDGE TAYLEE M 999999999 24 Coles 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 0 215 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 1707.12 0 0 0 0 0 0 1707.12 0 0 1006363182 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24154.76 0 0 0 0 0 0 0 0 0 0 0 0 0 24154.76 0 0 1006363199 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 22.68 0 0 0 0 0 0 22.68 0 0 1006363536 1801321229 10 Physicians ACEVES JORGE L 999999999 200 Cook 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 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 4027.21 0 0 0 0 0 0 4027.21 0 0 1006364480 1215354246 10 Physicians REED GRANT 999999999 15 Bureau 0 0 Family Practice 0 0 0 15 0 0 0 0 0 0 4 0 100 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 4 0 176 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 4 0 176 0 0 0 0 0 0 0 0 0 1540.33 0 0 0 0 0 0 40.21 0 4050.03 0 0 0 0 0 0 5630.57 0 0 1006364598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3650.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3650.67 0 0 1006364684 1598795585 30 General Hospitals WELLSTAR ATLANTA MEDICAL CENTE 999999999 811 Georgia ARS-LS Long-term stay hospitals paid under an ARS 0 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 1429.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1429.55 0 0 1006364893 1053773044 10 Physicians ARIMILLI SESHANK 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 0 194 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 2857.08 0 0 0 0 0 0 2857.08 0 0 1006364973 1669906731 23 Occupational Therapists KIRK GABRIELLE ELIZABETH 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 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 24836.78 24836.78 0 0 1006365009 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5629.23 0 0 0 0 0 0 0 0 0 0 0 0 0 5629.23 0 0 1006365333 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 245.71 0 0 0 0 0 0 0 0 0 0 0 0 0 245.71 0 0 1006365343 1174611537 16 Nurse Practitioners HOOD ANNETTE 999999999 83 Pike 0 0 0 0 0 0 0 0 0 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 0 125.11 0 0 0 0 0 0 125.11 0 0 1006365764 1093141251 89 Physician Assistant Only(Encounter Only) BORCHERS NICHOLAS 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 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 96.11 0 0 0 0 0 0 96.11 0 0 1006365965 89 Physician Assistant Only(Encounter Only) 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006366025 1306195920 10 Physicians ROUHI OMID 999999999 30 DuPage 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 0 300 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 2273.22 0 0 0 0 0 0 0 0 2273.22 0 0 1006366693 10 Physicians 49 Jefferson 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.71 0 0 0 0 0 0 184.71 0 0 1006367018 1821477241 10 Physicians VALERO DENISE 999999999 200 Cook 0 0 Internal Medicine 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 4 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.96 0 1856.91 0 0 0 0 0 0 1873.87 0 0 1006367498 1558522573 10 Physicians ZEPEDA ANDREA 999999999 50 Jersey 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 5171.75 0 0 0 0 0 0 5171.75 0 0 1006367558 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 0 226 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 6109.07 0 0 0 0 0 0 0 0 0 0 0 0 0 6109.07 0 0 1006367630 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25047.17 0 0 0 0 0 0 0 0 0 0 0 0 0 25047.17 0 0 1006367876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1316.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.67 0 0 1006368029 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8479.61 0 0 0 0 0 0 0 0 0 0 0 0 0 8479.61 0 0 1006368174 1477908614 86 Clinical Social Worker(Encounter Only) HULBERT SARAH 999999999 12 Bond 0 0 0 0 0 0 0 0 0 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 0 217.15 0 0 0 0 0 0 217.15 0 0 1006368183 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18826.19 0 0 0 0 0 0 0 0 0 0 0 0 0 18826.19 0 0 1006368275 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 4396.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4396.56 0 0 1006368904 1588957542 10 Physicians HOLLISTER HADYN 999999999 53 Kane 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 0 192 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 3655.01 0 0 0 0 0 0 3655.01 0 0 1006369083 1205964103 46 Ambulatory Surgical Treatment Centers FULLERTON KIMBALL MEDICAL AND 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 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 5550.68 0 0 0 0 0 5550.68 0 0 1006369363 1750644340 10 Physicians MARTINEZ DE UBAGO JULIANNE M 999999999 106 Whiteside 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 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 0 933.56 0 0 0 0 0 0 0 0 933.56 0 0 1006369364 16 Nurse Practitioners 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.08 0 0 0 0 0 0 37.08 0 0 1006369405 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15543.78 0 0 0 0 0 0 0 0 0 0 0 0 0 15543.78 0 0 1006369503 86 Clinical Social Worker(Encounter Only) 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006369554 1861622441 89 Physician Assistant Only(Encounter Only) KEORPES PETER 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 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 1024.54 0 0 0 0 0 0 1024.54 0 0 1006369713 1851739684 10 Physicians SERAFIN MATEUSZ 999999999 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 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 0 815.52 0 0 0 0 0 0 815.52 0 0 1006369739 1720049109 10 Physicians MOORE JASON L 999999999 200 Cook 0 0 Emergency 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1143.6 0 0 0 0 0 0 1143.6 0 0 1006369777 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23023.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23023.7 0 0 1006369890 1679989966 10 Physicians SHAIKH ARSHIBANOO M 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 0 282 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 4508.58 0 0 0 0 0 0 4508.58 0 0 1006369909 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 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 22.87 22.87 0 0 1006370087 1144795295 16 Nurse Practitioners WHALEN ERIN L 999999999 80 Peoria 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 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24170.45 0 0 0 0 0 0 24170.45 0 0 1006370842 1083104137 89 Physician Assistant Only(Encounter Only) JACK NICOLE M. 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 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 65.51 0 0 0 0 0 0 65.51 0 0 1006371202 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22839.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22839.2 0 0 1006372605 1346406162 16 Nurse Practitioners BUIER LINDA 999999999 200 Cook 0 0 0 0 0 100 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 11294.98 0 0 0 0 0 0 0 0 3738.96 0 0 0 0 0 0 15033.94 0 0 1006372658 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 47.77 0 0 0 0 0 0 47.77 0 0 1006372913 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 1.23 0 0 0 0 0 0 1.23 0 0 1006373319 10 Physicians 80 Peoria 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 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 0 0 0 0 0 0 0 0 0 0 1006374083 1861991069 16 Nurse Practitioners LENDABARKER KRISTINA D 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 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 0 648.83 0 0 0 0 0 0 648.83 0 0 1006374234 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 47.77 0 0 0 0 0 0 47.77 0 0 1006374297 1407378078 10 Physicians DAHER GHASSAN 999999999 200 Cook 0 0 Internal Medicine 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 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 0 542.03 0 0 0 0 0 0 542.03 0 0 1006374530 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 19527.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19527.46 0 0 1006374685 1083141485 60 Pharmacies CVS PHARMACY #10555 999999999 200 Cook 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4413 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3132.62 0 0 0 3132.62 0 0 1006375099 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26145.68 0 0 0 0 0 0 0 0 0 0 0 0 0 26145.68 0 0 1006375302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4026.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4026.49 0 0 1006375717 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17274.84 0 0 0 0 0 0 0 0 0 0 0 0 0 17274.84 0 0 1006376047 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1081.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1081.56 0 0 1006376190 1578048377 16 Nurse Practitioners CARROLL TAYLOR 999999999 60 Lee 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 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 1016.89 0 0 0 0 0 0 1016.89 0 0 1006376321 1033613849 10 Physicians SILVERMAN ERIC R 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429.22 0 0 0 0 0 0 429.22 0 0 1006376489 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 190.88 0 0 0 0 0 0 190.88 0 0 1006376493 1225311368 89 Physician Assistant Only(Encounter Only) MARTIN ERIN K 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 0 167 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 14.26 0 0 0 0 0 0 14.26 0 0 1006376707 1144647363 10 Physicians DONSKOY INNESSA M 999999999 200 Cook 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 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 4785.45 0 0 0 0 0 0 4785.45 0 0 1006376739 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12337.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12337.05 0 0 1006376760 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1233.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1233.9 0 0 1006376782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27409.46 0 0 0 0 0 0 0 0 0 0 0 0 0 27409.46 0 0 1006377358 91 Waiver service provider--Adults (DHS/DDD) 78 Moultrie 0 0 0 0 0 0 0 1 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 25071.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25071.2 0 0 1006377380 1730686015 16 Nurse Practitioners ZIMMERMAN KAYLA A 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 32 0 0 0 0 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 52 0 0 0 0 0 0 0 0 0 195.87 0 0 0 0 0 0 0 0 974.2 0 0 0 0 0 0 1170.07 0 0 1006377691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1074.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.48 0 0 1006377786 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21591.35 0 0 0 0 0 0 0 0 0 0 0 0 0 21591.35 0 0 1006377829 1356722961 10 Physicians HUSSAIN SADIA 999999999 200 Cook 0 0 Pediatrics 0 0 0 8 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 615.15 0 0 0 0 0 0 0 0 320.97 0 0 0 0 0 0 936.12 0 0 1006378534 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 0 198 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 15335.76 0 0 0 0 0 0 0 0 0 0 0 0 0 15335.76 0 0 1006378540 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 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 7163.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7163.2 0 0 1006379406 1851872741 16 Nurse Practitioners KIMBLE KIYOMI 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 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 1014.77 0 0 0 0 0 0 1014.77 0 0 1006379556 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 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 0 285.78 285.78 0 0 1006379650 1952828980 16 Nurse Practitioners PETRISHKA PAULINA A 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 4.11 0 0 0 0 0 0 4.11 0 0 1006379705 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.52 0 0 1006380254 1336346782 10 Physicians GUPTA UMANG 999999999 91 Sangamon 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 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 0 0 98.07 0 0 0 0 0 0 98.07 0 0 1006380342 1376926402 10 Physicians RIVEROS TONI A 999999999 200 Cook 0 0 Emergency 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 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 0 449.74 0 0 0 0 0 0 449.74 0 0 1006380809 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 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 1204.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.72 0 0 1006381095 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.77 0 0 0 0 0 0 0 0 10.77 0 0 1006381925 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40763.68 0 0 0 0 0 0 0 0 0 0 0 0 0 40763.68 0 0 1006382017 1033143599 10 Physicians MIRANPURI AMRENDRA S 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 5 0 21 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 6.12 0 1098.46 0 0 0 0 0 0 1104.58 0 0 1006382354 1588185631 16 Nurse Practitioners MARTY CATHERINE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 1013.86 0 0 0 0 0 0 1013.86 0 0 1006382540 1134474612 16 Nurse Practitioners PROKOP GAIL 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 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 0 751.63 0 0 0 0 0 0 751.63 0 0 1006382585 1871835777 10 Physicians ARDESHNA RISHI 999999999 53 Kane 0 0 Anesthesiology 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 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3495.3 0 0 0 0 0 0 3495.3 0 0 1006382648 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 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 5235.77 0 0 0 0 0 0 5235.77 0 0 1006382961 1528423019 16 Nurse Practitioners OYIBE CHRISTIAN 999999999 200 Cook 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 0 669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9317.14 0 0 0 0 0 0 9317.14 0 0 1006383310 1538541388 10 Physicians SHARMA MEERA 999999999 91 Sangamon 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 411.5 0 0 0 0 0 0 7.14 0 1280.01 0 0 0 0 0 0 1698.65 0 0 1006383556 1548775257 16 Nurse Practitioners BIVANS PETER 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 0 538.43 0 0 0 0 0 0 538.43 0 0 1006383876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3164.91 0 0 0 0 0 0 0 0 0 0 0 0 0 3164.91 0 0 1006383983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26945.93 0 0 0 0 0 0 0 0 0 0 0 0 0 26945.93 0 0 1006384086 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24496.01 0 0 0 0 0 0 0 0 0 0 0 0 0 24496.01 0 0 1006384353 1659868859 75 Department of Alcohol and Substance Abuse Provider NORTHWESTERN MEDICINE BEN GORD 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4472.65 0 0 4472.65 0 0 1006384674 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 2918.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2918.78 0 0 1006384786 1841727476 10 Physicians ELMUTI LENA F 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 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 0 893.5 0 0 0 0 0 0 893.5 0 0 1006385176 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 0 106 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 24456.63 0 0 0 0 0 0 0 0 0 0 0 0 0 24456.63 0 0 1006385745 1386142503 16 Nurse Practitioners DERHAM ALIVIA R 999999999 80 Peoria 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 0 159 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 2162.58 0 0 0 0 0 0 2162.58 0 0 1006385780 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20065.46 0 0 0 0 0 0 0 0 0 0 0 0 0 20065.46 0 0 1006385858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28974.76 0 0 0 0 0 0 0 0 0 0 0 0 0 28974.76 0 0 1006385910 1992112601 86 Clinical Social Worker(Encounter Only) WARNER ALEXANDRA 999999999 53 Kane 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 0 445 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 24886.06 0 0 0 0 0 0 24886.06 0 0 1006385936 1912363557 16 Nurse Practitioners ELLIS MEREDITH C 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 251.38 0 0 0 0 0 0 251.38 0 0 1006386006 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 49.22 0 0 0 0 0 0 49.22 0 0 1006386062 1205295458 16 Nurse Practitioners GREENSPOON SEVASTI 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 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 0 698.45 0 0 0 0 0 0 698.45 0 0 1006386123 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22987.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22987.1 0 0 1006386354 1184151193 16 Nurse Practitioners CAMPANELLA HAILI 999999999 98 Tazewell 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 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 1384.68 0 0 0 0 0 0 1384.68 0 0 1006386481 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1006387223 1689188369 16 Nurse Practitioners HALL KATLYN E 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 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1006387494 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22512.87 0 0 0 0 0 0 0 0 0 0 0 0 0 22512.87 0 0 1006387616 1518348622 10 Physicians FILSON-PINKLEY KATHRYN L 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 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 0 458.17 0 0 0 0 0 0 458.17 0 0 1006387683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 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Perry 0 0 0 0 0 0 0 0 0 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 1307.32 0 0 0 0 0 0 1307.32 0 0 1006391259 1699817593 86 Clinical Social Worker(Encounter Only) MEYER DAWN 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 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 0 817.38 0 0 0 0 0 0 817.38 0 0 1006391283 1841610961 10 Physicians HASE NAOMASA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437.62 0 829.07 0 0 0 0 0 0 1266.69 0 0 1006391288 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.23 0 0 1006391299 1184875254 22 Physical Therapists MAXWELL JOHN L 999999999 30 DuPage 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 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 0 467.34 467.34 0 0 1006391447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39971.49 0 0 0 0 0 0 0 0 0 0 0 0 0 39971.49 0 0 1006392253 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1312.63 0 0 1006392366 1437491834 10 Physicians THANKI SHAMEETA V 999999999 200 Cook 0 0 Anesthesiology 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 2 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1524.85 0 0 0 0 0 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1700043494 10 Physicians GOLDSTEIN SETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.62 0 4589.81 0 0 0 0 0 0 4607.43 0 0 1006393974 1720518434 16 Nurse Practitioners DANIEL SHINY 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 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 47.42 0 0 0 0 0 0 47.42 0 0 1006393997 1417487455 89 Physician Assistant Only(Encounter Only) DROESSLER SANDRA K 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 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 55.63 0 0 0 0 0 0 55.63 0 0 1006394517 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23820.14 0 0 0 0 0 0 0 0 0 0 0 0 0 23820.14 0 0 1006394918 1649795659 48 Rural Health Clinics HMC CLINIC AT MARION 629595270 108 Williamson 0 0 0 447 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1464 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1464 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21311.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21311.81 0 0 1006395332 1053750935 10 Physicians KHAN IMRAN 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 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 1 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 7923.92 0 0 0 0 0 0 7945.24 0 0 1006395820 1528473790 10 Physicians RANDHAWA UMAIR 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 0 152 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 3660.28 0 0 0 0 0 0 3660.28 0 0 1006396083 1780969923 16 Nurse Practitioners KYNION JAIME L 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 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0 0 0 0 0 0 0 0 10051.88 0 0 1006397807 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 1006398022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22420 0 0 0 0 0 0 0 0 0 0 0 0 0 22420 0 0 1006398051 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.35 172.35 0 0 1006398137 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1006399070 1497252811 16 Nurse Practitioners HIGH HANNAH E 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 0 177 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 0 830.06 0 0 0 0 0 0 830.06 0 0 1006399215 23 Occupational Therapists 65 Madison 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 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 0 837.54 837.54 0 0 1006399247 1841768181 16 Nurse Practitioners HASTINGS ANDREA 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 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68764.9 0 0 0 0 0 0 68764.9 0 0 1006399308 1730508318 10 Physicians SCHULMAN ZARA M 999999999 57 Lake 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 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17414.61 0 0 0 0 0 0 17414.61 0 0 1006399385 1184085847 16 Nurse Practitioners PITTMAN ELIZIBETH D 999999999 96 St 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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 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 1194.42 0 0 0 0 0 0 0 0 0 0 0 0 0 1194.42 0 0 1006400122 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18180.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18180.82 0 0 1006400150 1396740197 10 Physicians SUBBIAN ANANDI 999999999 10 Adams 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 0 227 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 3342.09 0 0 0 0 0 0 3342.09 0 0 1006400412 1265925317 91 Waiver service provider--Adults (DHS/DDD) BETTENCOURT ROBIN MOLLY C 999999999 200 Cook 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 1484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80498.36 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 47241.42 0 0 0 0 0 0 0 0 0 0 0 0 0 47241.42 0 0 1006402886 1700142718 10 Physicians LAVINE JEREMY 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.1 0 3154.18 0 0 0 0 0 0 3295.28 0 0 1006402902 1568720753 10 Physicians ZIFFRA JEFFREY B 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 10 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.87 0 5732.85 0 0 0 0 0 0 5790.72 0 0 1006402917 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8663.08 0 0 0 0 0 0 0 0 0 0 0 0 0 8663.08 0 0 1006402919 1740647437 10 Physicians BAIG JALAL S 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 473 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.52 0 11368 0 0 0 0 0 0 11373.52 0 0 1006403213 1700174638 10 Physicians KAMEL GHASSAN 999999999 30 DuPage 0 0 Internal Medicine 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 71 0 0 0 0 0 0 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 0 0 2957.74 0 0 0 0 0 0 2957.74 0 0 1006403215 1689949828 10 Physicians KAMAL SAAD 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 767.72 0 0 0 0 0 0 767.72 0 0 1006403491 86 Clinical Social Worker(Encounter Only) 100 Vermilion 0 0 0 0 0 0 0 0 0 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 0 640.5 0 0 0 0 0 0 640.5 0 0 1006403624 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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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CHILDREN HAVE OPPORTUNITIE 999999999 200 Cook 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 25637 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 25637 0 0 0 0 157.72 0 0 0 0 0 0 0 0 0 0 0 0 0 592729.88 0 592887.6 0 0 1006404035 1629543400 55 Early Intervention Services LUKE CLARISSA A 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 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26692.55 0 0 0 0 0 0 26692.55 0 0 1006404151 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 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 0 257.99 0 0 0 0 0 0 257.99 0 0 1006404163 91 Waiver service provider--Adults (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 0 143 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 9544.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9544.8 0 0 1006404187 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23860.61 0 0 0 0 0 0 0 0 0 0 0 0 0 23860.61 0 0 1006404484 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 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 0 251.08 0 0 0 0 0 0 251.08 0 0 1006404653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2100.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2100.56 0 0 1006404830 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.59 0 0 0 0 0 0 0 0 10.59 0 0 1006405235 1639606577 89 Physician Assistant Only(Encounter Only) BOSE SUCHARITHA 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 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 1302.83 0 0 0 0 0 0 1302.83 0 0 1006405238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11054.79 0 0 0 0 0 0 0 0 0 0 0 0 0 11054.79 0 0 1006405287 10 Physicians 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 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 92.8 0 0 0 0 0 0 92.8 0 0 1006405377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 683.55 0 0 0 0 0 0 0 0 0 0 0 0 0 683.55 0 0 1006405455 1427461581 86 Clinical Social Worker(Encounter Only) MEYER CORTNEY D 999999999 47 Jackson 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 0 710.08 0 0 0 0 0 0 710.08 0 0 1006405869 1538640941 16 Nurse Practitioners DUNKIRK SAMANTHA E 999999999 91 Sangamon 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 0 128 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 339.51 0 0 0 0 0 0 0 0 5336.67 0 0 0 0 0 0 5676.18 0 0 1006406327 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1176.83 0 0 1006406695 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 0 0 0 0 0 0 0 0 0 0 1006407034 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33881.17 0 0 0 0 0 0 0 0 0 0 0 0 0 33881.17 0 0 1006407504 1750864021 16 Nurse Practitioners JEPSEN JENNIFER 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 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 0 907.93 0 0 0 0 0 0 907.93 0 0 1006407927 1417434168 24 Speech Therapists MASON SAMANTHA 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 0 410 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 30390.99 30390.99 0 0 1006408026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.11 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.11 0 0 1006408929 1033360110 89 Physician Assistant Only(Encounter Only) ADAMSKI PATRICIA 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 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 52.12 0 0 0 0 0 0 52.12 0 0 1006408991 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7801.26 0 0 0 0 0 0 0 0 0 0 0 0 0 7801.26 0 0 1006409500 1437597457 10 Physicians GOSTINE ANDREW 999999999 200 Cook 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 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 0 0 1714.11 0 0 0 0 0 0 1714.11 0 0 1006409504 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 0 193 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 26166.68 0 0 0 0 0 0 0 0 0 0 0 0 0 26166.68 0 0 1006409768 1417341785 10 Physicians BIRKHEAD ANDREW GARTNER 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 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 0 541.31 0 0 0 0 0 0 541.31 0 0 1006410009 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 43.54 0 0 0 0 0 0 43.54 0 0 1006410099 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.2 0 0 0 0 0 0 159.2 0 0 1006410198 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24994.73 0 0 0 0 0 0 0 0 0 0 0 0 0 24994.73 0 0 1006410751 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 1006410799 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21808.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21808.5 0 0 1006410849 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3343.2 0 0 0 0 0 0 0 0 0 0 0 0 0 3343.2 0 0 1006411035 1396011540 10 Physicians CHUA WEE-JHONG 999999999 200 Cook 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 0 109 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 7054.46 0 0 0 0 0 0 7054.46 0 0 1006411283 10 Physicians 80 Peoria 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 0 152 0 0 0 0 0 0 152 0 0 1006411713 14 Chiropractors 27 Dekalb 0 0 0 0 0 0 0 0 0 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 48.66 0 0 0 0 0 0 48.66 0 0 1006412988 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35171.94 0 0 0 0 0 0 0 0 0 0 0 0 0 35171.94 0 0 1006413063 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18630.51 0 0 0 0 0 0 0 0 0 0 0 0 0 18630.51 0 0 1006413149 1912499971 16 Nurse Practitioners SPENCER LUCINDA M 999999999 22 Clay 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 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 0 949.59 0 0 0 0 0 0 949.59 0 0 1006413323 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11377.24 0 0 0 0 0 0 0 0 0 0 0 0 0 11377.24 0 0 1006413358 1609307305 10 Physicians GLUTH RYAN JEFFREY 999999999 80 Peoria 0 0 Emergency 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 0 227 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 6659.9 0 0 0 0 0 0 6659.9 0 0 1006413621 1649779596 22 Physical Therapists PORYS KATARZYNA A 999999999 91 Sangamon 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 0 763 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 763 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56892.57 56892.57 0 0 1006413665 1730564428 10 Physicians BISTA ROSHAN 999999999 47 Jackson 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 0 162 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 3308.97 0 0 0 0 0 0 3308.97 0 0 1006413858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14154.87 0 0 0 0 0 0 0 0 0 0 0 0 0 14154.87 0 0 1006413911 1770025496 16 Nurse Practitioners BARTEL ALISSA M 999999999 80 Peoria 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 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 577.44 0 0 0 0 0 0 646.96 0 0 1006414437 10 Physicians 53 Kane 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 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 48.31 0 0 0 0 0 0 48.31 0 0 1006415035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14076.57 0 0 0 0 0 0 0 0 0 0 0 0 0 14076.57 0 0 1006415218 1962799098 10 Physicians GONDAL BILAL 999999999 82 Piatt 0 0 Internal 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 0 213 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 8311.84 0 0 0 0 0 0 8311.84 0 0 1006415483 1093233561 16 Nurse Practitioners SCHIPPA DULCIE 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 0 850.66 0 0 0 0 0 0 850.66 0 0 1006415488 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3288.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3288.36 0 0 1006415490 1841778115 12 Optometrists SEIBERT SARA M 999999999 91 Sangamon 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 113 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2297.13 0 296.77 0 0 0 0 2593.9 0 0 1006415492 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 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 1807.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1807.9 0 0 1006415662 1548771595 16 Nurse Practitioners WELNOWSKI NICOLE M 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 0 461 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 2287.55 0 0 0 0 0 0 2287.55 0 0 1006415831 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9351.53 0 0 0 0 0 0 0 0 0 0 0 0 0 9351.53 0 0 1006415965 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 0 174.16 0 0 0 0 0 0 174.16 0 0 1006416218 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006416321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10555.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10555.8 0 0 1006416384 1285725481 10 Physicians LINN JASON J 999999999 80 Peoria 0 0 Emergency 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 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 1425.75 0 0 0 0 0 0 1425.75 0 0 1006416574 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.24 0 0 0 0 0 0 89.24 0 0 1006419566 1497234397 86 Clinical Social Worker(Encounter Only) MEISTER HEIDI 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 0 129 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 0 544.77 0 0 0 0 0 0 544.77 0 0 1006419581 1124515523 16 Nurse Practitioners THOPIAH SHRUTHI R 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 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 1382.78 0 0 0 0 0 0 1382.78 0 0 1006419715 1467799338 13 Podiatrists KUMAR AVIJIT 999999999 200 Cook 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 2460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3269.03 0 0 0 0 0 0 3269.03 0 0 1006420135 1922080498 10 Physicians NIELSEN DAVID 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 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Therapists VANN LIA 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 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 0 513.94 513.94 0 0 1006422054 1942710678 16 Nurse Practitioners FISHER DARCY 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 38.64 0 0 0 0 0 0 0 0 1286.87 0 0 0 0 0 0 1325.51 0 0 1006422270 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3190.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3190.88 0 0 1006422956 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3168.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3168.4 0 0 1006423232 1104104959 10 Physicians RAHMANI SAFA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 7 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.99 0 15557.88 0 0 0 0 0 0 15736.87 0 0 1006423243 1447758107 16 Nurse Practitioners HILL THERESA M 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 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 0 523.7 0 0 0 0 0 0 523.7 0 0 1006423559 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13855.45 0 0 0 0 0 0 0 0 0 0 0 0 0 13855.45 0 0 1006423597 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 0 174 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 7980.04 0 0 0 0 0 0 0 0 0 0 0 0 0 7980.04 0 0 1006423838 89 Physician 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0 0 1006426439 16 Nurse Practitioners 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006426771 1659352276 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 805 California 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 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52775.21 0 0 0 0 0 0 0 0 52775.21 0 0 1006427141 1043651516 10 Physicians TAYLOR CAMERON W 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 736 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6755.15 0 1603.24 0 0 0 0 0 0 8358.39 0 0 1006427149 1194291237 16 Nurse Practitioners DEPA ANGELA R 999999999 57 Lake 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 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 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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 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 0 779.69 0 0 0 0 0 0 779.69 0 0 1006444812 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 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 0 314.69 0 0 0 0 0 0 0 0 0 0 0 0 0 314.69 0 0 1006444993 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21797.41 0 0 0 0 0 0 0 0 0 0 0 0 0 21797.41 0 0 1006445914 1972016418 89 Physician Assistant Only(Encounter Only) DEISINGER MATTHEW 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 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 0 193.26 0 0 0 0 0 0 193.26 0 0 1006445948 16 Nurse Practitioners 10 Adams 0 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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 8918.14 0 0 0 0 0 0 0 0 0 0 0 0 0 8918.14 0 0 1006447016 1275064768 16 Nurse Practitioners HILMES TARA 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 0 106 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 4487.85 0 0 0 0 0 0 4487.85 0 0 1006447116 1548656747 10 Physicians ISLAM MAAROOF M 999999999 80 Peoria 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 0 368 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 4097.31 0 0 0 0 0 0 4097.31 0 0 1006447129 1043707201 12 Optometrists NELSON KATHERINE N 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 1378.55 0 0 0 0 0 0 1378.55 0 0 1006448013 1447744255 60 Pharmacies GENOA HEALTHCARE LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1885 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.24 0 0 0 580.24 0 0 1006448296 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19753.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19753.3 0 0 1006448528 1326516071 86 Clinical Social Worker(Encounter Only) FRANKEL MAXWELL 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 2647.47 0 0 0 0 0 0 2647.47 0 0 1006448532 1760909287 16 Nurse Practitioners ORTEGA SAMUEL 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 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 0 670.76 0 0 0 0 0 0 670.76 0 0 1006448564 1942478862 75 Department of Alcohol and Substance Abuse Provider PILLARS COMMUNITY HEALTH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 3993.6 0 0 3993.6 0 0 1006448585 1457877839 16 Nurse Practitioners ROSALES KAITLYN R 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 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 0 618.24 0 0 0 0 0 0 618.24 0 0 1006448630 1922413871 10 Physicians SHAH ANUSHI A 999999999 80 Peoria 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 0 181 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 2506.07 0 0 0 0 0 0 2506.07 0 0 1006449154 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 391.24 0 0 0 0 0 0 391.24 0 0 1006449510 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14766.05 0 0 0 0 0 0 0 0 0 0 0 0 0 14766.05 0 0 1006449621 1558742775 10 Physicians THOMAS ALEX A 999999999 88 Richland 0 0 0 0 0 0 0 0 0 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1006449913 1114471745 10 Physicians BECKER KARL N 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.17 0 4190.55 0 0 0 0 0 0 4412.72 0 0 1006450910 1396229522 16 Nurse Practitioners GERRINGER ALISON J 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 0 138 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 2313.9 0 0 0 0 0 0 2313.9 0 0 1006451694 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19316.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19316.22 0 0 1006452783 1760618789 10 Physicians SIDDIQUE FAIZAH 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867.81 0 0 0 0 0 0 867.81 0 0 1006452916 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 0 230 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 22231.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22231.2 0 0 1006453000 86 Clinical Social Worker(Encounter Only) 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.56 0 0 0 0 0 0 87.56 0 0 1006453699 1487068961 86 Clinical Social Worker(Encounter Only) DENECKE SUSAN 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 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 0 715.45 0 0 0 0 0 0 715.45 0 0 1006453816 1356826309 16 Nurse Practitioners LAHOOD AMANDA 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 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 19.58 0 0 0 0 0 0 0 0 542.08 0 0 0 0 0 0 561.66 0 0 1006453832 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26170.3 0 0 0 0 0 0 0 0 0 0 0 0 0 26170.3 0 0 1006454053 1043729189 16 Nurse Practitioners BRYANT JENNIFER 999999999 12 Bond 0 0 0 0 0 4 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 192.43 0 0 0 0 0 0 0 0 2252.42 0 0 0 0 0 0 2444.85 0 0 1006454397 1790273241 16 Nurse Practitioners MAY COURTNEY J 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 304.78 0 0 0 0 0 0 304.78 0 0 1006454447 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 78.09 0 0 0 0 0 0 78.09 0 0 1006454525 1205353778 16 Nurse Practitioners CHILDS MEGHAN 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 0 208 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 15665.27 0 0 0 0 0 0 15665.27 0 0 1006454790 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 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 18652.18 0 0 0 0 0 0 0 0 0 0 0 0 0 18652.18 0 0 1006454827 1023549862 16 Nurse Practitioners CRECELIUS KRYSTAL L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1006454885 1477086874 10 Physicians KRAMER OWEN 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 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 29.69 0 0 0 0 0 0 29.69 0 0 1006455469 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 15189.24 0 0 0 0 0 0 0 0 0 0 0 0 0 15189.24 0 0 1006455640 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 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 0 360.87 360.87 0 0 1006455811 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 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 1006455866 1962990309 16 Nurse Practitioners KHAPEKAR RAVI 999999999 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 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 0 219.71 0 0 0 0 0 0 219.71 0 0 1006455874 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11566.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11566.1 0 0 1006455923 1578976635 10 Physicians MITCHELL SARAH 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 0 711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43495.89 0 0 0 0 0 0 43495.89 0 0 1006456000 1629513965 16 Nurse Practitioners HILL AMY J 999999999 72 McLean 0 0 0 0 0 11 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 937.4 0 0 0 0 0 0 0 0 4051.28 0 0 0 0 0 0 4988.68 0 0 1006456400 1184010589 10 Physicians BROWN MICAHLA C 999999999 81 Perry 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 0 999.1 0 0 0 0 0 0 999.1 0 0 1006456505 1770077133 91 Waiver service provider--Adults (DHS/DDD) DEHART KAYLA 999999999 91 Sangamon 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 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34156.2 0 0 0 0 0 0 0 0 0 0 0 0 0 34156.2 0 0 1006457311 1750746285 30 General Hospitals LA PORTE HOSPITAL COMPANY LLC 999999999 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 4 0 0 0 0 3 0 0 0 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 4 0 0 0 3 0 0 0 0 0 0 0 0 0 5 0 0 0 0 53 0 0 0 3 0 0 0 0 0 0 0 0 0 519.12 0 0 0 0 0 0 0 0 139.31 0 0 0 0 0 658.43 0 0 1006457329 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 571.5 0 0 0 0 0 0 0 0 0 0 0 0 0 571.5 0 0 1006457653 60 Pharmacies 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 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 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.64 0 0 0 92.64 0 0 1006457946 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 0 294.5 0 0 0 0 0 0 294.5 0 0 1006458137 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24186.62 0 0 0 0 0 0 0 0 0 0 0 0 0 24186.62 0 0 1006458328 1285168229 89 Physician Assistant Only(Encounter Only) SPERRY COURTNEY 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 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 0 163.12 0 0 0 0 0 0 163.12 0 0 1006458896 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3369.57 0 0 0 0 0 0 0 0 0 0 0 0 0 3369.57 0 0 1006459136 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006459471 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 52.84 0 0 0 0 0 0 52.84 0 0 1006459765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1858.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1858.93 0 0 1006459780 1255744884 10 Physicians LOHANI SILU 999999999 57 Lake 0 0 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 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 0 862.18 0 0 0 0 0 0 862.18 0 0 1006459790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11277.97 0 0 0 0 0 0 0 0 0 0 0 0 0 11277.97 0 0 1006460578 1760918288 24 Speech Therapists REED MCCALL 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 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 2940.83 2940.83 0 0 1006460665 1679783260 12 Optometrists COHEN VANESA 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1006461786 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23007.71 0 0 0 0 0 0 0 0 0 0 0 0 0 23007.71 0 0 1006462538 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16050.74 0 0 0 0 0 0 0 0 0 0 0 0 0 16050.74 0 0 1006462621 1063771798 60 Pharmacies BETTER BALANCE PHARMACY 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1444.19 0 0 9.24 0 0 0 1453.43 0 0 1006462738 1487960019 10 Physicians RUTKOWSKI MAGDALENA M 999999999 200 Cook 0 0 0 0 0 13 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 1 0 132 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 1 0 132 0 0 0 0 0 0 0 0 0 1180.11 0 0 0 0 0 0 2.6 0 3823.96 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0 0 0 0 0 0 0 0 0 117880.2 0 0 1006463337 1578903613 10 Physicians DOSHI AMISH 999999999 200 Cook 0 0 Internal Medicine 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 91 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 2177.87 0 0 0 0 0 0 2282.83 0 0 1006463780 1558378166 10 Physicians SHIHABI AHMAD H 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.45 0 5014.57 0 0 0 0 0 0 5027.02 0 0 1006463931 1801180047 91 Waiver service provider--Adults (DHS/DDD) RIPLEY AMANDA L 999999999 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 0 197 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 11438.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11438.2 0 0 1006463993 1235618927 16 Nurse Practitioners SCHRUM MARISA M 999999999 54 Kankakee 0 0 0 0 0 5 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 60423.48 0 0 0 60423.48 0 0 1006464835 1881048163 10 Physicians MEMARI SINA 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 0 138 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 4433.58 0 0 0 0 0 0 4433.58 0 0 1006464846 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1006464946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15333.46 0 0 0 0 0 0 0 0 0 0 0 0 0 15333.46 0 0 1006465297 1942615489 10 Physicians LAURIDO-SOTO OSVALDO 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 83.23 0 0 0 0 0 0 83.23 0 0 1006465307 1952803355 16 Nurse Practitioners RUPERT KATELYN 616157831 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 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 1120.95 0 0 0 0 0 0 1120.95 0 0 1006465756 1902310469 16 Nurse Practitioners ACHIMOWICZ ALICJA M 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 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 0 671.94 0 0 0 0 0 0 671.94 0 0 1006465911 1851658694 10 Physicians BANGASH HAIDER K 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 398.52 0 0 0 0 0 0 398.52 0 0 1006465933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31541.85 0 0 0 0 0 0 0 0 0 0 0 0 0 31541.85 0 0 1006466215 1801308911 16 Nurse Practitioners DODD MICHELLE 999999999 91 Sangamon 0 0 0 0 0 12 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 770.23 0 0 0 0 0 0 0 0 1497.76 0 0 0 0 0 0 2267.99 0 0 1006466225 16 Nurse Practitioners 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 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 0 103.59 0 0 0 0 0 0 103.59 0 0 1006466291 10 Physicians 70 McDonough 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.18 0 0 0 0 0 0 9.18 0 0 1006466339 1952797714 89 Physician Assistant Only(Encounter Only) ASHCROFT LAUREN 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 11948.33 0 0 0 0 0 0 11948.33 0 0 1006469226 1922512458 16 Nurse Practitioners DOUGLASS JENNIFER M 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 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 0 395.6 0 0 0 0 0 0 395.6 0 0 1006469228 1194109454 89 Physician Assistant Only(Encounter Only) GARCIA SAUL 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 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 0 182 0 0 0 0 0 0 182 0 0 1006469419 1942700471 36 Community mental health provider JASPER COUNTY HEALTH DEPARTMEN 999999999 88 Richland 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 179.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3485.78 0 0 3665.38 0 0 1006469470 1376898536 10 Physicians RAMIRO JOANNA 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 86 0 0 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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 0 281.83 0 0 0 0 0 0 281.83 0 0 1006470199 36 Community mental health provider 58 La Salle 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 727.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 988.2 0 0 1715.6 0 0 1006470206 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4083.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4083.98 0 0 1006471034 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006471698 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 2612.55 0 0 1006472630 1871024786 16 Nurse Practitioners HORVATH SARA 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 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 1186.46 0 0 0 0 0 0 1186.46 0 0 1006472686 1588001754 10 Physicians ZAHATNANSKY JURAJ 999999999 200 Cook 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.63 0 1013.45 0 0 0 0 0 0 1019.08 0 0 1006472813 1912240797 10 Physicians DHILLON-JHATTU SANGEET 999999999 200 Cook 0 0 Internal Medicine 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 0 637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 902.57 0 0 0 0 0 0 902.57 0 0 1006473117 1093991028 86 Clinical Social Worker(Encounter Only) BAUERSFELD BRIDGET 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 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 6858.17 0 0 0 0 0 0 6858.17 0 0 1006473737 1700304508 16 Nurse Practitioners WITT KARIN C 999999999 45 Henry 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 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 0 485.41 0 0 0 0 0 0 485.41 0 0 1006474072 1104169077 89 Physician Assistant Only(Encounter Only) BRUCE REBECCA E 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 50.32 0 0 0 0 0 0 50.32 0 0 1006474777 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24041.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24041.4 0 0 1006474819 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 0 185.36 0 0 0 0 0 0 185.36 0 0 1006475148 1699115006 10 Physicians ORR WILLIAM B 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 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 1804.37 0 0 0 0 0 0 1804.37 0 0 1006475239 1033607726 33 Nursing Facilities OAK PARK OASIS 999999999 200 Cook 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 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4599 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534456.51 0 0 0 0 0 0 0 534456.51 0 0 1006475387 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 5 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 4316.38 4316.38 0 0 1006475397 1023171873 89 Physician Assistant Only(Encounter Only) FRANKEL EMMA 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 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 0 178.2 0 0 0 0 0 0 178.2 0 0 1006475645 1326452079 10 Physicians NATHAN JENNA 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 5 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.6 0 1053.91 0 0 0 0 0 0 1268.51 0 0 1006475775 1730488396 10 Physicians ARMSTRONG BRACKEN 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 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 3404.66 0 0 0 0 0 0 3404.66 0 0 1006475885 1336638279 16 Nurse Practitioners MCWILLIAMS KEANLYNN M 999999999 109 Winnebago 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 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 5740.67 0 0 0 0 0 0 5740.67 0 0 1006476132 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4007.28 0 0 0 0 0 0 4007.28 0 0 1006476819 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6879.71 0 0 0 0 0 0 0 0 0 0 0 0 0 6879.71 0 0 1006477039 1134410426 10 Physicians DERAKHSHAN JAMAL J 999999999 200 Cook 0 0 Radiology Diagnosis 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 0 129 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 3369.55 0 0 0 0 0 0 0 0 3369.55 0 0 1006477381 1891861969 25 Audiologists KWARTA KERI L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 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 1368.6 1368.6 0 0 1006477506 1851818462 16 Nurse Practitioners BUDAHAZY MELISSA L 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 0 197.2 0 0 0 0 0 0 197.2 0 0 1006477849 1407240914 10 Physicians ZHOU AMY Z 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 0 186.66 0 0 0 0 0 0 186.66 0 0 1006477932 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1762.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1762.31 0 0 1006478024 1609383066 75 Department of Alcohol and Substance Abuse Provider DUPAGE COUNTY HEALTH DEPARTMEN 601873977 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4131.65 0 0 4131.65 0 0 1006478274 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15429.37 0 0 0 0 0 0 0 0 0 0 0 0 0 15429.37 0 0 1006478375 1508112392 60 Pharmacies TARRYTOWN EXPOCARE 999999999 845 Texas 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 23245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278876.41 0 0 0 278876.41 0 0 1006478385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6678.3 0 0 0 0 0 0 0 0 0 0 0 0 0 6678.3 0 0 1006478929 1235541392 10 Physicians BALHARRY GHISLAINE B 999999999 30 DuPage 0 0 General 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 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 1307.19 0 0 0 0 0 0 1307.19 0 0 1006479132 1902293913 24 Speech Therapists JELIAZKOVA SILVIA 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0 0 0 0 0 0 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 4057.28 0 0 0 0 0 0 4057.28 0 0 1006480765 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 0 212 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 13550.3 0 0 0 0 0 0 0 0 0 0 0 0 0 13550.3 0 0 1006480891 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 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 1587 0 0 0 0 0 0 0 0 0 0 0 0 0 1587 0 0 1006480920 1093879892 74 Hospital-Based Transportation Providers HORIZON HEALTH EMERGENCY MEDIC 619442460 31 Edgar 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 1088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1088 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59686.97 0 0 0 0 0 0 59686.97 0 0 1006481111 1275962243 10 Physicians NASRAT TAOFIK 999999999 10 Adams 0 0 Neurology 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 3 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.64 0 8210.57 0 0 0 0 0 0 8218.21 0 0 1006481404 1801313077 89 Physician Assistant Only(Encounter Only) MILLER ERIN J 999999999 35 Ford 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 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 0 697.97 0 0 0 0 0 0 697.97 0 0 1006481851 1962986836 11 Dentists ZAEIMZADEH SHIMA 999999999 200 Cook 0 0 0 0 93 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 431 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 12496.79 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 13249.49 0 0 1006482072 1003340449 16 Nurse Practitioners MORDENO RACHEL A 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 0 126 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 1482.3 0 0 0 0 0 0 1482.3 0 0 1006482235 1003260498 46 Ambulatory Surgical Treatment Centers NORTHWEST ENDO CENTER LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 506.92 0 0 0 0 0 506.92 0 0 1006482269 1841599255 10 Physicians DUTTA SONIA 999999999 200 Cook 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 3 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.22 0 464.88 0 0 0 0 0 0 485.1 0 0 1006482585 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3992.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3992.8 0 0 1006482780 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 41.77 0 0 0 0 0 0 0 0 0 0 0 0 0 41.77 0 0 1006483059 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 982.68 0 0 0 0 0 0 0 0 0 0 0 0 0 982.68 0 0 1006483550 1023563533 16 Nurse Practitioners CARRINGTON CARMESHA 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 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 0 938.15 0 0 0 0 0 0 938.15 0 0 1006483594 1003308347 16 Nurse Practitioners FLOYD ELIZABETH 999999999 72 McLean 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 0 104 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 3194.77 0 0 0 0 0 0 3194.77 0 0 1006483911 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25038.15 0 0 0 0 0 0 0 0 0 0 0 0 0 25038.15 0 0 1006484711 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1265.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1265.32 0 0 1006485089 1033304431 10 Physicians MALHOTRA SAURABH 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 0 104 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 0 241.31 0 0 0 0 0 0 241.31 0 0 1006485266 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 18004.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18004.45 0 0 1006485324 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 0 317.48 0 0 0 0 0 0 317.48 0 0 1006485434 1629025044 91 Waiver service provider--Adults (DHS/DDD) BARDELL RAE 999999999 91 Sangamon 0 0 0 0 0 0 0 13 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 34245.6 0 0 0 0 0 0 0 0 0 0 0 0 0 34245.6 0 0 1006485816 1679741888 36 Community mental health provider PILLARS COMMUNITY HEALTH 605265653 200 Cook 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255 0 0 4020.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24796.3 0 0 28816.57 0 0 1006485818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30258.44 0 0 0 0 0 0 0 0 0 0 0 0 0 30258.44 0 0 1006486708 10 Physicians 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 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 0 188.22 0 0 0 0 0 0 188.22 0 0 1006486718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1006486821 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7957.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7957.19 0 0 1006487088 1487171328 16 Nurse Practitioners EPPERSON JESSIKA 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 0 165.22 0 0 0 0 0 0 165.22 0 0 1006487389 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25314.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25314.33 0 0 1006487522 16 Nurse Practitioners 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.4 0 0 0 0 0 0 76.4 0 0 1006488042 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5148.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5148.68 0 0 1006488148 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7283.06 0 0 0 0 0 0 0 0 0 0 0 0 0 7283.06 0 0 1006488212 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2287.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2287.1 0 0 1006488301 1154740231 10 Physicians MITCHELL JESSICA E. 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 23 0 58 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 35 0 101 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 35 0 101 0 0 0 0 0 0 0 0 0 35.65 0 0 0 0 0 0 66.49 0 7510.2 0 0 0 0 0 0 7612.34 0 0 1006488540 87 Psychologist(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 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 12.06 0 0 0 0 0 0 12.06 0 0 1006488573 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 784.76 0 0 0 0 0 0 0 0 0 0 0 0 0 784.76 0 0 1006488701 1871010579 22 Physical Therapists MARCONI KATE 999999999 30 DuPage 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 0 127 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 1022.06 1022.06 0 0 1006488911 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13063.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13063.35 0 0 1006489479 1962994707 16 Nurse Practitioners DEHNE MICHELLE S 999999999 80 Peoria 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 0 136 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 2757.37 0 0 0 0 0 0 2757.37 0 0 1006490068 10 Physicians 92 Schuyler 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 0 0 0 0 0 0 0 21.32 0 0 1006490367 1558853143 16 Nurse Practitioners CAMPBELL JOY 999999999 10 Adams 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 0 122 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 1397.13 0 0 0 0 0 0 1397.13 0 0 1006490405 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25960 0 0 0 0 0 0 0 0 0 0 0 0 0 25960 0 0 1006490760 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 96.62 0 0 0 0 0 0 0 0 96.62 0 0 1006490778 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 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 1006490779 1467685214 10 Physicians TEME TONYE 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4334.52 0 0 0 0 0 0 4334.52 0 0 1006490994 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 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 0 127.56 0 0 0 0 0 0 127.56 0 0 1006491276 1487166690 89 Physician Assistant Only(Encounter Only) CARMEAN ERIN 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 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 1155.5 0 0 0 0 0 0 1155.5 0 0 1006491277 10 Physicians 89 Rock Island 0 0 Orthopedic Surgery 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 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 0 114.8 0 171.37 0 0 0 0 0 0 286.17 0 0 1006491559 1851881908 16 Nurse Practitioners TAYLOR ALAINA M 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 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 0 779.48 0 0 0 0 0 0 779.48 0 0 1006491652 1871002048 16 Nurse Practitioners REGGUINTI BREANNA 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 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 1067.84 0 0 0 0 0 0 1067.84 0 0 1006491906 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 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 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.71 0 0 0 47.71 0 0 1006492153 30 General Hospitals 80 Peoria 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16330.28 0 0 0 0 0 0 0 0 0 16330.28 0 0 1006492246 1508331653 22 Physical Therapists VERDI JORDAN 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103769.34 103769.34 0 0 1006492407 1265954069 16 Nurse Practitioners MIKOL ELISSA 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 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 4927.03 0 0 0 0 0 0 4927.03 0 0 1006492417 1407376338 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 625264379 63 Macon 0 0 0 615 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2350 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2350 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97371 0 138.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97509.03 0 0 1006492558 1033344759 10 Physicians HOOFNAGLE MARK 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 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 0 910.97 0 0 0 0 0 0 910.97 0 0 1006493068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18778.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18778.5 0 0 1006493350 1780055624 28 Waiver service provider--Supportive living facility (HFS) ROYAL ESTATES ASSISTIVE LIVING 999999999 200 Cook 0 0 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 0 752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87470.72 0 0 0 0 0 0 0 0 0 0 0 0 0 87470.72 0 0 1006493851 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17247.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17247.43 0 0 1006494110 1912487976 100 Family Support Program "NEURORESTORATIVE, ILLINOIS" 999999999 47 Jackson 0 0 0 54 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 12595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7548000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7548000 0 0 1006494422 1225520166 11 Dentists MCQUINN ERIN 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 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 2949.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2949.82 0 0 1006494601 11 Dentists 200 Cook 0 0 General Dentistry 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 0 245.62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.62 0 0 1006494678 1306238860 16 Nurse Practitioners FILLIMAN TRISHA L. 999999999 80 Peoria 0 0 0 0 0 6 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 96.42 0 0 0 0 0 0 0 0 6123.86 0 0 0 0 0 0 6220.28 0 0 1006495170 1548787831 16 Nurse Practitioners KACZKOWSKI BEATA K 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 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 1837.88 0 0 0 0 0 0 1837.88 0 0 1006495310 1033628201 16 Nurse Practitioners KELLER LYNN P 999999999 88 Richland 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 0 128 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 1359.7 0 0 0 0 0 0 1359.7 0 0 1006495319 1588939045 10 Physicians STEFANIA MARAKA 999999999 200 Cook 0 0 Neurology 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 0 106 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 3263.25 0 0 0 0 0 0 3263.25 0 0 1006495747 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 49.22 0 0 0 0 0 0 49.22 0 0 1006496118 23 Occupational Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 6218.17 6218.17 0 0 1006496124 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12258.31 0 0 0 0 0 0 0 0 0 0 0 0 0 12258.31 0 0 1006496246 1891276341 11 Dentists MOORE ELIZABETH F 999999999 63 Macon 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006496589 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12325.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12325.5 0 0 1006496898 16 Nurse Practitioners 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 54.06 0 0 0 0 0 0 54.06 0 0 1006496975 1801390414 10 Physicians CUMMING JOSEPH 999999999 815 Indiana 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 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 0 536.89 0 0 0 0 0 0 536.89 0 0 1006497127 1245777911 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 25 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 5520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2848.37 0 0 0 2848.37 0 0 1006497324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23719.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23719.96 0 0 1006497402 1972968121 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 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 0 357 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 92541.54 0 0 92541.54 0 0 1006497537 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 0 625.21 0 0 0 0 0 0 0 0 0 0 0 0 0 625.21 0 0 1006497561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40114.68 0 0 0 0 0 0 0 0 0 0 0 0 0 40114.68 0 0 1006497987 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 0 855.17 0 0 0 0 0 0 0 0 0 0 0 0 0 855.17 0 0 1006498093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2211.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2211.19 0 0 1006498227 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 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 17068.32 0 0 0 0 0 0 0 0 0 0 0 0 0 17068.32 0 0 1006498297 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 1.85 0 0 0 0 0 0 1.85 0 0 1006498383 1629562939 10 Physicians SINGH PREET M 999999999 96 St Clair 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 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 1373.58 0 0 0 0 0 0 1373.58 0 0 1006498472 1831488295 10 Physicians MEHTA NEIL J 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 3 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919.13 0 0 0 0 0 0 919.13 0 0 1006498502 1255854204 16 Nurse Practitioners RIES KAREN 999999999 60 Lee 0 0 0 0 0 7 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 450.26 0 0 0 0 0 0 0 0 2406.96 0 0 0 0 0 0 2857.22 0 0 1006498922 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 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 23.4 23.4 0 0 1006499078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11161.05 0 0 0 0 0 0 0 0 0 0 0 0 0 11161.05 0 0 1006499483 1457852501 89 Physician Assistant Only(Encounter Only) BURESH ALEXA 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 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 77.15 0 0 0 0 0 0 77.15 0 0 1006499547 1609018050 10 Physicians NIEMEYER MATTHEW 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 73 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.1 0 14141.61 0 0 0 0 0 0 14460.71 0 0 1006499856 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.92 0 0 1006500093 1508360280 10 Physicians ACCOH PASCAL 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 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 0 557.02 0 0 0 0 0 0 557.02 0 0 1006501003 1427568740 89 Physician Assistant Only(Encounter Only) SCHACK AMY 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 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 0 552.62 0 0 0 0 0 0 552.62 0 0 1006501227 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 0 0 1221.83 0 0 0 0 0 0 1241.41 0 0 1006501252 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 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0 0 0 0 0 0 9948.69 0 0 1006502017 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33932.13 0 0 0 0 0 0 0 0 0 0 0 0 0 33932.13 0 0 1006502303 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 0 0 0 0 0 0 0 0 0 0 1006502514 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 0 0 0 0 0 0 0 0 0 0 1006502524 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 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 70.75 0 0 0 0 0 0 70.75 0 0 1006502533 1265929160 16 Nurse Practitioners ESTES BRIDGET 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.5 0 2497.04 0 0 0 0 0 0 2745.54 0 0 1006507724 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 96.99 0 0 0 0 0 0 96.99 0 0 1006507801 10 Physicians 91 Sangamon 0 0 Urology 0 0 0 0 0 0 0 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 0 160.81 0 0 0 0 0 0 160.81 0 0 1006507865 1811476542 22 Physical Therapists THOMAS MERRIN 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 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 0 632.77 632.77 0 0 1006507924 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1506.36 0 0 0 0 0 0 1506.36 0 0 1006510905 1619306750 10 Physicians PULIAEVA IRINA A 999999999 200 Cook 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.84 0 2538.9 0 0 0 0 0 0 2623.74 0 0 1006510944 1730655572 89 Physician Assistant Only(Encounter Only) BUDZIK SYLWIA 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 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 0 211 0 0 0 0 0 0 211 0 0 1006511115 1578945754 10 Physicians SHERIDAN STEPHEN 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 0 153 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 3651.9 0 0 0 0 0 0 3651.9 0 0 1006511255 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 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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 11587.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11587.8 0 0 1006512879 1467782037 36 Community mental health provider ONE HOPE UNITED 624014188 33 Effingham 0 0 Childrens Mental Health/SASS 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 23156.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26380.53 0 0 49537.03 0 0 1006513477 1114401833 16 Nurse Practitioners TARVESTAD JENNIFER M 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 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 0 864.19 0 0 0 0 0 0 864.19 0 0 1006513609 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 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 0 0 0 0 0 0 0 0 0 0 1006513622 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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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 1990.75 0 0 0 0 0 0 1990.75 0 0 1006516401 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 0 265 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 18766.77 0 0 0 0 0 0 0 0 0 0 0 0 0 18766.77 0 0 1006516593 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19404.14 0 0 0 0 0 0 0 0 0 0 0 0 0 19404.14 0 0 1006516613 1841426558 10 Physicians BHALAKIA NIRAJ 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 20 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.04 0 717.86 0 0 0 0 0 0 746.9 0 0 1006516907 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 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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 0 714.52 0 0 0 0 0 0 714.52 0 0 1006517489 1699130849 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122870.28 0 0 122870.28 0 0 1006517916 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16953.16 0 0 0 0 0 0 0 0 0 0 0 0 0 16953.16 0 0 1006518017 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 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 64.08 0 0 0 0 0 0 64.08 0 0 1006518033 1992280507 16 Nurse Practitioners WILLIAMS ANDREA 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 0 115 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 1005.2 0 0 0 0 0 0 1005.2 0 0 1006518250 16 Nurse Practitioners 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.01 0 0 0 0 0 0 31.01 0 0 1006518279 1972021723 25 Audiologists TADDEI STEVEN R 999999999 109 Winnebago 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 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 0 329.41 329.41 0 0 1006518478 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32783.49 0 0 0 0 0 0 0 0 0 0 0 0 0 32783.49 0 0 1006518704 1003136151 10 Physicians GRABOSCH SHANNON 999999999 96 St Clair 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 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 0 220.24 0 0 0 0 0 0 220.24 0 0 1006519712 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4643.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4643.8 0 0 1006519774 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006520230 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28782.98 0 0 0 0 0 0 0 0 0 0 0 0 0 28782.98 0 0 1006520483 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 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30102.24 0 0 0 0 0 0 0 0 0 0 0 0 0 30102.24 0 0 1006520835 1477817021 10 Physicians RICHARDSON CARRIE 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 0 137 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 1060.56 0 0 0 0 0 0 1060.56 0 0 1006520869 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 0 0 0 0 0 0 0 0 0 0 1006521457 1942680319 10 Physicians SHAH ARCHANA 999999999 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.96 0 7595.91 0 0 0 0 0 0 7654.87 0 0 1006521598 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 5226.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5226.01 0 0 1006521659 1043726011 89 Physician Assistant Only(Encounter Only) MCCABE CARRIE S 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 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 1045.76 0 0 0 0 0 0 1045.76 0 0 1006522082 1407294291 10 Physicians BICKLEY DANIEL J 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 5 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.02 0 4894.27 0 0 0 0 0 0 5033.29 0 0 1006522326 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17839.79 0 0 0 0 0 0 0 0 0 0 0 0 0 17839.79 0 0 1006523117 1598148769 91 Waiver service provider--Adults (DHS/DDD) WRIGHT LORI L 999999999 200 Cook 0 0 0 0 0 0 0 8 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 14803.03 0 0 0 0 0 0 0 0 0 0 0 0 0 14803.03 0 0 1006523298 1629569546 11 Dentists ATA RONNIE A 999999999 200 Cook 0 0 General Dentistry 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25570.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25570.89 0 0 1006523314 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16787.33 0 0 0 0 0 0 0 0 0 0 0 0 0 16787.33 0 0 1006523335 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 50113.41 0 0 0 0 0 0 0 0 0 0 0 0 0 50113.41 0 0 1006523422 1609246701 11 Dentists WOO REGINALD 999999999 200 Cook 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16821.83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16821.83 0 0 1006524442 1265743140 10 Physicians COCHRAN ABIGAIL 999999999 91 Sangamon 0 0 Plastic Surgery 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 0 175 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 19723.79 0 0 0 0 0 0 19723.79 0 0 1006524645 1831618099 22 Physical Therapists HAMPSTON KERRY 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 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 0 654.25 654.25 0 0 1006524671 1053765685 10 Physicians CORAGLIO VICTORIA J 999999999 53 Kane 0 0 Family Practice 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 3876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37382.07 0 0 0 0 0 0 37382.07 0 0 1006524928 1376809194 10 Physicians BASQUES KYLE D 999999999 54 Kankakee 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 477 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 736 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9631.95 0 870.15 0 0 0 0 0 0 10502.1 0 0 1006525046 86 Clinical Social Worker(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 0 354.32 0 0 0 0 0 0 354.32 0 0 1006525130 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 0 165.51 0 0 0 0 0 0 165.51 0 0 1006525163 1275851800 63 Other Providers of Medical Equipment/Supplies (Non-registered) ADAPTHEALTH PATIENT CARE SOLUT 368300257 801 Alabama 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 8227.84 0 0 0 0 0 0 8227.84 0 0 1006525494 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1903.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1903.35 0 0 1006525585 1750808127 89 Physician Assistant Only(Encounter Only) SCOTT LINDSEY M 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 0 920.56 0 0 0 0 0 0 920.56 0 0 1006525595 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 42.14 0 0 0 0 0 0 42.14 0 0 1006526824 1922524578 16 Nurse Practitioners LEWIS BRITNAE L 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 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 0 171.27 0 0 0 0 0 0 171.27 0 0 1006527163 1053707018 10 Physicians KUPPY JESSICA ELIZABETH 999999999 200 Cook 0 0 Internal 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 0 166 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 3209.77 0 0 0 0 0 0 3209.77 0 0 1006527230 1932619772 10 Physicians BELLORIN-FONT EZEQUIEL 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 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 0 941.36 0 0 0 0 0 0 941.36 0 0 1006527232 1518349133 10 Physicians KUKOYI OMOBOLAWA Y 999999999 19 Champaign 0 0 Emergency Medicine 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 0 122 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 4386.65 0 0 0 0 0 0 4386.65 0 0 1006527942 1639665540 12 Optometrists SHARP ABIGAIL E 999999999 89 Rock Island 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 35 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1175.97 0 1024.8 0 0 0 0 2200.77 0 0 1006528012 1487045423 52 Certified local public health department PERRY COUNTY HEALTH DEPARTMENT 999999999 81 Perry 0 0 0 112 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3518.68 0 493.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4011.75 0 0 1006528730 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006528795 10 Physicians 106 Whiteside 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.15 0 0 0 0 0 0 445.15 0 0 1006528984 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 0 269 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 18417.77 0 0 0 0 0 0 0 0 0 0 0 0 0 18417.77 0 0 1006529212 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1710.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1710.79 0 0 1006529653 1265951792 16 Nurse Practitioners ARROYO HEBAH 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 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 0 110.65 0 0 0 0 0 0 110.65 0 0 1006529846 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25071.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25071.2 0 0 1006530156 1588063192 10 Physicians WALD CHEN CORIDALIA 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 0 0 0 0 0 0 0 0 0 0 1006537002 1902244791 10 Physicians STIER MATTHEW W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 13 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.5 0 14704.26 0 0 0 0 0 0 14796.76 0 0 1006537066 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 22954.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22954.8 0 0 1006537129 1457578197 86 Clinical Social Worker(Encounter Only) SMITH JENNIFER 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 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 2259.49 0 0 0 0 0 0 2259.49 0 0 1006537238 1356752398 10 Physicians CLARK NATASHA 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1344.11 0 0 0 0 0 0 1344.11 0 0 1006537262 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 7857.77 0 0 0 0 0 0 0 0 0 0 0 0 0 7857.77 0 0 1006537395 1215960992 46 Ambulatory Surgical Treatment Centers HOFFMAN ESTATES SURGERY CENTER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 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 2393.13 0 0 0 0 0 2393.13 0 0 1006537438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23696.37 0 0 0 0 0 0 0 0 0 0 0 0 0 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Practitioners CARNEY LISA L 999999999 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 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 0 733.07 0 0 0 0 0 0 733.07 0 0 1006538125 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5003.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5003.64 0 0 1006538730 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16280 0 0 0 0 0 0 0 0 0 0 0 0 0 16280 0 0 1006538937 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21673.43 0 0 0 0 0 0 0 0 0 0 0 0 0 21673.43 0 0 1006539049 91 Waiver service 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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 12372.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12372.8 0 0 1006540419 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18509.78 0 0 0 0 0 0 0 0 0 0 0 0 0 18509.78 0 0 1006540560 1821583899 16 Nurse Practitioners UBAGHARA NGOZI V 999999999 200 Cook 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 1262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4384.18 0 0 0 0 0 0 4384.18 0 0 1006540830 24 Speech Therapists 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 508.2 508.2 0 0 1006541556 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.78 0 0 1006541787 1659533701 10 Physicians PEREZ-REISLER MARISA 999999999 200 Cook 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 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 2528.64 0 0 0 0 0 0 2528.64 0 0 1006541875 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 0 206 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 18540.86 0 0 0 0 0 0 0 0 0 0 0 0 0 18540.86 0 0 1006542034 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 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 2051.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2051.28 0 0 1006542104 1497018923 10 Physicians JAMIL UMER 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1006542758 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1781.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1781.84 0 0 1006542764 1396285649 24 Speech Therapists FREEMON ELISE B 999999999 30 DuPage 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 0 147 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 10490.24 10490.24 0 0 1006542801 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.34 0 0 0 0 0 0 0 0 0 0 0 0 0 8.34 0 0 1006542807 1780169664 16 Nurse Practitioners HANDELMAN JENNIFER 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 0 147 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 0 786.65 0 0 0 0 0 0 786.65 0 0 1006542845 1700126885 13 Podiatrists DOOKIE ANNABELLE 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 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 0 292.89 0 0 0 0 0 0 292.89 0 0 1006542914 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 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 0 627.4 0 0 0 0 0 0 627.4 0 0 1006543015 1073873675 10 Physicians BRINDISE JOSEPH P 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 46 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343.2 0 5788.01 0 0 0 0 0 0 6131.21 0 0 1006543079 1477070456 16 Nurse Practitioners GARCIA PAMELA J 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 407.15 0 0 0 0 0 0 0 0 1100.75 0 0 0 0 0 0 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Nurse Practitioners ZILIC MINDEE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 705.44 0 0 0 0 0 0 705.44 0 0 1006546136 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 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 0 129.04 0 0 0 0 0 0 129.04 0 0 1006546193 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24051.21 0 0 0 0 0 0 0 0 0 0 0 0 0 24051.21 0 0 1006546244 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1006546316 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 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Practitioners URIBE LISA N 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 0 209.3 0 0 0 0 0 0 209.3 0 0 1006547733 1578074753 16 Nurse Practitioners MAGDADARO DENNIS 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 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 2017.84 0 0 0 0 0 0 2017.84 0 0 1006548391 10 Physicians 88 Richland 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.65 0 52.89 0 0 0 0 0 0 54.54 0 0 1006548431 1174544514 10 Physicians LITTLEHALE MARK J 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 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 0 406.86 0 0 0 0 0 0 406.86 0 0 1006548947 92 Waiver service provider--Disability 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101 Wabash 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 0 574.1 0 0 0 0 0 0 574.1 0 0 1006552373 1437656550 25 Audiologists COLLOPY CATHRYN M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 184.88 184.88 0 0 1006552597 1205343514 16 Nurse Practitioners PAVLOVCIK NATASHA N 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 0 414.26 0 0 0 0 0 0 414.26 0 0 1006552644 1801866462 89 Physician Assistant Only(Encounter Only) POLANSKY IRINA Y 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166.96 0 0 0 0 0 0 166.96 0 0 1006552655 98 Waiver 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Physician Assistant Only(Encounter Only) BAUMAN MELODY A 999999999 80 Peoria 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 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 1711.51 0 0 0 0 0 0 1711.51 0 0 1006554405 1497784003 89 Physician Assistant Only(Encounter Only) FLORES WILLIAM 999999999 41 Hamilton 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 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 0 276.06 0 0 0 0 0 0 276.06 0 0 1006555158 94 Waiver service provider--Children's support (DHS/DDD) 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.8 0 0 0 0 0 0 0 0 0 0 0 0 0 958.8 0 0 1006555362 1063983500 16 Nurse Practitioners AMSBAUGH RACHEL A 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 111 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 6.4 0 0 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0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112.13 0 0 0 0 0 0 1112.13 0 0 1006558503 1497136733 10 Physicians OKEREKE GLORIA O 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 415.26 0 0 0 0 0 0 415.26 0 0 1006558724 1992817837 60 Pharmacies NATHAN PHARMACY 606455253 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4212 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64596.45 0 0 0 64596.45 0 0 1006558960 1639657414 30 General Hospitals ADVOCATE ILLINOIS MASONIC MEDI 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 2 524 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 6 2786 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 6 2786 0 0 0 0 0 0 0 831 0 0 0 0 0 0 0 0 0 182.13 124494.09 0 0 0 0 0 0 0 215724.01 0 0 0 0 0 0 0 0 0 340400.23 0 0 1006559049 10 Physicians 10 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0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729.54 0 0 0 0 0 0 0 0 0 0 0 0 0 729.54 0 0 1006560396 1740560812 10 Physicians EUGENIO-COLON JOSE 999999999 80 Peoria 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 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.86 0 47.62 0 0 0 0 0 0 143.48 0 0 1006561179 1306339189 10 Physicians PHEMISTER DOMINIC L 999999999 47 Jackson 0 0 Emergency 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 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 3195.03 0 0 0 0 0 0 3195.03 0 0 1006561221 1770558496 10 Physicians THANAWALLA FARID A 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 53 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.46 0 457.69 0 0 0 0 0 0 664.15 0 0 1006561386 1255780342 10 Physicians FANIYAN OLUMIDE A 999999999 200 Cook 0 0 0 0 0 19 0 0 0 0 0 0 16 0 65 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 17 0 88 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 17 0 88 0 0 0 0 0 0 0 0 0 684.52 0 0 0 0 0 0 116.9 0 2339.23 0 0 0 0 0 0 3140.65 0 0 1006561556 1972954436 86 Clinical Social Worker(Encounter Only) FITZPATRICK HELEN 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 0 330.68 0 0 0 0 0 0 330.68 0 0 1006561681 1689067357 89 Physician Assistant Only(Encounter Only) LE VAN 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.23 0 0 0 0 0 0 319.23 0 0 1006562216 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7601.76 0 0 0 0 0 0 0 0 0 0 0 0 0 7601.76 0 0 1006562313 1578501573 10 Physicians ROBERTSON DANIEL J 999999999 80 Peoria 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 0 156 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 15472.47 0 0 0 0 0 0 15472.47 0 0 1006562972 1932406287 91 Waiver service provider--Adults (DHS/DDD) RAMEY ANN C 622081639 96 St Clair 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 0 914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92183 0 0 0 0 0 0 0 0 0 0 0 0 0 92183 0 0 1006563099 1548642069 10 Physicians ANTOINE RANAE D 999999999 200 Cook 0 0 Internal Medicine 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 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8531.27 0 0 0 0 0 0 8531.27 0 0 1006563199 1265819924 10 Physicians MIRZAPOLOS ORHAY 999999999 200 Cook 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 0 260 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 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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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213.44 0 0 0 0 0 0 213.44 0 0 1006564393 1184039398 10 Physicians MARTIAL ANNIA 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 0 103 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 2724.53 0 0 0 0 0 0 2724.53 0 0 1006564503 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7200.66 0 0 0 0 0 0 0 0 0 0 0 0 0 7200.66 0 0 1006564699 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22703.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22703.5 0 0 1006564771 91 Waiver service provider--Adults (DHS/DDD) 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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 4062.64 0 0 0 0 0 0 4062.64 0 0 1006565697 1083920227 11 Dentists CALLAHAN NICHOLAS 999999999 200 Cook 0 0 Maxillofacial Surgery 0 0 57 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 17351.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17351.09 0 0 1006565790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12284.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12284.37 0 0 1006566012 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5581.24 0 0 0 0 0 0 0 0 0 0 0 0 0 5581.24 0 0 1006566217 1689153926 24 Speech Therapists DIAS DIONNE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 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 3105.88 0 0 0 0 0 0 3105.88 0 0 1006571420 1336642743 23 Occupational Therapists KUSS DEVAN G 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 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 1257.27 1257.27 0 0 1006571758 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 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 2403.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2403.07 0 0 1006571804 1528543105 16 Nurse Practitioners YORDING ANN M 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 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 51.73 0 0 0 0 0 0 51.73 0 0 1006572185 1437683117 11 Dentists ZAHDAN BADIA 999999999 200 Cook 0 0 0 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16477.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16477.38 0 0 1006572544 91 Waiver service provider--Adults (DHS/DDD) 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 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 12569.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12569.72 0 0 1006572644 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 0 111.58 0 0 0 0 0 0 111.58 0 0 1006572796 1730561747 10 Physicians EINSTEIN NOAH M 999999999 200 Cook 0 0 Emergency 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 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 0 422.26 0 0 0 0 0 0 422.26 0 0 1006572823 1013158989 30 General Hospitals FRESENIUS MEDICAL CARE PLAINFI 999999999 107 Will 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 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1805 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56953.55 0 0 0 0 0 56953.55 0 0 1006572979 1689652133 89 Physician Assistant Only(Encounter Only) SHAW WILLIAM 999999999 60 Lee 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 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 0 490.24 0 0 0 0 0 0 490.24 0 0 1006573417 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 1006573748 1366937575 10 Physicians FELLER NIDA NAEEM KHAN 999999999 91 Sangamon 0 0 Emergency 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 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 1987.54 0 0 0 0 0 0 1987.54 0 0 1006573964 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 164.15 0 0 0 0 0 0 0 0 0 0 0 0 0 164.15 0 0 1006573990 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 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 10.84 0 0 0 0 0 0 10.84 0 0 1006574931 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18906.12 0 0 0 0 0 0 0 0 0 0 0 0 0 18906.12 0 0 1006575048 1619228624 89 Physician Assistant Only(Encounter Only) PEDERSEN KEELY 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 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 0 724.2 0 0 0 0 0 0 724.2 0 0 1006575436 94 Waiver 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0 0 0 0 27015.07 0 0 0 0 0 27015.07 0 0 1006577194 1598028508 10 Physicians LONG DAVID A 999999999 200 Cook 0 0 Anesthesiology 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 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 4199.39 0 0 0 0 0 0 4199.39 0 0 1006577263 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 23332.86 0 0 0 0 0 0 0 0 0 0 0 0 0 23332.86 0 0 1006577989 10 Physicians 106 Whiteside 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 20.01 0 0 0 0 0 0 20.01 0 0 1006578062 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8213.42 0 0 0 0 0 0 0 0 0 0 0 0 0 8213.42 0 0 1006578064 1972899862 10 Physicians BICKHAUS JENNIFER 999999999 96 St Clair 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.6 0 78.44 0 0 0 0 0 0 88.04 0 0 1006578349 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 226.87 0 0 0 0 0 0 0 0 0 0 0 0 0 226.87 0 0 1006578912 1114456258 89 Physician Assistant Only(Encounter Only) BURLAND COURTNEY P 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 1524.73 0 0 0 0 0 0 1524.73 0 0 1006579133 1285115055 97 Waiver service provider--Children's residential (DHS/DDD) HANCOCK HEATHER K 627621000 91 Sangamon 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 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42902.4 0 0 0 0 0 0 0 0 0 0 0 0 0 42902.4 0 0 1006579675 1295129310 10 Physicians BAUBLY KATHRYN 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 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 0 316.49 0 0 0 0 0 0 316.49 0 0 1006579678 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24843.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24843.42 0 0 1006579915 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 49.22 0 0 0 0 0 0 49.22 0 0 1006580153 1609354133 16 Nurse Practitioners BRYANT RAYMOND 999999999 200 Cook 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 1303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23279.14 0 0 0 0 0 0 23279.14 0 0 1006580294 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 19366.49 0 0 0 0 0 0 0 0 0 0 0 0 0 19366.49 0 0 1006580911 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 0 978.62 0 0 0 0 0 0 0 0 0 0 0 0 0 978.62 0 0 1006580982 10 Physicians 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 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 0 537.38 0 0 0 0 0 0 537.38 0 0 1006581012 24 Speech Therapists 76 Montgomery 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 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 2417.53 2417.53 0 0 1006581228 60 Pharmacies 811 Georgia 0 0 0 0 0 0 0 0 0 0 0 0 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 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.01 0 0 0 64.01 0 0 1006581463 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 0 272 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 24615.36 0 0 0 0 0 0 0 0 0 0 0 0 0 24615.36 0 0 1006581642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2159.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2159.83 0 0 1006581757 1184103194 16 Nurse Practitioners WITOWSKI KATARZYNA 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 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 0 856.81 0 0 0 0 0 0 856.81 0 0 1006581766 91 Waiver service 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1006583907 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6590.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6590.27 0 0 1006583948 1821223520 10 Physicians MOWAKEAA SAMER 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.14 0 4189.01 0 0 0 0 0 0 4220.15 0 0 1006584103 1932383445 89 Physician Assistant Only(Encounter Only) MANDALA CASSIE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 181.06 0 0 0 0 0 0 181.06 0 0 1006584433 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 49.22 0 0 0 0 0 0 49.22 0 0 1006584558 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006584577 1578068656 47 Local Education Agencies EXCEPTIONAL LEARNERS COLLABORA 999999999 57 Lake 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 0 412 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 8017.32 0 8017.32 0 0 1006584602 1326459553 10 Physicians DAIF AHMAD A 999999999 200 Cook 0 0 Neurology 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 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2213.41 0 0 0 0 0 0 2213.41 0 0 1006584635 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 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 2929.96 2929.96 0 0 1006584744 1841701075 16 Nurse Practitioners BLACK ASHLEY R 999999999 200 Cook 0 0 0 0 0 10 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 257.74 0 0 0 0 0 0 0 0 1847.84 0 0 0 0 0 0 2105.58 0 0 1006584917 1063852556 10 Physicians PLAMOOTTIL ANN I 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 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 0 333.24 0 0 0 0 0 0 333.24 0 0 1006584983 1124405972 10 Physicians WILCZYNSKI NICHOLAS 999999999 45 Henry 0 0 Emergency 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 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 3917.66 0 0 0 0 0 0 3917.66 0 0 1006585141 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 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 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1006586046 1174732770 10 Physicians ROSE THERESA L 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 2 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 46 0 0 0 0 0 0 0 0 0 1 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 10.34 0 3716.61 0 0 0 0 0 0 3726.95 0 0 1006586047 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25203.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25203.2 0 0 1006586052 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7505.81 0 0 0 0 0 0 0 0 0 0 0 0 0 7505.81 0 0 1006586202 1346210234 22 Physical Therapists KROPSKI KATHRYN 999999999 109 Winnebago 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 0 150 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 1240.05 1240.05 0 0 1006586335 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 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25444.76 0 0 0 0 0 0 0 0 0 0 0 0 0 25444.76 0 0 1006586463 1912331901 24 Speech Therapists DOWLING AMY J 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 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 4823.28 4823.28 0 0 1006586711 1750874459 16 Nurse Practitioners WEZRAN VALERIE L 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 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 1087.43 0 0 0 0 0 0 1087.43 0 0 1006586996 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24541.65 0 0 0 0 0 0 0 0 0 0 0 0 0 24541.65 0 0 1006587044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.2 0 0 1006587349 1497169338 10 Physicians FISCHER MATTHEW K 999999999 80 Peoria 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 0 124 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 4877.16 0 0 0 0 0 0 4877.16 0 0 1006587364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31290.19 0 0 0 0 0 0 0 0 0 0 0 0 0 31290.19 0 0 1006587945 10 Physicians 815 Indiana 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 1006588662 1962947010 36 Community mental health provider NORTH SUBURBS NILES APARTMENTS 999999999 200 Cook 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 6449.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56218.65 0 0 62668.26 0 0 1006588712 1932303955 10 Physicians SURAL NEETHI 999999999 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 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 1479.61 0 0 0 0 0 0 1479.61 0 0 1006588774 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14684.56 0 0 0 0 0 0 0 0 0 0 0 0 0 14684.56 0 0 1006588923 1326452582 10 Physicians HOBBY JAMES H 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 4 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185.12 0 307000.94 0 0 0 0 0 0 307186.06 0 0 1006589146 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 23.76 0 0 0 0 0 0 23.76 0 0 1006589171 1669891107 10 Physicians VERSALLE MARISSA 999999999 200 Cook 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 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 1930.6 0 0 0 0 0 0 1930.6 0 0 1006589200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14958.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14958.45 0 0 1006589548 1124451794 10 Physicians KARJALA CHAKKARAVART DIVYA 999999999 200 Cook 0 0 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 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4822.02 0 0 0 0 0 0 4822.02 0 0 1006589618 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 1562.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1562.4 0 0 1006589888 1649749607 23 Occupational Therapists RODRIGUEZ ARIANA R 999999999 91 Sangamon 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 0 208 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 15748.54 15748.54 0 0 1006590238 1427559186 16 Nurse Practitioners CASHEN AGNES G 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 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 0 658.9 0 0 0 0 0 0 658.9 0 0 1006590436 1457647927 10 Physicians GABATHULER STEPHANIE M 999999999 200 Cook 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 0 217 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 2413.59 0 0 0 0 0 0 2413.59 0 0 1006590442 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 0 152 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 15732.5 0 0 0 0 0 0 0 0 0 0 0 0 0 15732.5 0 0 1006590556 1366889909 10 Physicians DOUGLAS KELLY M 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 326.7 0 0 0 0 0 0 326.7 0 0 1006590612 1871007385 75 Department of Alcohol and Substance Abuse Provider "ROSECRANCE, INC." 999999999 100 Vermilion 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 0 209 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 13704.02 0 0 13704.02 0 0 1006590960 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 0 114 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 6765.72 0 0 0 0 0 0 0 0 0 0 0 0 0 6765.72 0 0 1006590995 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 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 0 237.94 237.94 0 0 1006591010 1609396167 33 Nursing Facilities LITTLE VILLAGE NURSING AND REH 999999999 200 Cook 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329960.02 0 0 0 0 0 0 0 329960.02 0 0 1006591011 63 Other Providers of Medical Equipment/Supplies (Non-registered) 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.44 0 0 0 0 81.44 0 0 1006591507 86 Clinical Social Worker(Encounter Only) 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 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 84.63 0 0 0 0 0 0 84.63 0 0 1006591694 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1539.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1539.8 0 0 1006591873 10 Physicians 69 Massac 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 1006592266 1194721803 10 Physicians HARTZ WILLIAM H 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 48 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584.2 0 5.12 0 0 0 0 0 0 589.32 0 0 1006592474 1336689926 70 Ambulance Service Providers AROMA FIRE PROTECTION DISTRICT 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5661.33 0 0 0 0 0 0 5661.33 0 0 1006592553 1396255097 11 Dentists GONZALEZ MONTOYA EDWIN 999999999 200 Cook 0 0 General Dentistry 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2830.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2830.96 0 0 1006592665 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 0 314 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 16377.84 0 0 0 0 0 0 0 0 0 0 0 0 0 16377.84 0 0 1006592980 1659818607 16 Nurse Practitioners PATEL RADHIKA B 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 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 1945.24 0 0 0 0 0 0 1945.24 0 0 1006593121 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 0 668.68 0 0 0 0 0 0 668.68 0 0 1006593282 1831289750 60 Pharmacies FREEBURG COUNTRY MART 999999999 96 St Clair 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 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8395.89 0 0 0 8395.89 0 0 1006593578 1043606742 10 Physicians LLOYD JENIFER 999999999 200 Cook 0 0 Psychiatry 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 0 306 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 8639.59 0 0 0 0 0 0 8639.59 0 0 1006593698 1447563366 10 Physicians PARK EUN JOO 999999999 96 St Clair 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 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 0 514 0 0 0 0 0 0 514 0 0 1006594014 1033313481 10 Physicians LIU KAN 999999999 200 Cook 0 0 Internal Medicine 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 18 0 0 0 0 0 0 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 0 0 138.53 0 0 0 0 0 0 138.53 0 0 1006594116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15182.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15182.96 0 0 1006594677 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9815.44 0 0 0 0 0 0 0 0 0 0 0 0 0 9815.44 0 0 1006594755 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23250.14 0 0 0 0 0 0 0 0 0 0 0 0 0 23250.14 0 0 1006594801 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1006594900 1124424882 89 Physician Assistant Only(Encounter Only) WALTERS ELIZABETH 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 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 39 0 0 0 0 0 0 39 0 0 1006595098 1194106450 24 Speech Therapists GENENBACHER KARISSA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30163.64 30163.64 0 0 1006595134 1720489750 10 Physicians DANG THUAN 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 7153.26 0 0 0 0 0 0 7172.46 0 0 1006595320 1265531768 10 Physicians LAGUNA THERESA 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0 0 0 0 0 0 0 55203.06 0 0 1006596444 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24216.99 0 0 0 0 0 0 0 0 0 0 0 0 0 24216.99 0 0 1006596535 1609154418 10 Physicians PATEL TARPAN RAJNIKANT 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.73 0 3490.76 0 0 0 0 0 0 3494.49 0 0 1006596543 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 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 1006596560 1780686857 87 Psychologist(Encounter Only) GEPHART MOORE ANNE H 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 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 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0 0 0 0 1676.25 0 0 1006598066 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006598135 16 Nurse Practitioners 21 Clark 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85.52 0 0 0 0 0 0 85.52 0 0 1006598162 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 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 37.4 0 0 0 0 0 0 37.4 0 0 1006599213 1649652389 10 Physicians LENKART KEVIN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 19 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.35 0 1598.6 0 0 0 0 0 0 1819.95 0 0 1006599220 1427525252 89 Physician Assistant Only(Encounter Only) RICHIER JOHN W. 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 0 126.07 0 0 0 0 0 0 126.07 0 0 1006599467 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 21797.65 0 0 0 0 0 0 0 0 0 0 0 0 0 21797.65 0 0 1006599484 1467413948 10 Physicians GUIDOT CHARLES A 999999999 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2319.09 0 0 0 0 0 0 2319.09 0 0 1006599963 1619465689 63 Other Providers of Medical Equipment/Supplies (Non-registered) "ABACOA MEDICAL SUPPLIES, INC" 999999999 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 767.86 0 0 0 0 0 0 767.86 0 0 1006600315 1457866949 91 Waiver service provider--Adults (DHS/DDD) JORUDD ERINA 999999999 30 DuPage 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53046.7 0 0 0 0 0 0 0 0 0 0 0 0 0 53046.7 0 0 1006600905 1881188712 10 Physicians GOPI NAIK 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 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 0 126.25 0 0 0 0 0 0 126.25 0 0 1006600956 1083067250 10 Physicians SIVARAMAN ARJUN 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 12 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.07 0 2532.69 0 0 0 0 0 0 2543.76 0 0 1006601134 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17666.03 0 0 0 0 0 0 0 0 0 0 0 0 0 17666.03 0 0 1006601463 1922515220 16 Nurse Practitioners KRUEGER KATIE M 999999999 20 Christian 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 0 136 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 3638.94 0 0 0 0 0 0 3638.94 0 0 1006601476 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 1006601652 1922520022 10 Physicians PEREZ-GARCIA AMANDA L 999999999 109 Winnebago 0 0 Family Practice 0 0 0 10 0 0 0 0 0 0 16 0 53 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 24 0 83 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 24 0 83 0 0 0 0 0 0 0 0 0 398.53 0 0 0 0 0 0 143.86 0 2481.38 0 0 0 0 0 0 3023.77 0 0 1006601774 1699294140 16 Nurse Practitioners MCCAULEY KATHARINE L. 999999999 30 DuPage 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 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 1452.06 0 0 0 0 0 0 1452.06 0 0 1006601924 1588025084 89 Physician Assistant Only(Encounter Only) MIETUS ADAM 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 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 0 187.01 0 0 0 0 0 0 187.01 0 0 1006601989 1326123340 60 Pharmacies CVS PHARMACY 10738 999999999 61 Livingston 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 1167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27603.86 0 0 0 27603.86 0 0 1006602144 1134578974 16 Nurse Practitioners ARMSTRONG CENTURIA M 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 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 0 406.24 0 0 0 0 0 0 406.24 0 0 1006602345 1922492396 10 Physicians SCHNITZLER ALLISON 999999999 53 Kane 0 0 0 0 0 5 0 0 0 0 0 0 4 0 32 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 6 0 53 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 6 0 53 0 0 0 0 0 0 0 0 0 520.28 0 0 0 0 0 0 29.11 0 2131.08 0 0 0 0 0 0 2680.47 0 0 1006602632 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28524.13 0 0 0 0 0 0 0 0 0 0 0 0 0 28524.13 0 0 1006602703 1255831749 89 Physician Assistant Only(Encounter Only) BOSTEEL KATHRYN 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 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 93.18 0 0 0 0 0 0 93.18 0 0 1006602764 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 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 0 119 0 0 0 0 0 0 119 0 0 1006603092 1780164574 16 Nurse Practitioners TROKEY DANIELLE N. 999999999 200 Cook 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 0 197 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 5439.35 0 0 0 0 0 0 0 0 0 0 0 0 0 5439.35 0 0 1006604004 1073927422 10 Physicians FISHER ANDREW R 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232.26 0 7461.68 0 0 0 0 0 0 7693.94 0 0 1006604016 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 0 0 0 0 0 0 0 0 0 0 1006604170 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 0 414.44 0 0 0 0 0 0 414.44 0 0 1006604302 1477991297 10 Physicians COZACOV YANIV 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2238.4 0 0 0 0 0 0 2238.4 0 0 1006604378 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.11 65.11 0 0 1006604601 1558650614 10 Physicians GERTLER TRACY S 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 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 6.4 0 0 0 0 0 0 0 0 1089.58 0 0 0 0 0 0 1095.98 0 0 1006604768 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 801.58 0 0 0 0 0 0 801.58 0 0 1006604913 1700248549 10 Physicians ADAMS ALYSSA M 999999999 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 2 0 58 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 73 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 73 0 0 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Practitioners LIEBERT JESSICA 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 44.95 0 0 0 0 0 0 0 0 2733.39 0 0 0 0 0 0 2778.34 0 0 1006607702 1740793389 16 Nurse Practitioners SPRINGMAN MEGAN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2951.86 0 0 0 0 0 0 2951.86 0 0 1006607889 1508348053 22 Physical Therapists EHLBECK CLARE C 999999999 91 Sangamon 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 1358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37052.13 37052.13 0 0 1006608041 1841539640 36 Community mental health provider ONE HOPE UNITED 628646295 49 Jefferson 0 0 Childrens Mental Health/SASS 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 412 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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16 Nurse Practitioners SIEGRIST MEGAN D 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 0 128 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 1298.65 0 0 0 0 0 0 1298.65 0 0 1006610602 1689012833 10 Physicians WITTHAUS MATTHEW 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 2 0 93 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 2 0 93 0 0 0 0 0 0 0 0 0 88.72 0 0 0 0 0 0 8.61 0 3053.47 0 0 0 0 0 0 3150.8 0 0 1006610996 1003161993 10 Physicians BARRON ANASTASIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 25 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.5 0 30.12 0 0 0 0 0 0 137.62 0 0 1006611071 1023308483 10 Physicians PHAN JUBILEE T 999999999 37 Fulton 0 0 Urology 0 0 0 0 0 0 0 0 0 0 8 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 256 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.84 0 6393.09 0 0 0 0 0 0 6406.93 0 0 1006611398 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 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 0 702.81 0 0 0 0 0 0 702.81 0 0 1006611436 1710130919 89 Physician Assistant Only(Encounter Only) YOUNG LEE 999999999 96 St Clair 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 0 147 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 4540.38 0 0 0 0 0 0 4540.38 0 0 1006611579 1053846634 55 Early Intervention Services DANIELS RHONDA L 999999999 96 St Clair 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 0 440 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 28913.72 0 0 0 0 0 0 28913.72 0 0 1006611944 1821331596 10 Physicians SPRAKER MATTHEW B 999999999 53 Kane 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 314.5 0 0 0 0 0 0 314.5 0 0 1006612488 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28383.96 0 0 0 0 0 0 0 0 0 0 0 0 0 28383.96 0 0 1006612840 1154841807 10 Physicians KHAN MOHAMMED ABDUL-RAHMAN 999999999 200 Cook 0 0 General Practice 0 0 0 4 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 51.52 0 0 0 0 0 0 0 0 1452.62 0 0 0 0 0 0 1504.14 0 0 1006612919 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9225.73 0 0 0 0 0 0 0 0 0 0 0 0 0 9225.73 0 0 1006613190 1609383496 16 Nurse Practitioners MALEWICZ KRZYSZTOF P. 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 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 0 915.62 0 0 0 0 0 0 915.62 0 0 1006613211 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 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 0 137.71 0 0 0 0 0 0 0 0 0 0 0 0 0 137.71 0 0 1006613426 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.1 0 0 0 0 0 0 0 0 0 0 0 0 0 103.1 0 0 1006613896 1003391061 16 Nurse Practitioners WALLACE KENDALL E 999999999 91 Sangamon 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 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 1090.92 0 0 0 0 0 0 1090.92 0 0 1006614233 1306045646 10 Physicians LANDERAS VEEDA O 999999999 200 Cook 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 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8162.17 0 0 0 0 0 0 8162.17 0 0 1006614568 10 Physicians 53 Kane 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 1006614582 1730186271 70 Ambulance Service Providers ADAMS COUNTY AMBULANCE SERV 623012700 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1342 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555455.59 0 0 0 0 0 0 555455.59 0 0 1006614683 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.36 0 0 70.36 0 0 1006614708 1003117334 10 Physicians KIM CHRISTINA S 999999999 200 Cook 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 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 1463.76 0 0 0 0 0 0 1463.76 0 0 1006614779 1376022350 10 Physicians KHAN ATIQ 999999999 53 Kane 0 0 Neurology 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 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 0 750.89 0 0 0 0 0 0 750.89 0 0 1006614991 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 45156.32 0 0 0 0 0 0 0 0 0 0 0 0 0 45156.32 0 0 1006616008 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 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 0 421.24 421.24 0 0 1006616325 1619315413 10 Physicians SOUNDARRAJAN MALINI 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 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 0 994.5 0 0 0 0 0 0 994.5 0 0 1006616536 1437517547 39 Hospice DIVINE HOSPICE & PALLIATIVE CA 999999999 55 Kendall 0 0 0 0 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 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71310.75 0 0 0 0 0 0 0 0 0 0 0 71310.75 0 0 1006616557 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17772.3 0 0 0 0 0 0 0 0 0 0 0 0 0 17772.3 0 0 1006616779 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 21861.58 0 0 0 0 0 0 0 0 0 0 0 0 0 21861.58 0 0 1006616813 1538403548 89 Physician Assistant Only(Encounter Only) WALSH ELIZABETH A 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 0 250 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 1757.83 0 0 0 0 0 0 1757.83 0 0 1006616832 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24732.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24732.53 0 0 1006617069 10 Physicians 80 Peoria 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 4.53 0 0 0 0 0 0 4.53 0 0 1006617248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17366.14 0 0 0 0 0 0 0 0 0 0 0 0 0 17366.14 0 0 1006617434 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10563.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10563.76 0 0 1006618056 65 Independent Diagnostic Testing Facility (IDTF) 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 0 103.55 0 0 0 0 0 0 0 0 103.55 0 0 1006618085 1851869994 11 Dentists SHAH HEMANG H 999999999 30 DuPage 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 919 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 919 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 27267.24 0 0 0 0 0 0 0 0 0 0 0 3010.8 0 0 0 0 30278.04 0 0 1006618143 1073082384 16 Nurse Practitioners TURNER CAROLINE J 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 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 0 694.07 0 0 0 0 0 0 694.07 0 0 1006618210 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 0 162.74 0 0 0 0 0 0 162.74 0 0 1006618408 30 General Hospitals 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.54 0 0 0 0 0 20.54 0 0 1006618724 1902303662 10 Physicians RAMBO BRITTANY N 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 0 102 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 0 372.13 0 0 0 0 0 0 372.13 0 0 1006618864 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22867.39 0 0 0 0 0 0 0 0 0 0 0 0 0 22867.39 0 0 1006619162 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 0 828.89 828.89 0 0 1006619180 1538554282 10 Physicians RAYMOND ABBIE 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 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 0 431.45 0 0 0 0 0 0 431.45 0 0 1006619199 1609258805 10 Physicians SIDDIQUIE AREEB 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 1543.56 0 0 0 0 0 0 1543.56 0 0 1006619580 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.99 0 0 0 0 0 0 70.99 0 0 1006619788 1841719457 16 Nurse Practitioners ADVINCULA LINDA P 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 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 0 716.85 0 0 0 0 0 0 716.85 0 0 1006619842 1396264297 16 Nurse Practitioners KLINE KATELYN L 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 91.02 0 0 0 0 0 0 0 0 802.04 0 0 0 0 0 0 893.06 0 0 1006619843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1805.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1805.55 0 0 1006620173 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8005.02 0 0 0 0 0 0 0 0 0 0 0 0 0 8005.02 0 0 1006620444 1437647989 16 Nurse Practitioners MANA-AY MARGARITA 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 0 231.71 0 0 0 0 0 0 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Physicians MASSA SEAN T 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 867.09 0 0 0 0 0 0 867.09 0 0 1006621128 1306320031 16 Nurse Practitioners KEISER SHANNON 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 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 2731.31 0 0 0 0 0 0 2731.31 0 0 1006621219 1639532831 10 Physicians WEAVER LUKE 999999999 70 McDonough 0 0 Pediatrics 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 81 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 4758.36 0 0 0 0 0 0 4790.51 0 0 1006621226 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 0 151.16 0 0 0 0 0 0 151.16 0 0 1006621232 10 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258.43 0 0 0 0 0 0 258.43 0 0 1006635959 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.09 0 0 0 0 0 0 165.09 0 0 1006636019 1295270288 16 Nurse Practitioners LUGO JENNIFER L 999999999 19 Champaign 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 0 113 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 0 587.46 0 0 0 0 0 0 587.46 0 0 1006636548 1144575788 10 Physicians SHAH KETAN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 46 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425.66 0 22824.63 0 0 0 0 0 0 23250.29 0 0 1006636708 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 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 0 288.06 0 0 0 0 0 0 288.06 0 0 1006637756 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12097.23 0 0 0 0 0 0 0 0 0 0 0 0 0 12097.23 0 0 1006637828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18442.34 0 0 0 0 0 0 0 0 0 0 0 0 0 18442.34 0 0 1006638310 1477797645 10 Physicians HILL JUSTIN B 999999999 65 Madison 0 0 Family Practice 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 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 523.66 0 0 0 0 0 0 609.31 0 0 1006638881 1619464898 12 Optometrists NGUYEN NHAT 999999999 57 Lake 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 95 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1848.34 0 798.65 0 0 0 0 2646.99 0 0 1006639070 1265428593 10 Physicians LARDIZABAL DAVID 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 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 0 565.76 0 0 0 0 0 0 565.76 0 0 1006639366 1831516715 10 Physicians MONTGOMERY VICTORIA 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 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 1544.58 0 0 0 0 0 0 1544.58 0 0 1006639433 1184146920 33 Nursing Facilities AVONDALE ESTATE OF ELGIN 999999999 53 Kane 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1087 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133560.27 0 0 0 0 0 0 0 133560.27 0 0 1006639571 91 Waiver service provider--Adults 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0 0 0 0 0 1527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17045.72 0 0 0 0 0 17045.72 0 0 1006640612 1417454273 89 Physician Assistant Only(Encounter Only) REEVES JOSHUA M 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 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 1737.98 0 0 0 0 0 0 1737.98 0 0 1006640819 1205361177 55 Early Intervention Services BASALAY DANIELLE 999999999 33 Effingham 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 0 268 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 19516.23 0 0 0 0 0 0 19516.23 0 0 1006640923 89 Physician Assistant Only(Encounter Only) 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 1006641010 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 2 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0 0 0 0 0 0 0 0 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 0 545.15 0 0 0 0 0 0 545.15 0 0 1006650492 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 4952.79 0 0 0 0 0 0 0 0 0 0 0 0 0 4952.79 0 0 1006650533 1265878813 10 Physicians OLEAGA JAMIE MARIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.31 0 1277.84 0 0 0 0 0 0 1367.15 0 0 1006650642 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 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 3.71 0 0 0 0 0 0 3.71 0 0 1006650772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 996.14 0 0 0 0 0 0 0 0 0 0 0 0 0 996.14 0 0 1006650974 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2326.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2326.84 0 0 1006651129 11 Dentists 27 Dekalb 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 0 116.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.1 0 0 1006651255 1841707908 87 Psychologist(Encounter Only) EPSTEIN DAWN ERICA 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 370.1 0 0 0 0 0 0 370.1 0 0 1006651263 1053890392 22 Physical Therapists WISEMAN TRENTON L 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006653003 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 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 0 130.88 0 0 0 0 0 0 130.88 0 0 1006653278 1750873568 10 Physicians MAIDANA DANIEL E 999999999 200 Cook 0 0 Ophthalmology 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.88 0 3902.04 0 0 0 0 0 0 3906.92 0 0 1006653337 10 Physicians 87 Randolph 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 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 0 630.73 0 0 0 0 0 0 630.73 0 0 1006653358 1386634384 10 Physicians KYOBE MOSES 999999999 109 Winnebago 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 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8209.5 0 0 0 0 0 0 8209.5 0 0 1006653523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30565.2 0 0 0 0 0 0 0 0 0 0 0 0 0 30565.2 0 0 1006653596 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 0 114.29 0 0 0 0 0 0 114.29 0 0 1006653766 1437538311 10 Physicians WELTER KATHERINE 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 0 225 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 1857.24 0 0 0 0 0 0 1857.24 0 0 1006653839 1053833343 89 Physician Assistant Only(Encounter Only) LANKFORD STUART 999999999 47 Jackson 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 0 254 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 1194.36 0 0 0 0 0 0 1194.36 0 0 1006654124 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 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 8372.52 0 0 0 0 0 0 0 0 0 0 0 0 0 8372.52 0 0 1006654142 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11005.28 0 0 0 0 0 0 0 0 0 0 0 0 0 11005.28 0 0 1006654192 1386834901 10 Physicians NAVA BAHENA RUBEN G 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 0 174.8 0 0 0 0 0 0 174.8 0 0 1006654207 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 90.94 0 0 0 0 0 0 90.94 0 0 1006654418 1154641157 10 Physicians CHIRUVELLA AMARESHWAR 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 506.65 0 0 0 0 0 0 506.65 0 0 1006654836 1942789144 22 Physical Therapists LERCH ANDREW D 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 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 0 243.12 243.12 0 0 1006654967 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10718.65 0 0 0 0 0 0 0 0 0 0 0 0 0 10718.65 0 0 1006655028 1871096644 16 Nurse Practitioners SHAAR MICHELE V 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 0 136 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 0 881.8 0 0 0 0 0 0 881.8 0 0 1006655131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34152.81 0 0 0 0 0 0 0 0 0 0 0 0 0 34152.81 0 0 1006655185 86 Clinical Social Worker(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 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 1006655584 10 Physicians 30 DuPage 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972.07 0 0 0 0 0 0 972.07 0 0 1006655826 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1453.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1453.12 0 0 1006655859 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 0 251 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 21668.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21668.68 0 0 1006655906 1194247973 16 Nurse Practitioners MEYERS-ENGER LINDSEY M 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 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 0 551.17 0 0 0 0 0 0 551.17 0 0 1006655976 1790214930 16 Nurse Practitioners PAULL CAROLINE 999999999 200 Cook 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 1029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1029 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159055.02 0 0 0 0 0 0 159055.02 0 0 1006656030 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.29 0 0 0 0 0 0 75.29 0 0 1006656328 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 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 38.23 0 0 0 0 0 0 38.23 0 0 1006656609 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22520.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22520.26 0 0 1006656654 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2896.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2896.8 0 0 1006656725 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 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 9362.46 0 0 0 0 0 0 0 0 0 0 0 0 0 9362.46 0 0 1006656760 1912486440 16 Nurse Practitioners PRENDERGAST MOLLY A 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1356.22 0 0 0 0 0 0 1356.22 0 0 1006657226 1215415039 16 Nurse Practitioners FERGUSON JULIEANNE W 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 796.24 0 0 0 0 0 0 796.24 0 0 1006657236 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18640.65 0 0 0 0 0 0 0 0 0 0 0 0 0 18640.65 0 0 1006657901 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 4136.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4136.03 0 0 1006658233 1740523539 10 Physicians COTSEONES JILL 999999999 53 Kane 0 0 Dermatology 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.8 0 1619.63 0 0 0 0 0 0 1622.43 0 0 1006658337 1306236625 90 Waiver service provider--Elderly (DOA) SHILOH HEALTHCARE SERVICES INC 999999999 200 Cook 0 0 0 0 0 0 0 7 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 54509.91 0 0 0 0 0 0 0 0 0 0 0 0 0 54509.91 0 0 1006658404 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261.28 0 0 0 261.28 0 0 1006658536 1558848473 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 999999999 91 Sangamon 0 0 0 62 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 10227.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10227.44 0 0 1006658756 1912216458 89 Physician Assistant Only(Encounter Only) BRUCATO CATRINA A. 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 113.58 0 0 0 0 0 0 113.58 0 0 1006659007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2894.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2894.76 0 0 1006659779 1013267608 16 Nurse Practitioners PEARSON ANGELA 999999999 53 Kane 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 0 116 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 1869.4 0 0 0 0 0 0 1869.4 0 0 1006659969 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 1006659979 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 1006660393 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.2 72.2 0 0 1006660613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 885.67 0 0 0 0 0 0 0 0 0 0 0 0 0 885.67 0 0 1006660853 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 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 5710.21 0 0 0 0 0 0 0 0 0 0 0 0 0 5710.21 0 0 1006660878 1124459219 10 Physicians FRANCOIS MATILDE E 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 469.86 0 0 0 0 0 0 469.86 0 0 1006661100 1972950905 22 Physical Therapists PREISH MELISSA G 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 0 154 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 10652.81 10652.81 0 0 1006661180 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21374.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21374.5 0 0 1006661234 1598152704 10 Physicians AHMAD ANAM 999999999 200 Cook 0 0 Internal Medicine 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 0 327 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 3023.18 0 0 0 0 0 0 3023.18 0 0 1006661259 1508251109 10 Physicians NUVAL ANTHONY L 999999999 80 Peoria 0 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0 142 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 5628.62 0 0 0 0 0 0 5628.62 0 0 1006662360 1033451711 10 Physicians AL SARAF ALI A 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 931 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1278 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1278 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10717.7 0 2092.76 0 0 0 0 0 0 12810.46 0 0 1006662362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17931.74 0 0 0 0 0 0 0 0 0 0 0 0 0 17931.74 0 0 1006662580 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 1006663056 1639697956 60 Pharmacies LV HEALTH & WELLNESS PHARMACY 999999999 96 St Clair 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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 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 12713.99 0 0 0 0 0 0 0 0 0 0 0 0 0 12713.99 0 0 1006663385 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 5.52 0 0 0 0 0 0 5.52 0 0 1006663539 1982187357 16 Nurse Practitioners DENSON KAITLIN M 999999999 24 Coles 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 0 148 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 0 218.13 0 0 0 0 0 0 218.13 0 0 1006663586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9323.43 0 0 0 0 0 0 0 0 0 0 0 0 0 9323.43 0 0 1006664021 1821596503 16 Nurse Practitioners LAKHANI ALIYA F 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 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 0 369.96 0 0 0 0 0 0 382.76 0 0 1006664081 1831629401 10 Physicians BERG ETHAN PATRICK 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879.02 0 0 0 0 0 0 879.02 0 0 1006664240 1265846166 25 Audiologists REMEC TIMOTHY J 999999999 30 DuPage 0 0 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 1643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18324.43 18324.43 0 0 1006664844 1114453917 89 Physician Assistant Only(Encounter Only) HENKE BRIANA 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 0 112 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 6179.57 0 0 0 0 0 0 6179.57 0 0 1006664993 1902813454 89 Physician Assistant Only(Encounter Only) BIRD GINA 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 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 0 395.46 0 0 0 0 0 0 395.46 0 0 1006665369 1144714528 10 Physicians SIDHU NILOFER 999999999 200 Cook 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 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 0 235.7 0 0 0 0 0 0 235.7 0 0 1006665626 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3541.44 0 0 0 0 0 0 0 0 0 0 0 0 0 3541.44 0 0 1006665658 1629393624 10 Physicians REIDY ANDREA B 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 2287.14 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 25558.46 0 0 0 0 0 0 0 0 0 0 0 0 0 25558.46 0 0 1006667905 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 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 2068.27 0 0 0 0 0 0 0 0 0 0 0 0 0 2068.27 0 0 1006668553 1033500327 16 Nurse Practitioners WHITE JILL 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 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 0 439.46 0 0 0 0 0 0 439.46 0 0 1006668834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27613.94 0 0 0 0 0 0 0 0 0 0 0 0 0 27613.94 0 0 1006668948 1992064521 10 Physicians BORDIA RITU 999999999 65 Madison 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 153 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 5 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0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241.66 0 0 0 0 0 0 0 0 0 0 0 0 0 241.66 0 0 1006672955 1174919591 10 Physicians BUEHLER JENNIFER N 999999999 200 Cook 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 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 0 586.28 0 0 0 0 0 0 586.28 0 0 1006673130 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7629.06 0 0 0 0 0 0 0 0 0 0 0 0 0 7629.06 0 0 1006673185 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 726.95 0 0 0 0 0 0 0 0 0 0 0 0 0 726.95 0 0 1006673570 1306083985 89 Physician Assistant Only(Encounter Only) JANSEN ASHLEY 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 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0 0 0 0 0 0 0 25308.8 0 0 0 0 0 0 0 0 0 0 0 0 0 25308.8 0 0 1006676681 1033587613 24 Speech Therapists GOTLIEB SARA M 999999999 91 Sangamon 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 0 243 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 17425.76 17425.76 0 0 1006676923 1205367612 10 Physicians SETHI ANCHAL 999999999 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 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 1007.1 0 0 0 0 0 0 1007.1 0 0 1006677523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2906.23 0 0 0 0 0 0 0 0 0 0 0 0 0 2906.23 0 0 1006678104 1689193518 89 Physician Assistant Only(Encounter Only) TINARI KATHRYN M 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 99.23 0 0 0 0 0 0 99.23 0 0 1006678232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11592.87 0 0 0 0 0 0 0 0 0 0 0 0 0 11592.87 0 0 1006678351 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 18475.29 0 0 0 0 0 0 0 0 0 0 0 0 0 18475.29 0 0 1006678510 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10499.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10499.5 0 0 1006678717 1245748920 86 Clinical Social Worker(Encounter Only) BURTCH TAMMY 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 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 0 196.84 0 0 0 0 0 0 196.84 0 0 1006678853 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 1988.22 1988.22 0 0 1006678862 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 1006679019 1164915575 10 Physicians ADUSUMALLI MEGHA 999999999 109 Winnebago 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 2 0 29 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 35 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 35 0 0 0 0 0 0 0 0 0 48.22 0 0 0 0 0 0 0 0 425.07 0 0 0 0 0 0 473.29 0 0 1006679398 55 Early Intervention Services 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 4593.28 0 0 0 0 0 0 4593.28 0 0 1006679526 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 1006679649 11 Dentists 200 Cook 0 0 General Dentistry 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 49.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.25 0 0 1006679766 1851873459 33 Nursing Facilities "AUSTIN OASIS, THE" 999999999 200 Cook 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778137.13 0 0 0 0 0 0 0 778137.13 0 0 1006680538 1932435229 10 Physicians SAAFIR MUHAMMAD A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 18 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343.99 0 1237.34 0 0 0 0 0 0 1581.33 0 0 1006680903 1689185282 16 Nurse Practitioners MURPHY CAITLIN A 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 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 1447.91 0 0 0 0 0 0 1447.91 0 0 1006681379 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006681484 1225563380 65 Independent Diagnostic Testing Facility (IDTF) ROUND LAKE MEDICAL IMAGING INC 999999999 57 Lake 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 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 2262.97 0 0 0 0 0 0 0 0 2262.97 0 0 1006681640 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 0 178.26 0 0 0 0 0 0 178.26 0 0 1006681935 1508161407 22 Physical Therapists POWELL COLLEEN P 999999999 107 Will 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 0 104 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 8705.53 8705.53 0 0 1006682452 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19910.44 0 0 0 0 0 0 0 0 0 0 0 0 0 19910.44 0 0 1006682506 1265971204 16 Nurse Practitioners BASNILLO-SAN DIEGO VENUS LIEZL 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 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 0 238.5 0 0 0 0 0 0 238.5 0 0 1006682541 1023516796 60 Pharmacies WALGREENS #21143 999999999 57 Lake 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 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11961 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70292.05 0 0 0 70292.05 0 0 1006683084 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 0 113.18 0 0 0 0 0 0 113.18 0 0 1006683158 1801202833 10 Physicians TENNILL TAYLOR 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 0 211 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 0 938.84 0 0 0 0 0 0 938.84 0 0 1006683258 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12804.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12804.56 0 0 1006683434 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 4 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 2880.95 2880.95 0 0 1006683650 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 47.71 0 0 0 0 0 0 47.71 0 0 1006683740 1720585953 16 Nurse Practitioners HOLLANDSWORTH ERIN 999999999 107 Will 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 0 179 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 0 0 0 0 0 0 0 0 0 0 1006683920 1730659988 91 Waiver service provider--Adults (DHS/DDD) ISAAC CRYSTAL 999999999 91 Sangamon 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 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102291.7 0 0 0 0 0 0 0 0 0 0 0 0 0 102291.7 0 0 1006684475 10 Physicians 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006685492 86 Clinical Social Worker(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 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 0 740.44 0 0 0 0 0 0 740.44 0 0 1006685642 1851557201 10 Physicians DESAI NATARAJ 999999999 80 Peoria 0 0 Family Practice 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 0 100 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 1063.81 0 0 0 0 0 0 1063.81 0 0 1006685696 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25814.06 0 0 0 0 0 0 0 0 0 0 0 0 0 25814.06 0 0 1006686079 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 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 1670.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1670.9 0 0 1006686148 1851809560 89 Physician Assistant Only(Encounter Only) HOWARD DEIRDRE V 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 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 1144.8 0 0 0 0 0 0 1144.8 0 0 1006686308 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 1006686567 1760970073 16 Nurse Practitioners LARSEN KATHERINE M 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 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 0 448.96 0 0 0 0 0 0 448.96 0 0 1006686830 1912428723 10 Physicians KELLY MAUREEN E 999999999 53 Kane 0 0 General 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 0 107 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 3150.5 0 0 0 0 0 0 3150.5 0 0 1006686960 1447611702 60 Pharmacies MARIANOS PHARMACY #8537 605407354 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 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 0 422 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437.95 0 0 0 437.95 0 0 1006687205 1508251505 13 Podiatrists BONDI ELIZABETH 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 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 15.45 0 0 0 0 0 0 15.45 0 0 1006687224 1699268813 12 Optometrists HOPKINS GREIGHAM J 999999999 19 Champaign 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 0 202 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 3452.96 0 0 0 0 0 0 3452.96 0 0 1006687376 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 59.08 0 0 0 0 0 0 59.08 0 0 1006687381 1053834804 16 Nurse Practitioners JOHNSON ASHLEY M 999999999 200 Cook 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 0 187 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 1317.61 0 0 0 0 0 0 1317.61 0 0 1006687426 1992050702 10 Physicians BOUMITRI CHRISTINE 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 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 1894.07 0 0 0 0 0 0 1894.07 0 0 1006687517 1134428758 10 Physicians PET MITCHELL A 999999999 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 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 9136.1 0 0 0 0 0 0 9136.1 0 0 1006687594 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9878.28 0 0 0 0 0 0 0 0 0 0 0 0 0 9878.28 0 0 1006687643 92 Waiver service 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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 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 1429.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1429.68 0 0 1006688600 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.37 0 0 0 141.37 0 0 1006689193 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29276.01 0 0 0 0 0 0 0 0 0 0 0 0 0 29276.01 0 0 1006689202 1225541469 16 Nurse Practitioners RYDER JESSICA M 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 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3769.48 0 0 0 0 0 0 3769.48 0 0 1006689427 1316327976 10 Physicians CHOW KELSEY S 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 0 227 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 2108.44 0 0 0 0 0 0 2108.44 0 0 1006689752 10 Physicians 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 281.35 0 0 0 0 0 0 281.35 0 0 1006690210 1487010856 55 Early Intervention Services ERVIN PAMELA M 999999999 24 Coles 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 0 349 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 20653.95 0 0 0 0 0 0 20653.95 0 0 1006690246 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006690419 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 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19428.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19428.91 0 0 1006690577 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8583.63 0 0 0 0 0 0 0 0 0 0 0 0 0 8583.63 0 0 1006691288 30 General Hospitals 818 Kentucky ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.2 0 0 0 0 0 76.2 0 0 1006691832 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25258.42 0 0 0 0 0 0 0 0 0 0 0 0 0 25258.42 0 0 1006691949 1548671829 10 Physicians ZINDRICK DANIEL 999999999 33 Effingham 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 0 243 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 8871.6 0 0 0 0 0 0 8871.6 0 0 1006691977 1396288502 16 Nurse Practitioners KORTE JANAE 999999999 23 Clinton 0 0 0 0 0 0 0 0 0 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 0 236.4 0 0 0 0 0 0 236.4 0 0 1006692004 1891206991 33 Nursing Facilities APERION CARE PRINCETON 999999999 15 Bureau 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 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334885.02 0 0 0 0 0 0 0 334885.02 0 0 1006692294 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 14759.05 0 0 0 0 0 0 0 0 0 0 0 0 0 14759.05 0 0 1006693021 1093214249 16 Nurse Practitioners KATZENBERGER CASSANDRA S 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 4245.77 0 0 0 0 0 0 4252.17 0 0 1006693133 86 Clinical Social Worker(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 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 2211.01 0 0 0 0 0 0 2211.01 0 0 1006693244 1225547946 16 Nurse Practitioners BEAR JULIE A 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 187.06 0 0 0 0 0 0 0 0 2658 0 0 0 0 0 0 2845.06 0 0 1006693577 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 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 14.45 0 0 0 0 0 0 14.45 0 0 1006693893 1245708130 16 Nurse Practitioners ROBERTS ALYSSA 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 5 0 0 0 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 1006694042 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.09 0 0 0 0 0 0 43.09 0 0 1006694110 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006694409 1730447038 10 Physicians HENTEA CRISTIANA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 4021.02 0 0 0 0 0 0 4021.02 0 0 1006695415 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22789.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22789.2 0 0 1006695771 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 94.83 0 0 0 0 0 0 94.83 0 0 1006695773 1376958728 10 Physicians NEME JAMIL R 999999999 200 Cook 0 0 Family Practice 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484.8 0 0 0 0 0 0 484.8 0 0 1006696272 1124447198 10 Physicians VOLDEN JOANNE C 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 0 196 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 3077.13 0 0 0 0 0 0 3077.13 0 0 1006697269 1962646992 10 Physicians TSENG JENNIFER 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 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 1173.46 0 0 0 0 0 0 1173.46 0 0 1006697348 1770059305 89 Physician Assistant Only(Encounter Only) MITCHELL RICHARD CARDALL 999999999 52 Johnson 0 0 0 0 0 0 0 0 0 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 0 513.21 0 0 0 0 0 0 513.21 0 0 1006697543 1053725788 10 Physicians BROWN CARLOS E 999999999 19 Champaign 0 0 Emergency 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 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 3191.4 0 0 0 0 0 0 3191.4 0 0 1006697789 1861879694 10 Physicians SHUKLA ARCHANA 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 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 4295.83 0 0 0 0 0 0 4295.83 0 0 1006698517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14960.05 0 0 0 0 0 0 0 0 0 0 0 0 0 14960.05 0 0 1006698870 1821452533 16 Nurse Practitioners EVANS DAYNA L 999999999 22 Clay 0 0 0 0 0 0 0 0 0 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 33.6 0 0 0 0 0 0 33.6 0 0 1006698895 1164704201 10 Physicians ROMANO ANDREA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 33 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.32 0 19759.7 0 0 0 0 0 0 20026.02 0 0 1006698954 1588051122 10 Physicians ANDER ROBERT C 999999999 200 Cook 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 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 84.62 0 0 0 0 0 0 0 0 324.14 0 0 0 0 0 0 408.76 0 0 1006699181 1124438064 10 Physicians MAAMARI ROBI N 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 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 1219.24 0 0 0 0 0 0 1219.24 0 0 1006699611 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7123.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7123.15 0 0 1006699690 1952656761 12 Optometrists FROHM CHRISTOPHER J. 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 18 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1059.01 0 290.59 0 0 0 0 1349.6 0 0 1006699704 1760775233 10 Physicians IANNONE ALEXANDRA B 999999999 200 Cook 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 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 0 216.03 0 0 0 0 0 0 216.03 0 0 1006699999 1275909483 89 Physician Assistant Only(Encounter Only) BATRA ASHIMA 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 0 273 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 1707.88 0 0 0 0 0 0 1707.88 0 0 1006700067 1750769832 30 General Hospitals NORTHSIDE HOME TRAINING 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 1874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13330.04 0 0 0 0 0 13330.04 0 0 1006700330 1114120490 10 Physicians PLOWRIGHT LEON N 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.12 0 1435.17 0 0 0 0 0 0 1438.29 0 0 1006700360 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29624.2 0 0 0 0 0 0 0 0 0 0 0 0 0 29624.2 0 0 1006700443 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.88 55.88 0 0 1006700563 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13846.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13846.63 0 0 1006700629 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 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 1006701020 1992226369 16 Nurse Practitioners POHL DONNA K 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 459.14 0 0 0 0 0 0 459.14 0 0 1006701207 1558869081 87 Psychologist(Encounter Only) THIES KRISTIN E 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 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 1843.95 0 0 0 0 0 0 1843.95 0 0 1006701310 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 78.34 0 0 0 0 0 0 78.34 0 0 1006701501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505.75 0 0 0 0 0 0 0 0 0 0 0 0 0 505.75 0 0 1006701537 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 1006701558 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 2126.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2126.63 0 0 1006701742 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 0 0 0 0 0 0 0 0 0 0 1006702366 1083027619 10 Physicians LAMBETH SARAH A. 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 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 2981.93 0 0 0 0 0 0 2981.93 0 0 1006702461 1942365267 22 Physical Therapists HESSEL AMANDA 999999999 65 Madison 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 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 0 272.37 272.37 0 0 1006702852 1558889188 16 Nurse Practitioners LAFAYETTE K-SHAYLA 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 228.65 0 0 0 0 0 0 228.65 0 0 1006702991 1134381650 10 Physicians SIMPSON ERIC E 999999999 60 Lee 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3390.32 0 0 0 0 0 0 3390.32 0 0 1006703166 1164934972 16 Nurse Practitioners HOLMES ANDREA A 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 0 277.98 0 0 0 0 0 0 277.98 0 0 1006703214 10 Physicians 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 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 0 812.11 0 0 0 0 0 0 812.11 0 0 1006703422 1720225873 16 Nurse Practitioners LEWIS ROBBIN 999999999 66 Marion 0 0 0 0 0 0 0 0 0 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 0 852.09 0 0 0 0 0 0 852.09 0 0 1006703482 1255758728 10 Physicians ELLIOTT MARY 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 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 1087.72 0 0 0 0 0 0 1087.72 0 0 1006704108 1336634179 16 Nurse Practitioners GROSVENOR MOLLY 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 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 0 535.02 0 0 0 0 0 0 535.02 0 0 1006704277 1760400592 10 Physicians GEHLE KIM 999999999 53 Kane 0 0 Pediatrics 0 0 0 25 0 0 0 0 0 0 6 0 35 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 7 0 57 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 7 0 57 0 0 0 0 0 0 0 0 0 2587.2 0 0 0 0 0 0 155.18 0 2541.97 0 0 0 0 0 0 5284.35 0 0 1006704492 1891294195 16 Nurse Practitioners HALVORSON AMANDA L 999999999 53 Kane 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 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 0 848.23 0 0 0 0 0 0 848.23 0 0 1006704898 1235337031 12 Optometrists KURZAWA MONICA K 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 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 0 611.16 0 0 0 0 0 0 611.16 0 0 1006704942 1023464716 10 Physicians TUMMALA SANDEEP 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 0 204 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 2796.86 0 0 0 0 0 0 2796.86 0 0 1006705021 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3346.73 0 0 0 0 0 0 0 0 0 0 0 0 0 3346.73 0 0 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76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3037.41 0 0 0 0 0 0 3037.41 0 0 1006722611 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15796.65 0 0 0 0 0 0 0 0 0 0 0 0 0 15796.65 0 0 1006722819 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2840.86 0 0 0 0 0 0 0 0 0 0 0 0 0 2840.86 0 0 1006722886 11 Dentists 94 Shelby 0 0 General Dentistry 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 0 374.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.42 0 0 1006722902 1902285323 10 Physicians JUNKINS DAVID 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 2 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.08 0 3067.37 0 0 0 0 0 0 3078.45 0 0 1006723086 1033527809 10 Physicians LUO QING K. 999999999 200 Cook 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 0 528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3191.78 0 0 0 0 0 0 3191.78 0 0 1006723529 1871016014 16 Nurse Practitioners GREGORY KAYLA N 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 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 2004.87 0 0 0 0 0 0 2004.87 0 0 1006723611 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 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 12915.84 0 0 0 0 0 0 0 0 0 0 0 0 0 12915.84 0 0 1006724215 1316343858 16 Nurse Practitioners CLAY ADAM 999999999 200 Cook 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 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 0 800.7 0 0 0 0 0 0 807.1 0 0 1006724253 1346743234 16 Nurse Practitioners TROTTA PAMELA 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 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 0 729.42 0 0 0 0 0 0 729.42 0 0 1006724669 1346729399 23 Occupational Therapists RANCATORE JILLIAN N 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 0 119 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 8011.05 8011.05 0 0 1006724830 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18273.56 0 0 0 0 0 0 0 0 0 0 0 0 0 18273.56 0 0 1006725110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13250.82 0 0 0 0 0 0 0 0 0 0 0 0 0 13250.82 0 0 1006725111 1184044117 16 Nurse Practitioners MARONEY MARY A 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 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 0 674.06 0 0 0 0 0 0 674.06 0 0 1006725179 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23907.18 0 0 0 0 0 0 0 0 0 0 0 0 0 23907.18 0 0 1006725445 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12791.7 0 0 0 0 0 0 0 0 0 0 0 0 0 12791.7 0 0 1006725466 1922029362 60 Pharmacies MEDSCRIPT LTC PHARMACY 460603303 815 Indiana 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 1047 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10561.63 0 0 0 10561.63 0 0 1006725745 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 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 2536.28 0 0 2536.28 0 0 1006725889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1398.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1398.27 0 0 1006726286 1154642494 10 Physicians TYSON ANNA F. 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 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 2899.06 0 0 0 0 0 0 2899.06 0 0 1006726446 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.78 0 0 0 0 0 0 0 0 0 0 0 0 0 101.78 0 0 1006726494 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2312.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2312.08 0 0 1006726694 1154616530 10 Physicians MALONE CHRISTOPHER D 999999999 109 Winnebago 0 0 Radiology Diagnosis 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 15 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.81 0 2351.18 0 0 0 0 0 0 2388.99 0 0 1006726716 1215344650 89 Physician Assistant Only(Encounter Only) HOGOBOOM KATEE 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 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 13.01 0 0 0 0 0 0 13.01 0 0 1006726805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12547.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12547.56 0 0 1006726919 1942473947 10 Physicians ALI STEFANIE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 28 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.12 0 0 0 0 0 0 0 0 35.12 0 0 1006726946 1497132435 10 Physicians YOO CHRIS BYUNG 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 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 0 846.65 0 0 0 0 0 0 846.65 0 0 1006727254 1730357955 36 Community mental health provider PILLARS COMMUNITY HEALTH 604571189 200 Cook 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 981.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21680.4 0 0 22661.76 0 0 1006727948 1497751994 10 Physicians HAITHCOCK ROBYN L 999999999 96 St Clair 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 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 1951.9 0 0 0 0 0 0 1951.9 0 0 1006728018 1790238921 10 Physicians RIVAS-LOPEZ VANESSA 999999999 30 DuPage 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 1696.93 0 0 0 0 0 0 1709.73 0 0 1006728084 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 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 0 150.31 0 0 0 0 0 0 150.31 0 0 1006728272 1205222320 10 Physicians ESMAEELI AMIRHOSSEIN 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 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 0 208.39 0 0 0 0 0 0 208.39 0 0 1006728287 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 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 0 394.96 0 0 0 0 0 0 394.96 0 0 1006728454 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14484.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14484.41 0 0 1006728601 1194010157 10 Physicians TROIANI BLAKE M 999999999 30 DuPage 0 0 Dermatology 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 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 0 529.14 0 0 0 0 0 0 529.14 0 0 1006728922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21448.51 0 0 0 0 0 0 0 0 0 0 0 0 0 21448.51 0 0 1006729387 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18559.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18559.2 0 0 1006729489 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 194.51 0 0 0 0 0 0 194.51 0 0 1006729820 1265916704 89 Physician Assistant Only(Encounter Only) ARREGUIN PETER 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 0 102 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 2484.98 0 0 0 0 0 0 2484.98 0 0 1006729944 1730442203 10 Physicians MALIK MOKERRUM F 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.62 0 1313.65 0 0 0 0 0 0 1404.27 0 0 1006730133 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6852.04 0 0 0 0 0 0 0 0 0 0 0 0 0 6852.04 0 0 1006730445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25656.41 0 0 0 0 0 0 0 0 0 0 0 0 0 25656.41 0 0 1006730463 1891113775 10 Physicians CARROLL BRIAN JOHN 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 3 0 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 223.05 0 1247.63 0 0 0 0 0 0 1575.64 0 0 1006730469 1003297888 10 Physicians ESTES AVRAM N 999999999 81 Perry 0 0 Emergency 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 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 0 659.47 0 0 0 0 0 0 659.47 0 0 1006730497 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 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 0 112.48 112.48 0 0 1006730628 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11917.14 0 0 0 0 0 0 0 0 0 0 0 0 0 11917.14 0 0 1006730901 1669622767 10 Physicians MARTIRES JOANNE S 999999999 200 Cook 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 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4507.84 0 0 0 0 0 0 4507.84 0 0 1006731733 1215422142 10 Physicians HAQUE ZOHAIB 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 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 0 190.9 0 0 0 0 0 0 190.9 0 0 1006731763 97 Waiver service provider--Children's residential (DHS/DDD) 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 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 4378.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4378.8 0 0 1006732250 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 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 1179.29 0 0 0 0 0 0 1179.29 0 0 1006732825 1376051292 16 Nurse Practitioners DETERS KAYLA R 999999999 24 Coles 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 0 143 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 2062.64 0 0 0 0 0 0 2062.64 0 0 1006732917 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006733003 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8443.19 0 0 0 0 0 0 0 0 0 0 0 0 0 8443.19 0 0 1006734341 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 22946.07 0 0 0 0 0 0 0 0 0 0 0 0 0 22946.07 0 0 1006734675 1356825483 60 Pharmacies ST. ALEXIUS MEDICAL CENTER OUT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2449.07 0 0 0 2449.07 0 0 1006735022 1558704874 10 Physicians HAQUE SARA 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 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 0 801.99 0 0 0 0 0 0 801.99 0 0 1006735114 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 22150.97 0 0 0 0 0 0 0 0 0 0 0 0 0 22150.97 0 0 1006735208 1740769298 86 Clinical Social Worker(Encounter Only) NOLTE LONI F 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 0 104 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 4222.4 0 0 0 0 0 0 4222.4 0 0 1006735342 1710430467 11 Dentists PATEL AENA Y 999999999 200 Cook 0 0 General Dentistry 0 0 59 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 268 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 7693.86 0 0 0 0 0 0 0 0 0 0 0 3387.15 0 0 0 0 11081.01 0 0 1006735705 1194015248 10 Physicians HUSSAINI ZUHAIR 999999999 30 DuPage 0 0 Urology 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 4 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.54 0 3381.79 0 0 0 0 0 0 3478.33 0 0 1006735773 1497268783 33 Nursing Facilities GALLATIN MANOR 999999999 38 Gallatin 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269657.64 0 0 0 0 0 0 0 269657.64 0 0 1006736021 1790134039 86 Clinical Social Worker(Encounter Only) SWIDERSKA DOROTHEA 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 0 218.52 0 0 0 0 0 0 218.52 0 0 1006736320 1376020339 91 Waiver service provider--Adults (DHS/DDD) CAVANAGH ERIN 999999999 96 St Clair 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 0 814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139546 0 0 0 0 0 0 0 0 0 0 0 0 0 139546 0 0 1006736454 1639608854 11 Dentists STERN ABIGAIL L 999999999 30 DuPage 0 0 General Dentistry 0 0 47 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 170 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5379.53 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 6132.23 0 0 1006736582 1184938284 10 Physicians CAVANAUGH KEVIN P 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 0 191 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 1597.85 0 0 0 0 0 0 1597.85 0 0 1006736586 1871758870 10 Physicians BAKER TODD 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 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 4957.24 0 0 0 0 0 0 4957.24 0 0 1006736854 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 0 0 0 0 0 0 0 0 0 0 1006736865 1235557877 10 Physicians SAVINO ANGELO M 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.19 0 126.58 0 0 0 0 0 0 237.77 0 0 1006737029 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 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 13721.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13721.96 0 0 1006737485 1336501824 16 Nurse Practitioners EMERY ERNEST J 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 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 1648.42 0 0 0 0 0 0 1648.42 0 0 1006737495 1699130856 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 91 Sangamon 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 2708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701967.76 0 0 701967.76 0 0 1006738048 4006738048 92 Waiver service provider--Disability (DHS/DRS) SCN AMERICA 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 0 179 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 255706.68 0 0 0 0 0 0 0 0 0 0 0 0 0 255706.68 0 0 1006738192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1006738311 1639444375 10 Physicians HUSSAIN SANA 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PRAIRIE OASIS 999999999 200 Cook 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518350.72 0 0 0 0 0 0 0 518350.72 0 0 1006740596 16 Nurse Practitioners 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 1.4 0 0 0 0 0 0 1.4 0 0 1006740983 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11287.79 0 0 0 0 0 0 0 0 0 0 0 0 0 11287.79 0 0 1006741133 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21513.43 0 0 0 0 0 0 0 0 0 0 0 0 0 21513.43 0 0 1006741441 1811383573 10 Physicians MARKOVIC IRENA 999999999 97 Stephenson 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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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314.84 0 0 0 0 0 0 0 0 0 0 0 0 0 314.84 0 0 1006742528 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 593.25 0 0 0 0 0 0 0 0 0 0 0 0 0 593.25 0 0 1006742622 1568953545 24 Speech Therapists PRESTON STEPHANIE 999999999 98 Tazewell 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 0 144 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 10783.11 10783.11 0 0 1006742683 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 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 93.49 93.49 0 0 1006742744 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 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 1006743125 1093827628 16 Nurse Practitioners BINGNER ERIC 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349.82 0 0 0 0 0 0 349.82 0 0 1006743283 1629331277 10 Physicians FRANZ COLIN K 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 663.97 0 0 0 0 0 0 663.97 0 0 1006743300 1063729895 10 Physicians KALIMULLAH FAIYAAZ A 999999999 200 Cook 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 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.7 0 1042.26 0 0 0 0 0 0 1046.96 0 0 1006743306 1508332453 16 Nurse Practitioners BOYD SHERRY L 999999999 91 Sangamon 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 0 129 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 23878.38 0 0 0 0 0 0 23878.38 0 0 1006744586 1255859534 16 Nurse Practitioners AMARO GABRIELA 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 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 0 295.25 0 0 0 0 0 0 295.25 0 0 1006744620 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 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 1006744621 1740520907 16 Nurse Practitioners GOODWIN ROBIN L 999999999 30 DuPage 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 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 1460.38 0 0 0 0 0 0 1460.38 0 0 1006744720 1114205861 16 Nurse Practitioners ZUNIGA SRAH JN 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 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 0 787.56 0 0 0 0 0 0 787.56 0 0 1006745008 1013493824 46 Ambulatory Surgical Treatment Centers LURIE CHILDREN''S SURGERY CENT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 37392.59 0 0 0 0 0 37392.59 0 0 1006745157 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 362.63 0 0 0 0 0 0 362.63 0 0 1006745447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3827.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3827.37 0 0 1006745528 1578970422 16 Nurse Practitioners DAMON AMANDA J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 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0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 17077.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17077.9 0 0 1006746052 1649790510 30 General Hospitals FRESENIUS MEDICAL CARE BEVERLY 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2909.84 0 0 0 0 0 2909.84 0 0 1006746146 1841721487 16 Nurse Practitioners KUNCHERIA MINI 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 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 2107 0 0 0 0 0 0 2107 0 0 1006746159 1558620146 10 Physicians KHISTY RAUNAK S 999999999 54 Kankakee 0 0 Psychiatry 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 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19923.37 0 0 0 0 0 0 19923.37 0 0 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1006748680 1861902025 16 Nurse Practitioners MCCARTHY KAYLA J 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 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 59.06 0 0 0 0 0 0 59.06 0 0 1006748710 1982959219 10 Physicians DOMBROWSKI JAMES M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 296 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 494 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5126.36 0 1330.57 0 0 0 0 0 0 6456.93 0 0 1006748834 11 Dentists 100 Vermilion 0 0 General Dentistry 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 240 0 0 1006748980 12 Optometrists 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 81.26 0 0 0 0 0 0 81.26 0 0 1006749397 1750506481 10 Physicians HUNSAKER KEITH 999999999 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 600 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7987.98 0 272.9 0 0 0 0 0 0 8260.88 0 0 1006749404 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 0 0 0 0 1006749889 1497295125 89 Physician Assistant Only(Encounter Only) HEMBREY ALEXANDER J 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 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 0 501.36 0 0 0 0 0 0 501.36 0 0 1006750169 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006750467 72 Taxicabs and Livery Companies 24 Coles 0 0 0 0 0 0 0 0 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999999999 15 Bureau 0 0 0 0 0 7 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 537.21 0 0 0 0 0 0 0 0 2289.84 0 0 0 0 0 0 2827.05 0 0 1006751685 1629249867 10 Physicians PILATI STAMATOULA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 88 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.82 0 105.69 0 0 0 0 0 0 343.51 0 0 1006751836 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32177.09 0 0 0 0 0 0 0 0 0 0 0 0 0 32177.09 0 0 1006752152 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 0 313 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 43714.56 0 0 0 0 0 0 0 0 0 0 0 0 0 43714.56 0 0 1006752548 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 22.1 0 0 0 0 0 0 22.1 0 0 1006752654 1952897001 16 Nurse Practitioners OLSEN DIANA M 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 386.59 0 0 0 0 0 0 386.59 0 0 1006752855 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 1006753277 1447686704 86 Clinical Social Worker(Encounter Only) GAZDZIAK BRIAN D 999999999 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 1354.75 0 0 0 0 0 0 1354.75 0 0 1006753312 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 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 51.08 0 0 0 0 0 0 51.08 0 0 1006753786 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 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 67.22 0 0 0 0 0 0 67.22 0 0 1006754004 10 Physicians 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 77.5 0 0 0 0 0 0 77.5 0 0 1006754704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11068.89 0 0 0 0 0 0 0 0 0 0 0 0 0 11068.89 0 0 1006755593 1659380426 10 Physicians LAWRENCE SANDRA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 31 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.94 0 8.64 0 0 0 0 0 0 69.58 0 0 1006756563 1215322235 10 Physicians CHARNOGURSKY CARA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.1 0 589.44 0 0 0 0 0 0 653.54 0 0 1006756644 1811415920 11 Dentists TRINH KIMBERLY 999999999 200 Cook 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12324.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12324.96 0 0 1006756722 1417928110 89 Physician Assistant Only(Encounter Only) MCKAY SCOTT 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 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 20.86 0 0 0 0 0 0 20.86 0 0 1006756881 1841777687 89 Physician Assistant Only(Encounter Only) ALLEN KATHRYN 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 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 0 347.57 0 0 0 0 0 0 347.57 0 0 1006757146 1588071294 10 Physicians JAROSZEWSKA ANNA 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 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 0 322.23 0 0 0 0 0 0 322.23 0 0 1006757695 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 0 216 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 7789.98 0 0 0 0 0 0 0 0 0 0 0 0 0 7789.98 0 0 1006757780 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 65.99 0 0 0 0 0 0 65.99 0 0 1006757860 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 210.7 0 0 0 0 0 0 210.7 0 0 1006757892 1689151409 16 Nurse Practitioners SECKINGER KAYTLIN 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 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 1108.92 0 0 0 0 0 0 1108.92 0 0 1006758264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6725.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6725.92 0 0 1006758272 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3304.27 0 0 0 0 0 0 0 0 0 0 0 0 0 3304.27 0 0 1006758280 1831629575 16 Nurse Practitioners VAHLE TAYLOR 999999999 10 Adams 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 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 1087.52 0 0 0 0 0 0 1087.52 0 0 1006758934 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8365.78 0 0 0 0 0 0 0 0 0 0 0 0 0 8365.78 0 0 1006759865 1902321367 11 Dentists ALRATA MAMDOUH 999999999 96 St Clair 0 0 General Dentistry 0 0 80 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 10017.23 0 0 0 0 0 0 0 0 0 0 0 6021.6 0 0 0 0 16038.83 0 0 1006760262 1780110346 16 Nurse Practitioners SPURLARK ROXANNE 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 0 603.47 0 0 0 0 0 0 603.47 0 0 1006760349 1407933302 10 Physicians MOUSSA ISSAM D 999999999 88 Richland 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 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 0 554.22 0 0 0 0 0 0 554.22 0 0 1006760538 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 1006760541 1255816369 16 Nurse Practitioners MARCOTTE MELISA 999999999 107 Will 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 0 148 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 0 344.47 0 0 0 0 0 0 344.47 0 0 1006760607 1437634987 16 Nurse Practitioners GARNETT LINDSEY 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 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 0 367.03 0 0 0 0 0 0 367.03 0 0 1006760752 1477063519 16 Nurse Practitioners MURRIN LEE 999999999 60 Lee 0 0 0 0 0 9 0 0 0 0 0 0 0 0 52 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 0 524.27 0 0 0 0 0 0 0 0 4339.76 0 0 0 0 0 0 4864.03 0 0 1006761152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453.58 0 0 0 0 0 0 0 0 0 0 0 0 0 453.58 0 0 1006761167 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 74.95 0 0 0 0 0 0 74.95 0 0 1006761248 10 Physicians 30 DuPage 0 0 Emergency Medicine 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 27.99 0 126.14 0 0 0 0 0 0 154.13 0 0 1006761452 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 0 185.88 0 0 0 0 0 0 185.88 0 0 1006761790 1558771220 10 Physicians SUTTON CHRISTOPHER 999999999 91 Sangamon 0 0 Internal Medicine 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 0 367 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 2894.68 0 0 0 0 0 0 2894.68 0 0 1006761834 1558701045 10 Physicians SLOAN PATRICK E 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 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 8851.5 0 0 0 0 0 0 8851.5 0 0 1006762657 1063846962 22 Physical Therapists SZWEISTIS JANELLE M 999999999 30 DuPage 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 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 0 811.92 811.92 0 0 1006762982 1063686624 10 Physicians THEODOROU WILLIAM W 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1195.05 0 21.07 0 0 0 0 0 0 1216.12 0 0 1006763148 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 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 10146.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10146.76 0 0 1006763243 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 83.23 0 0 0 0 0 0 83.23 0 0 1006763288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18671.9 0 0 0 0 0 0 0 0 0 0 0 0 0 18671.9 0 0 1006763593 1699299297 89 Physician Assistant Only(Encounter Only) SHEEHY BRITTANY A 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 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 1006763697 1790804144 70 Ambulance Service Providers NEW MILFORD FIRE AMBULANCE 611094854 109 Winnebago 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 0 142 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 82699.29 0 0 0 0 0 0 82699.29 0 0 1006764289 1528417912 10 Physicians KELLY STEPHANIE B 999999999 30 DuPage 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 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 0 496.9 0 0 0 0 0 0 496.9 0 0 1006764358 1427588631 30 General Hospitals HOME DIALYSIS SERVICES FOX VAL 999999999 53 Kane DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 1410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883.63 0 0 0 0 0 883.63 0 0 1006764418 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20956.43 0 0 0 0 0 0 0 0 0 0 0 0 0 20956.43 0 0 1006764494 1326549387 16 Nurse Practitioners ASTELL-RICHARDSON SUZETTE 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 639.57 0 0 0 0 0 0 639.57 0 0 1006764498 1942393137 10 Physicians NUSAIR MAEN 999999999 200 Cook 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 0 117 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 2499.32 0 0 0 0 0 0 2499.32 0 0 1006764597 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 871.15 0 0 0 0 0 0 0 0 0 0 0 0 0 871.15 0 0 1006764714 30 General Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 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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 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 0 151.12 0 0 0 0 0 0 151.12 0 0 1006766112 1457868689 16 Nurse Practitioners IPPENSEN BRITTANY N 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 0 183 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 1107.7 0 0 0 0 0 0 1107.7 0 0 1006766717 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 0 0 0 0 0 0 0 0 0 0 1006767004 1801375415 16 Nurse Practitioners COFFEY STEPHANIE B 999999999 19 Champaign 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 0 160 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 1184.6 0 0 0 0 0 0 1184.6 0 0 1006767075 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 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HUNSBERGER SARAH L 999999999 19 Champaign 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 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 0 840.13 0 0 0 0 0 0 840.13 0 0 1006768883 1669906038 10 Physicians NAVON GABRIELLE 999999999 200 Cook 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 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 1085.64 0 0 0 0 0 0 1085.64 0 0 1006769040 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 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 8354.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8354.5 0 0 1006769087 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 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 0 603.12 0 0 0 0 0 0 0 0 0 0 0 0 0 603.12 0 0 1006769117 1386027076 10 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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 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 0 110.47 110.47 0 0 1006770429 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3202.54 0 0 0 0 0 0 0 0 0 0 0 0 0 3202.54 0 0 1006770556 1730551771 89 Physician Assistant Only(Encounter Only) REIBEL JOSEPH 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 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 0 762.71 0 0 0 0 0 0 762.71 0 0 1006770994 1316452246 16 Nurse Practitioners KELLY MEGHAN R 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 0 109 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 1165.39 0 0 0 0 0 0 1165.39 0 0 1006771029 1700307709 16 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0 0 0 0 0 0 0 0 17 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.89 0 234.38 0 0 0 0 0 0 266.27 0 0 1006780669 1265915797 16 Nurse Practitioners VOHRA SAMIR 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 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 0 492.15 0 0 0 0 0 0 492.15 0 0 1006780885 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23893.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23893.55 0 0 1006781162 1952899940 16 Nurse Practitioners GRAY KELSEY 999999999 10 Adams 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 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 0 558.66 0 0 0 0 0 0 558.66 0 0 1006781667 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 48 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5259.31 0 0 0 0 0 0 5259.31 0 0 1006785728 1093128720 10 Physicians CHYZHYK VADZIM N 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17020.13 0 0 0 0 0 0 17020.13 0 0 1006786172 1831691765 16 Nurse Practitioners MAHLER SARAH M 999999999 53 Kane 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 0 718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2880.74 0 0 0 0 0 0 2880.74 0 0 1006786286 1598175531 10 Physicians AKTHAR ADIL S 999999999 200 Cook 0 0 Radiation Oncology 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.94 0 650.5 0 0 0 0 0 0 670.44 0 0 1006786591 1174919229 10 Physicians KRUKOWSKI MARLA 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 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0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.62 0 0 0 0 0 0 76.62 0 0 1006787695 1750830162 40 Federally Qualified Health Centers LEGACY MEDICAL CARE INC. 601204339 200 Cook 0 0 0 249 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 779 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 779 0 430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76233.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76233.36 0 0 1006788038 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 14.7 0 0 0 0 0 0 14.7 0 0 1006788121 1336624196 16 Nurse Practitioners BOWSER NICOLE M 999999999 19 Champaign 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 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 0 398.55 0 0 0 0 0 0 398.55 0 0 1006788182 1114247087 10 Physicians EDENS CUOGHI 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 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0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 8460.85 0 0 0 0 0 0 0 0 0 0 0 0 0 8460.85 0 0 1006789966 1831644749 23 Occupational Therapists LEE TESSA M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 8970.5 8970.5 0 0 1006789969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24045.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24045.56 0 0 1006790220 1073833745 10 Physicians HUSSAIN ARIF 999999999 30 DuPage 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 3010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8657.17 0 0 0 0 0 0 8657.17 0 0 1006790446 1336166024 10 Physicians NUCATOLA DEBORAH R 999999999 200 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service provider--Adults (DHS/DDD) MIROUX MICHAEL E 999999999 15 Bureau 0 0 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4276.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4276.98 0 0 1006791911 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15343.59 0 0 0 0 0 0 0 0 0 0 0 0 0 15343.59 0 0 1006791999 1164913430 16 Nurse Practitioners HENLINE STEFANIE L 999999999 40 Grundy 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 0 103 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 1414.59 0 0 0 0 0 0 1414.59 0 0 1006792428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7172.88 0 0 0 0 0 0 0 0 0 0 0 0 0 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Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 1849.77 1849.77 0 0 1006842097 1043754765 16 Nurse Practitioners MCKEAGUE KAITLIN 999999999 30 DuPage 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 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 1287.58 0 0 0 0 0 0 1287.58 0 0 1006842682 10 Physicians 87 Randolph 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 0 277.82 0 0 0 0 0 0 277.82 0 0 1006843023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3057.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3057.06 0 0 1006843065 1124501606 16 Nurse Practitioners OVERMEYER ASHLEY H 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 161.42 0 0 0 0 0 0 0 0 2352.02 0 0 0 0 0 0 2513.44 0 0 1006843261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699.35 0 0 0 0 0 0 0 0 0 0 0 0 0 699.35 0 0 1006843423 1871854257 10 Physicians HUSSAIN WALID A 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 0 106 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 19929.9 0 0 0 0 0 0 19929.9 0 0 1006843597 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6488.88 0 0 0 0 0 0 0 0 0 0 0 0 0 6488.88 0 0 1006843607 1013303064 86 Clinical Social Worker(Encounter Only) HONEY KIMBERLY M 999999999 99 Union 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 0 229 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 1900.09 0 0 0 0 0 0 1900.09 0 0 1006843635 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4764.44 0 0 0 0 0 0 0 0 0 0 0 0 0 4764.44 0 0 1006843877 1346564879 10 Physicians TOBEY RICHARD W 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 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 0 201.44 0 0 0 0 0 0 201.44 0 0 1006844198 1013262666 10 Physicians LEON PETERS JOCELYN 999999999 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 13 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 16 0 53 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 16 0 53 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 1150.4 0 5277.14 0 0 0 0 0 0 6447.12 0 0 1006844399 1245472455 10 Physicians LIEBERMAN ELLIOT D 999999999 57 Lake 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 31.01 0 0 0 0 0 0 31.01 0 0 1006844690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24099.59 0 0 0 0 0 0 0 0 0 0 0 0 0 24099.59 0 0 1006844691 1013273150 10 Physicians WAKADE ZUIE 999999999 200 Cook 0 0 Internal Medicine 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 0 134 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 4471.2 0 0 0 0 0 0 4471.2 0 0 1006844752 1659636009 10 Physicians HOEFGEN ERIK R 999999999 81 Perry 0 0 Pediatrics 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 214.16 0 0 0 0 0 0 214.16 0 0 1006845563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14870.99 0 0 0 0 0 0 0 0 0 0 0 0 0 14870.99 0 0 1006845762 4006845762 72 Taxicabs and Livery Companies B & Q TRANSPORTATION 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 5432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32576.96 0 0 0 0 0 0 32576.96 0 0 1006845834 1447790969 36 Community mental health provider "TRILOGY, INC" 999999999 200 Cook 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 381 0 0 3286.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35280.98 0 0 38567.66 0 0 1006845997 1841718087 16 Nurse Practitioners NAURECKI MICHELLE 999999999 57 Lake 0 0 0 0 0 37 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 50 0 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0 0 0 104 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4723.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4723.97 0 0 1006846913 1518168244 16 Nurse Practitioners THOMAS ANGELA M. 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 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 0 330.39 0 0 0 0 0 0 330.39 0 0 1006847242 1598209041 16 Nurse Practitioners ODEH JALLWA 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 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 1197.47 0 0 0 0 0 0 1197.47 0 0 1006847367 1104246230 10 Physicians MUENSTER JOSEPH E 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 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 0 270.4 0 0 0 0 0 0 270.4 0 0 1006847529 1568975514 16 Nurse Practitioners MORROW LAURA 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 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 25.27 0 0 0 0 0 0 25.27 0 0 1006847571 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 4 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 4024.66 4024.66 0 0 1006848339 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24108.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24108.7 0 0 1006848489 4006848489 91 Waiver service provider--Adults (DHS/DDD) LEAF KAREN 999999999 91 Sangamon 0 0 0 0 0 0 0 14 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 18554.53 0 0 0 0 0 0 0 0 0 0 0 0 0 18554.53 0 0 1006849060 11 Dentists 30 DuPage 0 0 General Dentistry 0 0 2 0 0 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1006871326 1568891299 89 Physician Assistant Only(Encounter Only) KADIWALA KUNJAL 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 77.45 0 0 0 0 0 0 77.45 0 0 1006871336 1700014289 10 Physicians SOULT MICHAEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 9 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.45 0 4372.23 0 0 0 0 0 0 4395.68 0 0 1006871370 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 0 0 0 0 0 0 0 0 0 0 1006871543 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25994.42 0 0 0 0 0 0 0 0 0 0 0 0 0 25994.42 0 0 1006871592 1780093187 89 Physician Assistant Only(Encounter Only) JOHNSON ELLIOT P 999999999 53 Kane 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 0 349 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 11513.8 0 0 0 0 0 0 11513.8 0 0 1006871837 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 0 129.39 0 0 0 0 0 0 129.39 0 0 1006871997 1659884229 16 Nurse Practitioners SAPITULA ALMIRA 999999999 200 Cook 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 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2131.17 0 0 0 0 0 0 2131.17 0 0 1006872042 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1417.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1417.91 0 0 1006872217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26295.4 0 0 0 0 0 0 0 0 0 0 0 0 0 26295.4 0 0 1006872263 1932522323 89 Physician Assistant Only(Encounter Only) FOSTER ELIZABETH 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 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 0 964.45 0 0 0 0 0 0 964.45 0 0 1006872382 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 84.87 0 0 0 0 0 0 84.87 0 0 1006872395 1114333978 10 Physicians WILSON SENETTA 999999999 200 Cook 0 0 Family Practice 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 0 228 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 4074.73 0 0 0 0 0 0 4074.73 0 0 1006872512 1851891030 16 Nurse Practitioners ROBERTS HANNAH 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 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 0 567.45 0 0 0 0 0 0 567.45 0 0 1006872519 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 1006872535 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 13560.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13560.05 0 0 1006872708 1457801748 75 Department of Alcohol and Substance Abuse Provider SINNISSIPPI CENTERS INC 610814151 106 Whiteside 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 0 118 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 6290.25 0 0 6290.25 0 0 1006872789 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21758.22 0 0 0 0 0 0 0 0 0 0 0 0 0 21758.22 0 0 1006872881 1528577657 89 Physician Assistant Only(Encounter Only) REMBIALKOWSKI ALEX J 999999999 50 Jersey 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 0 171 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 6198.78 0 0 0 0 0 0 6198.78 0 0 1006872961 1568989424 16 Nurse Practitioners GUIEB ROBIN 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 0 126 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 1380.4 0 0 0 0 0 0 1380.4 0 0 1006873009 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 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 7551.6 0 0 0 0 0 0 0 0 0 0 0 0 0 7551.6 0 0 1006873052 1649203316 10 Physicians PRUETT WESLEY C 999999999 200 Cook 0 0 0 0 0 0 0 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 0 323.14 0 0 0 0 0 0 0 0 323.14 0 0 1006873230 1225515273 16 Nurse Practitioners BERGSTROM RENEE C 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 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 0 407.61 0 0 0 0 0 0 407.61 0 0 1006873297 1508388372 16 Nurse Practitioners PAINTER AMBER L 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 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 1016.24 0 0 0 0 0 0 1016.24 0 0 1006873570 1467746651 10 Physicians LACHER CASSANDRA J 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 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 79.76 0 0 0 0 0 0 79.76 0 0 1006873617 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 0 0 0 0 0 0 0 0 0 0 1006873945 86 Clinical Social Worker(Encounter Only) 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 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 0 166.15 0 0 0 0 0 0 166.15 0 0 1006874068 1992259337 46 Ambulatory Surgical Treatment Centers ADVOCATE CONDELL AMBULATORY SU 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1266.95 0 0 0 0 0 1266.95 0 0 1006874107 1003813601 10 Physicians PAULK EDDIE L 999999999 65 Madison 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 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 0 808.49 0 0 0 0 0 0 808.49 0 0 1006874250 1881128494 10 Physicians LANE ALEX 999999999 826 Missouri 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 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 0 296.51 0 0 0 0 0 0 296.51 0 0 1006874302 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 20.07 0 0 0 0 0 0 20.07 0 0 1006874612 25 Audiologists 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 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 87.91 87.91 0 0 1006874694 1386175834 10 Physicians BUNCH SARAH M 999999999 53 Kane 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 0 216 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 8044.12 0 0 0 0 0 0 8044.12 0 0 1006874704 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23385.57 0 0 0 0 0 0 0 0 0 0 0 0 0 23385.57 0 0 1006875310 1366732364 10 Physicians DAVIDSON KELSEY E 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.69 0 0 0 0 0 0 1014.69 0 0 1006875503 1295225068 16 Nurse Practitioners BERRINI SARA A 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 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 0 206.53 0 0 0 0 0 0 206.53 0 0 1006875841 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.82 0 0 0 0 0 0 45.82 0 0 1006876026 1932613148 22 Physical Therapists YEMM ALLISON 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 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 1412.5 1412.5 0 0 1006876080 1669769246 10 Physicians GHARAIBEH KAMEL 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 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 0 981.9 0 0 0 0 0 0 981.9 0 0 1006876188 1053419721 63 Other Providers of Medical Equipment/Supplies (Non-registered) GOOD SAMARITAN HOSPITAL 475911038 815 Indiana 0 0 0 0 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 23 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.98 0 432.88 0 0 0 0 528.86 0 0 1006876372 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 2463.47 0 0 0 0 0 0 2463.47 0 0 1006876568 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.56 0 0 0 0 0 0 0 0 0 0 0 0 0 70.56 0 0 1006876575 1841601796 10 Physicians MUNOZ AMANDA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 6 0 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 12 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 513.29 0 1322.47 0 0 0 0 0 0 1855.34 0 0 1006876605 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13040.28 0 0 0 0 0 0 0 0 0 0 0 0 0 13040.28 0 0 1006876626 1205178340 10 Physicians NEAL KEVIN A 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 905 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8307.7 0 977.42 0 0 0 0 0 0 9285.12 0 0 1006876649 1275054348 30 General Hospitals HUNTLEY 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15914.21 0 0 0 0 0 15914.21 0 0 1006876751 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.52 0 0 0 0 0 0 105.52 0 0 1006877000 1730199241 10 Physicians YOUNG ROBERT 999999999 53 Kane 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 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 1575.3 0 0 0 0 0 0 1575.3 0 0 1006877333 1962708644 10 Physicians KOLOMEYEVSKAYA NONNA V 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 0 442.53 0 0 0 0 0 0 442.53 0 0 1006877444 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 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 6830 0 0 0 0 0 0 0 0 0 0 0 0 0 6830 0 0 1006877771 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12491.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12491.9 0 0 1006877798 1598064750 10 Physicians BERG STEPHANIE 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 0 190 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 1994.04 0 0 0 0 0 0 1994.04 0 0 1006877854 1457865172 16 Nurse Practitioners O'DONNELL TERESA A. 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 0 112 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 1401.69 0 0 0 0 0 0 1401.69 0 0 1006877933 1538663190 10 Physicians RODRIGUEZ RIVERA YOLANDA 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 0 134 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 1496.92 0 0 0 0 0 0 1496.92 0 0 1006878018 1346506607 10 Physicians EL-SEDFY ABRAHAM N 999999999 47 Jackson 0 0 Colon - Rectal Surgery 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 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 2331.02 0 0 0 0 0 0 2331.02 0 0 1006878301 1689180978 16 Nurse Practitioners MERKLEY HOPE E 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 601.58 0 0 0 0 0 0 601.58 0 0 1006878833 1093213308 48 Rural Health Clinics HAMMOND-HENRY HOSPITAL MEDICAL 999999999 45 Henry 0 0 0 148 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14680.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14680.79 0 0 1006879297 1790166569 10 Physicians GRINDEM DAVID 999999999 19 Champaign 0 0 Family Practice 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 0 100 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 3229.86 0 0 0 0 0 0 3229.86 0 0 1006879424 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 28386.23 0 0 0 0 0 0 0 0 0 0 0 0 0 28386.23 0 0 1006879469 1801301494 89 Physician Assistant Only(Encounter Only) KRIPPINGER CHRISTOPHER 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 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 0 265.63 0 0 0 0 0 0 265.63 0 0 1006879514 1457822207 91 Waiver service provider--Adults (DHS/DDD) MANIGAULT-MCELVEEN DESMA 999999999 91 Sangamon 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 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90700.8 0 0 0 0 0 0 0 0 0 0 0 0 0 90700.8 0 0 1006879669 1124159454 87 Psychologist(Encounter Only) BERGHOLTZ AMY 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 0 357 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 19620.53 0 0 0 0 0 0 19620.53 0 0 1006879690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22508.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22508.28 0 0 1006879976 1891151676 22 Physical Therapists LIFKA RYAN D 999999999 30 DuPage 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 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 0 658.64 658.64 0 0 1006880050 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 58.76 0 0 0 0 0 0 58.76 0 0 1006880083 1982197216 16 Nurse Practitioners BICHL JANNELL A. 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 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 5137.22 0 0 0 0 0 0 5137.22 0 0 1006880856 1942643168 10 Physicians OMOWANILE YEWANDE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 1571.51 0 0 0 0 0 0 1571.51 0 0 1006881040 1326565979 30 General Hospitals FOXPOINT DIALYSIS 999999999 65 Madison 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 63 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 24722.38 0 0 0 0 0 24722.38 0 0 1006881116 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.15 0 0 0 0 0 0 79.15 0 0 1006881147 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21829.03 0 0 0 0 0 0 0 0 0 0 0 0 0 21829.03 0 0 1006881185 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 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 13734.44 0 0 0 0 0 0 0 0 0 0 0 0 0 13734.44 0 0 1006881776 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1584.61 1584.61 0 0 1006881831 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 0 192 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 20939.2 0 0 0 0 0 0 0 0 0 0 0 0 0 20939.2 0 0 1006882331 1134629777 22 Physical Therapists GAFFNEY ERIN M 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 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 6284.81 6284.81 0 0 1006882443 1871869040 10 Physicians HUGHES IAN F 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 283 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2308.52 0 137.26 0 0 0 0 0 0 2445.78 0 0 1006882630 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.71 0 0 0 0 0 0 0 0 0 0 0 0 0 33.71 0 0 1006883086 1558749226 10 Physicians RIKARDSEN LARS 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 0 0 0 548.61 0 0 0 0 0 0 13.72 0 624.09 0 0 0 0 0 0 1186.42 0 0 1006883319 1578887063 10 Physicians HUSHION MICHAEL J 999999999 91 Sangamon 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 0 230 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 4899.13 0 0 0 0 0 0 4899.13 0 0 1006883584 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 4191.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4191.56 0 0 1006883797 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15550.71 0 0 0 0 0 0 0 0 0 0 0 0 0 15550.71 0 0 1006884394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16130.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16130.35 0 0 1006884613 10 Physicians 10 Adams 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 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 0 247.45 0 0 0 0 0 0 247.45 0 0 1006885211 1356857890 16 Nurse Practitioners ZELEK KRISTEN M 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 2275.41 0 0 0 0 0 0 2371.86 0 0 1006885376 1093222895 16 Nurse Practitioners SALISE JAIMIE 999999999 57 Lake 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 28 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 0 0 1140.66 0 0 0 0 0 0 1153.54 0 0 1006885575 1972018398 16 Nurse Practitioners WINQUIST HEATHER 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 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 0 109.94 0 0 0 0 0 0 109.94 0 0 1006885677 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11683.76 0 0 0 0 0 0 0 0 0 0 0 0 0 11683.76 0 0 1006885796 1568880599 10 Physicians MIHALOV SARAH 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3165.46 0 0 0 0 0 0 3165.46 0 0 1006885808 10 Physicians 90 Saline 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 38.75 0 0 0 0 0 0 57.95 0 0 1006885858 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 0 338.8 0 0 0 0 0 0 338.8 0 0 1006885987 1922554757 89 Physician Assistant Only(Encounter Only) KOZLOWSKI JESSICA 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 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 1006886526 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 24308.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24308.2 0 0 1006886605 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 33.39 0 0 0 0 0 0 33.39 0 0 1006886771 1104819424 46 Ambulatory Surgical Treatment Centers VALLEY AMBULATORY SURGERY CENT 999999999 53 Kane 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 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 2660.48 0 0 0 0 0 2660.48 0 0 1006887018 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30883.24 0 0 0 0 0 0 0 0 0 0 0 0 0 30883.24 0 0 1006887946 1891177978 13 Podiatrists KRATZMEYER RIDHI M. 601234703 53 Kane 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 0 125 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 1195.79 0 0 0 0 0 0 1195.79 0 0 1006887951 1083813653 10 Physicians GOLLAPALLI ESLI 999999999 200 Cook 0 0 Emergency 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 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 0 423.75 0 0 0 0 0 0 423.75 0 0 1006888252 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34326.9 0 0 0 0 0 0 0 0 0 0 0 0 0 34326.9 0 0 1006888525 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 0 225 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 14476.61 0 0 0 0 0 0 0 0 0 0 0 0 0 14476.61 0 0 1006888608 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1238.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1238.6 0 0 1006888674 1811409196 47 Local Education Agencies GAVIN SCHOOL DISTRICT 999999999 57 Lake 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 1513 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 1513 0 0 0 0 435.93 0 0 0 0 0 0 0 0 0 0 0 0 0 34483.47 0 34919.4 0 0 1006888988 1760835714 16 Nurse Practitioners ANERINO ALAYNA C 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 0 419.02 0 0 0 0 0 0 419.02 0 0 1006889128 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24957.24 0 0 0 0 0 0 0 0 0 0 0 0 0 24957.24 0 0 1006889701 1245727536 16 Nurse Practitioners LAWSON LAUREN 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 0 130 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 0 826.42 0 0 0 0 0 0 826.42 0 0 1006889959 1518161512 10 Physicians KIM JON R 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 93 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2822.1 0 24.06 0 0 0 0 0 0 2846.16 0 0 1006890246 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 0 0 0 0 0 0 0 0 0 0 0 0 1006890676 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 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 0 243.45 0 0 0 0 0 0 243.45 0 0 1006890903 1396293809 89 Physician Assistant Only(Encounter Only) BRAIDA REBECCA 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 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 2176.8 0 0 0 0 0 0 2176.8 0 0 1006891305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2547.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2547.33 0 0 1006891350 55 Early Intervention Services 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 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 1120.24 0 0 0 0 0 0 1120.24 0 0 1006891547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 188.44 0 0 0 0 0 0 0 0 0 0 0 0 0 188.44 0 0 1006891642 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2590.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2590.98 0 0 1006892183 1225548027 16 Nurse Practitioners JOR'DAN NAFEESAH S 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 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 0 358.44 0 0 0 0 0 0 358.44 0 0 1006892307 1689192676 16 Nurse Practitioners SCHAEFFER KELLY A 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299.56 0 0 0 0 0 0 299.56 0 0 1006892321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 65550.39 0 0 0 0 0 0 0 0 0 0 0 0 0 65550.39 0 0 1006892559 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10238.09 0 0 0 0 0 0 0 0 0 0 0 0 0 10238.09 0 0 1006892626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29488.09 0 0 0 0 0 0 0 0 0 0 0 0 0 29488.09 0 0 1006892690 1467786988 10 Physicians KNAB LAWRENCE 999999999 53 Kane 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408.6 0 0 0 0 0 0 408.6 0 0 1006892840 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31484.84 0 0 0 0 0 0 0 0 0 0 0 0 0 31484.84 0 0 1006892891 1023470754 13 Podiatrists NORDQUIST THOMAS S 999999999 27 Dekalb 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 0 272 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 1036.36 0 0 0 0 0 0 1036.36 0 0 1006893083 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 8.62 0 0 0 0 0 0 8.62 0 0 1006893450 1083108856 11 Dentists VARMA KARAN 999999999 200 Cook 0 0 0 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8654.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8654.55 0 0 1006893851 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 1006894043 1366955601 23 Occupational Therapists BAUMANN BROOKE A 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 0 106 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 5945.18 5945.18 0 0 1006894975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18169.91 0 0 0 0 0 0 0 0 0 0 0 0 0 18169.91 0 0 1006895052 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5040.59 0 0 0 0 0 0 0 0 0 0 0 0 0 5040.59 0 0 1006895095 1871081711 16 Nurse Practitioners BENNER MONIKA 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 0 141.4 0 0 0 0 0 0 141.4 0 0 1006896043 1992060180 10 Physicians SCHOETTLER NATHAN R 999999999 30 DuPage 0 0 Internal Medicine 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 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 3627.91 0 0 0 0 0 0 3627.91 0 0 1006896231 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19920.08 0 0 0 0 0 0 0 0 0 0 0 0 0 19920.08 0 0 1006896268 89 Physician Assistant Only(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.4 0 0 0 0 0 0 31.4 0 0 1006896694 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9981.98 0 0 0 0 0 0 0 0 0 0 0 0 0 9981.98 0 0 1006897046 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1277.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1277.1 0 0 1006897099 1932675006 16 Nurse Practitioners IKERODAH GLORY O 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 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 0 555.13 0 0 0 0 0 0 555.13 0 0 1006897136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10259.46 0 0 0 0 0 0 0 0 0 0 0 0 0 10259.46 0 0 1006897317 1821166505 89 Physician Assistant Only(Encounter Only) HONEYCUTT TERYN 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 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 0 129.24 0 0 0 0 0 0 129.24 0 0 1006897476 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 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 1643.84 1643.84 0 0 1006897644 1306186861 10 Physicians KAPILESHWARKAR YAMINI S 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 0 136 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 33802.88 0 0 0 0 0 0 33802.88 0 0 1006897692 92 Waiver 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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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.24 0 0 0 0 0 0 176.24 0 0 1006898760 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 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 1006899009 40 Federally Qualified Health Centers 200 Cook 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.91 0 0 1006899152 1154550119 10 Physicians GROVES ELLIOTT 999999999 200 Cook 0 0 Internal Medicine 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 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.71 0 3736.33 0 0 0 0 0 0 3740.04 0 0 1006899193 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 0 1006899232 1699802363 86 Clinical Social Worker(Encounter Only) ROSENFELDT LAUREN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 9.14 0 0 0 0 0 0 9.14 0 0 1006899382 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3095.29 0 0 0 0 0 0 0 0 0 0 0 0 0 3095.29 0 0 1006899827 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 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 4421.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4421.36 0 0 1006899963 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1045.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1045.86 0 0 1006900458 1689150963 16 Nurse Practitioners LAHENDRO COLLEEN M 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 0 573.9 0 0 0 0 0 0 573.9 0 0 1006900469 1093190019 12 Optometrists KOUTNIK CASSANDRA ANNE 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 0 126 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 3079.19 0 0 0 0 0 0 3079.19 0 0 1006900712 1316343031 55 Early Intervention Services GARNETT KATRINA L 999999999 65 Madison 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 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40935.47 0 0 0 0 0 0 40935.47 0 0 1006900729 1447544903 10 Physicians TOOTLA YASMIN FAROUK 999999999 47 Jackson 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 0 331 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 27670.24 0 0 0 0 0 0 27670.24 0 0 1006900831 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25090.34 0 0 0 0 0 0 0 0 0 0 0 0 0 25090.34 0 0 1006900990 1104891704 10 Physicians MAHADEVIA AKSHAY K 999999999 65 Madison 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 21.96 0 0 0 0 0 0 21.96 0 0 1006901183 1124369855 10 Physicians CHOUDHRY IRFAN 999999999 200 Cook 0 0 Internal Medicine 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 0 789.37 0 0 0 0 0 0 789.37 0 0 1006902006 10 Physicians 200 Cook 0 0 Family Practice 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 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 43.31 0 0 0 0 0 0 45.91 0 0 1006902087 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19695.16 0 0 0 0 0 0 0 0 0 0 0 0 0 19695.16 0 0 1006902110 1366860876 10 Physicians HOUSER ELIZABETH E 999999999 80 Peoria 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 0 215 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 1817.74 0 0 0 0 0 0 1817.74 0 0 1006902963 1073865697 89 Physician Assistant Only(Encounter Only) ABRAMS MADELINE 999999999 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 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 0 337.25 0 0 0 0 0 0 337.25 0 0 1006903821 1700363827 16 Nurse Practitioners GEDUTIS GINA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 603.36 0 0 0 0 0 0 603.36 0 0 1006903856 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1006904183 1366591646 89 Physician Assistant Only(Encounter Only) KNOX SCOTT 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 0 367 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 4693.36 0 0 0 0 0 0 4693.36 0 0 1006904618 1386927192 10 Physicians MATTEI TOBIAS 999999999 109 Winnebago 0 0 Neurology Surgery 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 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 21638.89 0 0 0 0 0 0 21638.89 0 0 1006905018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10109.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10109.88 0 0 1006905473 1457746240 13 Podiatrists STASKIEWICZ CHRISTINA 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 0 217 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 1712.57 0 0 0 0 0 0 1712.57 0 0 1006906015 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1856.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1856.26 0 0 1006906436 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32926.17 0 0 0 0 0 0 0 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1073007746 87 Psychologist(Encounter Only) ROSADO DANA 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 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 0 124.36 0 0 0 0 0 0 124.36 0 0 1006911204 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 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 1006911356 1013303692 10 Physicians THESING CLAIRE E 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 958.28 0 0 0 0 0 0 958.28 0 0 1006911757 11 Dentists 30 DuPage 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 0 407.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407.6 0 0 1006912028 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 19609.26 0 0 1006921364 1386137925 40 Federally Qualified Health Centers IMAN 999999999 200 Cook 0 0 0 79 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21129.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21129.72 0 0 1006921432 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 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 16935.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16935.4 0 0 1006921443 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18054.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18054.4 0 0 1006921569 1326337130 10 Physicians MALICK OWAIS M 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 0 142 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 1982.9 0 0 0 0 0 0 1982.9 0 0 1006921805 1932467198 10 Physicians LEISHMAN LISA L 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257.8 0 20708.89 0 0 0 0 0 0 20966.69 0 0 1006922040 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18428.53 0 0 0 0 0 0 0 0 0 0 0 0 0 18428.53 0 0 1006922536 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35278.45 0 0 0 0 0 0 0 0 0 0 0 0 0 35278.45 0 0 1006922905 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 0 210 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 15065.92 0 0 0 0 0 0 0 0 0 0 0 0 0 15065.92 0 0 1006922911 1750874426 11 Dentists KALOTA ORUSA 999999999 30 DuPage 0 0 General Dentistry 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352 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 10348.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10348.61 0 0 1006922918 1982118287 89 Physician Assistant Only(Encounter Only) BRUNNER JEREMY D 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 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 1077.64 0 0 0 0 0 0 1077.64 0 0 1006923236 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 13.01 0 0 0 0 0 0 13.01 0 0 1006925685 1770891756 89 Physician Assistant Only(Encounter Only) FRERKER LEE 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 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 96.2 0 0 0 0 0 0 96.2 0 0 1006925763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21436.94 0 0 0 0 0 0 0 0 0 0 0 0 0 21436.94 0 0 1006925854 1346582822 10 Physicians PEEVEY JOSEPH 999999999 200 Cook 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 0 255 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 2104.74 0 0 0 0 0 0 0 0 2104.74 0 0 1006926145 1083130298 16 Nurse Practitioners KLUNICK MARY E 999999999 91 Sangamon 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 0 741.77 0 0 0 0 0 0 741.77 0 0 1006926313 1760923056 10 Physicians O''BYRNE BRIAN 999999999 200 Cook 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 0 263 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 5442.81 0 0 0 0 0 0 5442.81 0 0 1006926631 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 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 0 542.5 0 0 0 0 0 0 0 0 0 0 0 0 0 542.5 0 0 1006926894 1740629906 10 Physicians BURMEISTER JAY D 999999999 19 Champaign 0 0 Otolaryngology 0 0 0 14 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 10229.82 0 0 0 0 0 0 10381.82 0 0 1006927052 1568982742 16 Nurse Practitioners HOFFMAN INNA 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 0 306 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 3660.32 0 0 0 0 0 0 3660.32 0 0 1006927099 1811401540 33 Nursing Facilities "CITADEL OF STERLING, THE" 999999999 106 Whiteside 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 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600766.58 0 0 0 0 0 0 0 600766.58 0 0 1006927157 1790851301 89 Physician Assistant Only(Encounter Only) KOOPMAN MELISSA 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 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 0 278.06 0 0 0 0 0 0 278.06 0 0 1006927452 1275976268 10 Physicians GARG RAVI 999999999 200 Cook 0 0 Neurology 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 0 130 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 6409 0 0 0 0 0 0 6409 0 0 1006927458 1114463049 16 Nurse Practitioners LONG DYMOND D 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 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 0 133.96 0 0 0 0 0 0 133.96 0 0 1006927684 1194015172 16 Nurse Practitioners LAWLOR KYLENE 999999999 30 DuPage 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 0 251 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 0 271 0 0 0 0 0 0 271 0 0 1006927822 1548757552 16 Nurse Practitioners MCMEEKIN MAGDALENA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.37 0 0 0 0 0 0 333.37 0 0 1006927910 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 0 0 0 0 0 0 0 0 0 0 1006928114 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 0 138.01 0 0 0 0 0 0 138.01 0 0 1006928177 1720574676 60 Pharmacies "CRITICAL CARE RX, LLC" 999999999 80 Peoria 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 2987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47980.42 0 0 0 47980.42 0 0 1006928446 20 Registered nurse 76 Montgomery 0 0 0 0 0 0 0 0 0 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 0 103.22 0 0 0 0 0 0 103.22 0 0 1006928652 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29223.46 0 0 0 0 0 0 0 0 0 0 0 0 0 29223.46 0 0 1006928801 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26018.01 0 0 0 0 0 0 0 0 0 0 0 0 0 26018.01 0 0 1006928996 1467965004 16 Nurse Practitioners GOODWIN NATASHA R. 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 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 0 206.16 0 0 0 0 0 0 206.16 0 0 1006929087 1316334287 10 Physicians TRIPP MARIAN MARY 999999999 53 Kane 0 0 Family Practice 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 0 240 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 2064.09 0 0 0 0 0 0 2064.09 0 0 1006929465 1295966695 10 Physicians SHOPE ADAM M 999999999 53 Kane 0 0 Internal Medicine 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 0 224 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 3739.24 0 0 0 0 0 0 3739.24 0 0 1006929524 1770003055 12 Optometrists EL-KHAZENDAR SARAH M 999999999 30 DuPage 0 0 Therapeutic 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 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 0 544.51 0 0 0 0 0 0 544.51 0 0 1006929599 1912296757 10 Physicians PETERSEN ROBERT 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 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 2403.54 0 0 0 0 0 0 2403.54 0 0 1006929667 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 0 117.97 0 0 0 0 0 0 0 0 0 0 0 0 0 117.97 0 0 1006930030 1518352400 10 Physicians TABOR AARON V 999999999 200 Cook 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 0 256 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 9406.68 0 0 0 0 0 0 9406.68 0 0 1006930044 1063938082 16 Nurse Practitioners GRIFFIN ANTHONY 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 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 0 828.9 0 0 0 0 0 0 828.9 0 0 1006930287 1285160622 16 Nurse Practitioners PARTIDA SARA T 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 0 805.22 0 0 0 0 0 0 805.22 0 0 1006930400 89 Physician Assistant Only(Encounter Only) 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 1006930547 1053546564 10 Physicians DESAI ZANKHANA M 999999999 109 Winnebago 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 0 102 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 11981.16 0 0 0 0 0 0 11981.16 0 0 1006931070 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1163.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1163.66 0 0 1006931165 1134638240 16 Nurse Practitioners JACKSON-FORD KINSEY M 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 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 1217.52 0 0 0 0 0 0 1217.52 0 0 1006931504 1033621594 89 Physician Assistant Only(Encounter Only) RAY LAUREN 999999999 91 Sangamon 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 0 120 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 1068.5 0 0 0 0 0 0 1068.5 0 0 1006931608 1013391077 12 Optometrists DIENES CAROLYN A 999999999 55 Kendall 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 43 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1499.85 0 591.65 0 0 0 0 2091.5 0 0 1006931650 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.58 0 0 0 0 0 0 48.58 0 0 1006931749 1598251571 89 Physician Assistant Only(Encounter Only) GIAMMARCO ASIA 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640.71 0 0 0 0 0 0 640.71 0 0 1006931859 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30959.35 0 0 0 0 0 0 0 0 0 0 0 0 0 30959.35 0 0 1006932053 1598718157 10 Physicians GIERBOLINI MAYTE 999999999 24 Coles 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 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 0 383.84 0 0 0 0 0 0 0 0 383.84 0 0 1006932323 1366830275 16 Nurse Practitioners CHASE CATHERINE 999999999 200 Cook 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 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 659.85 0 0 0 0 0 0 659.85 0 0 1006932466 1972863124 10 Physicians WREN JAMES 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.18 0 2771.18 0 0 0 0 0 0 2771.36 0 0 1006932481 1548657737 10 Physicians BERTELS KAREN M 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 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 1895.31 0 0 0 0 0 0 1895.31 0 0 1006932529 1295000495 10 Physicians TEBO KRISTINA 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 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 0 157.26 0 0 0 0 0 0 157.26 0 0 1006932539 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24108.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24108.7 0 0 1006932545 1467951483 16 Nurse Practitioners TSE LAURA 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 8 0 0 0 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 1006933281 1881957611 10 Physicians BAIG YOUSUF M 999999999 200 Cook 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 0 310 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 5079.49 0 0 0 0 0 0 5079.49 0 0 1006933693 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1034.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1034.79 0 0 1006934216 1144586538 10 Physicians CHRISTENSON CHANCEY L 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 137 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178.81 0 0 0 0 0 0 0 0 1178.81 0 0 1006934523 1700296647 13 Podiatrists OTT ANDREW 999999999 76 Montgomery 0 0 0 0 0 0 0 0 0 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 1050.72 0 0 0 0 0 0 1050.72 0 0 1006934680 1689981029 89 Physician Assistant Only(Encounter Only) LYNCH JAKLYN B 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 69.84 0 0 0 0 0 0 69.84 0 0 1006935267 75 Department of Alcohol and Substance Abuse Provider 13 Boone 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 5923.79 0 0 5923.79 0 0 1006935652 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.11 0 0 0 0 0 0 90.11 0 0 1006935993 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 0 199.98 0 0 0 0 0 0 199.98 0 0 1006935996 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 80.23 0 0 0 0 0 0 80.23 0 0 1006936127 10 Physicians 89 Rock Island 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 75.92 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 125.14 0 0 1006936268 1457618555 60 Pharmacies ALLIANCERX WALGREENS PRIME #16 328198601 810 Florida 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2862 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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S 999999999 19 Champaign 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 1268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80740 0 0 0 0 0 0 0 0 0 0 0 0 0 80740 0 0 1006968784 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 0 250.77 0 0 0 0 0 0 250.77 0 0 1006968852 10 Physicians 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006968886 10 Physicians 53 Kane 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 0 0 0 0 0 0 0 0 0 0 1006969039 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13135.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13135.79 0 0 1006969172 1770096950 16 Nurse Practitioners ALEXANDER JESSIE 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 38.64 0 0 0 0 0 0 0 0 425.1 0 0 0 0 0 0 463.74 0 0 1006969230 1528073178 60 Pharmacies FREEBURG PHARMACY 622431541 96 St Clair 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 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35762.31 0 0 0 35762.31 0 0 1006969319 1861768053 10 Physicians MCMAHON CHARLES 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 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 1630.53 0 0 0 0 0 0 1630.53 0 0 1006969381 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11122.95 0 0 0 0 0 0 0 0 0 0 0 0 0 11122.95 0 0 1006969421 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15196.13 0 0 0 0 0 0 0 0 0 0 0 0 0 15196.13 0 0 1006969808 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 403.68 0 0 0 0 0 0 0 0 0 0 0 0 0 403.68 0 0 1006970057 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4897.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4897.45 0 0 1006970677 1982016325 89 Physician Assistant Only(Encounter Only) JOHN BRANDON C 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 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 0 210.23 0 0 0 0 0 0 210.23 0 0 1006970841 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 42.14 0 0 0 0 0 0 42.14 0 0 1006970855 1598106874 10 Physicians SOUDAGAR TURKEY MOMINA 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 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 1430.43 0 0 0 0 0 0 1430.43 0 0 1006971047 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 0 106.28 0 0 0 0 0 0 106.28 0 0 1006971102 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 22356.94 0 0 0 0 0 0 0 0 0 0 0 0 0 22356.94 0 0 1006971134 72 Taxicabs and Livery Companies 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 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 0 547.27 0 0 0 0 0 0 547.27 0 0 1006971147 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 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 0 0 10.41 0 0 0 0 0 0 10.41 0 0 1006971390 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10983.46 0 0 0 0 0 0 0 0 0 0 0 0 0 10983.46 0 0 1006971409 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13724.04 0 0 0 0 0 0 0 0 0 0 0 0 0 13724.04 0 0 1006971420 1760973101 12 Optometrists ROSENTHAL BETHANY T 999999999 96 St Clair 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 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 1188.01 0 0 0 0 0 0 1188.01 0 0 1006971450 1518433564 16 Nurse Practitioners STAHL LAQUISHA M 999999999 53 Kane 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 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 1598.82 0 0 0 0 0 0 1598.82 0 0 1006972141 1831392620 89 Physician Assistant Only(Encounter Only) EMMENDORFER CANDACE N 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 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 0 168.77 0 0 0 0 0 0 168.77 0 0 1006972250 1659620342 16 Nurse Practitioners SIMONS KAYLA A 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 32 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 85.65 0 0 0 0 0 0 0 0 1042.22 0 0 0 0 0 0 1127.87 0 0 1006972408 1740781889 86 Clinical Social Worker(Encounter Only) VALIENTE LISA A 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 0 199 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 5722.44 0 0 0 0 0 0 5722.44 0 0 1006972433 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10978.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10978.7 0 0 1006972511 1447766050 16 Nurse Practitioners GOOD SARA K 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 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 0 973.73 0 0 0 0 0 0 980.13 0 0 1006972689 1083053896 10 Physicians DIMAGGIO VINCENT A 999999999 30 DuPage 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 0 256 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 1799.35 0 0 0 0 0 0 1799.35 0 0 1006973141 1457509853 89 Physician Assistant Only(Encounter Only) ROBBINS CRYSTIN J 999999999 30 DuPage 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 0 778.54 0 0 0 0 0 0 778.54 0 0 1006973462 1780131334 11 Dentists AGARWAL RAJESH K 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 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 1535.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1535.45 0 0 1006973905 1043553704 10 Physicians XIONG WENLU W 999999999 200 Cook 0 0 Internal 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 0 165 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 1544.85 0 0 0 0 0 0 1544.85 0 0 1006974231 1104111400 10 Physicians SCHIMPKE SCOTT W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 0 792.83 0 0 0 0 0 0 792.83 0 0 1006974895 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 17290.32 0 0 0 0 0 0 0 0 0 0 0 0 0 17290.32 0 0 1006975120 1548754039 16 Nurse Practitioners LAMBEY LEROY 999999999 30 DuPage 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 0 187 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 0 941.4 0 0 0 0 0 0 941.4 0 0 1006975145 1174910707 10 Physicians FINKELSHTEYN ILYA 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 0 247 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 3225.03 0 0 0 0 0 0 3225.03 0 0 1006975447 1336586734 10 Physicians SHETTY RAKSHIT 999999999 91 Sangamon 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 0 125 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 4095.06 0 0 0 0 0 0 4095.06 0 0 1006975545 1700251451 30 General Hospitals FRESENIUS MEDICAL CARE NEW CIT 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 1674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15631.59 0 0 0 0 0 15631.59 0 0 1006975634 1699032516 10 Physicians KUMAR MADAN 999999999 200 Cook 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 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 4255.9 0 0 0 0 0 0 4255.9 0 0 1006975839 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21259.55 0 0 0 0 0 0 0 0 0 0 0 0 0 21259.55 0 0 1006976026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24362.84 0 0 0 0 0 0 0 0 0 0 0 0 0 24362.84 0 0 1006976496 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22633.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22633.26 0 0 1006976857 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23182.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23182.48 0 0 1006977026 1619234275 10 Physicians PAUL JENNIFER T 999999999 30 DuPage 0 0 Obstetric-Gynecology 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 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 7118.15 0 0 0 0 0 0 7118.15 0 0 1006977210 10 Physicians 200 Cook 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 0 131.17 0 0 0 0 0 0 131.17 0 0 1006977220 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 7195.82 0 0 0 0 0 0 0 0 0 0 0 0 0 7195.82 0 0 1006977603 1730594615 10 Physicians MUKERJI BARENYA 999999999 49 Jefferson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 71 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7000.49 0 9062.96 0 0 0 0 0 0 16063.45 0 0 1006977907 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1432.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1432.2 0 0 1006978003 1235627712 16 Nurse Practitioners RIOS JAZMINE T 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 0 767.82 0 0 0 0 0 0 767.82 0 0 1006978214 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 0 128.6 0 0 0 0 0 0 128.6 0 0 1006978667 1639679756 16 Nurse Practitioners MAHER AMY MARIE 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 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 2127.93 0 0 0 0 0 0 2213.58 0 0 1006979065 1962493205 10 Physicians NUGENT ALAN 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 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 5799.54 0 0 0 0 0 0 5799.54 0 0 1006979255 1033658349 30 General Hospitals MACHESNEY PARK DIALYSIS 999999999 109 Winnebago DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1707 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82677.36 0 0 0 0 0 82677.36 0 0 1006979382 1699869842 89 Physician Assistant Only(Encounter Only) WEITZEL MELISSA G 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 0 152 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 0 860.55 0 0 0 0 0 0 860.55 0 0 1006979662 1306258033 87 Psychologist(Encounter Only) BENSMAN CORREA SHANI 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 0 129 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 2257.13 0 0 0 0 0 0 2257.13 0 0 1006980080 30 General Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1006980416 1508129594 10 Physicians CIPRIANI VERONICA P 999999999 30 DuPage 0 0 Neurology 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 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 1494.17 0 0 0 0 0 0 1494.17 0 0 1006980501 1538423371 10 Physicians DEPERSIA ALLISON W 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.35 0 0 0 0 0 0 201.35 0 0 1006981079 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15689.94 0 0 0 0 0 0 0 0 0 0 0 0 0 15689.94 0 0 1006981202 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 42.14 0 0 0 0 0 0 42.14 0 0 1006981507 1588698476 89 Physician Assistant Only(Encounter Only) LEE JUNG M 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 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 0 226.21 0 0 0 0 0 0 226.21 0 0 1006981596 1619390275 16 Nurse Practitioners ROUBI MAISOUN 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 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 0 925.03 0 0 0 0 0 0 925.03 0 0 1006982203 1760601116 10 Physicians KOPAR PIROSKA K 999999999 47 Jackson 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 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 0 976.86 0 0 0 0 0 0 976.86 0 0 1006982294 86 Clinical Social Worker(Encounter Only) 27 Dekalb 0 0 0 0 0 0 0 0 0 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 1006983283 1487806394 87 Psychologist(Encounter Only) BONSKY LAURA A 999999999 97 Stephenson 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 0 255 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 0 986.69 0 0 0 0 0 0 986.69 0 0 1006984098 86 Clinical Social Worker(Encounter Only) 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006984181 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11386.54 0 0 0 0 0 0 0 0 0 0 0 0 0 11386.54 0 0 1006984346 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5000 0 0 0 0 0 0 0 0 0 0 0 0 0 5000 0 0 1006984415 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1006984873 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 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 0 213 0 0 0 0 0 0 213 0 0 1006984911 1215209366 11 Dentists MANDADI SIRISHA 999999999 107 Will 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168.45 0 0 1006984981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1642.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1642.05 0 0 1006985304 1952815177 16 Nurse Practitioners PEPPER SANDRA 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 0 584.03 0 0 0 0 0 0 584.03 0 0 1006985403 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7367.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7367.73 0 0 1006986052 1285053561 10 Physicians JONNA JAMES G 999999999 19 Champaign 0 0 Anesthesiology 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 0 151 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 15775.23 0 0 0 0 0 0 15775.23 0 0 1006986470 11 Dentists 200 Cook 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 0 106.22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.22 0 0 1006986780 10 Physicians 108 Williamson 0 0 0 0 0 0 0 0 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Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 130.56 0 0 0 0 0 0 0 0 2335.8 0 0 0 0 0 0 2466.36 0 0 1006987945 1992187934 10 Physicians LEVEK KELLI 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 0 134 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 2560.02 0 0 0 0 0 0 2560.02 0 0 1006988226 1023202769 10 Physicians CHRISTIE CARL 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 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 0 190.07 0 0 0 0 0 0 190.07 0 0 1006988387 1598267981 16 Nurse Practitioners WACHTER DANIEL 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 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 0 166.26 0 0 0 0 0 0 166.26 0 0 1006988536 1467937599 89 Physician Assistant Only(Encounter Only) GEORGE BENJAMIN A 999999999 30 DuPage 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 0 110 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 0 788.67 0 0 0 0 0 0 788.67 0 0 1006988683 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12623.53 0 0 0 0 0 0 0 0 0 0 0 0 0 12623.53 0 0 1006988778 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21255.06 0 0 0 0 0 0 0 0 0 0 0 0 0 21255.06 0 0 1006989116 1053854729 16 Nurse Practitioners MILLER ANTOINETTE M 999999999 47 Jackson 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 0 309 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 3163.34 0 0 0 0 0 0 3163.34 0 0 1006989361 10 Physicians 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 0 153.12 0 0 0 0 0 0 153.12 0 0 1006989470 1609040575 10 Physicians GARRIGUES GRANT 999999999 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 38 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 959.91 0 3233.78 0 0 0 0 0 0 4193.69 0 0 1006989631 1245742352 89 Physician Assistant Only(Encounter Only) LONG MIRANDA 999999999 106 Whiteside 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 92 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 987.46 0 0 0 0 0 0 1083.91 0 0 1006989921 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35383.68 0 0 0 0 0 0 0 0 0 0 0 0 0 35383.68 0 0 1006990454 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 27450.34 0 0 0 0 0 0 0 0 0 0 0 0 0 27450.34 0 0 1006990528 1891182515 10 Physicians MATHUR JAY L 999999999 80 Peoria 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 0 169 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 1892.58 0 0 0 0 0 0 1892.58 0 0 1006990829 1316309511 10 Physicians BETENIA NICOLE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2060.27 0 0 0 0 0 0 2060.27 0 0 1006990930 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13895.21 0 0 0 0 0 0 0 0 0 0 0 0 0 13895.21 0 0 1006990965 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3106.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3106.62 0 0 1006991042 1184840290 10 Physicians SCHIRF BRIAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 15 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.44 0 2087.31 0 0 0 0 0 0 2148.75 0 0 1006991290 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11498.87 0 0 0 0 0 0 0 0 0 0 0 0 0 11498.87 0 0 1006991346 1518057769 30 General Hospitals MT SINAI HOSP MED CTR CHICAGO 606081704 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 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 0 133 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 472276.88 0 0 0 0 0 0 0 0 0 472276.88 0 0 1006991435 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1006991443 1336614676 16 Nurse Practitioners SAFRANSKI ARIKA C 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 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 0 308.24 0 0 0 0 0 0 308.24 0 0 1006992514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6244.36 0 0 0 0 0 0 0 0 0 0 0 0 0 6244.36 0 0 1006992566 1578901799 10 Physicians BIGART KEVIN 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 12 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2087.18 0 0 0 0 0 0 2087.18 0 0 1006992567 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33.37 0 0 0 0 0 0 0 0 0 0 0 0 0 33.37 0 0 1006992623 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5062.93 0 0 0 0 0 0 5062.93 0 0 1006992734 1578856407 10 Physicians VERMA RINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.17 0 2574.94 0 0 0 0 0 0 2656.11 0 0 1006992845 1750645503 10 Physicians SPATARO EMILY A 999999999 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 361.71 0 0 0 0 0 0 361.71 0 0 1006992928 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23295.88 0 0 0 0 0 0 0 0 0 0 0 0 0 23295.88 0 0 1006993012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4425.06 0 0 0 0 0 0 0 0 0 0 0 0 0 4425.06 0 0 1006993212 1245739515 16 Nurse Practitioners WYSOCKA-PIESIEWICZ URSZULA 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 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 0 654.71 0 0 0 0 0 0 654.71 0 0 1006993674 87 Psychologist(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 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0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.72 0 0 0 0 0 0 0 0 37.72 0 0 1006999104 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 1006999436 1467711168 10 Physicians WETTERS NATHAN G 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 46 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.79 0 6200.63 0 0 0 0 0 0 6364.42 0 0 1006999616 1730448481 10 Physicians KICHKO ILONA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 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 0 0 4324.54 0 0 0 0 0 0 4324.54 0 0 1006999991 1356821383 89 Physician Assistant Only(Encounter Only) RITZHEIMER NATALIE 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 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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 1884.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1884.41 0 0 1007001869 1932457686 22 Physical Therapists WIELECHOWSKI ADAM 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 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 0 131.02 131.02 0 0 1007002315 1841685724 10 Physicians ISKANDAR JOY 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.97 0 0 0 0 0 0 167.97 0 0 1007002445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7958.3 0 0 0 0 0 0 0 0 0 0 0 0 0 7958.3 0 0 1007002551 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 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 48174 0 0 0 0 0 0 0 0 0 0 0 0 0 48174 0 0 1007003762 1639618036 46 Ambulatory Surgical Treatment Centers DES PLAINES ENDOSCOPY CENTER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 5041.68 0 0 0 0 0 5041.68 0 0 1007003844 1922369248 10 Physicians MUQEET ADNAN MOHAMMED M 999999999 80 Peoria 0 0 Internal 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 0 236 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 8998.84 0 0 0 0 0 0 8998.84 0 0 1007004210 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 0 160 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 15379.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15379.86 0 0 1007004244 1174865323 89 Physician Assistant Only(Encounter Only) WERNER MIA D 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 0 103 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 1501.95 0 0 0 0 0 0 1501.95 0 0 1007004416 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21598.38 0 0 0 0 0 0 0 0 0 0 0 0 0 21598.38 0 0 1007004692 1245523968 10 Physicians TORRES EUNICE 999999999 91 Sangamon 0 0 Pediatrics 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 0 167 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 49305.98 0 0 0 0 0 0 49305.98 0 0 1007005085 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 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 0 341.84 341.84 0 0 1007005408 1679846919 75 Department of Alcohol and Substance Abuse Provider DREXEL COUNSELING SERVICES INC 999999999 200 Cook 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 1937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1937 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124041.44 0 0 124041.44 0 0 1007005845 1932448396 89 Physician Assistant Only(Encounter Only) RANKIN KELLY L 999999999 107 Will 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 0 112 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 0 361.4 0 0 0 0 0 0 361.4 0 0 1007006149 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10089.3 0 0 0 0 0 0 0 0 0 0 0 0 0 10089.3 0 0 1007006254 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12039.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12039.72 0 0 1007006660 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 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 1032.56 0 0 0 0 0 0 1032.56 0 0 1007006959 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1007007036 1558560680 16 Nurse Practitioners SMITH TIFFANY 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 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 0 692.91 0 0 0 0 0 0 692.91 0 0 1007007138 1669409371 10 Physicians MCLEAN ERIKA 999999999 19 Champaign 0 0 Pediatrics 0 0 0 22 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1754.23 0 0 0 0 0 0 0 0 1197.59 0 0 0 0 0 0 2951.82 0 0 1007007201 4007007201 72 Taxicabs and Livery Companies MJKNIGHT ENTERPRISE LLC 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 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4802.24 0 0 0 0 0 0 4802.24 0 0 1007007491 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2704.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2704.08 0 0 1007008021 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 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22752.08 0 0 0 0 0 0 0 0 0 0 0 0 0 22752.08 0 0 1007008574 1265709224 22 Physical Therapists GUINGON GISSELLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 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 1517.74 1517.74 0 0 1007008753 1760822597 10 Physicians MANSOUR ALI 999999999 30 DuPage 0 0 Neurology 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 0 264 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 14368.41 0 0 0 0 0 0 14368.41 0 0 1007008950 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15155.12 0 0 0 0 0 0 0 0 0 0 0 0 0 15155.12 0 0 1007008977 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.05 0 0 0 0 0 0 19.05 0 0 1007009783 1104315571 16 Nurse Practitioners MEDICI KATHLEEN 999999999 24 Coles 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 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 0 505.03 0 0 0 0 0 0 505.03 0 0 1007009953 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261.4 0 0 0 0 0 0 261.4 0 0 1007010116 1336435296 10 Physicians FORSHEE MEGAN 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 15 0 33 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 38 0 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 38 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103.92 0 2195.8 0 0 0 0 0 0 3299.72 0 0 1007010286 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29177.46 0 0 0 0 0 0 0 0 0 0 0 0 0 29177.46 0 0 1007010780 1780196311 16 Nurse Practitioners TOOHILL JENNIFER 999999999 72 McLean 0 0 0 0 0 0 0 0 0 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 1047.77 0 0 0 0 0 0 1047.77 0 0 1007011410 1689638595 10 Physicians KAMALESH MASOOR 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 0 228 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 1860.26 0 0 0 0 0 0 1860.26 0 0 1007011561 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 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 0 408.52 0 0 0 0 0 0 408.52 0 0 1007011615 1851786545 13 Podiatrists HAQUE FARAZ 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 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 0 109.68 0 0 0 0 0 0 109.68 0 0 1007011908 1750659595 10 Physicians CHAUHAN AAKASH 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 12 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.02 0 1971.57 0 0 0 0 0 0 2186.59 0 0 1007011931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 614.92 0 0 0 0 0 0 0 0 0 0 0 0 0 614.92 0 0 1007011941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29548.7 0 0 0 0 0 0 0 0 0 0 0 0 0 29548.7 0 0 1007012184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1007012208 1972057925 16 Nurse Practitioners PERION KAREN E 999999999 30 DuPage 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 0 324 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 1479.53 0 0 0 0 0 0 1479.53 0 0 1007012252 61 Independent Laboratories 807 Connecticut 0 0 0 0 0 0 0 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 0 187.85 0 0 0 0 0 0 0 0 187.85 0 0 1007012439 1578089843 48 Rural Health Clinics HMC CLINIC AT HARRISBURG 629462640 90 Saline 0 0 0 390 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1506 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1506 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.86 0 0 1007012464 1316252463 39 Hospice BJC HCS HOSPICE- IL 999999999 65 Madison 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189141.29 0 0 0 0 0 0 0 0 0 0 0 189141.29 0 0 1007012541 1073008363 57 Home Nursing Agency "LIFELINE NURSING AGENCY, INC." 999999999 71 McHenry 0 0 0 0 0 0 0 4 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379946.78 27365.68 0 0 0 0 0 0 0 0 0 0 0 0 407312.46 0 0 1007012590 1609213909 10 Physicians GHEITH TARIQ A 999999999 80 Peoria 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 0 268 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 10582.64 0 0 0 0 0 0 10582.64 0 0 1007012645 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 5 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 3220.12 0 0 0 0 0 0 3220.12 0 0 1007012913 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24362.84 0 0 0 0 0 0 0 0 0 0 0 0 0 24362.84 0 0 1007013492 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14635.52 0 0 0 0 0 0 0 0 0 0 0 0 0 14635.52 0 0 1007013564 1285017947 10 Physicians BRAND TYRONE 999999999 60 Lee 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 0 109 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 2454.78 0 0 0 0 0 0 2454.78 0 0 1007013636 1699205724 10 Physicians HAILEY CLAIRE E 999999999 200 Cook 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 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 1365.41 0 0 0 0 0 0 1365.41 0 0 1007013673 1235424656 10 Physicians DAHDALEH FADI 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 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 2621.76 0 0 0 0 0 0 2621.76 0 0 1007013977 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 32 0 0 0 0 0 0 32 0 0 1007014722 16 Nurse Practitioners 79 Ogle 0 0 0 0 0 0 0 0 0 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 0 104.07 0 0 0 0 0 0 104.07 0 0 1007015103 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2847.04 0 0 0 0 0 0 0 0 0 0 0 0 0 2847.04 0 0 1007015458 1245279884 10 Physicians DERICK AMY 999999999 57 Lake 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 95 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.74 0 0 0 0 0 0 0 0 186.74 0 0 1007015484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2383.13 0 0 0 0 0 0 0 0 0 0 0 0 0 2383.13 0 0 1007015676 1629572490 10 Physicians PATEL KUNAL PARITOSH 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 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 5231.8 0 0 0 0 0 0 5231.8 0 0 1007015937 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 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 18236.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18236.82 0 0 1007016054 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13600.87 0 0 0 0 0 0 0 0 0 0 0 0 0 13600.87 0 0 1007016276 1861888372 10 Physicians BUXBAUM LAUREN E. 999999999 200 Cook 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 1130.82 0 0 0 0 0 0 1130.82 0 0 1007016320 1578976775 10 Physicians SYLVESTER JILLIAN E 999999999 96 St Clair 0 0 Family Practice 0 0 0 0 0 0 0 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332.42 0 0 0 0 0 0 332.42 0 0 1007016499 10 Physicians 10 Adams 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.79 0 0 0 0 0 0 1131.79 0 0 1007016502 1487968665 89 Physician Assistant Only(Encounter Only) MOLINA HEATHER A 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 66.04 0 0 0 0 0 0 66.04 0 0 1007016554 1598257545 16 Nurse Practitioners MEI JENNY X 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 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 0 227.3 0 0 0 0 0 0 227.3 0 0 1007016813 1619454840 16 Nurse Practitioners RICOBENE ANNA 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 4051.55 0 0 0 0 0 0 4115.85 0 0 1007017348 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20304.54 0 0 0 0 0 0 0 0 0 0 0 0 0 20304.54 0 0 1007017361 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4539.18 0 0 0 0 0 0 0 0 0 0 0 0 0 4539.18 0 0 1007017542 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23741.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23741.52 0 0 1007017795 1326441072 10 Physicians RAZA MUSTANSAR 999999999 80 Peoria 0 0 Psychiatry 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 18544.18 0 0 0 0 0 0 18544.18 0 0 1007018065 1093184087 89 Physician Assistant Only(Encounter Only) CARLSON ALLISON 600162359 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 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 0 157.97 0 0 0 0 0 0 157.97 0 0 1007018238 1891178349 10 Physicians OXMAN DANIEL 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5478.46 0 0 0 0 0 0 5478.46 0 0 1007018311 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1123.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1123.49 0 0 1007018866 1013412634 10 Physicians JACKSON EVAN 999999999 200 Cook 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 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 0 338.93 0 0 0 0 0 0 338.93 0 0 1007018965 16 Nurse Practitioners 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 1007019427 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15362.79 0 0 0 0 0 0 0 0 0 0 0 0 0 15362.79 0 0 1007019572 1184993552 16 Nurse Practitioners CLARK AIMEE P 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 2661.82 0 0 0 0 0 0 2661.82 0 0 1007019579 1326435074 10 Physicians EDWARDS LAURA L 999999999 19 Champaign 0 0 0 0 0 45 0 0 0 0 0 0 31 0 40 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 75 0 60 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 75 0 60 0 0 0 0 0 0 0 0 0 4787.73 0 0 0 0 0 0 452.51 0 2578.02 0 0 0 0 0 0 7818.26 0 0 1007019693 1306353735 55 Early Intervention Services LA RABIDA CHILDRENS HOSPITAL 60615 200 Cook 0 0 1094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6990 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756925.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 756925.72 0 0 1007019698 1457846792 22 Physical Therapists GAUGHAN BRIANNA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19855.77 19855.77 0 0 1007019744 1508359969 16 Nurse Practitioners VOYLES REBECCA A 999999999 91 Sangamon 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 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 0 399.91 0 0 0 0 0 0 399.91 0 0 1007020011 1316393473 10 Physicians MARCU IOANA 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.51 0 2585.26 0 0 0 0 0 0 2647.77 0 0 1007020080 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20414.54 0 0 0 0 0 0 0 0 0 0 0 0 0 20414.54 0 0 1007020143 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12461.14 0 0 0 0 0 0 0 0 0 0 0 0 0 12461.14 0 0 1007020206 1821530320 23 Occupational Therapists SCANLON KELLY 999999999 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 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 3695.5 0 0 0 0 0 0 3695.5 0 0 1007038186 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6197.72 0 0 0 0 0 0 0 0 0 0 0 0 0 6197.72 0 0 1007038428 1700330214 25 Audiologists BEYER LYDIA M 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.35 191.35 0 0 1007038454 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22051.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22051.26 0 0 1007038730 1396144721 89 Physician Assistant Only(Encounter Only) WARGOLET LEAH 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 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 0 297.55 0 0 0 0 0 0 297.55 0 0 1007038805 1366823627 10 Physicians OPARA CHIDIEBERE M 999999999 53 Kane 0 0 Pediatrics 0 0 0 50 0 0 0 0 0 0 15 0 39 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 23 0 47 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 23 0 47 0 0 0 0 0 0 0 0 0 5450.55 0 0 0 0 0 0 136.04 0 2307.32 0 0 0 0 0 0 7893.91 0 0 1007038822 1881169381 16 Nurse Practitioners PYLES KATHLEEN N 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 0 199.81 0 0 0 0 0 0 199.81 0 0 1007038870 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23977.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23977.36 0 0 1007038877 1366741548 10 Physicians VALIKA TAHER 999999999 200 Cook 0 0 Otolaryngology 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 0 303 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 43354.99 0 0 0 0 0 0 43354.99 0 0 1007039151 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 1361.65 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.65 0 0 1007039192 1831578293 10 Physicians KETO ANDREW J 999999999 19 Champaign 0 0 General Practice 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 0 251 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 1834.01 0 0 0 0 0 0 1834.01 0 0 1007039265 1710998737 89 Physician Assistant Only(Encounter Only) BAKKER DAVID 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 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 39.82 0 0 0 0 0 0 39.82 0 0 1007039449 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5291.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5291.4 0 0 1007039473 1710328851 10 Physicians MAFEE MARIAM 999999999 200 Cook 0 0 Dermatology 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 0 132 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 2476.62 0 0 0 0 0 0 2476.62 0 0 1007040128 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14787.42 0 0 0 0 0 0 0 0 0 0 0 0 0 14787.42 0 0 1007040363 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 0 924.45 0 0 0 0 0 0 924.45 0 0 1007040523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9757.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9757.69 0 0 1007040609 1174670368 89 Physician Assistant Only(Encounter Only) HOBSON TAMIKA 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 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 0 130.94 0 0 0 0 0 0 130.94 0 0 1007041095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13697.76 0 0 0 0 0 0 0 0 0 0 0 0 0 13697.76 0 0 1007041227 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 16972.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16972.66 0 0 1007041289 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3551.39 0 0 0 0 0 0 0 0 0 0 0 0 0 3551.39 0 0 1007041451 1528385093 10 Physicians MEMON SHERMEEN B 604631081 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 13 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380.9 0 3692.55 0 0 0 0 0 0 4073.45 0 0 1007041590 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 11.69 0 0 0 11.69 0 0 1007041633 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41091.08 0 0 0 0 0 0 0 0 0 0 0 0 0 41091.08 0 0 1007041635 1508128737 10 Physicians ANGERAME MARC 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 19 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.46 0 3573.96 0 0 0 0 0 0 3643.42 0 0 1007041783 1326355850 89 Physician Assistant Only(Encounter Only) SPINDLER ASHLEY 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 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 8.3 0 0 0 0 0 0 8.3 0 0 1007041824 4007041824 90 Waiver service provider--Elderly (DOA) LIFECARE HOME HEALTH & IN HOME 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 3110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298484.16 0 0 0 0 0 0 0 0 0 0 0 0 0 298484.16 0 0 1007042099 1609972645 89 Physician Assistant Only(Encounter Only) GREMLEY CANDICE N 953586411 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 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 1761.85 0 0 0 0 0 0 1761.85 0 0 1007042274 1972080463 11 Dentists RATHORE SOBIA 999999999 200 Cook 0 0 General Dentistry 0 0 124 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 17096.76 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 17849.46 0 0 1007042451 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7703.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7703.5 0 0 1007042479 1992140958 10 Physicians LEE ANDREW R 999999999 80 Peoria 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.26 0 4330.52 0 0 0 0 0 0 4401.78 0 0 1007042539 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 425.24 0 0 0 0 0 0 0 0 0 0 0 0 0 425.24 0 0 1007042905 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 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 0 177.26 0 0 0 0 0 0 177.26 0 0 1007042927 1770059289 23 Occupational Therapists STAAB RACHEL C 999999999 200 Cook 0 0 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 4301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42000.56 42000.56 0 0 1007043048 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.54 0 0 0 0 0 0 0 0 5.54 0 0 1007043239 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 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 0 821.92 821.92 0 0 1007043315 1013410547 55 Early Intervention Services ELAYYAN NAHED 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 0 273 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 15963.4 0 0 0 0 0 0 15963.4 0 0 1007043390 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 0 0 0 0 0 0 0 0 0 0 1007043837 12 Optometrists 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 0 153.17 0 0 0 0 0 0 153.17 0 0 1007043899 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23410.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 1007044110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3557.93 0 0 0 0 0 0 0 0 0 0 0 0 0 3557.93 0 0 1007044270 1336371277 10 Physicians KHALID BILAL 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 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 2443.1 0 0 0 0 0 0 2443.1 0 0 1007044672 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23003.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23003.64 0 0 1007044975 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 23997.05 0 0 0 0 0 0 0 0 0 0 0 0 0 23997.05 0 0 1007045138 1568738755 10 Physicians FREIBURG LUKE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 22 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.94 0 1815.15 0 0 0 0 0 0 1913.09 0 0 1007045200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15720.06 0 0 0 0 0 0 0 0 0 0 0 0 0 15720.06 0 0 1007045316 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24490.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24490.4 0 0 1007045551 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1304.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1304.61 0 0 1007045708 1659717437 87 Psychologist(Encounter Only) ROSENOW MELISSA 999999999 54 Kankakee 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 0 188 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 0 645.98 0 0 0 0 0 0 645.98 0 0 1007045801 1497264865 16 Nurse Practitioners CARNEY JOSEPH 999999999 27 Dekalb 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 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 0 460.84 0 0 0 0 0 0 460.84 0 0 1007045837 1245756113 16 Nurse Practitioners ZUELKE ELIZABETH M 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 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 0 266.35 0 0 0 0 0 0 266.35 0 0 1007046153 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 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 6342.23 0 0 0 0 0 0 0 0 0 0 0 0 0 6342.23 0 0 1007046339 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2002.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2002.44 0 0 1007046436 1205218658 10 Physicians KWAK YE EUN 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 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 1004.3 0 0 0 0 0 0 1004.3 0 0 1007046646 1295218378 89 Physician Assistant Only(Encounter Only) LOGAN ALEXIS 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 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 1064.26 0 0 0 0 0 0 1064.26 0 0 1007046853 1760932867 16 Nurse Practitioners PATEL HINA 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 0 614 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 3988.26 0 0 0 0 0 0 3988.26 0 0 1007047125 1578938338 16 Nurse Practitioners LEE HEATHER L 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 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 0 129.24 0 0 0 0 0 0 129.24 0 0 1007047253 1619403458 11 Dentists CORDELL SAMANTHA CLAIRE 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 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 2150.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2150.58 0 0 1007047477 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 1007047485 1033604855 25 Audiologists BOCZAR CAROLINE M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 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 10472.4 10472.4 0 0 1007047784 1598836678 61 Independent Laboratories "WCP LABORATORIES, INC." 999999999 826 Missouri 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 0 194 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 0 160.66 0 0 0 0 0 0 0 0 160.66 0 0 1007047892 1215317409 10 Physicians ECKERLE PAUL 999999999 91 Sangamon 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 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 0 981.42 0 0 0 0 0 0 981.42 0 0 1007048076 1740625052 10 Physicians MBADIWE NINA 999999999 200 Cook 0 0 Emergency Medicine 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 0 153 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 7128.13 0 0 0 0 0 0 7128.13 0 0 1007048456 1043586480 10 Physicians KNEY ADAM K 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 1417.12 0 0 0 0 0 0 1417.12 0 0 1007048809 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4852.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4852.14 0 0 1007049007 1285651869 10 Physicians BUITEWEG JOHANNES J 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 117 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1298.04 0 12.08 0 0 0 0 0 0 1310.12 0 0 1007049035 1417469438 16 Nurse Practitioners LOBIANCO BROOKE 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 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 1007049323 1073803599 10 Physicians STEWART MELISSA 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1738.13 0 0 0 0 0 0 1738.13 0 0 1007049637 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 0 122 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 8835.9 8835.9 0 0 1007050250 1053830828 57 Home Nursing Agency CARING SHEPHERDS HEALTHCARE IN 999999999 200 Cook 0 0 0 0 0 0 0 28 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4233 4691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4233 4691 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1675971.95 671007.49 0 0 0 0 0 0 0 0 0 0 0 0 2346979.44 0 0 1007050709 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12070.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12070.58 0 0 1007050742 1144649856 13 Podiatrists WISHAU TYLER J 999999999 200 Cook 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 0 698 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6134.68 0 0 0 0 0 0 6134.68 0 0 1007050867 1467689695 89 Physician Assistant Only(Encounter Only) CHEESMAN MICHAEL 999999999 22 Clay 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 0 105 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 1144.34 0 0 0 0 0 0 1144.34 0 0 1007051328 1568531655 87 Psychologist(Encounter Only) STEAR CINDY A 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 1153.54 0 0 0 0 0 0 1153.54 0 0 1007051573 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.9 0 0 0 0 0 0 0 0 0 0 0 0 0 111.9 0 0 1007051715 1396237095 10 Physicians TRACE ELIAS D 999999999 91 Sangamon 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 0 105 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 2307.51 0 0 0 0 0 0 2307.51 0 0 1007051904 63 Other Providers of Medical Equipment/Supplies (Non-registered) 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3623.09 0 0 0 0 3623.09 0 0 1007052072 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 2.87 0 0 0 0 0 0 2.87 0 0 1007052307 1164711537 10 Physicians BOCHENSKA KATARZYNA 999999999 30 DuPage 0 0 Obstetric-Gynecology 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 0 248 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 1948.32 0 0 0 0 0 0 1948.32 0 0 1007052436 1629086913 86 Clinical Social Worker(Encounter Only) TENNILL JULIE 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 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 0 606.04 0 0 0 0 0 0 606.04 0 0 1007052437 1093281420 16 Nurse Practitioners MWAURA ALICE W 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 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 0 732.88 0 0 0 0 0 0 732.88 0 0 1007052545 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15848.67 0 0 0 0 0 0 0 0 0 0 0 0 0 15848.67 0 0 1007052579 1598215022 89 Physician Assistant Only(Encounter Only) TANG NIKKI B 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 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 0 387.21 0 0 0 0 0 0 387.21 0 0 1007052592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18620.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18620.28 0 0 1007052633 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3451.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3451.85 0 0 1007052719 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24677.41 0 0 0 0 0 0 0 0 0 0 0 0 0 24677.41 0 0 1007052853 24 Speech Therapists 45 Henry 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 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 0 259.8 259.8 0 0 1007052904 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 24705.45 0 0 0 0 0 0 0 0 0 0 0 0 0 24705.45 0 0 1007052952 1134583263 30 General Hospitals VERMILION COUNTY DIALYSIS 618346308 100 Vermilion DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 894 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28333.92 0 0 0 0 0 28333.92 0 0 1007053338 1457732455 10 Physicians MORGAN ZACHARY A 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 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 0 222.86 0 0 0 0 0 0 222.86 0 0 1007053655 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4992.73 0 0 0 0 0 0 0 0 0 0 0 0 0 4992.73 0 0 1007053677 1083163570 89 Physician Assistant Only(Encounter Only) JEFFRIES MICHAEL 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.65 0 0 0 0 0 0 223.65 0 0 1007054015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19191.2 0 0 0 0 0 0 0 0 0 0 0 0 0 19191.2 0 0 1007054234 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 61.76 0 0 0 0 0 0 61.76 0 0 1007054394 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24504.67 0 0 0 0 0 0 0 0 0 0 0 0 0 24504.67 0 0 1007054806 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8719.92 0 0 0 0 0 0 0 0 0 0 0 0 0 8719.92 0 0 1007054875 1992168322 10 Physicians FYDA JACOB P 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1686 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97507.37 0 0 0 0 0 0 97507.37 0 0 1007055089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20689.68 0 0 0 0 0 0 0 0 0 0 0 0 0 20689.68 0 0 1007055109 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 0 187 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 15803.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15803.81 0 0 1007055110 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 22390.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22390.06 0 0 1007055310 1104246321 10 Physicians NADIRI MOJTABA 999999999 200 Cook 0 0 Internal Medicine 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 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5817.27 0 0 0 0 0 0 5817.27 0 0 1007055351 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 1007055413 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 13767.53 0 0 0 0 0 0 0 0 0 0 0 0 0 13767.53 0 0 1007055543 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.12 0 0 0 0 0 0 0 0 0 0 0 0 0 65.12 0 0 1007055556 1194107573 10 Physicians LUCHTEFELD ZACHARY 999999999 91 Sangamon 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 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.45 0 556.25 0 0 0 0 0 0 580.7 0 0 1007055678 1639583560 10 Physicians ALCALA CARMEN A 999999999 91 Sangamon 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 0 586.76 0 0 0 0 0 0 586.76 0 0 1007056238 1790138006 55 Early Intervention Services ABATE CARLY E 606543506 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 0 113 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 6442.88 0 0 0 0 0 0 6442.88 0 0 1007056331 1902164437 10 Physicians AHMED NIDA 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 4 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.6 0 1621.94 0 0 0 0 0 0 1632.54 0 0 1007057055 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12235.44 0 0 0 0 0 0 0 0 0 0 0 0 0 12235.44 0 0 1007057056 1740794619 25 Audiologists TEDNES MELISSA N 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 187.07 187.07 0 0 1007057136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1007058190 1205343357 16 Nurse Practitioners GRAMZA CRISTINE 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 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 0 149.45 0 0 0 0 0 0 149.45 0 0 1007058415 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 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 2.73 0 0 0 0 0 0 2.73 0 0 1007058662 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 20537.22 0 0 0 0 0 0 0 0 0 0 0 0 0 20537.22 0 0 1007058984 1407237134 10 Physicians BARRON DILLON 999999999 10 Adams 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5338.67 0 0 0 0 0 0 5338.67 0 0 1007059068 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 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 0 419.98 0 0 0 0 0 0 419.98 0 0 1007059255 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3946.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3946.8 0 0 1007059481 89 Physician Assistant Only(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 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 0 125.96 0 0 0 0 0 0 125.96 0 0 1007060380 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.54 0 0 0 0 0 0 115.54 0 0 1007060804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 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1007063610 1528562071 16 Nurse Practitioners COOK HEIDI N 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 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 20.01 0 0 0 0 0 0 20.01 0 0 1007063704 1861870099 10 Physicians GUTIERREZ WHITNEY C 999999999 19 Champaign 0 0 Pediatrics 0 0 0 40 0 0 0 0 0 0 29 0 50 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 78 0 70 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 78 0 70 0 0 0 0 0 0 0 0 0 3587.45 0 0 0 0 0 0 562.04 0 3260.62 0 0 0 0 0 0 7410.11 0 0 1007063784 1811383334 10 Physicians PISE MAYURIKA N 999999999 200 Cook 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 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15364.21 0 0 0 0 0 0 15364.21 0 0 1007063981 1871828947 10 Physicians DOUGHERTY EVAN 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 24 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512.02 0 9770.84 0 0 0 0 0 0 10282.86 0 0 1007064124 1669854667 10 Physicians OKUBANJO OYINKANSOLA 999999999 200 Cook 0 0 Emergency Medicine 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 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 3402.7 0 0 0 0 0 0 3402.7 0 0 1007064429 1619499829 16 Nurse Practitioners CARTER LESLIE E 999999999 109 Winnebago 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 1771.57 0 0 0 0 0 0 1771.57 0 0 1007064564 1588143002 16 Nurse Practitioners HELMHOLT JENNIFER 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 0 124 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 0 572.04 0 0 0 0 0 0 572.04 0 0 1007064623 1093228835 74 Hospital-Based Transportation Providers OSF HEART OF MARY MEDICAL CENT 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 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Occupational Therapists 65 Madison 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 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 0 461.32 461.32 0 0 1007068514 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 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 66.49 0 0 0 0 0 0 66.49 0 0 1007068528 1588183735 16 Nurse Practitioners PANGILINAN MA APRIL 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 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 1053.21 0 0 0 0 0 0 1053.21 0 0 1007068547 23 Occupational Therapists 108 Williamson 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 26.75 26.75 0 0 1007068572 1588943567 25 Audiologists PARDUE KATHRYN M. 999999999 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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 0 227.04 0 0 0 0 0 0 227.04 0 0 1009595348 10 Physicians 30 DuPage 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 1009595622 1154826501 16 Nurse Practitioners WEDE AARON D 999999999 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 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 1390.35 0 0 0 0 0 0 1390.35 0 0 1009596335 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 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 43.09 0 0 0 0 0 0 43.09 0 0 1009597072 1124014071 10 Physicians NEWBERG BARBARA E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 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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 0 0 2983.31 0 0 0 0 0 0 2983.31 0 0 1009635312 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5838.66 0 0 0 0 0 0 0 0 0 0 0 0 0 5838.66 0 0 1009635492 1720438021 91 Waiver service provider--Adults (DHS/DDD) POWYER CAMERON J 999999999 91 Sangamon 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87586.1 0 0 0 0 0 0 0 0 0 0 0 0 0 87586.1 0 0 1009635750 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1009637025 1922274620 10 Physicians DIAZ EDWARD C 999999999 200 Cook 0 0 Urology 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 0 132 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 12491.61 0 0 0 0 0 0 12491.61 0 0 1009637075 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 8148.14 0 0 0 0 0 0 0 0 0 0 0 0 0 8148.14 0 0 1009637333 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8071.02 0 0 0 0 0 0 0 0 0 0 0 0 0 8071.02 0 0 1009639336 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 69.55 0 0 0 0 0 0 69.55 0 0 1009639409 1841601838 10 Physicians COLGROVE MINDY C 999999999 30 DuPage 0 0 Obstetric-Gynecology 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 9 0 15 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 23468.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23468.41 0 0 1009648864 1881795474 89 Physician Assistant Only(Encounter Only) CARPENTER SELINA 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 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 0 322.49 0 0 0 0 0 0 322.49 0 0 1009650845 30 General Hospitals 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4355.71 0 0 0 0 0 4355.71 0 0 1009651117 10 Physicians 30 DuPage 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296.45 0 0 0 0 0 0 296.45 0 0 1009651477 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16843.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16843.35 0 0 1009652303 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6683.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6683.6 0 0 1009653302 1902371313 16 Nurse Practitioners ANGELLY DIETRA LEIGH 999999999 200 Cook 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 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 0 343.08 0 0 0 0 0 0 343.08 0 0 1009653433 1508334780 33 Nursing Facilities LOFT REHAB AND NRSG OF NORMAL 999999999 72 McLean 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 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 553375.22 0 0 0 0 0 0 0 553375.22 0 0 1009653527 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 1009654270 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9379.3 0 0 0 0 0 0 0 0 0 0 0 0 0 9379.3 0 0 1009654687 16 Nurse Practitioners 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 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 95.4 0 0 0 0 0 0 95.4 0 0 1009655779 1245702067 89 Physician Assistant Only(Encounter Only) MCDOWELL LISA A 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 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 0 235.87 0 0 0 0 0 0 235.87 0 0 1009656380 10 Physicians 200 Cook 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 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 0 826.37 0 0 0 0 0 0 826.37 0 0 1009656454 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 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 13082.55 0 0 0 0 0 0 0 0 0 0 0 0 0 13082.55 0 0 1009659718 1700132628 10 Physicians CORDOBA NICOLAS 999999999 30 DuPage 0 0 Internal Medicine 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 0 621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5720.75 0 0 0 0 0 0 5720.75 0 0 1009660302 1902255185 10 Physicians STOB ELZBIETA I 999999999 30 DuPage 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 0 125 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 0 655.13 0 0 0 0 0 0 655.13 0 0 1009660884 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17397.02 0 0 0 0 0 0 0 0 0 0 0 0 0 17397.02 0 0 1009660911 10 Physicians 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.47 0 0 0 0 0 0 0 0 221.47 0 0 1009660918 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 1009663611 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1009665856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 58729.67 0 0 0 0 0 0 0 0 0 0 0 0 0 58729.67 0 0 1009665939 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 0 221 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 19392.76 0 0 0 0 0 0 0 0 0 0 0 0 0 19392.76 0 0 1009667022 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1009667210 1235662370 10 Physicians KHOURY KEVIN PAUL 999999999 200 Cook 0 0 Internal Medicine 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 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 6.3 0 888.5 0 0 0 0 0 0 894.8 0 0 1009667432 1093100554 10 Physicians FLORENCE NICHOLAS 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 88 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1510.84 0 188.34 0 0 0 0 0 0 1699.18 0 0 1009667666 1922492867 10 Physicians STELTER JACOB 999999999 200 Cook 0 0 Emergency Medicine 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 0 123 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 5397.1 0 0 0 0 0 0 5397.1 0 0 1009668648 1235633538 10 Physicians PFISTER BROOKE K 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 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 12 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 93.5 0 0 0 0 0 0 0 0 640.07 0 0 0 0 0 0 733.57 0 0 1009669049 1942520671 10 Physicians DHAR CHERIE P 999999999 200 Cook 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 7 0 30 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 7 0 56 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 7 0 56 0 0 0 0 0 0 0 0 0 161.56 0 0 0 0 0 0 28.17 0 2994.57 0 0 0 0 0 0 3184.3 0 0 1009669102 1518320704 10 Physicians DE LA PENA ANTHONY P 999999999 30 DuPage 0 0 Internal Medicine 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 0 236 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 3244.56 0 0 0 0 0 0 3244.56 0 0 1009672323 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 23898.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23898.6 0 0 1009672667 1255895108 16 Nurse Practitioners ANDERSON BRITTANY 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 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 0 354.05 0 0 0 0 0 0 354.05 0 0 1009672750 1881083640 10 Physicians IRELAND ALEX 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 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 0 915.63 0 0 0 0 0 0 915.63 0 0 1009675614 1487137832 60 Pharmacies LENA DRUG STORE 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5469.09 0 0 0 5469.09 0 0 1009676876 1033650338 10 Physicians VANCE-UTSET LEAH 999999999 200 Cook 0 0 Pediatrics 0 0 0 7 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 213.65 0 0 0 0 0 0 0 0 1191.57 0 0 0 0 0 0 1405.22 0 0 1009676950 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4291.57 0 0 0 0 0 0 0 0 0 0 0 0 0 4291.57 0 0 1009677663 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23740.31 0 0 0 0 0 0 0 0 0 0 0 0 0 23740.31 0 0 1009679010 1689148892 48 Rural Health Clinics WABASH GENERAL HOSPITAL ALBIO 999999999 32 Edwards 0 0 0 100 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 307 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6651.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6651.79 0 0 1009679790 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.82 0 0 0 0 0 0 128.82 0 0 1009680565 16 Nurse Practitioners 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 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 0 212.96 0 0 0 0 0 0 212.96 0 0 1009681088 10 Physicians 89 Rock Island 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.89 0 0 0 0 0 0 0 0 8.89 0 0 1009681385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2394.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2394.95 0 0 1009683405 1851875470 16 Nurse Practitioners CONROY KAYLA 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Worker(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 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 1009689439 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23353.63 0 0 0 0 0 0 0 0 0 0 0 0 0 23353.63 0 0 1009689639 1033453519 10 Physicians GONDI HARSHA 999999999 200 Cook 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 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6369.93 0 0 0 0 0 0 6369.93 0 0 1009689865 4009689865 71 Medicar Provider TRAVELABLE MEDICAL TRANSPORTAT 999999999 96 St Clair 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 6004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79031.12 0 0 0 0 0 0 79031.12 0 0 1009692228 1518942325 10 Physicians WALICK KRISTINA 999999999 91 Sangamon 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 0 104 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 6124.66 0 0 0 0 0 0 6124.66 0 0 1009692389 10 Physicians 53 Kane 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 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 1009695140 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 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 2997.5 2997.5 0 0 1009696089 1578030151 16 Nurse Practitioners AMITI AMANDA K 999999999 200 Cook 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 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3370.89 0 0 0 0 0 0 3370.89 0 0 1009696490 1407081987 10 Physicians DAVIDSON BEAUJON O 999999999 19 Champaign 0 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0 1009716296 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19691.89 0 0 0 0 0 0 0 0 0 0 0 0 0 19691.89 0 0 1009716704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14579.61 0 0 0 0 0 0 0 0 0 0 0 0 0 14579.61 0 0 1009717591 1093246282 10 Physicians LATTELL JONATHAN D 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 0 110 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 1058.21 0 0 0 0 0 0 1058.21 0 0 1009718362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24501.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24501.4 0 0 1009720073 1770074486 16 Nurse Practitioners CERALDE JOEL 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 0 240.28 0 0 0 0 0 0 240.28 0 0 1009721651 1174017164 10 Physicians LIU SONYA 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 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 0 331.97 0 0 0 0 0 0 331.97 0 0 1009722005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3945.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3945.36 0 0 1009722339 1649684945 10 Physicians DEVRIES CLARABELLE A 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 10 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416.15 0 3135.25 0 0 0 0 0 0 3551.4 0 0 1009722390 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 15221.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15221.8 0 0 1009722575 1003371691 16 Nurse Practitioners REMINGTON EMILY 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 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 1818.79 0 0 0 0 0 0 1818.79 0 0 1009723163 1932665791 16 Nurse Practitioners ZOLFAGHARI JENI L 999999999 80 Peoria 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 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 415.14 0 0 0 0 0 0 447.29 0 0 1009725118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 292.92 0 0 0 0 0 0 0 0 0 0 0 0 0 292.92 0 0 1009727741 87 Psychologist(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 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 1009728864 16 Nurse Practitioners 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.09 0 0 0 0 0 0 138.09 0 0 1009728987 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 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 23333 0 0 0 0 0 0 0 0 0 0 0 0 0 23333 0 0 1009729528 1386001311 75 Department of Alcohol and Substance Abuse Provider LSSI ACA ADD ELGIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190211.76 0 0 190211.76 0 0 1009729745 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18887.02 0 0 0 0 0 0 0 0 0 0 0 0 0 18887.02 0 0 1009731476 1528599560 10 Physicians KOSIROG 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 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 0 297.25 0 0 0 0 0 0 297.25 0 0 1009734374 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7251.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7251.64 0 0 1009735494 1417422361 16 Nurse Practitioners KULASIC AZRA 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 0 191.17 0 0 0 0 0 0 191.17 0 0 1009735592 1508248774 89 Physician Assistant Only(Encounter Only) CANADA AMALIA M 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 0 180 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 1476.8 0 0 0 0 0 0 1476.8 0 0 1009736062 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2061.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2061.69 0 0 1009736505 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23390.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23390.9 0 0 1009737441 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20627.58 0 0 0 0 0 0 0 0 0 0 0 0 0 20627.58 0 0 1009739719 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24998.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24998.4 0 0 1009740736 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8584.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8584.8 0 0 1009740773 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 0 306 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 21750.04 0 0 0 0 0 0 0 0 0 0 0 0 0 21750.04 0 0 1009740896 1639518459 10 Physicians ADAMSKY MELANIE A 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 9 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.34 0 2181.91 0 0 0 0 0 0 2204.25 0 0 1009740938 1376062844 25 Audiologists BUSKIRK LAURA 999999999 53 Kane 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 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 0 434.99 434.99 0 0 1009741374 1952480550 10 Physicians GRECULA MICHAEL J 999999999 80 Peoria 0 0 Orthopedic Surgery 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 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.1 0 1207.42 0 0 0 0 0 0 1248.52 0 0 1009742719 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 2514.81 0 0 0 0 0 0 2514.81 0 0 1009745437 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26081.11 0 0 0 0 0 0 0 0 0 0 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Practitioners KATSINIS RENEE N 999999999 30 DuPage 0 0 0 0 0 17 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 1502.57 0 0 0 0 0 0 0 0 1301.99 0 0 0 0 0 0 2804.56 0 0 1009856769 1265916415 16 Nurse Practitioners DOBREZ EMILY A 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.94 0 0 0 0 0 0 116.94 0 0 1009857708 1346744018 10 Physicians SILBERMAN ERIC 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 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 0 496.5 0 0 0 0 0 0 496.5 0 0 1009858100 1356769012 10 Physicians JAEGER LINDSAY 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 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 5977.96 0 0 0 0 0 0 5977.96 0 0 1009858312 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 23728.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23728.1 0 0 1009858365 1518439454 47 Local Education Agencies NORTHBROOK/GLENVIEW SCHOOL DIS 999999999 200 Cook 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 0 764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17391.38 0 17391.38 0 0 1009860465 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 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 1257.94 0 0 0 0 0 0 1257.94 0 0 1009860991 1164902318 89 Physician Assistant Only(Encounter Only) SHELTON CLAYTON 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 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 19.79 0 0 0 0 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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 0 0 2255.82 0 0 0 0 0 0 2255.82 0 0 1009901011 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 0 100 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 8831.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8831.84 0 0 1009902083 1134274301 75 Department of Alcohol and Substance Abuse Provider CORNELL INTERVENTIONS SOUTHWOO 999999999 200 Cook 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130881.69 0 0 130881.69 0 0 1009902194 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19390.56 0 0 0 0 0 0 0 0 0 0 0 0 0 19390.56 0 0 1009903678 86 Clinical Social Worker(Encounter Only) 49 Jefferson 0 0 0 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0 0 0 0 0 0 0 0 9 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477.42 0 128093.1 0 0 0 0 0 0 128570.52 0 0 1009926124 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 1009926385 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 0 301.25 0 0 0 0 0 0 301.25 0 0 1009926533 1548742463 33 Nursing Facilities GENERATIONS AT RIVERVIEW 999999999 98 Tazewell 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2081 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165075.24 0 0 0 0 0 0 0 165075.24 0 0 1009927263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4244.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4244.98 0 0 1009927321 1548649197 10 Physicians ASHLEY SARVER 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 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 3431.56 0 0 0 0 0 0 3431.56 0 0 1009927525 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 43.73 0 0 0 0 0 0 43.73 0 0 1009927965 1346602877 10 Physicians CONNOLLY SEAN B 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 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 1391.29 0 0 0 0 0 0 1391.29 0 0 1009928825 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 42.5 0 0 1009940076 1750849873 89 Physician Assistant Only(Encounter Only) FRENCH ALLISON C 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 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 0 400.32 0 0 0 0 0 0 400.32 0 0 1009942110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3012.15 0 0 0 0 0 0 0 0 0 0 0 0 0 3012.15 0 0 1009942511 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 815.02 0 0 0 0 0 0 815.02 0 0 1009944186 10 Physicians 200 Cook 0 0 Emergency Medicine 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 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 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Physician Assistant Only(Encounter Only) DETLOFF SCOTT M 999999999 41 Hamilton 0 0 0 0 0 0 0 0 0 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 0 345.15 0 0 0 0 0 0 345.15 0 0 1009948458 1558878181 16 Nurse Practitioners SMITH CHANDRA N 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 0 150 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 0 744.06 0 0 0 0 0 0 744.06 0 0 1009949177 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 14005.85 0 0 0 0 0 0 0 0 0 0 0 0 0 14005.85 0 0 1009950632 1871021030 10 Physicians SHEIKH BELAAL 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 664.02 0 0 0 0 0 0 664.02 0 0 1009953575 1316404429 91 Waiver service provider--Adults (DHS/DDD) FRY BRITTANY L 999999999 53 Kane 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 0 176 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 11783.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11783.4 0 0 1009959180 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10367.01 0 0 0 0 0 0 0 0 0 0 0 0 0 10367.01 0 0 1009962238 1013482777 89 Physician Assistant Only(Encounter Only) ELAYAN AMANI 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 0 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5216.65 0 0 0 0 0 0 5216.65 0 0 1009962267 1730628678 16 Nurse Practitioners STANLEY CAROL M 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 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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 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 0 350.02 0 0 0 0 0 0 350.02 0 0 1009987137 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 0 0 0 0 0 0 0 0 0 0 1009987547 1356744593 87 Psychologist(Encounter Only) MOORE MINDY 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 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 1313.49 0 0 0 0 0 0 1313.49 0 0 1009987638 1487183794 86 Clinical Social Worker(Encounter Only) SCHAEFFER HELEN R 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 0 393.22 0 0 0 0 0 0 393.22 0 0 1009987797 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14914.47 0 0 0 0 0 0 0 0 0 0 0 0 0 14914.47 0 0 1009999613 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15123.11 0 0 0 0 0 0 0 0 0 0 0 0 0 15123.11 0 0 1010000209 1508209925 11 Dentists PATEL DHARA 999999999 200 Cook 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.52 0 0 1010000895 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 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 20 0 0 0 0 0 0 0 0 0 98.04 0 0 0 0 0 0 0 0 1334.94 0 0 0 0 0 0 1432.98 0 0 1010003246 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 725.33 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0 21774.5 0 0 1010008095 1780954784 16 Nurse Practitioners WELCH MELISSA 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 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 1270.88 0 0 0 0 0 0 1270.88 0 0 1010008746 1245265388 60 Pharmacies OSF PHARMACY - DANVILLE 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7584.09 0 0 0 7584.09 0 0 1010009478 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 78.09 0 0 0 0 0 0 78.09 0 0 1010011467 1780901652 10 Physicians JAMEEL MOHAMMED ABDUL 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 51.52 0 0 0 0 0 0 15.7 0 1416.65 0 0 0 0 0 0 1483.87 0 0 1010011647 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 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 3873.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3873.4 0 0 1010013177 1962841122 10 Physicians EDISON JESSICA 999999999 90 Saline 0 0 Pediatrics 0 0 0 14 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 1143.24 0 0 0 0 0 0 0 0 9090.44 0 0 0 0 0 0 10233.68 0 0 1010013274 1861968307 55 Early Intervention Services GOAD MARIA ANN 999999999 78 Moultrie 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 2220.45 0 0 0 0 0 0 2220.45 0 0 1010013410 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 1689.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1689.34 0 0 1010014092 1710210059 89 Physician Assistant Only(Encounter Only) HUA LING Y 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 0 164.41 0 0 0 0 0 0 164.41 0 0 1010014333 1942270004 10 Physicians NICKELL KENT A 999999999 200 Cook 0 0 Clinical Pathology 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 0 216 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 2708.17 0 0 0 0 0 0 0 0 2708.17 0 0 1010015385 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 0 105 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 14660.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14660.14 0 0 1010015445 10 Physicians 30 DuPage 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 66.4 0 0 0 0 0 0 66.4 0 0 1010015460 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 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 3642.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3642.65 0 0 1010015806 1952888299 16 Nurse Practitioners WITTER DINA B 999999999 56 Knox 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 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 0 104.96 0 0 0 0 0 0 0 0 2898.97 0 0 0 0 0 0 3003.93 0 0 1010017492 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 16438.14 0 0 0 0 0 0 0 0 0 0 0 0 0 16438.14 0 0 1010018663 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 325.5 0 0 0 0 0 0 0 0 0 0 0 0 0 325.5 0 0 1010018902 1770575201 30 General Hospitals LASALLE BEHAVIORAL HEALTH 475911038 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1305.04 0 0 0 0 0 0 0 0 0 1305.04 0 0 1010019198 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 16483.29 0 0 0 0 0 0 0 0 0 0 0 0 0 16483.29 0 0 1010019228 1033508817 10 Physicians KONG BETTY 999999999 200 Cook 0 0 Dermatology 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 0 189 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 4091.37 0 0 0 0 0 0 4091.37 0 0 1010019983 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 642.03 0 0 0 0 0 0 0 0 0 0 0 0 0 642.03 0 0 1010020447 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.6 0 0 1010021145 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22378.09 0 0 0 0 0 0 0 0 0 0 0 0 0 22378.09 0 0 1010021354 10 Physicians 24 Coles 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 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 5.33 0 0 0 0 0 0 0 0 5.33 0 0 1010022029 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238.7 0 0 0 0 0 0 0 0 0 0 0 0 0 238.7 0 0 1010022046 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8387.54 0 0 0 0 0 0 0 0 0 0 0 0 0 8387.54 0 0 1010022255 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8522.58 0 0 0 0 0 0 0 0 0 0 0 0 0 8522.58 0 0 1010022294 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.06 0 0 0 0 0 0 243.06 0 0 1010024330 1649742883 91 Waiver service provider--Adults (DHS/DDD) FELIX LARA GABRIEL M 999999999 91 Sangamon 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90233.7 0 0 0 0 0 0 0 0 0 0 0 0 0 90233.7 0 0 1010025627 1720586688 16 Nurse Practitioners MILES JENNIFER L 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 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 0 317.62 0 0 0 0 0 0 317.62 0 0 1010026484 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14847.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14847.39 0 0 1010026722 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22743.16 0 0 0 0 0 0 0 0 0 0 0 0 0 22743.16 0 0 1010027450 1871030478 11 Dentists DESAI RIDDHI 999999999 53 Kane 0 0 General Dentistry 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 3420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3420 0 0 1010028132 1457706772 10 Physicians MCGUIRE BRIAN 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 0 184 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 0 522.93 0 0 0 0 0 0 522.93 0 0 1010028446 1659726016 10 Physicians BUDRIS LINDSEY M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 1 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 3649.52 0 0 0 0 0 0 3685.47 0 0 1010028619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20655.92 0 0 0 0 0 0 0 0 0 0 0 0 0 20655.92 0 0 1010028927 4010028927 72 Taxicabs and Livery Companies MAYE COMPANY 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 0 769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7506.44 0 0 0 0 0 0 7506.44 0 0 1010029203 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1609.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1609.91 0 0 1010029497 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010030168 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 79.51 0 0 0 0 0 0 79.51 0 0 1010031769 1881114932 10 Physicians FUEST STEPHEN 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 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 29.38 0 0 0 0 0 0 29.38 0 0 1010031869 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 0 313 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 7399.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7399.35 0 0 1010033279 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010035623 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10787.09 0 0 0 0 0 0 0 0 0 0 0 0 0 10787.09 0 0 1010037169 1184197410 16 Nurse Practitioners OLUGBILE MUSTAPHA 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 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 0 647.68 0 0 0 0 0 0 647.68 0 0 1010037537 1811481062 10 Physicians BROW JEFFREY DAVID 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 1347.09 0 0 0 0 0 0 1353.39 0 0 1010040046 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 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 0 803.24 803.24 0 0 1010043285 1588135529 16 Nurse Practitioners BLAISDELL CONSTANCE 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 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 70.67 0 0 0 0 0 0 70.67 0 0 1010043293 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1389.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1389.35 0 0 1010045524 1992966451 10 Physicians VESELIK JILL J 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 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 4397.76 0 0 0 0 0 0 4397.76 0 0 1010048340 1356884993 48 Rural Health Clinics FAMILY HEALTH CARE OF CISSNA P 999999999 46 Iroquois 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 0 108.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.68 0 0 1010049776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 59008.39 0 0 0 0 0 0 0 0 0 0 0 0 0 59008.39 0 0 1010050275 1417451022 10 Physicians CAMERON NATALIE 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 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 0 206.29 0 0 0 0 0 0 206.29 0 0 1010050596 1497160584 10 Physicians WANG AMY Y 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 62.74 0 0 0 0 0 0 62.74 0 0 1010052903 1780142174 16 Nurse Practitioners LAURUSONIS STEPHANIE 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 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 12.88 0 0 0 0 0 0 0 0 865.32 0 0 0 0 0 0 878.2 0 0 1010054331 1356754113 10 Physicians SCHURLE ALAN 999999999 30 DuPage 0 0 Anesthesiology 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 0 115 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 6363.57 0 0 0 0 0 0 6363.57 0 0 1010054524 1629414651 10 Physicians CHOUFANI JOE N 999999999 53 Kane 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 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 0 243.94 0 0 0 0 0 0 243.94 0 0 1010056052 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26578.16 0 0 0 0 0 0 0 0 0 0 0 0 0 26578.16 0 0 1010056970 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13674.94 0 0 0 0 0 0 0 0 0 0 0 0 0 13674.94 0 0 1010057176 1659840908 11 Dentists CHI HOGUEN 999999999 89 Rock Island 0 0 0 0 31 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 3075.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3075.7 0 0 1010057211 1225592470 16 Nurse Practitioners FANALE STEPHANIE T 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.93 0 0 0 0 0 0 53.93 0 0 1010059129 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 0 194 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 12474.61 0 0 0 0 0 0 0 0 0 0 0 0 0 12474.61 0 0 1010060364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8078.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8078.97 0 0 1010060437 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 0 163 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 15813.84 0 0 0 0 0 0 0 0 0 0 0 0 0 15813.84 0 0 1010060812 1578037669 89 Physician Assistant Only(Encounter Only) HANEBUTT KELSEY M 999999999 200 Cook 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 0 140 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 6048.82 0 0 0 0 0 0 6048.82 0 0 1010061246 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 11.05 0 0 0 0 0 0 11.05 0 0 1010063680 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14908.98 0 0 0 0 0 0 0 0 0 0 0 0 0 14908.98 0 0 1010064879 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11041.97 0 0 0 0 0 0 0 0 0 0 0 0 0 11041.97 0 0 1010064999 1700250651 16 Nurse Practitioners SALEKI-HADAVAND ARMITA 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 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 1406.39 0 0 0 0 0 0 1406.39 0 0 1010066272 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22222.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22222.2 0 0 1010066690 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11706.51 0 0 0 0 0 0 0 0 0 0 0 0 0 11706.51 0 0 1010070446 1053708594 10 Physicians BALLARD DAVID H 999999999 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 114 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3151.97 0 218.84 0 0 0 0 0 0 3370.81 0 0 1010070867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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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Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.16 224.16 0 0 1010131558 1609142074 10 Physicians WALLACE GABRIEL A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.97 0 8189.97 0 0 0 0 0 0 8230.94 0 0 1010134303 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 0 410 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 42281.1 0 0 0 0 0 0 0 0 0 0 0 0 0 42281.1 0 0 1010134437 1548216195 10 Physicians WYNN RAYMOND 601545716 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493.6 0 0 0 0 0 0 493.6 0 0 1010134679 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 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 18879.6 0 0 0 0 0 0 0 0 0 0 0 0 0 18879.6 0 0 1010137492 1316477045 10 Physicians LUCIA DIANDRA 999999999 200 Cook 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 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 1666.05 0 0 0 0 0 0 1666.05 0 0 1010137845 10 Physicians 200 Cook 0 0 Orthopedic 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 259.06 0 0 0 0 0 0 259.06 0 0 1010138695 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10858.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10858.76 0 0 1010139962 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1459.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1459.02 0 0 1010140101 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 4.4 0 31.01 0 0 0 0 0 0 35.41 0 0 1010142102 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 987.27 0 0 0 0 0 0 0 0 0 0 0 0 0 987.27 0 0 1010142415 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11217.81 0 0 0 0 0 0 0 0 0 0 0 0 0 11217.81 0 0 1010142561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22336.27 0 0 0 0 0 0 0 0 0 0 0 0 0 22336.27 0 0 1010143029 4010143029 89 Physician Assistant Only(Encounter Only) ZALOT JOSHUA 999999999 37 Fulton 0 0 0 0 0 0 0 0 0 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 0 661.98 0 0 0 0 0 0 661.98 0 0 1010143685 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3144.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3144.65 0 0 1010145712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12198.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12198.88 0 0 1010146823 89 Physician Assistant Only(Encounter Only) 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 47.62 0 0 0 0 0 0 47.62 0 0 1010146866 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4395.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4395.6 0 0 1010150543 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 8656.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8656.5 0 0 1010151119 1316384258 10 Physicians KHOKAR AMNA M 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 0 140.56 0 0 0 0 0 0 140.56 0 0 1010151267 1275987984 10 Physicians DESAI MIHIR SAMIR 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 0 244 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 2774.87 0 0 0 0 0 0 2774.87 0 0 1010152962 10 Physicians 24 Coles 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 52.94 0 0 0 0 0 0 0 0 52.94 0 0 1010153486 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 0 176 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 13014.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13014.4 0 0 1010154151 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 0 0 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 19954.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19954.46 0 0 1010157317 1538625983 16 Nurse Practitioners CONFORTI JULIE 999999999 53 Kane 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 0 142 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 0 0 0 0 0 0 0 0 0 0 1010157918 1093270795 16 Nurse Practitioners ANWER MOHAMMAD FAHAD 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 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 1605.54 0 0 0 0 0 0 1605.54 0 0 1010160459 1992275291 75 Department of Alcohol and Substance Abuse Provider CORNELL INTERVENTIONS 999999999 30 DuPage 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 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320426.82 0 0 320426.82 0 0 1010160846 1134449119 10 Physicians FEELY MELINDA M 999999999 80 Peoria 0 0 Family Practice 0 0 0 35 0 0 0 0 0 0 36 0 137 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 45 0 250 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 45 0 250 0 0 0 0 0 0 0 0 0 4585.95 0 0 0 0 0 0 834.05 0 9408 0 0 0 0 0 0 14828 0 0 1010162243 1467926097 16 Nurse Practitioners SALAZAR BENJAMIN 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 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 1107.6 0 0 0 0 0 0 1107.6 0 0 1010163147 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 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 0 328.53 0 0 0 0 0 0 328.53 0 0 1010163806 1548726912 16 Nurse Practitioners RITZ DANIEL 999999999 53 Kane 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 1979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1979 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2949.39 0 0 0 0 0 0 2949.39 0 0 1010164592 1619404969 10 Physicians PETROPULOS PETER A 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 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 0 183.73 0 0 0 0 0 0 183.73 0 0 1010166081 86 Clinical Social Worker(Encounter Only) 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 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 1010166183 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18019.3 0 0 0 0 0 0 0 0 0 0 0 0 0 18019.3 0 0 1010166287 1437505765 10 Physicians FLORIDO PATRICK J 999999999 91 Sangamon 0 0 Internal Medicine 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 0 303 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 3081.46 0 0 0 0 0 0 3081.46 0 0 1010166412 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177.15 0 0 0 0 0 0 177.15 0 0 1010167779 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 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 12785.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12785.39 0 0 1010168482 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 17712.18 0 0 0 0 0 0 0 0 0 0 0 0 0 17712.18 0 0 1010169093 1609353226 16 Nurse Practitioners SHRADER VICTORIA L 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 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 0 577.02 0 0 0 0 0 0 577.02 0 0 1010169862 1225593890 23 Occupational Therapists RANDLE-MAYES JASMINE 999999999 200 Cook 0 0 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 3494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262295.73 262295.73 0 0 1010172148 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6126.25 0 0 0 0 0 0 0 0 0 0 0 0 0 6126.25 0 0 1010173256 1558835702 23 Occupational Therapists BERMAN EMILIE E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 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 17209.68 17209.68 0 0 1010173352 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20864.43 0 0 0 0 0 0 0 0 0 0 0 0 0 20864.43 0 0 1010173569 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14178.69 0 0 0 0 0 0 0 0 0 0 0 0 0 14178.69 0 0 1010174215 1003340050 39 Hospice SUNCREST HOSPICE ILLINOIS LLC 999999999 200 Cook 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 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3034 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 677201.45 0 0 0 0 0 0 0 0 0 0 0 677201.45 0 0 1010174434 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1749.64 0 0 0 0 0 0 0 0 0 0 0 0 0 1749.64 0 0 1010176753 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 22690.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22690.22 0 0 1010177015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7912.55 0 0 0 0 0 0 0 0 0 0 0 0 0 7912.55 0 0 1010177157 1437672656 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 107 Will 0 0 0 0 0 0 0 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 77.4 0 0 0 0 0 0 0 0 77.4 0 0 1010177579 1508204488 10 Physicians HEDBERG HERBERT MASON 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 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 0 431.72 0 0 0 0 0 0 431.72 0 0 1010178392 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16142.35 0 0 0 0 0 0 0 0 0 0 0 0 0 16142.35 0 0 1010178967 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.88 0 0 0 0 0 0 15.88 0 0 1010179021 10 Physicians 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.92 0 0 0 0 0 0 0 0 223.92 0 0 1010180556 63 Other Providers of Medical Equipment/Supplies (Non-registered) 810 Florida 0 0 0 0 0 0 0 0 0 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 0 117.04 0 0 0 0 0 0 117.04 0 0 1010180768 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24979.62 0 0 0 0 0 0 0 0 0 0 0 0 0 24979.62 0 0 1010181862 1750740650 16 Nurse Practitioners ASBELL MICHELLE D 999999999 30 DuPage 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 0 111 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 3325.52 0 0 0 0 0 0 3325.52 0 0 1010184593 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 36173.41 0 0 0 0 0 0 0 0 0 0 0 0 0 36173.41 0 0 1010184810 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12793.71 0 0 0 0 0 0 0 0 0 0 0 0 0 12793.71 0 0 1010186778 1639518814 10 Physicians VENTE TERESA 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 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 1690.13 0 0 0 0 0 0 1690.13 0 0 1010187078 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16548.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16548.93 0 0 1010188252 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 0 182 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 14936.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14936.9 0 0 1010189610 1861956286 16 Nurse Practitioners PIQUARD-CAPRANICA STEPHANIE M 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 0 0 1353.37 0 0 0 0 0 0 1445.27 0 0 1010189773 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1163.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1163.2 0 0 1010190097 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1494.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1494.47 0 0 1010190881 1164993622 16 Nurse Practitioners SHERO ALEXANDRA 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 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 0 691.8 0 0 0 0 0 0 691.8 0 0 1010190959 1750853719 16 Nurse Practitioners CRAMER MICHAEL 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 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 0 550.71 0 0 0 0 0 0 550.71 0 0 1010193534 1689144347 16 Nurse Practitioners MAIER SARAH 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 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 0 121.7 0 0 0 0 0 0 121.7 0 0 1010194040 1215404710 16 Nurse Practitioners BARTELS JESSICA 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 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 83.23 0 0 0 0 0 0 83.23 0 0 1010195244 1265901227 89 Physician Assistant Only(Encounter Only) LYONS LISA J 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 0 144 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 1705.66 0 0 0 0 0 0 1705.66 0 0 1010195894 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24929.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24929.75 0 0 1010196372 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.84 0 0 1010197541 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20665.55 0 0 0 0 0 0 0 0 0 0 0 0 0 20665.55 0 0 1010198686 1346712593 16 Nurse Practitioners RANA ROSHNI 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 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 1430.14 0 0 0 0 0 0 1430.14 0 0 1010198961 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19879.33 0 0 0 0 0 0 0 0 0 0 0 0 0 19879.33 0 0 1010199329 1669884276 10 Physicians LEVENSON ANNE 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 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 32.13 0 0 0 0 0 0 32.13 0 0 1010199448 1093973893 10 Physicians BUTLER MAUREEN 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 15 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 77.87 0 0 0 0 0 0 0 0 568.17 0 0 0 0 0 0 646.04 0 0 1010201162 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25119 0 0 0 0 0 0 0 0 0 0 0 0 0 25119 0 0 1010201692 1952796005 10 Physicians KING ALEXA 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 631.49 0 0 0 0 0 0 631.49 0 0 1010202741 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 94.38 0 0 0 0 0 0 0 0 0 0 0 0 0 94.38 0 0 1010202874 1326498569 10 Physicians PARIKH MANAS 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 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 1725.74 0 0 0 0 0 0 1725.74 0 0 1010203687 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6725.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6725.5 0 0 1010204363 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 0 180.12 0 0 0 0 0 0 180.12 0 0 1010205060 1851747406 10 Physicians PORTER JUSTIN R 999999999 30 DuPage 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 0 229 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 1213.6 0 0 0 0 0 0 1213.6 0 0 1010208241 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 1010208426 1356879605 10 Physicians PATEL VASU 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 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 0 716.21 0 0 0 0 0 0 716.21 0 0 1010210120 1891114278 89 Physician Assistant Only(Encounter Only) HARRIS DANIEL 999999999 53 Kane 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 0 137 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 7174 0 0 0 0 0 0 7174 0 0 1010211079 1467808162 10 Physicians FERNANDES CHRISTOPHER R 999999999 200 Cook 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 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13139.98 0 0 0 0 0 0 13139.98 0 0 1010212469 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.69 0 0 0 0 0 0 0 0 13.69 0 0 1010213424 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 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 0 324.16 0 0 0 0 0 0 324.16 0 0 1010213725 1720547383 16 Nurse Practitioners SMITH JOANNA M 999999999 30 DuPage 0 0 0 0 0 11 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 751.25 0 0 0 0 0 0 0 0 3645.89 0 0 0 0 0 0 4397.14 0 0 1010214646 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 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 0 200.88 0 0 0 0 0 0 200.88 0 0 1010215117 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17379.15 0 0 0 0 0 0 0 0 0 0 0 0 0 17379.15 0 0 1010215257 1912427956 10 Physicians ANNAN FRANCES NL 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 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10 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4172.65 0 0 0 0 0 0 4172.65 0 0 1010218262 1770937658 10 Physicians BODNYA JULIA 999999999 200 Cook 0 0 Neurology 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 0 121 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 3956.97 0 0 0 0 0 0 3956.97 0 0 1010218449 1295078558 10 Physicians SPROLES LON A 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 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 1849.48 0 0 0 0 0 0 1849.48 0 0 1010220084 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010221372 1285119495 36 Community mental health provider AID WINDMILL MANOR 999999999 53 Kane 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2743 0 0 602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2743 0 0 24115.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304654.56 0 0 328770.29 0 0 1010222238 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15518.91 0 0 0 0 0 0 0 0 0 0 0 0 0 15518.91 0 0 1010222480 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1748.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1748.59 0 0 1010223912 1699257170 16 Nurse Practitioners BATTIG KARA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 265.86 0 0 0 0 0 0 265.86 0 0 1010225153 1780154013 12 Optometrists BENGTSON HANNAH L 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3949.02 0 2254.56 0 0 0 0 6203.58 0 0 1010225366 10 Physicians 98 Tazewell 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 0 874.95 0 0 0 0 0 0 874.95 0 0 1010226453 1093800245 10 Physicians BLAKE SIDNEY A 999999999 80 Peoria 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 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 0 341.17 0 0 0 0 0 0 341.17 0 0 1010226918 1841303708 60 Pharmacies OSF PHARMACY - URBANA 618012334 19 Champaign 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20781.76 0 0 0 20781.76 0 0 1010227692 1558839084 16 Nurse Practitioners WARD HEATHER R 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 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 85.51 0 0 0 0 0 0 85.51 0 0 1010228822 1659785236 10 Physicians URAIZEE IMRAN 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 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 0 453.22 0 0 0 0 0 0 0 0 453.22 0 0 1010228916 1215235361 10 Physicians PATEL ARPIT A 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 648 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10916.84 0 39.39 0 0 0 0 0 0 10956.23 0 0 1010229224 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 0 319 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 22059.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22059.4 0 0 1010229515 10 Physicians 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.75 0 0 0 0 0 0 0 0 10.75 0 0 1010230928 1801285689 10 Physicians DHAKE SARAH S 999999999 200 Cook 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 0 118 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 4264.45 0 0 0 0 0 0 4264.45 0 0 1010231120 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9969.67 0 0 0 0 0 0 0 0 0 0 0 0 0 9969.67 0 0 1010232512 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 47.62 0 0 0 0 0 0 47.62 0 0 1010233283 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 7304.12 0 0 0 0 0 0 0 0 0 0 0 0 0 7304.12 0 0 1010233581 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23402.47 0 0 0 0 0 0 0 0 0 0 0 0 0 23402.47 0 0 1010234276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010235568 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15776.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15776.85 0 0 1010235793 1225464290 10 Physicians VENTURA IAZSMIN 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 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 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876.41 0 0 1010303595 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24975.3 0 0 0 0 0 0 0 0 0 0 0 0 0 24975.3 0 0 1010305377 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 21133.69 0 0 0 0 0 0 0 0 0 0 0 0 0 21133.69 0 0 1010305861 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 23951.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 1010306532 71 Medicar Provider 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 0 505 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 3730.75 0 0 0 0 0 0 3730.75 0 0 1010306952 1851620561 16 Nurse Practitioners BROWN JULIE 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 2 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 333.72 0 0 0 0 0 0 0 0 3295.91 0 0 0 0 0 0 3629.63 0 0 1010307859 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 79.72 0 0 0 0 0 0 79.72 0 0 1010308269 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 0 184.9 0 0 0 0 0 0 184.9 0 0 1010308345 1598240145 16 Nurse Practitioners BLANDFORD AMY J 999999999 57 Lake 0 0 0 0 0 1 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 98.44 0 0 0 0 0 0 0 0 2752.94 0 0 0 0 0 0 2851.38 0 0 1010309551 1114375367 10 Physicians CHIU ARTHUR H 999999999 80 Peoria 0 0 Emergency 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 0 152.96 0 0 0 0 0 0 152.96 0 0 1010310380 1063802676 10 Physicians DIAZ BAEZ YUDITH 999999999 200 Cook 0 0 Emergency Medicine 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 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 2721.36 0 0 0 0 0 0 2721.36 0 0 1010310503 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25339.62 0 0 0 0 0 0 0 0 0 0 0 0 0 25339.62 0 0 1010311437 1154897254 48 Rural Health Clinics HEARTLAND WOMENS HEALTHCARE 999999999 66 Marion 0 0 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18402.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18402.45 0 0 1010311454 1003266586 10 Physicians BAKEER FARIS 999999999 80 Peoria 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 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 0 174.16 0 0 0 0 0 0 174.16 0 0 1010311637 1790165090 10 Physicians GUNNING SAMANTHA 999999999 200 Cook 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 0 578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2680.37 0 0 0 0 0 0 2680.37 0 0 1010312178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.1 0 0 0 0 0 0 0 0 0 0 0 0 0 65.1 0 0 1010313018 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 0 126.42 0 0 0 0 0 0 126.42 0 0 1010313854 1326357351 86 Clinical Social Worker(Encounter Only) JURA CARRIE 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 0 222 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 1192.27 0 0 0 0 0 0 1192.27 0 0 1010314668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20724.85 0 0 0 0 0 0 0 0 0 0 0 0 0 20724.85 0 0 1010316708 1528543774 16 Nurse Practitioners NWANKWO FELICIA E 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 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 0 819.1 0 0 0 0 0 0 819.1 0 0 1010316777 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 0 104 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 14468.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14468.44 0 0 1010316920 1962510222 16 Nurse Practitioners NELSON STACY 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 67.3 0 0 0 0 0 0 67.3 0 0 1010317153 1740719905 10 Physicians HUTCHINS COURTNEY 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 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 2019.88 0 0 0 0 0 0 2019.88 0 0 1010320542 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2125.32 0 0 0 0 0 0 0 0 0 0 0 0 0 2125.32 0 0 1010320820 1366794695 12 Optometrists "BALDWIN, OD SCOTT M" 999999999 30 DuPage 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 0 153 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 2575.27 0 0 0 0 0 0 2575.27 0 0 1010320853 1063484814 10 Physicians OTSUKA NORMAN 999999999 91 Sangamon 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 0 335 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 24876.94 0 0 0 0 0 0 24876.94 0 0 1010321034 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 0 154 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 13423.62 0 0 0 0 0 0 0 0 0 0 0 0 0 13423.62 0 0 1010323361 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5390.28 0 0 0 0 0 0 0 0 0 0 0 0 0 5390.28 0 0 1010323395 55 Early Intervention Services 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 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 1122.78 0 0 0 0 0 0 1122.78 0 0 1010324340 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24206.35 0 0 0 0 0 0 0 0 0 0 0 0 0 24206.35 0 0 1010324898 1124433230 10 Physicians SOLIZ LUIS J 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 3 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.31 0 1981.4 0 0 0 0 0 0 1991.71 0 0 1010324975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 986.64 0 0 0 0 0 0 0 0 0 0 0 0 0 986.64 0 0 1010325210 1861912917 10 Physicians BROWN ASHLEY 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 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 0 885.13 0 0 0 0 0 0 885.13 0 0 1010327298 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.54 0 0 0 0 0 0 13.54 0 0 1010328089 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 12.88 0 0 1010329892 1336626738 16 Nurse Practitioners NEWBY JESSICA 999999999 72 McLean 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 0 115 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 2737.47 0 0 0 0 0 0 2737.47 0 0 1010330374 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 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 3240.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3240.74 0 0 1010331288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14352.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14352.39 0 0 1010331451 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 4 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 5844.36 5844.36 0 0 1010331487 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25547.39 0 0 0 0 0 0 0 0 0 0 0 0 0 25547.39 0 0 1010331731 1861806994 10 Physicians GUPTA NINA 999999999 30 DuPage 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 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 1815.95 0 0 0 0 0 0 1815.95 0 0 1010333428 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.13 0 0 0 0 0 0 175.13 0 0 1010333899 1003370255 91 Waiver service provider--Adults (DHS/DDD) MCCAULEY DONNELL 999999999 36 Franklin 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1573 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90471.13 0 0 0 0 0 0 0 0 0 0 0 0 0 90471.13 0 0 1010337634 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20316.6 0 0 0 0 0 0 0 0 0 0 0 0 0 20316.6 0 0 1010337704 1083146161 89 Physician Assistant Only(Encounter Only) CONNOLLY MEGAN T 999999999 72 McLean 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 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 0 532.05 0 0 0 0 0 0 532.05 0 0 1010337742 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1238.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1238.1 0 0 1010338897 1518964980 10 Physicians LEE TENNYSON 999999999 81 Perry 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 68 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 677 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 972.72 0 6203.06 0 0 0 0 0 0 7175.78 0 0 1010339105 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 0 280 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 22954.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22954.8 0 0 1010339155 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 0 148.3 0 0 0 0 0 0 148.3 0 0 1010339310 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23924.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.25 0 0 1010344202 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9365.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9365.04 0 0 1010344542 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9254.09 0 0 0 0 0 0 0 0 0 0 0 0 0 9254.09 0 0 1010346704 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 0 589 0 0 0 0 0 0 589 0 0 1010347247 1801277058 10 Physicians LI HAN 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 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 0 275.49 0 0 0 0 0 0 275.49 0 0 1010348498 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 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 0 482.91 0 0 0 0 0 0 482.91 0 0 1010349565 1528449824 10 Physicians EVERETT ELYSE A 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 0 204.01 0 0 0 0 0 0 204.01 0 0 1010349817 1891252151 23 Occupational Therapists GREEN LAUREN 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 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 2649.55 2649.55 0 0 1010350027 1386774388 10 Physicians WILSON ALAN J 999999999 47 Jackson 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 0 111 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 2504.84 0 0 0 0 0 0 2504.84 0 0 1010352104 1689024234 10 Physicians BUETTNER BENJAMIN P 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 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 0 331.04 0 0 0 0 0 0 331.04 0 0 1010352120 1205274131 10 Physicians BENJAMIN ANDREW J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.29 0 8225.21 0 0 0 0 0 0 8232.5 0 0 1010352579 1336526458 10 Physicians DOYEL RYAN 999999999 200 Cook 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 0 383 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 5663.26 0 0 0 0 0 0 5663.26 0 0 1010353055 1700356912 12 Optometrists IBISCH ANDREW 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 647 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9839.87 0 3470.52 0 0 0 0 13310.39 0 0 1010353239 1427520253 89 Physician Assistant Only(Encounter Only) MITRANO AMY L 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 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 0 605.54 0 0 0 0 0 0 605.54 0 0 1010353587 1902347156 10 Physicians JOHNSON MEREDITH 999999999 200 Cook 0 0 0 0 0 14 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 551.25 0 0 0 0 0 0 0 0 852.07 0 0 0 0 0 0 1403.32 0 0 1010354389 1417303181 48 Rural Health Clinics MASSAC MEMORIAL FAMILY CARE CL 999999999 69 Massac 0 0 0 179 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10865.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10865.07 0 0 1010355813 1023513025 10 Physicians NAVARRETE DEYGER J 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 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 0 542.49 0 0 0 0 0 0 542.49 0 0 1010357634 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25535.18 0 0 0 0 0 0 0 0 0 0 0 0 0 25535.18 0 0 1010359198 1376007393 16 Nurse Practitioners FIGUEROA STEPHANI 999999999 200 Cook 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 0 749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.88 0 0 0 0 0 0 686.88 0 0 1010359798 1598247330 16 Nurse Practitioners FAZLIBASIC STEPHANIE 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 0 289 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 2997.01 0 0 0 0 0 0 2997.01 0 0 1010361939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17362.45 0 0 0 0 0 0 0 0 0 0 0 0 0 17362.45 0 0 1010365137 1063992055 16 Nurse Practitioners SANCHEZ PRINCIPE ROSARIO I 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 329.32 0 0 0 0 0 0 0 0 1039.4 0 0 0 0 0 0 1368.72 0 0 1010366896 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9637.13 0 0 0 0 0 0 0 0 0 0 0 0 0 9637.13 0 0 1010367892 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 0 190 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 17915.44 0 0 0 0 0 0 0 0 0 0 0 0 0 17915.44 0 0 1010369622 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13447.62 0 0 0 0 0 0 0 0 0 0 0 0 0 13447.62 0 0 1010371094 1568803211 89 Physician Assistant Only(Encounter Only) MORAN KATHRYN E 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 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 1694.16 0 0 0 0 0 0 1694.16 0 0 1010374002 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 0 702.55 702.55 0 0 1010375421 1619210820 10 Physicians MOHIUDDIN SYED 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 297 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3451.21 0 973.08 0 0 0 0 0 0 4424.29 0 0 1010377063 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 0 0 0 0 0 0 0 0 0 0 1010378164 1861605990 10 Physicians BOWMAN DEBRA 999999999 106 Whiteside 0 0 Obstetric-Gynecology 0 0 0 2 0 0 0 0 0 0 44 0 40 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 53 0 72 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 53 0 72 0 0 0 0 0 0 0 0 0 15.52 0 0 0 0 0 0 2082.08 0 4523.47 0 0 0 0 0 0 6621.07 0 0 1010378531 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9632.07 0 0 0 0 0 0 0 0 0 0 0 0 0 9632.07 0 0 1010381263 1447735923 16 Nurse Practitioners HA CHAU M 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 1216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2677.9 0 0 0 0 0 0 2677.9 0 0 1010382604 22 Physical Therapists 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 1170.83 1170.83 0 0 1010384365 10 Physicians 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 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 0 313.7 0 0 0 0 0 0 313.7 0 0 1010384544 1194106724 10 Physicians REIZINE NATALIE 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 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 1435.23 0 0 0 0 0 0 1435.23 0 0 1010386920 1154841070 10 Physicians ANDERSON LESLIE 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 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 2999.49 0 0 0 0 0 0 2999.49 0 0 1010387163 1316405590 16 Nurse Practitioners DERER KRISTIN M. 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1373 0 0 0 0 0 0 1373 0 0 1010388964 1003370990 16 Nurse Practitioners MORGAN RANDI M 999999999 80 Peoria 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 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 2216.62 0 0 0 0 0 0 2216.62 0 0 1010390392 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 0 636 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 23508.99 0 0 0 0 0 0 0 0 0 0 0 0 0 23508.99 0 0 1010390473 1649774142 10 Physicians LEE JESSICA G 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 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 2266.86 0 0 0 0 0 0 2266.86 0 0 1010391876 91 Waiver service provider--Adults (DHS/DDD) 107 Will 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767.31 0 0 0 0 0 0 0 0 0 0 0 0 0 767.31 0 0 1010393142 1942615596 10 Physicians CASIMIRO ISABEL 999999999 30 DuPage 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.48 0 0 0 0 0 0 267.48 0 0 1010393779 1134581739 10 Physicians NEILL LUKE 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 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 2700.21 0 0 0 0 0 0 2700.21 0 0 1010393812 1013404151 16 Nurse Practitioners KOLKA LINDA 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 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 0 845.23 0 0 0 0 0 0 845.23 0 0 1010394049 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 1010395989 10 Physicians 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.67 0 0 0 0 0 0 251.67 0 0 1010396901 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16170.57 0 0 0 0 0 0 0 0 0 0 0 0 0 16170.57 0 0 1010397668 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 0 435.67 0 0 0 0 0 0 435.67 0 0 1010397800 1568657328 10 Physicians FRISCIA MARISA 999999999 24 Coles 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 0 176 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 1406.09 0 0 0 0 0 0 1406.09 0 0 1010397945 1043785793 16 Nurse Practitioners DANKS RACHEL L 999999999 109 Winnebago 0 0 0 0 0 12 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 1090.96 0 0 0 0 0 0 0 0 435.34 0 0 0 0 0 0 1526.3 0 0 1010398826 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26730.54 0 0 0 0 0 0 0 0 0 0 0 0 0 26730.54 0 0 1010401540 1003351339 16 Nurse Practitioners WARNECKE JULIE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.25 0 0 0 0 0 0 126.25 0 0 1010401692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4267.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4267.98 0 0 1010402601 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9848.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9848.78 0 0 1010402994 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 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 0 106.89 0 0 0 0 0 0 106.89 0 0 1010405555 1659846624 10 Physicians BORLE ANURADHA 999999999 200 Cook 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 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 2060.56 0 0 0 0 0 0 2060.56 0 0 1010405752 1275018020 16 Nurse Practitioners BROWN ANDREA 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 1188.34 0 0 0 0 0 0 1188.34 0 0 1010407305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41390.92 0 0 0 0 0 0 0 0 0 0 0 0 0 41390.92 0 0 1010407814 1700372174 16 Nurse Practitioners CALANDRIELLO AMY E 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 1601.69 0 0 0 0 0 0 1601.69 0 0 1010408405 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 988.79 0 0 0 0 0 0 0 0 0 0 0 0 0 988.79 0 0 1010409144 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 0 0 0 0 0 0 0 0 0 0 1010411173 1689173965 16 Nurse Practitioners SLATTERY SARAH ANN 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 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 0 442.98 0 0 0 0 0 0 442.98 0 0 1010412240 1366924888 70 Ambulance Service Providers RANDOLPH TOWNSHIP FIRE PROTECT 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9490.61 0 0 0 0 0 0 9490.61 0 0 1010412735 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3117.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3117.62 0 0 1010412950 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 1149 0 0 1010414240 1710416508 10 Physicians IQBAL MOHAMMAD T 999999999 200 Cook 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 0 163 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 1563.21 0 0 0 0 0 0 1563.21 0 0 1010414320 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22882.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22882.64 0 0 1010415964 1487118550 16 Nurse Practitioners CHINAVONG NAOMI 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 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 1011.09 0 0 0 0 0 0 1011.09 0 0 1010415979 1861918914 63 Other Providers of Medical Equipment/Supplies (Non-registered) CRANIAL TECHNOLOGIES 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 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 20651.52 0 0 0 0 0 0 20651.52 0 0 1010417731 1023498714 10 Physicians KAZANTSEV STEPHANIE M 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 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 1859.37 0 0 0 0 0 0 1859.37 0 0 1010418029 1427542307 10 Physicians MALLICK SALEHA 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 2325.33 0 0 0 0 0 0 2325.33 0 0 1010418092 10 Physicians 72 McLean 0 0 Otolaryngology 0 0 0 0 0 0 0 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 25.69 0 0 0 0 0 0 25.69 0 0 1010419266 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 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 0 955.24 0 0 0 0 0 0 955.24 0 0 1010420214 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 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 1010420890 1780179838 30 General Hospitals EDENS HOME DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9748.31 0 0 0 0 0 9748.31 0 0 1010424858 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 1010426089 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.65 0 0 0 0 0 0 25.65 0 0 1010426818 63 Other Providers of Medical Equipment/Supplies (Non-registered) 830 New Hampshire 0 0 0 0 0 0 0 0 0 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 9261.2 0 0 0 0 0 0 9261.2 0 0 1010427752 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 1010428638 1326541970 91 Waiver service provider--Adults (DHS/DDD) "DIVINE TOUCH CILA HOMES, INC." 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 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200947.05 0 0 0 0 0 0 0 0 0 0 0 0 0 200947.05 0 0 1010428756 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 0 140 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 15734.62 0 0 0 0 0 0 0 0 0 0 0 0 0 15734.62 0 0 1010428968 1326577792 10 Physicians O'BRIEN THOMAS 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 0 121 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 3589.4 0 0 0 0 0 0 3589.4 0 0 1010432747 1578880738 10 Physicians COLLINS CATHERINE 999999999 200 Cook 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 0 109 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 20722.14 0 0 0 0 0 0 20722.14 0 0 1010433220 1780188367 36 Community mental health provider IROQUOIS MENTAL HEALTH CENTER 999999999 54 Kankakee 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 251.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21484.31 0 0 21735.75 0 0 1010433489 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12377.68 0 0 0 0 0 0 0 0 0 0 0 0 0 12377.68 0 0 1010434111 1174751440 10 Physicians BHATIA SANJEEV 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 17 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.2 0 2363.6 0 0 0 0 0 0 2582.8 0 0 1010434172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20679.98 0 0 0 0 0 0 0 0 0 0 0 0 0 20679.98 0 0 1010434410 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 3519.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3519.36 0 0 1010434568 1497022826 89 Physician Assistant Only(Encounter Only) LEVERENTZ CHARU 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1233.99 0 0 0 0 0 0 1233.99 0 0 1010435103 1740710029 10 Physicians BERG CAITLYN 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 39 0 0 0 0 0 0 19 0 72 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 22 0 109 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 22 0 109 0 0 0 0 0 0 0 0 0 4793.69 0 0 0 0 0 0 111.37 0 7075.14 0 0 0 0 0 0 11980.2 0 0 1010436770 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 0 219.98 0 0 0 0 0 0 219.98 0 0 1010437979 1164440368 12 Optometrists BLANKENSHIP TIMOTHY J 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 0 270.11 0 0 0 0 0 0 270.11 0 0 1010438999 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 0 128 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 23418.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23418.78 0 0 1010439837 1609226901 10 Physicians WATSON JAMES 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 0 430.48 0 0 0 0 0 0 430.48 0 0 1010441358 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 27603.61 0 0 0 0 0 0 0 0 0 0 0 0 0 27603.61 0 0 1010441895 1851861231 55 Early Intervention Services LOTHSON EMILIE 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 0 227 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 11544.4 0 0 0 0 0 0 11544.4 0 0 1010442958 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3893.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3893.25 0 0 1010445331 1780157024 89 Physician Assistant Only(Encounter Only) BOI KIMBERLY T 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 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 1654.33 0 0 0 0 0 0 1654.33 0 0 1010446378 1376079707 10 Physicians LEE SWAN 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 0 161 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 2808.09 0 0 0 0 0 0 2808.09 0 0 1010446653 1265873111 10 Physicians "CLARK, II RANDALL B" 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1677 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2394 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2394 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16568.9 0 593.21 0 0 0 0 0 0 17162.11 0 0 1010446969 1437667037 89 Physician Assistant Only(Encounter Only) JONES LEIGH 999999999 200 Cook 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 0 301 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 10302.42 0 0 0 0 0 0 10302.42 0 0 1010447533 1013327089 10 Physicians MEHTA SHAMA 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 1860 0 0 0 0 0 0 1860 0 0 1010447678 1437477932 16 Nurse Practitioners BIRD MERIELLE 999999999 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 2012.82 0 0 0 0 0 0 2012.82 0 0 1010448955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16798.46 0 0 0 0 0 0 0 0 0 0 0 0 0 16798.46 0 0 1010450643 1407235518 10 Physicians ONKKA PATRICK E 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 0 102 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 11416.48 0 0 0 0 0 0 11416.48 0 0 1010451668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10869.29 0 0 0 0 0 0 0 0 0 0 0 0 0 10869.29 0 0 1010451704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28952.58 0 0 0 0 0 0 0 0 0 0 0 0 0 28952.58 0 0 1010453503 1275002701 16 Nurse Practitioners CARTER VICTORIA 999999999 91 Sangamon 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 59 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1395.09 0 0 0 0 0 0 1395.09 0 0 1010453720 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8683.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8683.44 0 0 1010453805 1831656362 16 Nurse Practitioners BROWN AARON J. 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 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 0 592.12 0 0 0 0 0 0 592.12 0 0 1010453901 16 Nurse Practitioners 36 Franklin 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 2 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 29.2 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 185.38 0 0 1010454542 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 1010454651 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18705.61 0 0 0 0 0 0 0 0 0 0 0 0 0 18705.61 0 0 1010456067 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11138.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11138.4 0 0 1010456667 1710073416 10 Physicians MONTALTO GREGG J 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 4 0 14 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 136.33 0 0 0 0 0 0 10.37 0 1944.51 0 0 0 0 0 0 2091.21 0 0 1010456760 1346225166 10 Physicians SLONE RICHARD 999999999 91 Sangamon 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 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 0 578.01 0 0 0 0 0 0 0 0 578.01 0 0 1010456988 1760953889 16 Nurse Practitioners GANDHI URVI A 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 0 683.42 0 0 0 0 0 0 683.42 0 0 1010457014 1780140806 89 Physician Assistant Only(Encounter Only) URBACH JESSICA R 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 0 126 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 1062.18 0 0 0 0 0 0 1062.18 0 0 1010457083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24996.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24996.64 0 0 1010457852 1366837171 10 Physicians NOLAN PAUL E 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 343 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5103.85 0 308.83 0 0 0 0 0 0 5412.68 0 0 1010458911 1336615186 11 Dentists SHAH NIKHAR 999999999 109 Winnebago 0 0 0 0 569 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 2783 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 2783 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 96889.31 0 0 0 0 0 0 0 0 0 0 0 11920.3 0 0 0 0 108809.61 0 0 1010458948 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 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 4730.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4730.6 0 0 1010459309 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20122.07 0 0 0 0 0 0 0 0 0 0 0 0 0 20122.07 0 0 1010459798 1942764501 16 Nurse Practitioners LITTLE DEVON N 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 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 0 477.66 0 0 0 0 0 0 477.66 0 0 1010459862 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18998.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18998.45 0 0 1010459916 1861963217 33 Nursing Facilities TRI-STATE VILLAGE NRSG REHAB 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4881 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592862.54 0 0 0 0 0 0 0 592862.54 0 0 1010460110 1093289969 89 Physician Assistant Only(Encounter Only) HANSON COURTNEY A 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 0 248 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 7452.09 0 0 0 0 0 0 7452.09 0 0 1010460756 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17108.89 0 0 0 0 0 0 0 0 0 0 0 0 0 17108.89 0 0 1010461797 1255803052 16 Nurse Practitioners SPANGLER JENNIFER 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 78.63 0 0 0 0 0 0 78.63 0 0 1010461917 1639584030 10 Physicians ROSELMAN JONATHAN M 999999999 200 Cook 0 0 Internal Medicine 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 0 292 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 3074.26 0 0 0 0 0 0 3074.26 0 0 1010461995 1609330596 16 Nurse Practitioners HOERR ANDREA 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 279.22 0 0 0 0 0 0 0 0 498.73 0 0 0 0 0 0 777.95 0 0 1010462000 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 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 1370.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1370.25 0 0 1010462051 1760864755 10 Physicians DENK JENNIFER A 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 0 127 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 3471.01 0 0 0 0 0 0 3471.01 0 0 1010462262 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 24531.92 0 0 0 0 0 0 0 0 0 0 0 0 0 24531.92 0 0 1010463113 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 0 169.02 0 0 0 0 0 0 169.02 0 0 1010464780 1902288210 10 Physicians MAZAHERI PARISA 999999999 200 Cook 0 0 Radiology Diagnosis 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 49 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1272.06 0 141.22 0 0 0 0 0 0 1413.28 0 0 1010467589 1114303302 10 Physicians SIKAVI CAMERON SOLAMAN 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 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 0 559.47 0 0 0 0 0 0 559.47 0 0 1010469185 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 0 131.2 0 0 0 0 0 0 131.2 0 0 1010470454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14743.67 0 0 0 0 0 0 0 0 0 0 0 0 0 14743.67 0 0 1010473651 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12878.95 0 0 0 0 0 0 0 0 0 0 0 0 0 12878.95 0 0 1010475291 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22473.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22473.54 0 0 1010475653 1396134078 10 Physicians NESBIT ERIC G 999999999 200 Cook 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 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 0 281.8 0 0 0 0 0 0 281.8 0 0 1010481284 1962858209 86 Clinical Social Worker(Encounter Only) LEVINSON JENNA 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 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 0 518.49 0 0 0 0 0 0 518.49 0 0 1010481347 1144791807 89 Physician Assistant Only(Encounter Only) BRANNICK ROBERT THOMAS 999999999 200 Cook 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 0 113 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 6205.22 0 0 0 0 0 0 6205.22 0 0 1010482264 1770076929 10 Physicians DAS ANUP 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 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 1626.03 0 0 0 0 0 0 1626.03 0 0 1010482703 1265822928 10 Physicians SERRITELLA ANTHONY V 999999999 30 DuPage 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 0 113 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 0 780.48 0 0 0 0 0 0 780.48 0 0 1010484757 1336614882 89 Physician Assistant Only(Encounter Only) KNIES ASHLEY M 999999999 200 Cook 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 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 0 748.59 0 0 0 0 0 0 748.59 0 0 1010485198 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16258.71 0 0 0 0 0 0 0 0 0 0 0 0 0 16258.71 0 0 1010485459 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18965.52 0 0 0 0 0 0 0 0 0 0 0 0 0 18965.52 0 0 1010485471 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 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 2800.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2800.79 0 0 1010485494 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25958.57 0 0 0 0 0 0 0 0 0 0 0 0 0 25958.57 0 0 1010485575 1154841815 16 Nurse Practitioners DAWSON MEGAN K 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 2408.82 0 0 0 0 0 0 2408.82 0 0 1010485750 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13995.74 0 0 0 0 0 0 0 0 0 0 0 0 0 13995.74 0 0 1010485770 1386161248 11 Dentists JAKKULA CHARLOTTE 999999999 80 Peoria 0 0 General Dentistry 0 0 166 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1409 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1409 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 54129.94 0 0 0 0 0 0 0 0 0 0 0 4516.2 0 0 0 0 58646.14 0 0 1010485866 1104313667 16 Nurse Practitioners GARCIA LAURA M 999999999 24 Coles 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 0 155 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 6720.66 0 0 0 0 0 0 6720.66 0 0 1010485994 1770992935 11 Dentists PATEL NIPA 999999999 30 DuPage 0 0 General Dentistry 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 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 27846.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27846.6 0 0 1010486013 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 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 4387.46 0 0 0 0 0 0 0 0 0 0 0 0 0 4387.46 0 0 1010486015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20536.62 0 0 0 0 0 0 0 0 0 0 0 0 0 20536.62 0 0 1010486097 1396127239 10 Physicians PATEL KRUNAL R 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 1 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 80 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 366.94 0 0 0 0 0 0 0 0 1890.09 0 0 0 0 0 0 2257.03 0 0 1010486162 1487916482 10 Physicians SLATTERY SUSAN M. 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 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 7251.14 0 0 0 0 0 0 7251.14 0 0 1010486496 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14509.42 0 0 0 0 0 0 0 0 0 0 0 0 0 14509.42 0 0 1010486906 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 1010487630 1467947051 23 Occupational Therapists DAGUE NANCY W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70980.51 70980.51 0 0 1010487963 1336637248 74 Hospital-Based Transportation Providers RUSH COPLEY HEALTHCARE CENTER 999999999 55 Kendall 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 0 220 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 20244.63 0 0 0 0 0 0 20244.63 0 0 1010488012 1407146657 10 Physicians WEBER BRENT 999999999 24 Coles 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 0 140 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 4937.06 0 0 0 0 0 0 4937.06 0 0 1010488133 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5949.55 0 0 0 0 0 0 0 0 0 0 0 0 0 5949.55 0 0 1010488218 1508192923 10 Physicians KUDSI JIHAD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 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 1.57 0 581.78 0 0 0 0 0 0 583.35 0 0 1010488251 1720368145 10 Physicians VELY AELA P 999999999 47 Jackson 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 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 0 811.19 0 0 0 0 0 0 811.19 0 0 1010488325 10 Physicians 66 Marion 0 0 0 0 0 0 0 0 0 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 0 380.72 0 0 0 0 0 0 380.72 0 0 1010488461 1639663446 60 Pharmacies ELIZABETH PHARMACY 999999999 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1670.26 0 0 0 1670.26 0 0 1010488469 1851864839 16 Nurse Practitioners DESPE JOYCE 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 0 209.92 0 0 0 0 0 0 209.92 0 0 1010489117 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010489156 1720597891 89 Physician Assistant Only(Encounter Only) EMMERICH KATELYN 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 0 232.84 0 0 0 0 0 0 232.84 0 0 1010489210 1902972524 89 Physician Assistant Only(Encounter Only) HUISMAN ANGELA 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 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3749.93 0 0 0 0 0 0 3749.93 0 0 1010489409 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 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 4678.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4678.52 0 0 1010489423 1295104784 86 Clinical Social Worker(Encounter Only) GARCIA AMY 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 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 1938.45 0 0 0 0 0 0 1938.45 0 0 1010489597 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22315.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22315.63 0 0 1010489804 1427315423 10 Physicians LARSEN PAUL 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 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 34.61 0 0 0 0 0 0 34.61 0 0 1010489829 1346787058 60 Pharmacies BELMONT & WESTERN FARMACIA LLC 999999999 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 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6834 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11099.5 0 0 0 11099.5 0 0 1010489882 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20954.06 0 0 0 0 0 0 0 0 0 0 0 0 0 20954.06 0 0 1010489993 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6910.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6910.24 0 0 1010490080 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22484.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22484.04 0 0 1010490202 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14578.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14578.6 0 0 1010490326 1700224573 10 Physicians XU HANNA 999999999 200 Cook 0 0 Family Practice 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 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 1019.26 0 0 0 0 0 0 1019.26 0 0 1010490482 1497265011 89 Physician Assistant Only(Encounter Only) VOLLMER ELIZABETH 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 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 0 564.56 0 0 0 0 0 0 564.56 0 0 1010490608 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22344.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22344.13 0 0 1010490992 1841586211 10 Physicians COHN AARON 999999999 200 Cook 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4193.36 0 0 0 0 0 0 4193.36 0 0 1010491263 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.42 0 0 0 0 0 0 0 0 105.42 0 0 1010491545 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 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 1706.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1706.72 0 0 1010491579 1568818060 87 Psychologist(Encounter Only) BROWN DANIEL S 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 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 0 340.29 0 0 0 0 0 0 340.29 0 0 1010491639 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1582.82 0 0 0 0 0 0 0 0 0 0 0 0 0 1582.82 0 0 1010491943 1982990065 10 Physicians NGUYEN KIM-PHUNG 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 0 135 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 4057.8 0 0 0 0 0 0 4057.8 0 0 1010492060 1144729716 65 Independent Diagnostic Testing Facility (IDTF) "HSHS IMAGING CENTER, BELLEVILL" 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.86 0 0 0 0 0 0 0 0 162.86 0 0 1010492135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2292.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2292.55 0 0 1010492182 1083670111 10 Physicians ROSEN MARIANNE 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1172.56 0 0 0 0 0 0 1172.56 0 0 1010492222 1801814108 10 Physicians BERGOM MICHAEL 999999999 96 St Clair 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 0 173 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 3502.81 0 0 0 0 0 0 3502.81 0 0 1010492432 1386999001 10 Physicians GILLETTE KRISTI 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.9 0 0 0 0 0 0 45.9 0 0 1010492804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11288.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11288.52 0 0 1010492950 1639581937 44 Healthy Kids (EPSDT) screening clinics COORDINATED YOUTH AND HUMAN SE 620404657 65 Madison 0 0 0 0 0 145 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 2417.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2417.92 0 0 1010493146 1699270488 10 Physicians KANG IAN 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 0 136 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 2967.95 0 0 0 0 0 0 2967.95 0 0 1010493225 1053845909 16 Nurse Practitioners SEABAUGH REBECCA 999999999 87 Randolph 0 0 0 0 0 0 0 0 0 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 14490.75 0 0 0 0 0 0 14490.75 0 0 1010493253 1205348976 89 Physician Assistant Only(Encounter Only) MONTOYA CASTILLO JOHANNA C. 999999999 30 DuPage 0 0 0 0 0 17 0 0 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 621 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 621 0 0 0 0 0 0 0 0 0 1008.4 0 0 0 0 0 0 0 0 20612.59 0 0 0 0 0 0 21620.99 0 0 1010493323 10 Physicians 96 St Clair 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 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 0 208.62 0 0 0 0 0 0 208.62 0 0 1010493424 14 Chiropractors 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.61 0 0 0 0 0 0 1.61 0 0 1010493661 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 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 10898.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10898.36 0 0 1010493818 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 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 0 235.44 0 0 0 0 0 0 235.44 0 0 1010493852 1861628364 10 Physicians SHANKARAN SHIVANJALI 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 0 157 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 1508.56 0 0 0 0 0 0 1508.56 0 0 1010494023 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 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 2428.4 2428.4 0 0 1010494235 1083159982 16 Nurse Practitioners KOTZ-JOOB NANETTE S 999999999 200 Cook 0 0 0 0 0 22 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 1868.64 0 0 0 0 0 0 0 0 1681.86 0 0 0 0 0 0 3550.5 0 0 1010494707 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 0 182 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 18514.43 0 0 0 0 0 0 0 0 0 0 0 0 0 18514.43 0 0 1010494926 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.7 0 0 0 0 0 0 194.7 0 0 1010494970 1609295518 10 Physicians DWADASI SUJAATA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 1 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.23 0 0 6618.54 0 0 0 0 0 0 6701.77 0 0 1010495043 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10762.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10762.84 0 0 1010495122 1912414327 89 Physician Assistant Only(Encounter Only) HILTON EMILY 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 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 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1010495427 1831281914 33 Nursing Facilities WINDSOR PARK MANOR 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 716 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48688.95 0 0 0 0 0 0 0 48688.95 0 0 1010495569 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 23261.16 0 0 0 0 0 0 0 0 0 0 0 0 0 23261.16 0 0 1010495629 10 Physicians 30 DuPage 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 0 147.26 0 0 0 0 0 0 147.26 0 0 1010495719 1003268061 87 Psychologist(Encounter Only) LANCASTER MELISSA A 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 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 0 384.86 0 0 0 0 0 0 384.86 0 0 1010495887 1831531300 10 Physicians SCHINDLER THOMAS 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 758.15 0 0 0 0 0 0 758.15 0 0 1010495907 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1446.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1446.49 0 0 1010496234 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15875.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15875.35 0 0 1010496255 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 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 8.8 0 93.03 0 0 0 0 0 0 101.83 0 0 1010496279 1528279031 10 Physicians CARMICHAEL JASON 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 735 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 929 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 929 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12282.53 0 90.2 0 0 0 0 0 0 12372.73 0 0 1010496535 1003223470 10 Physicians ACKERSON ELIZABETH 999999999 19 Champaign 0 0 Emergency Medicine 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 0 148 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 3441.2 0 0 0 0 0 0 3441.2 0 0 1010496551 1780138925 16 Nurse Practitioners LAUB CAROLINE 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 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 0 125.97 0 0 0 0 0 0 125.97 0 0 1010496773 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 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 1010496826 1023548054 10 Physicians LABADIE BRIAN 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 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 0 690.14 0 0 0 0 0 0 690.14 0 0 1010497380 1669961074 55 Early Intervention Services WALK MELANIE E 999999999 26 Cumberland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31022.9 0 0 0 0 0 0 31022.9 0 0 1010497389 1912313883 10 Physicians WINDISH STEPHANIE A 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 0 123 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 1891.3 0 0 0 0 0 0 1891.3 0 0 1010497397 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11755.92 0 0 0 0 0 0 0 0 0 0 0 0 0 11755.92 0 0 1010497532 1669883914 10 Physicians DE LOS REYES SAMANTHA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 45 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1744.04 0 2933.71 0 0 0 0 0 0 4677.75 0 0 1010497578 1962960138 16 Nurse Practitioners TYLER MARGUERITE 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 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 0 354.89 0 0 0 0 0 0 354.89 0 0 1010497667 1730632407 16 Nurse Practitioners HUTSON JOANNA 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 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 1025.65 0 0 0 0 0 0 1025.65 0 0 1010498040 1720416274 22 Physical Therapists MARCOTTE ANGELA P 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 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 13192.96 13192.96 0 0 1010498147 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 31.01 0 0 0 0 0 0 31.01 0 0 1010498477 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13250.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13250.98 0 0 1010498651 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 1010498850 1043638570 10 Physicians PETRAS KATARINA G 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 0 181 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 2911.25 0 0 0 0 0 0 2911.25 0 0 1010499020 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 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 3718.45 0 0 0 0 0 0 0 0 0 0 0 0 0 3718.45 0 0 1010499099 1689150948 16 Nurse Practitioners WEIS BARBARA 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 2 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 975.13 0 0 0 0 0 0 1039.43 0 0 1010499368 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 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 8354.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8354.5 0 0 1010499501 1427585272 10 Physicians BUSH BRIAN R 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8337.86 0 0 0 0 0 0 8337.86 0 0 1010499873 1760975544 89 Physician Assistant Only(Encounter Only) PEREZ KAYLEE 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 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 0 103.89 0 0 0 0 0 0 103.89 0 0 1010499894 1992187074 10 Physicians DESTEFANI MATTHEW THOMAS 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 5792.33 0 0 0 0 0 0 5792.33 0 0 1010499932 1003315680 60 Pharmacies MEIJER PHARMACY #301 999999999 54 Kankakee 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 0 898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24417 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38913.09 0 0 0 38913.09 0 0 1010499978 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1338.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1338.3 0 0 1010500066 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 0 523.04 523.04 0 0 1010500077 1487077194 10 Physicians SHEIKH SHAMLAN M 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 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6072.57 0 0 0 0 0 0 6072.57 0 0 1010500367 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8047.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8047.44 0 0 1010500785 1427303585 89 Physician Assistant Only(Encounter Only) MCNULTY JESSICA L 999999999 53 Kane 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 0 102 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 4774.18 0 0 0 0 0 0 4774.18 0 0 1010500888 1609398973 16 Nurse Practitioners PALERMO AMANDA R 999999999 57 Lake 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 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 4319.42 0 0 0 0 0 0 4319.42 0 0 1010500908 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8765.52 0 0 0 0 0 0 0 0 0 0 0 0 0 8765.52 0 0 1010501070 1649685306 10 Physicians BECHIR GEORGE H 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 0 134 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 4284.43 0 0 0 0 0 0 4284.43 0 0 1010501120 1124593462 89 Physician Assistant Only(Encounter Only) STEEN MACKENZIE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010501473 1144583105 10 Physicians MITCHELL ALLISON D 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 2707.92 0 0 0 0 0 0 2707.92 0 0 1010501789 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 5 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 2850.42 2850.42 0 0 1010501897 1598148314 24 Speech Therapists ZUERCHER ALLISON N 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 0 167 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 12457.28 12457.28 0 0 1010501969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 13658.92 0 0 0 0 0 0 0 0 0 0 0 0 0 13658.92 0 0 1010503394 89 Physician Assistant Only(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 42.14 0 0 0 0 0 0 42.14 0 0 1010503533 1225408289 16 Nurse Practitioners JAFRI EJAZ N 999999999 30 DuPage 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 0 783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 783 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14688.8 0 0 0 0 0 0 14688.8 0 0 1010503568 1013472406 16 Nurse Practitioners YORK GRETCHEN 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.05 0 0 0 0 0 0 126.05 0 0 1010503588 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 39.86 0 0 0 0 0 0 39.86 0 0 1010503653 1568878718 10 Physicians MALGHANI SHAHRUKH 999999999 53 Kane 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 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6710.22 0 0 0 0 0 0 6710.22 0 0 1010503679 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 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 1599.06 1599.06 0 0 1010503687 1376902908 16 Nurse Practitioners KRAL DIANE 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 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4076.56 0 0 0 0 0 0 4076.56 0 0 1010503779 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 4 0 0 0 0 0 0 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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Physicians SIDDHARTH SAPNA 999999999 91 Sangamon 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 0 171 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 4043.62 0 0 0 0 0 0 4043.62 0 0 1010506036 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010506185 1144798299 16 Nurse Practitioners FLOWERS DIANA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 304 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 930 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138200.29 0 0 0 0 0 0 138200.29 0 0 1010506511 1316439235 11 Dentists AWAIS SALIHA S 999999999 200 Cook 0 0 0 0 153 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 25336.29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25336.29 0 0 1010506798 92 Waiver service 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1010507795 1073086252 16 Nurse Practitioners FAIRHURST SCOTT 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 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 0 210.24 0 0 0 0 0 0 210.24 0 0 1010508000 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 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 1603.76 0 0 0 0 0 0 1603.76 0 0 1010508085 10 Physicians 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 39.86 0 0 0 0 0 0 39.86 0 0 1010508124 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1207.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1207.02 0 0 1010508351 16 Nurse Practitioners 19 Champaign 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MILINCIC ALLISON 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 22.66 0 0 0 0 0 0 22.66 0 0 1010510208 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6620.57 0 0 0 0 0 0 0 0 0 0 0 0 0 6620.57 0 0 1010510305 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 83.23 0 0 0 0 0 0 83.23 0 0 1010510446 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21873.56 0 0 0 0 0 0 0 0 0 0 0 0 0 21873.56 0 0 1010510700 91 Waiver service provider--Adults (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 1 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 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 2846.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2846.1 0 0 1010511825 1063774735 10 Physicians ISLAM SHERAZAD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 501 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8058.33 0 1318.87 0 0 0 0 0 0 9377.2 0 0 1010511903 1285118356 16 Nurse Practitioners WATSON ANNA 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 0 102 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 0 653.64 0 0 0 0 0 0 653.64 0 0 1010512141 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 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 0 251.75 251.75 0 0 1010512161 1851380570 89 Physician Assistant Only(Encounter Only) REESE ANDREW S 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Waiver service provider--Elderly (DOA) XILIN ASSOCIATION 999999999 30 DuPage 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 4756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462966.65 0 0 0 0 0 0 0 0 0 0 0 0 0 462966.65 0 0 1010514368 1760688428 10 Physicians MUNACO ANTHONY J 616151941 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 0 188 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 13659.05 0 0 0 0 0 0 13659.05 0 0 1010514394 1821561291 33 Nursing Facilities LANDMARK OF RICHTON PARK 999999999 200 Cook 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 0 385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125429.12 0 0 0 0 0 0 0 1125429.12 0 0 1010514404 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 22361.82 0 0 0 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0 0 43.54 0 0 0 0 0 0 43.54 0 0 1010514860 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 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 1073.3 1073.3 0 0 1010515019 1053593780 10 Physicians BHAMA ANURADHA 999999999 200 Cook 0 0 Colon - Rectal Surgery 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 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 0 801.16 0 0 0 0 0 0 801.16 0 0 1010515139 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25529.23 0 0 0 0 0 0 0 0 0 0 0 0 0 25529.23 0 0 1010515202 1063737799 10 Physicians WICK CAMERON C 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1799.17 0 0 0 0 0 0 1799.17 0 0 1010516406 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 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 0 334.16 0 0 0 0 0 0 0 0 0 0 0 0 0 334.16 0 0 1010516426 10 Physicians 10 Adams 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010516515 1548569858 10 Physicians KHOURY CHARBEL C 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 6 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2162.11 0 0 0 0 0 0 2162.11 0 0 1010516613 55 Early Intervention Services 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 0 430 0 0 0 0 0 0 430 0 0 1010516890 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1010517015 88 Other behavior health professional 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 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 0 838.36 0 0 0 0 0 0 838.36 0 0 1010517049 1295761724 89 Physician Assistant Only(Encounter Only) LENDERMAN MELISSA 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 0 130.19 0 0 0 0 0 0 130.19 0 0 1010517052 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6933.15 0 0 0 0 0 0 0 0 0 0 0 0 0 6933.15 0 0 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1679066146 22 Physical Therapists YEE VANESSA C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 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 2414.68 2414.68 0 0 1010519374 1205292059 89 Physician Assistant Only(Encounter Only) JOHNSON BROOKE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 615.74 0 0 0 0 0 0 647.74 0 0 1010519406 1437648755 16 Nurse Practitioners MEDLER KRISIE L 999999999 69 Massac 0 0 0 0 0 0 0 0 0 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 0 205.76 0 0 0 0 0 0 205.76 0 0 1010519450 10 Physicians 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 43.54 0 0 0 0 0 0 43.54 0 0 1010519988 1477062651 16 Nurse Practitioners FORTIER VALERIE 999999999 80 Peoria 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 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 4595.87 0 0 0 0 0 0 4595.87 0 0 1010520036 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 62188.29 0 0 0 0 0 0 0 0 0 0 0 0 0 62188.29 0 0 1010520149 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21924.24 0 0 0 0 0 0 0 0 0 0 0 0 0 21924.24 0 0 1010520319 1841767084 89 Physician Assistant Only(Encounter Only) STRAWSER CODY J 999999999 19 Champaign 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 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 1386.47 0 0 0 0 0 0 1386.47 0 0 1010520610 10 Physicians 80 Peoria 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 0 180.12 0 0 0 0 0 0 180.12 0 0 1010521154 1780186049 16 Nurse Practitioners MELENDEZ KRISTIN 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 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 0 485.54 0 0 0 0 0 0 485.54 0 0 1010521246 1558650697 10 Physicians TOTH-MANIKOWSKI STEPHANIE 999999999 200 Cook 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 0 258 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 2858.27 0 0 0 0 0 0 2858.27 0 0 1010521877 1407366842 16 Nurse Practitioners JONES JEANICE D 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 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 0 729.74 0 0 0 0 0 0 729.74 0 0 1010521935 91 Waiver service provider--Adults (DHS/DDD) 75 Monroe 0 0 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 4110.7 0 0 0 0 0 0 0 0 0 0 0 0 0 4110.7 0 0 1010522309 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14425.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14425.9 0 0 1010522322 1891921235 10 Physicians ALLISON DAVID 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.3 0 547.2 0 0 0 0 0 0 735.5 0 0 1010522389 1336623917 16 Nurse Practitioners GANDEZA FAYE 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 1.05 0 0 0 0 0 0 1.05 0 0 1010522555 1821288499 10 Physicians VEDATI DURGA P 999999999 200 Cook 0 0 Family 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 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 1182.04 0 0 0 0 0 0 1182.04 0 0 1010522596 1275562951 10 Physicians LLANA ANGELO 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 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 0 106.6 0 0 0 0 0 0 106.6 0 0 1010522683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24546.82 0 0 0 0 0 0 0 0 0 0 0 0 0 24546.82 0 0 1010522821 1871830141 89 Physician Assistant Only(Encounter Only) JOHNSTON GLENNON 999999999 200 Cook 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010526321 1588182281 16 Nurse Practitioners RYAN SUSANNE 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 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 2879.59 0 0 0 0 0 0 2879.59 0 0 1010526370 1447715420 16 Nurse Practitioners PYTEL TETYANA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 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 12.88 0 0 0 0 0 0 0 0 1248.95 0 0 0 0 0 0 1261.83 0 0 1010526401 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1010527046 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 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0 0 108.45 0 0 0 0 0 0 108.45 0 0 1010527788 1144733783 16 Nurse Practitioners VANNORSDEL REBECCA A 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 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 0 334.72 0 0 0 0 0 0 334.72 0 0 1010527936 1336650035 23 Occupational Therapists DUNCAN MELISSA 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 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 7162.12 7162.12 0 0 1010528208 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4262.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4262.25 0 0 1010528625 1215128194 10 Physicians TIHONOV NIKITA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 7 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 255 0 0 0 0 0 0 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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 22996.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22996.57 0 0 1010542604 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 0 466.06 0 0 0 0 0 0 466.06 0 0 1010542847 1134572340 10 Physicians BOSTON VINCENT L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 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 8102.14 0 0 0 0 0 0 8102.14 0 0 1010542938 1780108985 36 Community mental health provider NORTH CENTRAL BEHAVIORAL HEALT 999999999 58 La Salle 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409 0 0 1187.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32707.12 0 0 33894.56 0 0 1010542956 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18504.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18504.4 0 0 1010543058 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11375.65 0 0 0 0 0 0 0 0 0 0 0 0 0 11375.65 0 0 1010543409 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 0 150.2 0 0 0 0 0 0 150.2 0 0 1010543782 1275056236 12 Optometrists RODRIGUEZ JAVIER R 999999999 71 McHenry 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 52 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2663.5 0 1141.92 0 0 0 0 3805.42 0 0 1010543909 1376905323 10 Physicians NAZE SAWYER A 999999999 200 Cook 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 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 0 489.11 0 0 0 0 0 0 489.11 0 0 1010543923 10 Physicians 200 Cook 0 0 General 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 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 0 134.44 0 0 0 0 0 0 134.44 0 0 1010544326 4010544326 16 Nurse Practitioners LILLWITZ ANNE MARIE 999999999 200 Cook 0 0 0 0 0 11 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 846.58 0 0 0 0 0 0 0 0 2259.94 0 0 0 0 0 0 3106.52 0 0 1010544329 1861942344 48 Rural Health Clinics COMMUNITY MEDICAL CLINIC OF NO 620751647 76 Montgomery 0 0 0 29 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3070.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3070.08 0 0 1010544598 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8023.37 0 0 0 0 0 0 0 0 0 0 0 0 0 8023.37 0 0 1010544664 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 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 1010544739 1770569048 10 Physicians DONIS JOSHUA 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 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 0 351.51 0 0 0 0 0 0 351.51 0 0 1010545455 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28505.69 0 0 0 0 0 0 0 0 0 0 0 0 0 28505.69 0 0 1010545638 10 Physicians 200 Cook 0 0 Preventive 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 1010545649 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7525.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7525.09 0 0 1010545817 1548754542 10 Physicians RANJHA SUHAYB 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 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 2318.27 0 0 0 0 0 0 2318.27 0 0 1010545832 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9759.95 0 0 0 0 0 0 0 0 0 0 0 0 0 9759.95 0 0 1010546084 1629515606 89 Physician Assistant Only(Encounter Only) MILLER KIRK W 999999999 108 Williamson 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 0 179 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 1610.32 0 0 0 0 0 0 1610.32 0 0 1010546203 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 21294.24 0 0 0 0 0 0 0 0 0 0 0 0 0 21294.24 0 0 1010546545 1174961999 10 Physicians KASSIM OLUFEMI 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 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 3218 0 0 0 0 0 0 3218 0 0 1010546659 1750373189 10 Physicians KHAN SHAGUFTA 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 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 9 0 0 0 0 0 0 0 0 0 161.42 0 0 0 0 0 0 0 0 441.18 0 0 0 0 0 0 602.6 0 0 1010547344 1053402735 16 Nurse Practitioners HENDRICKS JENNIFER A 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 189.47 0 0 0 0 0 0 0 0 1284.32 0 0 0 0 0 0 1473.79 0 0 1010547481 1033626254 33 Nursing Facilities PRAIRIE CREEK VILLAGE 999999999 63 Macon 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 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4503 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356222.74 0 0 0 0 0 0 0 356222.74 0 0 1010547532 86 Clinical Social Worker(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 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 1021.63 0 0 0 0 0 0 1021.63 0 0 1010547544 1740794882 60 Pharmacies CVS PHARMACY #18039 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 481 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 14542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.49 0 0 13915.2 0 0 0 14032.69 0 0 1010547840 1699933903 10 Physicians JOHNSON WILLIAM A 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 2 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1733.22 0 0 0 0 0 0 1733.22 0 0 1010548052 1568494771 10 Physicians OLSON JOHN 999999999 10 Adams 0 0 Neurology Surgery 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 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 3012.22 0 0 0 0 0 0 3012.22 0 0 1010548069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1208.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1208.25 0 0 1010548313 1518147693 10 Physicians PARK SOOK HYEON 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 0 157 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 0 481.76 0 0 0 0 0 0 481.76 0 0 1010548449 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 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 0 190.11 190.11 0 0 1010548685 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 25673.52 0 0 0 0 0 0 0 0 0 0 0 0 0 25673.52 0 0 1010548718 1326300120 10 Physicians HUNG ADELINA 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 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 3303.7 0 0 0 0 0 0 3303.7 0 0 1010548860 1356640601 10 Physicians PHAN PETER-TRUNG D 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 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 0 693.45 0 0 0 0 0 0 693.45 0 0 1010548882 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 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 0 346.56 0 0 0 0 0 0 346.56 0 0 1010548981 1134697683 11 Dentists KERMANI GHAZAL 999999999 200 Cook 0 0 General Dentistry 0 0 65 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 369 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 10357.87 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 11110.57 0 0 1010549839 1366896631 16 Nurse Practitioners LUZENTALES JENNIFER 999999999 200 Cook 0 0 0 0 0 12 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 714.6 0 0 0 0 0 0 0 0 1391.01 0 0 0 0 0 0 2105.61 0 0 1010549937 1912418799 16 Nurse Practitioners HOLTMAN CHASE 999999999 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 0 637.56 0 0 0 0 0 0 637.56 0 0 1010550123 1396184446 10 Physicians POWELL KEISHA 999999999 91 Sangamon 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 0 237 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 9977.1 0 0 0 0 0 0 9977.1 0 0 1010550178 1437696119 60 Pharmacies KIRKS PHARMACY LLC 628221222 36 Franklin 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351.21 0 0 0 1351.21 0 0 1010550218 1144725987 10 Physicians KRAFT MICHAEL 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 259.56 0 0 0 0 0 0 0 0 908.83 0 0 0 0 0 0 1168.39 0 0 1010550310 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17273.08 0 0 0 0 0 0 0 0 0 0 0 0 0 17273.08 0 0 1010550329 1306829775 89 Physician Assistant Only(Encounter Only) WACHTEL JESSICA 999999999 200 Cook 0 0 0 0 0 12 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 1160.46 0 0 0 0 0 0 0 0 1629.58 0 0 0 0 0 0 2790.04 0 0 1010550409 91 Waiver service provider--Adults (DHS/DDD) 15 Bureau 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252 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 66473.86 0 0 0 0 0 0 0 0 0 0 0 0 0 66473.86 0 0 1010550863 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1010550934 1366741688 10 Physicians KHO JANELLE P 999999999 30 DuPage 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 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 0 326.37 0 0 0 0 0 0 326.37 0 0 1010551121 1003327834 16 Nurse Practitioners STANN-MCCARTHY TANYA 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 0 308.75 0 0 0 0 0 0 308.75 0 0 1010551378 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 1010551429 1447746201 16 Nurse Practitioners OBMAN SUSAN 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 0 107 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 0 172.76 0 0 0 0 0 0 172.76 0 0 1010551634 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22801.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22801.2 0 0 1010551692 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12569.52 0 0 0 0 0 0 0 0 0 0 0 0 0 12569.52 0 0 1010551939 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.44 149.44 0 0 1010551940 1043791445 16 Nurse Practitioners OSLUND JESSICA 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.86 0 0 0 0 0 0 406.86 0 0 1010552162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10482.44 0 0 0 0 0 0 0 0 0 0 0 0 0 10482.44 0 0 1010552242 1104191444 10 Physicians AHMED SAMEER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 89 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404.12 0 1112.74 0 0 0 0 0 0 1516.86 0 0 1010552377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18119.64 0 0 0 0 0 0 0 0 0 0 0 0 0 18119.64 0 0 1010552405 1104113091 10 Physicians PATEL NILAM B 999999999 53 Kane 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 5 0 18 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 29 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 29 0 0 0 0 0 0 0 0 0 274.89 0 0 0 0 0 0 172.72 0 595.94 0 0 0 0 0 0 1043.55 0 0 1010552550 1710451588 23 Occupational Therapists WELDING MARIA 999999999 10 Adams 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 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 1465.68 1465.68 0 0 1010552632 91 Waiver service provider--Adults (DHS/DDD) 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 0 256 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 18184.76 0 0 0 0 0 0 0 0 0 0 0 0 0 18184.76 0 0 1010552702 1790273837 36 Community mental health provider AID ANTHONY PLACE 999999999 55 Kendall 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 12636.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32748.91 0 0 45385.71 0 0 1010552753 1417067521 90 Waiver service provider--Elderly (DOA) LIFECARE HOME HEALTH & IN HOME 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 4591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497817.45 0 0 0 0 0 0 0 0 0 0 0 0 0 497817.45 0 0 1010553062 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 85.88 0 0 0 0 0 0 85.88 0 0 1010553132 1134119902 10 Physicians CARROLL JOHN 999999999 47 Jackson 0 0 Radiology Diagnosis 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 8 0 1 0 0 0 0 0 0 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 0 160.4 0 10.08 0 0 0 0 0 0 170.48 0 0 1010553249 1861874349 11 Dentists KOSTELAC JACLYN S 999999999 65 Madison 0 0 Orthodontist 0 0 49 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 34770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34770 0 0 1010553297 10 Physicians 90 Saline 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1010553747 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 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 46.94 0 0 0 0 0 0 46.94 0 0 1010554449 1235648221 89 Physician Assistant Only(Encounter Only) WOODRUFF MATTHEW 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 553.22 0 0 0 0 0 0 553.22 0 0 1010554524 1528473170 10 Physicians DHARMAPURI SANJAYA 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 0 276 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 10143.86 0 0 0 0 0 0 10143.86 0 0 1010554565 1548762412 55 Early Intervention Services SCOTT BRENDA K 999999999 107 Will 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 1046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1046 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61395.1 0 0 0 0 0 0 61395.1 0 0 1010554706 1740608058 10 Physicians BARDOLPH SUSAN 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 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 0 703.69 0 0 0 0 0 0 703.69 0 0 1010554750 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9537.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9537.8 0 0 1010554966 1073093803 16 Nurse Practitioners CONSTANTINESCU CORINA 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 0 107 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 3699.67 0 0 0 0 0 0 3699.67 0 0 1010555256 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 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 6015.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6015.1 0 0 1010555260 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 21526.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21526.5 0 0 1010555362 1336590249 10 Physicians BROWN JEFFREY 999999999 89 Rock Island 0 0 Emergency 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 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 3519.51 0 0 0 0 0 0 3519.51 0 0 1010555463 1952667982 10 Physicians CASINI REBECCA ANNE 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 1652.12 0 0 0 0 0 0 1652.12 0 0 1010555561 10 Physicians 91 Sangamon 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 52.15 0 0 0 0 0 0 0 0 52.15 0 0 1010556423 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.54 0 0 0 0 0 0 36.54 0 0 1010556615 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16898.64 0 0 0 0 0 0 0 0 0 0 0 0 0 16898.64 0 0 1010556827 1699074237 10 Physicians KUPER SPENCER G 999999999 91 Sangamon 0 0 Obstetric-Gynecology 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 20 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.24 0 411.25 0 0 0 0 0 0 737.49 0 0 1010557009 1417497165 16 Nurse Practitioners BRISBOIS JOSEPH A 999999999 57 Lake 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 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1570 0 0 0 0 0 0 1570 0 0 1010557075 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30889.51 0 0 0 0 0 0 0 0 0 0 0 0 0 30889.51 0 0 1010557533 1396087318 10 Physicians CHANG LAURA S. 999999999 200 Cook 0 0 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 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 1483.13 0 0 0 0 0 0 1483.13 0 0 1010557672 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22898.82 0 0 0 0 0 0 0 0 0 0 0 0 0 22898.82 0 0 1010557757 10 Physicians 200 Cook 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 84.28 0 0 0 0 0 0 84.28 0 0 1010557853 1134534654 10 Physicians FONGE JOHN N 999999999 80 Peoria 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 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 5079.16 0 0 0 0 0 0 5079.16 0 0 1010557981 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 0 156 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 15340.98 0 0 0 0 0 0 0 0 0 0 0 0 0 15340.98 0 0 1010558189 1861985194 60 Pharmacies RECEPT PHARMACY #125 999999999 200 Cook 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 0 493 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137426.4 0 0 0 137426.4 0 0 1010558456 1770072340 16 Nurse Practitioners FERRELL SHAWNDRA L. 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 0 116 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 0 0 0 0 0 0 0 0 0 0 1010558628 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23244.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23244.25 0 0 1010558646 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20130.22 0 0 0 0 0 0 0 0 0 0 0 0 0 20130.22 0 0 1010558657 1881183580 16 Nurse Practitioners GROZA DELIA M 999999999 200 Cook 0 0 0 0 0 19 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 784.66 0 0 0 0 0 0 0 0 7530.06 0 0 0 0 0 0 8314.72 0 0 1010558831 1316328982 10 Physicians NIGHOHOSSIAN KYLA 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 0 507 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 30675.43 0 0 0 0 0 0 30675.43 0 0 1010559087 1558701151 10 Physicians HINCKER ALEXANDER M 999999999 109 Winnebago 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 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 1266.35 0 0 0 0 0 0 1266.35 0 0 1010559236 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4323.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4323.61 0 0 1010559328 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 5 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 4386.48 4386.48 0 0 1010559470 1164882379 60 Pharmacies ERIE TELEPHARMACY 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905.49 0 0 0 905.49 0 0 1010559488 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.08 0 0 0 0 0 0 87.08 0 0 1010559904 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 1010559943 1033504212 10 Physicians PARK PETER S 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 0 291 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 2468.29 0 0 0 0 0 0 2468.29 0 0 1010560384 1861979189 16 Nurse Practitioners ROCHE JESSICA 999999999 57 Lake 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 0 195 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 3245.9 0 0 0 0 0 0 3245.9 0 0 1010560580 1952692949 10 Physicians POUPPIRT NICOLE 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 0 142 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 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0 0 0 0 0 0 0 0 0 0 0 707.95 0 0 0 0 0 0 707.95 0 0 1010561605 1083105878 11 Dentists ROO KUNMIN 999999999 98 Tazewell 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 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2386.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2386.32 0 0 1010561657 1265799282 10 Physicians KELAHAN LINDA C 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 323 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 417 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5680.72 0 26.76 0 0 0 0 0 0 5707.48 0 0 1010561697 1659878635 16 Nurse Practitioners MODIEH LENA D 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 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 1024.46 0 0 0 0 0 0 1024.46 0 0 1010561883 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 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 3220.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3220.47 0 0 1010562081 1699262550 16 Nurse Practitioners FARRIS LORI A 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1900.28 0 0 0 0 0 0 1932.43 0 0 1010562440 1841756293 89 Physician Assistant Only(Encounter Only) NIELSEN CARLY L 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 0 283.56 0 0 0 0 0 0 283.56 0 0 1010562690 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35289.86 0 0 0 0 0 0 0 0 0 0 0 0 0 35289.86 0 0 1010562768 16 Nurse Practitioners 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.85 0 0 0 0 0 0 18.85 0 0 1010562794 1629553888 16 Nurse Practitioners CECCHETTI LAUREN 999999999 106 Whiteside 0 0 0 0 0 2 0 0 0 0 0 0 0 0 30 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 64.3 0 0 0 0 0 0 0 0 630.12 0 0 0 0 0 0 694.42 0 0 1010562824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 762.65 0 0 0 0 0 0 0 0 0 0 0 0 0 762.65 0 0 1010562852 1972950103 10 Physicians SAAVEDRA MARIA F 999999999 53 Kane 0 0 Pediatrics 0 0 0 5 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 163 0 0 0 0 0 0 0 0 0 593.64 0 0 0 0 0 0 0 0 5647.89 0 0 0 0 0 0 6241.53 0 0 1010562974 1790923324 10 Physicians SHEEHAN JESSICA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 81.3 0 0 0 0 0 0 81.3 0 0 1010563196 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010563204 1538653894 16 Nurse Practitioners PALKA NATALIE A 999999999 54 Kankakee 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 2762 0 0 0 0 0 0 2762 0 0 1010563366 1518315092 22 Physical Therapists HARE ELIZABETH 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 0 264 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 21464.88 21464.88 0 0 1010563902 1003933797 30 General Hospitals SILVER CROSS HOSPITAL 604519509 107 Will 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 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85391.01 0 0 0 0 0 0 0 0 0 85391.01 0 0 1010563914 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 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 0 717.52 717.52 0 0 1010563965 1174010839 24 Speech Therapists BELLISARIO GIORGIANA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24578.78 24578.78 0 0 1010564099 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15957.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15957.9 0 0 1010564410 1619235561 10 Physicians HOGUE MATTHEW H 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 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 2204.83 0 0 0 0 0 0 2204.83 0 0 1010564855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11453.17 0 0 0 0 0 0 0 0 0 0 0 0 0 11453.17 0 0 1010565299 1245220243 89 Physician Assistant Only(Encounter Only) WILLIAMS THOMAS L 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 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 0 284.14 0 0 0 0 0 0 284.14 0 0 1010565661 1225364219 89 Physician Assistant Only(Encounter Only) CREMEENS ALICIA 999999999 47 Jackson 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 0 177 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 1962.31 0 0 0 0 0 0 1962.31 0 0 1010565681 91 Waiver service provider--Adults (DHS/DDD) 70 McDonough 0 0 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 23768.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23768.8 0 0 1010565715 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 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 5208 0 0 0 0 0 0 0 0 0 0 0 0 0 5208 0 0 1010565840 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18803.69 0 0 0 0 0 0 0 0 0 0 0 0 0 18803.69 0 0 1010566115 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 674.16 0 0 0 0 0 0 0 0 0 0 0 0 0 674.16 0 0 1010566289 1174066617 91 Waiver service provider--Adults (DHS/DDD) ILLINOIS HOUSING AND DISABILIT 999999999 30 DuPage 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337120.51 0 0 0 0 0 0 0 0 0 0 0 0 0 337120.51 0 0 1010566979 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 0 146.58 0 0 0 0 0 0 146.58 0 0 1010567050 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 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 0 374.52 374.52 0 0 1010567499 10 Physicians 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 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 1010567624 1508336538 16 Nurse Practitioners STASZEL ZUZANNA 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 0 100 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 1490.2 0 0 0 0 0 0 1490.2 0 0 1010567795 1760793434 10 Physicians RICHTER EDWARD K 999999999 74 Mercer 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 0 199 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 6414.49 0 0 0 0 0 0 6414.49 0 0 1010567903 1386156917 16 Nurse Practitioners RYAN KELLY 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 0 177.37 0 0 0 0 0 0 177.37 0 0 1010567978 1649531054 89 Physician Assistant Only(Encounter Only) MCRAE ANNE 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 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 1738.63 0 0 0 0 0 0 1738.63 0 0 1010568209 1922009133 16 Nurse Practitioners HAHN-BROWN TAMMY 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 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 0 137.93 0 0 0 0 0 0 137.93 0 0 1010568249 1215184635 16 Nurse Practitioners ALLAN DARLA 999999999 102 Warren 0 0 0 0 0 3 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 109.25 0 0 0 0 0 0 0 0 2418.02 0 0 0 0 0 0 2527.27 0 0 1010568271 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 1408.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1408.92 0 0 1010568677 1801301866 30 General Hospitals FRESENIUS MEDICAL CARE MOUNT P 999999999 200 Cook 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 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9243.5 0 0 0 0 0 9243.5 0 0 1010568851 1861483307 33 Nursing Facilities HERITAGE HEALTH WALNUT 613769364 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143176.2 0 0 0 0 0 0 0 143176.2 0 0 1010568874 1801345228 89 Physician Assistant Only(Encounter Only) SPINGOLA KATHRYN 600162359 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 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 59.06 0 0 0 0 0 0 59.06 0 0 1010568882 10 Physicians 30 DuPage 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 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 0 584.16 0 0 0 0 0 0 584.16 0 0 1010568939 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 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0 1873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561775.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561775.75 0 0 1010569840 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24975.86 0 0 0 0 0 0 0 0 0 0 0 0 0 24975.86 0 0 1010570070 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 32.61 0 0 0 0 0 0 32.61 0 0 1010570087 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010570091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22933.59 0 0 0 0 0 0 0 0 0 0 0 0 0 22933.59 0 0 1010570327 94 Waiver service provider--Children's support (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 0 129 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 10153.59 0 0 0 0 0 0 0 0 0 0 0 0 0 10153.59 0 0 1010570382 1104365980 16 Nurse Practitioners KATIGBAK JOHANNA 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 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 0 263.15 0 0 0 0 0 0 263.15 0 0 1010570514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14659.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14659.88 0 0 1010570763 1528562931 16 Nurse Practitioners ISMAILOVA IRINA 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 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 56.42 0 0 1010570924 1730655309 16 Nurse Practitioners RINGNESS SARAH 999999999 53 Kane 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 0 157 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 3946.75 0 0 0 0 0 0 3946.75 0 0 1010571033 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010571104 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 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 0 240.02 240.02 0 0 1010571324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25551.46 0 0 0 0 0 0 0 0 0 0 0 0 0 25551.46 0 0 1010571672 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2190.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2190.25 0 0 1010571716 1063894780 10 Physicians SCHULTZ ERIK 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 0 231 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 3390.91 0 0 0 0 0 0 3390.91 0 0 1010571887 1205346244 16 Nurse Practitioners PIERCE SHEENA L 999999999 91 Sangamon 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 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 0 202.09 0 0 0 0 0 0 202.09 0 0 1010571990 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16289.24 0 0 0 0 0 0 0 0 0 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21064.59 0 0 0 0 0 0 0 0 0 0 0 0 0 21064.59 0 0 1010573054 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 0 149.88 0 0 0 0 0 0 149.88 0 0 1010573086 1679647358 89 Physician Assistant Only(Encounter Only) ABBINANTI SUSAN 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 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 0 140.19 0 0 0 0 0 0 140.19 0 0 1010573330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19578.98 0 0 0 0 0 0 0 0 0 0 0 0 0 19578.98 0 0 1010573340 10 Physicians 70 McDonough 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 0 101.08 0 0 0 0 0 0 0 0 101.08 0 0 1010573571 1790047439 10 Physicians LIPOWSKA ANNA 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 0 197 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 12706.59 0 0 0 0 0 0 12706.59 0 0 1010573738 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24218.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24218.42 0 0 1010574069 91 Waiver service provider--Adults (DHS/DDD) 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 0 244 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 21733.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21733.8 0 0 1010574120 1447603246 16 Nurse Practitioners DUDENBOSTEL MINDY M 999999999 47 Jackson 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 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 0 905.13 0 0 0 0 0 0 905.13 0 0 1010574301 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3490.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3490.07 0 0 1010574599 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 59.7 0 0 0 0 0 0 0 0 0 0 0 0 0 59.7 0 0 1010574696 1932691292 10 Physicians CAMP JASE 999999999 91 Sangamon 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 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 0 675.74 0 0 0 0 0 0 675.74 0 0 1010574895 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 0 0 0 0 0 0 0 0 0 0 1010575081 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 1010575149 1548352248 86 Clinical Social Worker(Encounter Only) COLE KENDRA 999999999 24 Coles 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 0 196 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 0 690.37 0 0 0 0 0 0 690.37 0 0 1010575299 75 Department of Alcohol and Substance Abuse Provider 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.92 0 0 66.92 0 0 1010575331 1912147349 10 Physicians HU YUE-YUNG 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 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 7024.17 0 0 0 0 0 0 7024.17 0 0 1010575542 1114437902 16 Nurse Practitioners KEESEE TAMARA A 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 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 0 490.79 0 0 0 0 0 0 490.79 0 0 1010575706 1265917371 16 Nurse Practitioners MUTUA EVANS L 999999999 91 Sangamon 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 0 211 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 8356.39 0 0 0 0 0 0 8356.39 0 0 1010575801 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34597.91 0 0 0 0 0 0 0 0 0 0 0 0 0 34597.91 0 0 1010575887 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 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 6232.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6232.24 0 0 1010576065 1851701601 89 Physician Assistant Only(Encounter Only) NEAL AMBER 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 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 1010576078 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 0 121.23 0 0 0 0 0 0 121.23 0 0 1010576277 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352.62 0 0 0 0 0 0 0 0 0 0 0 0 0 352.62 0 0 1010576386 1871023770 10 Physicians XIAO JIANZHOU T 999999999 30 DuPage 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 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 2752.06 0 0 0 0 0 0 2752.06 0 0 1010576398 1780032441 10 Physicians HICKEY ERIN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 5 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 201 0 0 0 0 0 0 0 0 0 425.47 0 0 0 0 0 0 0 0 6423.11 0 0 0 0 0 0 6848.58 0 0 1010576462 1932352457 89 Physician Assistant Only(Encounter Only) VAN WIEREN ALIZABETH 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 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 1330.32 0 0 0 0 0 0 1330.32 0 0 1010576528 1053812974 33 Nursing Facilities ALDEN ESTATES CTS OF HUNTLEY 999999999 53 Kane 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250873.72 0 0 0 0 0 0 0 250873.72 0 0 1010577287 1093129553 10 Physicians HENKE LAUREN E 999999999 200 Cook 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 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 1268.64 0 0 0 0 0 0 1268.64 0 0 1010578114 1275950263 10 Physicians EYLER STEPHEN J 999999999 80 Peoria 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 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6563.19 0 0 0 0 0 0 6563.19 0 0 1010578225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7045.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7045.18 0 0 1010578261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010578406 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1010578577 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298.88 298.88 0 0 1010578620 1730607227 16 Nurse Practitioners COOK JAMIE C 999999999 80 Peoria 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 0 142 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 6124.56 0 0 0 0 0 0 6124.56 0 0 1010578941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2284.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2284.44 0 0 1010578983 1508348590 16 Nurse Practitioners EVANS KELLI 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 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 0 306.88 0 0 0 0 0 0 306.88 0 0 1010578987 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 0 355.52 0 0 0 0 0 0 355.52 0 0 1010579182 1467979260 16 Nurse Practitioners MAINOR JENNIFER 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 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 0 378.1 0 0 0 0 0 0 378.1 0 0 1010579235 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16912.85 0 0 0 0 0 0 0 0 0 0 0 0 0 16912.85 0 0 1010579400 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 1010579562 1750815924 89 Physician Assistant Only(Encounter Only) MANIKAS ANN R 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 33 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 0 0 0 0 0 0 0 0 0 416.79 0 0 0 0 0 0 416.79 0 0 1010579817 1366960759 16 Nurse Practitioners PAGADUAN NINA R 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 0 130 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 5355.96 0 0 0 0 0 0 5355.96 0 0 1010580133 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3272.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3272.74 0 0 1010580288 1013059781 10 Physicians TANNER EDWARD J 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 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 38493.45 0 0 0 0 0 0 38493.45 0 0 1010580513 1912476714 16 Nurse Practitioners HARDEN ROCHELLE B 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 64.4 0 0 0 0 0 0 0 0 1093.36 0 0 0 0 0 0 1157.76 0 0 1010580612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 390.72 0 0 0 0 0 0 0 0 0 0 0 0 0 390.72 0 0 1010580668 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 20.1 0 0 0 0 0 0 20.1 0 0 1010580953 1336659119 16 Nurse Practitioners SANTOS AILEEN 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 0 316.46 0 0 0 0 0 0 316.46 0 0 1010581107 1639325681 10 Physicians VAVRA ASHLEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4914.8 0 0 0 0 0 0 4914.8 0 0 1010581194 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8067.57 0 0 0 0 0 0 0 0 0 0 0 0 0 8067.57 0 0 1010581274 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.97 0 0 0 0 0 0 1.97 0 0 1010581346 1396269668 16 Nurse Practitioners TOLLEY ELIZABETH S 999999999 91 Sangamon 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 0 842.65 0 0 0 0 0 0 842.65 0 0 1010581446 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 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 0 836.71 836.71 0 0 1010581641 1588041891 16 Nurse Practitioners SWIERAD MELISSA 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 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 0 396.4 0 0 0 0 0 0 396.4 0 0 1010581761 1629592639 10 Physicians MIMA MAHMOUD 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8794.58 0 0 0 0 0 0 8794.58 0 0 1010581765 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 13711.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13711.79 0 0 1010582655 1891057949 10 Physicians RAHN HEIDI 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 95 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1510.55 0 48.93 0 0 0 0 0 0 1559.48 0 0 1010582846 1932611282 24 Speech Therapists THOMAS STACEY 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 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 1834.48 1834.48 0 0 1010582932 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23036.15 0 0 0 0 0 0 0 0 0 0 0 0 0 23036.15 0 0 1010582993 1578829644 10 Physicians VOSS RAINA 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1 0 35 0 0 0 0 0 0 0 0 0 126.62 0 0 0 0 0 0 5.17 0 2785.26 0 0 0 0 0 0 2917.05 0 0 1010583139 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2107.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2107.35 0 0 1010583367 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18477.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18477.8 0 0 1010583582 1942788070 11 Dentists ADES KYRIAKI 999999999 200 Cook 0 0 General Dentistry 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50157.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50157.14 0 0 1010583721 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14039.76 0 0 0 0 0 0 0 0 0 0 0 0 0 14039.76 0 0 1010583733 1386162808 89 Physician Assistant Only(Encounter Only) HIGH RACHEL ANN 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 0 977.78 0 0 0 0 0 0 977.78 0 0 1010583908 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 0 170.73 0 0 0 0 0 0 170.73 0 0 1010584025 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 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 0 376.86 0 0 0 0 0 0 376.86 0 0 1010584054 30 General Hospitals 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1010584827 1669764635 10 Physicians SELVARAJAH ANDREW N 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 18 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 21 0 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 21 0 47 0 0 0 0 0 0 0 0 0 12.3 0 0 0 0 0 0 290.72 0 796.74 0 0 0 0 0 0 1099.76 0 0 1010585063 1245753417 89 Physician Assistant Only(Encounter Only) ANTLE KALYA MARIE 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 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 0 910.1 0 0 0 0 0 0 910.1 0 0 1010585265 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 0 0 0 0 0 0 0 0 0 0 1010585371 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4198.41 0 0 0 0 0 0 0 0 0 0 0 0 0 4198.41 0 0 1010586036 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.82 0 0 0 0 0 0 246.82 0 0 1010586049 1255859260 86 Clinical Social Worker(Encounter Only) TOBIAS KELSIE A 999999999 20 Christian 0 0 0 0 0 0 0 0 0 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 0 392.74 0 0 0 0 0 0 392.74 0 0 1010586182 91 Waiver service provider--Adults (DHS/DDD) 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 0 190 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 22930.38 0 0 0 0 0 0 0 0 0 0 0 0 0 22930.38 0 0 1010586209 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6979.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6979.92 0 0 1010586760 1700318631 10 Physicians SAVANI UMAIR IQBAL 999999999 200 Cook 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 0 109 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 1794.52 0 0 0 0 0 0 1794.52 0 0 1010586846 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 0 493.89 0 0 0 0 0 0 493.89 0 0 1010586933 1417218405 10 Physicians KAR AROOP 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 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 1591.42 0 0 0 0 0 0 1591.42 0 0 1010586988 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 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 1815.8 1815.8 0 0 1010587008 1912426479 16 Nurse Practitioners SCHWEISS NICOLE M. 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 241.2 0 0 0 0 0 0 241.2 0 0 1010587410 1346563343 22 Physical Therapists SAMUEL RENY ANNA 999999999 107 Will 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 0 153 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 1776.84 1776.84 0 0 1010587443 1073809570 10 Physicians CHUNG BOW Y 999999999 30 DuPage 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 0 214 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 2202.88 0 0 0 0 0 0 2202.88 0 0 1010588039 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5919.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5919.08 0 0 1010588441 1316350705 10 Physicians LINARES VICTORIA 999999999 200 Cook 0 0 Family Practice 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 0 115 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 2002.84 0 0 0 0 0 0 2002.84 0 0 1010588594 11 Dentists 200 Cook 0 0 General Dentistry 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 0 125.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.1 0 0 1010588740 10 Physicians 107 Will 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 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 0 454.95 0 0 0 0 0 0 454.95 0 0 1010588775 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8263.86 0 0 0 0 0 0 0 0 0 0 0 0 0 8263.86 0 0 1010588804 1639512965 10 Physicians BLAKE MARTIN C 999999999 53 Kane 0 0 Emergency Medicine 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 0 599.4 0 0 0 0 0 0 599.4 0 0 1010588893 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 2273 0 0 0 0 0 0 0 0 0 0 0 0 0 2273 0 0 1010588922 1053723767 10 Physicians YAMADA AKIRA 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 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 6574.2 0 0 0 0 0 0 6574.2 0 0 1010588991 1467961326 16 Nurse Practitioners SEAGREN BRITTANI 999999999 54 Kankakee 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 0 104 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 1885.18 0 0 0 0 0 0 1885.18 0 0 1010589017 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.77 0 0 0 0 0 0 24.77 0 0 1010589025 1821522319 10 Physicians ZHANG CECILIA 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 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 0 705.37 0 0 0 0 0 0 705.37 0 0 1010589570 10 Physicians 200 Cook 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2076.95 0 0 0 0 0 0 2076.95 0 0 1010589597 1669815015 10 Physicians WEINSTEIN DANIEL V 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 581 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9738.14 0 346.05 0 0 0 0 0 0 10084.19 0 0 1010589859 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 184.97 0 0 0 0 0 0 184.97 0 0 1010590159 1083930101 10 Physicians ZIA MARYAM 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 0 108 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 0 171.42 0 0 0 0 0 0 171.42 0 0 1010590449 1184882185 10 Physicians TOMASKO JONATHAN 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 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 4535.76 0 0 0 0 0 0 4535.76 0 0 1010590905 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24295.58 0 0 0 0 0 0 0 0 0 0 0 0 0 24295.58 0 0 1010591099 1487128468 16 Nurse Practitioners WHITE LAURA J. 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 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 0 575.1 0 0 0 0 0 0 575.1 0 0 1010591461 1861759805 10 Physicians HALGRIMSON WHITNEY RYAN 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 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 0 257.72 0 0 0 0 0 0 257.72 0 0 1010591520 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12497.24 0 0 0 0 0 0 0 0 0 0 0 0 0 12497.24 0 0 1010591997 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 0 179.94 0 0 0 0 0 0 179.94 0 0 1010592138 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 1070.45 0 0 0 0 0 0 1070.45 0 0 1010592216 1073048120 16 Nurse Practitioners HEATHERLY RHONDA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435.52 0 0 0 0 0 0 435.52 0 0 1010592530 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 0 307 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 40818.52 0 0 0 0 0 0 0 0 0 0 0 0 0 40818.52 0 0 1010592705 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.04 40.04 0 0 1010592720 1740752351 22 Physical Therapists CICHON BRIAN 999999999 89 Rock Island 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 0 127 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 2349.48 2349.48 0 0 1010592764 1972922532 10 Physicians AL-SABTI RAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 265 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7049.28 0 34.92 0 0 0 0 0 0 7084.2 0 0 1010593110 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 23262.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23262.35 0 0 1010593197 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 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 0 542.5 0 0 0 0 0 0 0 0 0 0 0 0 0 542.5 0 0 1010593284 1033699509 16 Nurse Practitioners PARKS ASHLEY N 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 126.77 0 0 0 0 0 0 126.77 0 0 1010593300 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27522.34 0 0 0 0 0 0 0 0 0 0 0 0 0 27522.34 0 0 1010593589 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 65.72 0 0 0 0 0 0 0 0 0 0 0 0 0 65.72 0 0 1010593637 1649492463 10 Physicians VANCE JOSHUA N 999999999 200 Cook 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 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 1560.26 0 0 0 0 0 0 1560.26 0 0 1010593730 1871907261 10 Physicians HEEGER ALLEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 1 0 0 0 0 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 0 103.34 0 0 0 0 0 0 0 0 103.34 0 0 1010594160 1568872901 10 Physicians MWANTHI MUITHI M 999999999 200 Cook 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 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 0 645.52 0 0 0 0 0 0 645.52 0 0 1010594217 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.89 142.89 0 0 1010594338 1871058644 91 Waiver service provider--Adults (DHS/DDD) DEROSA REBECCA R 999999999 91 Sangamon 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 0 323 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 4662.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4662.56 0 0 1010594623 10 Physicians 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 1010594675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3210.61 0 0 0 0 0 0 0 0 0 0 0 0 0 3210.61 0 0 1010594697 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 1 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 8 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 90.67 0 0 0 0 0 0 0 0 577.97 0 0 0 0 0 0 668.64 0 0 1010595103 1063949840 16 Nurse Practitioners THOMAS TREESA 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 0 145 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 0 476.51 0 0 0 0 0 0 476.51 0 0 1010595308 1659816189 16 Nurse Practitioners THOMAS-KNOWLTON JENNIFER 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 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 0 173.98 0 0 0 0 0 0 173.98 0 0 1010595726 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21488.41 0 0 0 0 0 0 0 0 0 0 0 0 0 21488.41 0 0 1010595822 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 1010595882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27303 0 0 0 0 0 0 0 0 0 0 0 0 0 27303 0 0 1010595889 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 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 0 0 0 0 0 0 0 0 0 0 1010595948 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25936.87 0 0 0 0 0 0 0 0 0 0 0 0 0 25936.87 0 0 1010596016 1417481912 70 Ambulance Service Providers AIR EVAC EMS INC 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 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 3138.66 0 0 0 0 0 0 3138.66 0 0 1010596080 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1010596275 1568753846 10 Physicians SHARMA NITIN 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 16 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.09 0 3899.2 0 0 0 0 0 0 3929.29 0 0 1010596309 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 1010596781 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20834.72 0 0 0 0 0 0 0 0 0 0 0 0 0 20834.72 0 0 1010596835 1285128504 10 Physicians SMITH CHARELLE O 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 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 0 230.69 0 0 0 0 0 0 230.69 0 0 1010596936 1770002677 16 Nurse Practitioners KRAMER CORY J 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1010597196 1306073044 10 Physicians HENRY CHRISTOPHER A 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 0 210 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 1261.35 0 0 0 0 0 0 1261.35 0 0 1010597285 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24976.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24976.53 0 0 1010597480 1104302561 89 Physician Assistant Only(Encounter Only) RINEHART JAMIE J 999999999 98 Tazewell 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 0 298 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 2731.19 0 0 0 0 0 0 2731.19 0 0 1010598061 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 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 1062.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1062.27 0 0 1010599384 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26197.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 1010600054 1518386580 10 Physicians BRAVERMAN ALEXIS 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5127.12 0 0 0 0 0 0 5127.12 0 0 1010600199 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19862.15 0 0 0 0 0 0 0 0 0 0 0 0 0 19862.15 0 0 1010600601 1508321936 33 Nursing Facilities PALOS HEIGHTS REHABILITATION 999999999 200 Cook 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9607 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1660878.56 0 0 0 0 0 0 0 1660878.56 0 0 1010600692 1821105628 10 Physicians CULHANE JOHN 999999999 71 McHenry 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 0 115 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 13161.7 0 0 0 0 0 0 13161.7 0 0 1010600832 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 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 13.47 0 0 0 0 0 0 13.47 0 0 1010600934 1801296397 10 Physicians GADAPA SAI PRASAD 999999999 200 Cook 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 75 0 0 0 0 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 0 0 1989.55 0 0 0 0 0 0 1989.55 0 0 1010601064 1316388796 10 Physicians BATISTA JOSEFINA 999999999 54 Kankakee 0 0 0 0 0 51 0 0 0 0 0 0 13 0 46 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 14 0 79 0 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 14 0 79 0 0 0 0 0 0 0 0 0 5525 0 0 0 0 0 0 67.84 0 3330.16 0 0 0 0 0 0 8923 0 0 1010601093 1609119932 10 Physicians KARAGODIN ILYA M 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 0 145 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 0 652.21 0 0 0 0 0 0 652.21 0 0 1010601616 1053730895 10 Physicians HYDER RYYAN S 999999999 30 DuPage 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 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 0 790.96 0 0 0 0 0 0 790.96 0 0 1010601842 1144685397 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 53 Kane 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 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 86320.26 0 0 86320.26 0 0 1010602054 1467962712 33 Nursing Facilities APERION CARE MARSEILLES 999999999 58 La Salle 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 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565062.04 0 0 0 0 0 0 0 565062.04 0 0 1010602520 1477038743 16 Nurse Practitioners HARRIS MICHELLE 999999999 53 Kane 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 1835.48 0 0 0 0 0 0 1835.48 0 0 1010602628 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 0 0 0 0 0 0 0 0 0 0 1010602710 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 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 3500.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3500.64 0 0 1010602822 1952309981 89 Physician Assistant Only(Encounter Only) PURCELL STACY 999999999 30 DuPage 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 0 110 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 0 389.47 0 0 0 0 0 0 389.47 0 0 1010602915 91 Waiver service provider--Adults (DHS/DDD) 816 Iowa 0 0 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 1679.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1679.03 0 0 1010603006 89 Physician Assistant Only(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 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 4.18 0 0 0 0 0 0 4.18 0 0 1010603350 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31310.95 0 0 0 0 0 0 0 0 0 0 0 0 0 31310.95 0 0 1010603474 1922325844 10 Physicians COX KELLY L. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351.38 0 4649.21 0 0 0 0 0 0 5000.59 0 0 1010603528 1578918637 16 Nurse Practitioners SATTERLY MICHELLE RHEA 999999999 89 Rock Island 0 0 0 0 0 3 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 249.26 0 0 0 0 0 0 0 0 929.07 0 0 0 0 0 0 1178.33 0 0 1010603602 1265812739 89 Physician Assistant Only(Encounter Only) PIMENTEL AMANDA 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 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 0 566.56 0 0 0 0 0 0 566.56 0 0 1010603687 1316987423 10 Physicians VRICELLA LUCA 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 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 7280 0 0 0 0 0 0 7280 0 0 1010603819 1265981021 30 General Hospitals FRESENIUS KIDNEY CARE SCHAUMBU 999999999 200 Cook 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37826.31 0 0 0 0 0 37826.31 0 0 1010604018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24582.93 0 0 0 0 0 0 0 0 0 0 0 0 0 24582.93 0 0 1010604677 1285923078 10 Physicians KRIEGERMEIER ALYSSA A 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 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 1724.13 0 0 0 0 0 0 1724.13 0 0 1010604678 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3361.82 0 0 0 0 0 0 0 0 0 0 0 0 0 3361.82 0 0 1010604879 1154662856 10 Physicians COMPTON LEIGH ANNE 999999999 826 Missouri 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 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 0 845.87 0 0 0 0 0 0 0 0 845.87 0 0 1010604985 1659635977 10 Physicians KAM AUDREY E 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 0 185 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 4304.95 0 0 0 0 0 0 4304.95 0 0 1010605076 1881171197 16 Nurse Practitioners PERRY TINA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.26 0 0 0 0 0 0 256.26 0 0 1010605318 16 Nurse Practitioners 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010605361 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 0 149 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 23734.37 0 0 0 0 0 0 0 0 0 0 0 0 0 23734.37 0 0 1010605406 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18132.88 0 0 0 0 0 0 0 0 0 0 0 0 0 18132.88 0 0 1010605621 1407371859 55 Early Intervention Services SAXTON ELIZABETH C 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 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 5756.05 0 0 0 0 0 0 5756.05 0 0 1010605802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1808.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1808.05 0 0 1010606409 1457613531 10 Physicians CHEVALIER NIKITA 999999999 200 Cook 0 0 Urology 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.51 0 2083.53 0 0 0 0 0 0 2090.04 0 0 1010606638 1568920981 16 Nurse Practitioners SCHULZE LAUREN E 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 0 140 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 0 243.96 0 0 0 0 0 0 243.96 0 0 1010606950 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 0 325.5 0 0 0 0 0 0 0 0 0 0 0 0 0 325.5 0 0 1010607268 1982149209 16 Nurse Practitioners PATEL YESHA 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 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 0 320.4 0 0 0 0 0 0 320.4 0 0 1010607346 1770944571 16 Nurse Practitioners DUFFIN JESSICA 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 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 0 282.8 0 0 0 0 0 0 282.8 0 0 1010607354 1720058001 10 Physicians BOGAN JENNIFER K 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 10 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 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 92.07 0 34.99 0 0 0 0 0 0 127.06 0 0 1010607475 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19542.06 0 0 0 0 0 0 0 0 0 0 0 0 0 19542.06 0 0 1010607868 16 Nurse Practitioners 74 Mercer 0 0 0 0 0 0 0 0 0 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 1010607932 1366915860 91 Waiver service provider--Adults (DHS/DDD) RYAN MELISSA L 999999999 91 Sangamon 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 3322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107411.87 0 0 0 0 0 0 0 0 0 0 0 0 0 107411.87 0 0 1010608036 1669812053 10 Physicians WILLIS DANIEL N. 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 0 813.6 0 0 0 0 0 0 813.6 0 0 1010608185 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20280.7 0 0 0 0 0 0 0 0 0 0 0 0 0 20280.7 0 0 1010608374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 24909.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24909.42 0 0 1010608469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27525.25 0 0 0 0 0 0 0 0 0 0 0 0 0 27525.25 0 0 1010608572 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15499.78 0 0 0 0 0 0 0 0 0 0 0 0 0 15499.78 0 0 1010608756 30 General Hospitals 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 1010608776 1558852699 16 Nurse Practitioners MARTIS JENA C 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 0 106 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 2500.22 0 0 0 0 0 0 2500.22 0 0 1010608940 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6147.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6147.98 0 0 1010609207 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21481.76 0 0 0 0 0 0 0 0 0 0 0 0 0 21481.76 0 0 1010609512 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 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 40.69 0 0 0 0 0 0 40.69 0 0 1010609572 1265442370 89 Physician Assistant Only(Encounter Only) SCHILTZ JAMES 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 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 2104.29 0 0 0 0 0 0 2104.29 0 0 1010609693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25875.4 0 0 0 0 0 0 0 0 0 0 0 0 0 25875.4 0 0 1010610063 1013471267 89 Physician Assistant Only(Encounter Only) KUSELIAUSKAS RITA A. 999999999 54 Kankakee 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 0 102 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 4028.3 0 0 0 0 0 0 4028.3 0 0 1010610088 1083179576 91 Waiver service provider--Adults (DHS/DDD) HENTHORN KYLENE 999999999 200 Cook 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 2267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45065.02 0 0 0 0 0 0 0 0 0 0 0 0 0 45065.02 0 0 1010610428 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.51 0 0 0 0 0 0 89.51 0 0 1010610495 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1104.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1104.49 0 0 1010610589 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 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 50194.66 0 0 0 0 0 0 0 0 0 0 0 0 0 50194.66 0 0 1010611023 1275035594 16 Nurse Practitioners ZIMMERMAN SARA 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 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 1836.58 0 0 0 0 0 0 1836.58 0 0 1010611848 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2370.21 0 0 0 0 0 0 0 0 0 0 0 0 0 2370.21 0 0 1010612283 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 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 64.35 0 0 0 0 0 0 64.35 0 0 1010612625 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 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 63.77 0 0 0 0 0 0 63.77 0 0 1010612669 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 3 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 3 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 125.65 0 0 0 0 0 0 0 0 83.42 0 0 0 0 0 0 209.07 0 0 1010613015 1265871636 10 Physicians LIN JIANPING 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 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 0 254.31 0 0 0 0 0 0 0 0 254.31 0 0 1010613040 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 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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 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 12657.48 0 0 0 0 0 0 12657.48 0 0 1010614304 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010614342 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 1010614625 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 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 54.51 0 0 0 0 0 0 54.51 0 0 1010614669 1477783926 10 Physicians LAKSHMINARAYAN GOWRI 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 11 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717.4 0 0 0 0 0 0 717.4 0 0 1010616114 1467429233 46 Ambulatory Surgical Treatment Centers "JUSTICE MED SURG CENTER,LTD" 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 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 3765.6 0 0 0 0 0 3765.6 0 0 1010616193 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 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 0 299.62 0 0 0 0 0 0 0 0 299.62 0 0 1010616311 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 0 112 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 29910.79 0 0 0 0 0 0 0 0 0 0 0 0 0 29910.79 0 0 1010616508 1356845283 10 Physicians JORDAN LILLY CLAIRE 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 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 0 916.79 0 0 0 0 0 0 916.79 0 0 1010616519 10 Physicians 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010616644 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11225.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11225.06 0 0 1010616921 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 0 138.15 0 0 0 0 0 0 138.15 0 0 1010617015 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.13 15.13 0 0 1010617156 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21692.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21692.5 0 0 1010617300 1245738814 60 Pharmacies MARIANOS PHARMACY #544 999999999 71 McHenry 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2284.54 0 0 0 2284.54 0 0 1010617321 1386127595 16 Nurse Practitioners OCHAB HEIDI 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 0 432.7 0 0 0 0 0 0 432.7 0 0 1010617336 1699034546 10 Physicians HALPERN JOSHUA A 999999999 200 Cook 0 0 Urology 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 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 0 932.13 0 0 0 0 0 0 932.13 0 0 1010617537 1700319878 10 Physicians TRENKAMP MELANIE 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 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 4019.34 0 0 0 0 0 0 4019.34 0 0 1010617566 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 0 285 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 41407.03 0 0 0 0 0 0 0 0 0 0 0 0 0 41407.03 0 0 1010617587 1851891170 16 Nurse Practitioners ZUMBAHLEN LUKE R 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299.8 0 0 0 0 0 0 299.8 0 0 1010617671 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 30.47 0 0 0 0 0 0 30.47 0 0 1010617829 92 Waiver service provider--Disability 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0 0 0 0 0 0 0 3269.45 0 0 0 0 0 0 3269.45 0 0 1010618806 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 0 186 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 13431 0 0 0 0 0 0 0 0 0 0 0 0 0 13431 0 0 1010619134 1457734808 10 Physicians JOSEPH THOMAS 999999999 53 Kane 0 0 Internal Medicine 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 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4263.12 0 0 0 0 0 0 4263.12 0 0 1010619242 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18620.81 0 0 0 0 0 0 0 0 0 0 0 0 0 18620.81 0 0 1010619340 1518466077 89 Physician Assistant Only(Encounter Only) SHAW ANGELA 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 482.72 0 0 0 0 0 0 482.72 0 0 1010633733 1881099596 10 Physicians KOVACEVIC MARINA 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 0 208 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 2112.38 0 0 0 0 0 0 2112.38 0 0 1010633845 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1985.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1985.34 0 0 1010633869 1548508187 25 Audiologists WINBORN SARAH E 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1817.5 1817.5 0 0 1010634178 1306332697 16 Nurse Practitioners ASUNCION KRISTINE 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 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 0 453.26 0 0 0 0 0 0 453.26 0 0 1010634627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33784.33 0 0 0 0 0 0 0 0 0 0 0 0 0 33784.33 0 0 1010634653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8294.66 0 0 0 0 0 0 0 0 0 0 0 0 0 8294.66 0 0 1010634782 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 49.22 0 0 0 0 0 0 49.22 0 0 1010634899 1013372895 63 Other Providers of Medical Equipment/Supplies (Non-registered) "ALDEN MANAGEMENT SERVICES, INC" 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 0 171 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 17043.1 0 0 0 0 0 0 17043.1 0 0 1010634956 1417478553 16 Nurse Practitioners EL HAWARY FATIMA M 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 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 0 539.6 0 0 0 0 0 0 539.6 0 0 1010635077 1033471131 10 Physicians MILLS KATHRYN A 999999999 30 DuPage 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345.62 0 0 0 0 0 0 345.62 0 0 1010635083 1134643646 89 Physician Assistant Only(Encounter Only) CLEMENT AMY E 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 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2683.28 0 0 0 0 0 0 2683.28 0 0 1010635128 1740546118 10 Physicians KURIAN DINESH J 999999999 30 DuPage 0 0 Anesthesiology 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 10185.72 0 0 0 0 0 0 10185.72 0 0 1010635189 1912905563 10 Physicians CARTER WILLIAM R 999999999 200 Cook 0 0 Radiology Diagnosis 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 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 1090.12 0 0 0 0 0 0 0 0 1090.12 0 0 1010635230 1184950685 10 Physicians HWANG SARAH K 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 260.69 0 0 0 0 0 0 260.69 0 0 1010635369 1700171261 10 Physicians RAZZAK SAMAN 999999999 53 Kane 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 7 0 67 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 16 0 142 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 16 0 142 0 0 0 0 0 0 0 0 0 182.04 0 0 0 0 0 0 193.3 0 806.92 0 0 0 0 0 0 1182.26 0 0 1010635386 1831573898 10 Physicians AGARWAL INDU 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 112 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2157.85 0 34.92 0 0 0 0 0 0 2192.77 0 0 1010635598 1649682675 10 Physicians XIE SHAN SHAN 999999999 30 DuPage 0 0 Family Practice 0 0 0 11 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 1201.34 0 0 0 0 0 0 0 0 1591.51 0 0 0 0 0 0 2792.85 0 0 1010635681 1720427982 10 Physicians MINTZ AARON J 999999999 108 Williamson 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 93 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2270.95 0 26.3 0 0 0 0 0 0 2297.25 0 0 1010635775 1144562125 10 Physicians MANSOUR MENA 999999999 200 Cook 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 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 0 195.61 0 0 0 0 0 0 0 0 195.61 0 0 1010635845 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 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 26807.42 0 0 0 0 0 0 0 0 0 0 0 0 0 26807.42 0 0 1010636135 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 0 115 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 9238.9 0 0 0 0 0 0 0 0 0 0 0 0 0 9238.9 0 0 1010636542 10 Physicians 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 764.79 0 0 0 0 0 0 764.79 0 0 1010636760 1811464340 16 Nurse Practitioners BERTOLINI ADRIA 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 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 0 745.91 0 0 0 0 0 0 745.91 0 0 1010636927 1386602407 10 Physicians LYTOLLIS WILLIAM 999999999 200 Cook 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 0 139 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 1091.89 0 0 0 0 0 0 1091.89 0 0 1010637523 1417430216 86 Clinical Social Worker(Encounter Only) KANNALA TOMY 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 0 102 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 2753.69 0 0 0 0 0 0 2753.69 0 0 1010637548 1992240758 16 Nurse Practitioners NICOLA CHRISTINE 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 860.43 0 0 0 0 0 0 860.43 0 0 1010637574 1972891216 10 Physicians LADO JUAN 999999999 200 Cook 0 0 Pediatrics 0 0 0 5 0 0 0 0 0 0 4 0 65 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 4 0 91 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 4 0 91 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 7.88 0 3566.62 0 0 0 0 0 0 3606.5 0 0 1010637625 1184153157 60 Pharmacies OAK STREET PHARMACY 999999999 200 Cook 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2312.69 0 0 0 2312.69 0 0 1010637805 1588075576 10 Physicians KHAN MOHAMMED 999999999 200 Cook 0 0 Internal Medicine 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 0 237 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 5219.55 0 0 0 0 0 0 5219.55 0 0 1010637889 1003380510 16 Nurse Practitioners SMITH HANNAH E 999999999 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 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 1622.35 0 0 0 0 0 0 1622.35 0 0 1010637930 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10560.52 0 0 0 0 0 0 0 0 0 0 0 0 0 10560.52 0 0 1010638000 1902370703 16 Nurse Practitioners GREVE JACKIE 999999999 106 Whiteside 0 0 0 0 0 48 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 5745.38 0 0 0 0 0 0 0 0 2207.01 0 0 0 0 0 0 7952.39 0 0 1010638253 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 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 12677.14 0 0 0 0 0 0 0 0 0 0 0 0 0 12677.14 0 0 1010638643 1942620745 10 Physicians TATEBE KEN T 999999999 200 Cook 0 0 Radiation Oncology 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 0 205 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 2592.21 0 0 0 0 0 0 2592.21 0 0 1010638913 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16807.76 0 0 0 0 0 0 0 0 0 0 0 0 0 16807.76 0 0 1010638942 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 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 0 217.11 217.11 0 0 1010639045 1861671844 10 Physicians SHAH HEMANT 999999999 27 Dekalb 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 401 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6094.11 0 247.78 0 0 0 0 0 0 6341.89 0 0 1010639137 1962959908 87 Psychologist(Encounter Only) PIERRE CYNTHIA 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 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 2267.62 0 0 0 0 0 0 2267.62 0 0 1010639438 1477070233 11 Dentists YESKKAVARAPU SRAVANI 999999999 200 Cook 0 0 General Dentistry 0 0 215 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 962 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 962 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 26954.5 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 27707.2 0 0 1010640039 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 1010640276 1124586565 16 Nurse Practitioners ADAMS ASHLEY E 999999999 24 Coles 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 0 221 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 221 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 5187.77 0 0 0 0 0 0 5272.39 0 0 1010640308 1801318951 16 Nurse Practitioners SPANN JENNIFER 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 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 0 144.46 0 0 0 0 0 0 144.46 0 0 1010640554 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 19049.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19049.86 0 0 1010640826 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010640939 1073031936 16 Nurse Practitioners CRUM NATHANIEL C 999999999 47 Jackson 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1399.68 0 0 0 0 0 0 1399.68 0 0 1010640996 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 1010641132 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 22870 0 0 0 0 0 0 0 0 0 0 0 0 0 22870 0 0 1010641340 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681.78 0 0 0 0 0 0 0 0 0 0 0 0 0 681.78 0 0 1010641363 1629547781 36 Community mental health provider ASSOCIATES IN PSYCHOLOGICAL AN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 17855.28 0 0 17855.28 0 0 1010641373 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3923.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3923.5 0 0 1010641463 1730594094 10 Physicians SOKRAB AHMED 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 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GUTIERREZ ISMAEL 999999999 200 Cook 0 0 General Practice 0 0 0 1 0 0 0 0 0 0 6 0 39 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 9 0 82 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 9 0 82 0 0 0 0 0 0 0 0 0 83.24 0 0 0 0 0 0 10.24 0 1537.16 0 0 0 0 0 0 1630.64 0 0 1010643578 1851378426 10 Physicians PARSLEY LEA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 548.62 0 0 0 0 0 0 548.62 0 0 1010643696 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23130.22 0 0 0 0 0 0 0 0 0 0 0 0 0 23130.22 0 0 1010644091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 779.98 0 0 0 0 0 0 0 0 0 0 0 0 0 779.98 0 0 1010644139 1790045862 10 Physicians KAPILA AAYSHA 999999999 53 Kane 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 0 115 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 1377.26 0 0 0 0 0 0 1377.26 0 0 1010644173 1467946517 16 Nurse Practitioners JACKSON JENNIFER D 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 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 0 104.74 0 0 0 0 0 0 104.74 0 0 1010644314 1699297465 16 Nurse Practitioners SARANGAY CLARITESS 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 1091.22 0 0 0 0 0 0 1091.22 0 0 1010644316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3072.36 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 2829.83 0 0 0 0 0 0 2829.83 0 0 1010645550 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24780 0 0 0 0 0 0 0 0 0 0 0 0 0 24780 0 0 1010645698 1972011930 16 Nurse Practitioners NICK JAMIE N 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 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 0 203.8 0 0 0 0 0 0 203.8 0 0 1010645712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1747.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1747.33 0 0 1010645768 1154850667 10 Physicians SCHWARTZ TOVAH 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 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1010646643 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 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 9.12 0 0 0 0 0 0 9.12 0 0 1010646652 1518042688 60 Pharmacies CVS PHARMACY 10599 604161534 40 Grundy 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 0 843 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46195.04 0 0 0 46195.04 0 0 1010646654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26822.52 0 0 0 0 0 0 0 0 0 0 0 0 0 26822.52 0 0 1010646810 1780151142 24 Speech Therapists HOWLAND JOSELYN 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 0 134 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 8384.88 8384.88 0 0 1010647111 12 Optometrists 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 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 28.35 0 0 0 0 0 0 28.35 0 0 1010647140 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21273.21 0 0 0 0 0 0 0 0 0 0 0 0 0 21273.21 0 0 1010647235 1770507246 89 Physician Assistant Only(Encounter Only) HOLMAN BENJAMIN M 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 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 0 627.98 0 0 0 0 0 0 627.98 0 0 1010647499 1679960959 10 Physicians KALIYADAN GEORGE JOSEPH 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 4 0 7 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 5 0 9 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 5 0 9 0 0 0 0 0 0 0 0 0 200.74 0 0 0 0 0 0 586.22 0 381.74 0 0 0 0 0 0 1168.7 0 0 1010647712 1801235700 10 Physicians LONDONO DIANA 999999999 80 Peoria 0 0 Neurology 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 0 118 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 1174.93 0 0 0 0 0 0 1174.93 0 0 1010647912 16 Nurse Practitioners 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.34 0 0 0 0 0 0 138.34 0 0 1010648091 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010648098 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.55 0 0 0 0 0 0 133.55 0 0 1010648320 1780002543 10 Physicians LUDWIG DANIEL R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 116 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3138.46 0 234.07 0 0 0 0 0 0 3372.53 0 0 1010648515 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 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 1010648561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3774.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3774.21 0 0 1010648869 1518465632 16 Nurse Practitioners BOLANOS ELIZABETH 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 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 0 126.32 0 0 0 0 0 0 126.32 0 0 1010649309 1437533098 10 Physicians KANDRA KALYAN E 999999999 91 Sangamon 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 0 322 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 11733.8 0 0 0 0 0 0 11733.8 0 0 1010649387 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 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 83.23 0 0 0 0 0 0 83.23 0 0 1010649442 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 5 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 0 393.76 393.76 0 0 1010649478 1932462611 16 Nurse Practitioners DREIKORN RYAN S 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 727.68 0 0 0 0 0 0 727.68 0 0 1010649720 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 1010650075 1386051142 10 Physicians WENZINGER MICHAEL 999999999 826 Missouri 0 0 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 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 1067.17 0 0 0 0 0 0 1067.17 0 0 1010650243 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32039.11 0 0 0 0 0 0 0 0 0 0 0 0 0 32039.11 0 0 1010650320 1518323195 63 Other Providers of Medical Equipment/Supplies (Non-registered) "PROHEALTH PREVENTION, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 962 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 962 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15719.49 0 299.16 0 0 0 0 16018.65 0 0 1010650576 1447593223 10 Physicians KURANI PINKY 999999999 200 Cook 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 0 130 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 2019.16 0 0 0 0 0 0 2019.16 0 0 1010650630 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23723.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23723.48 0 0 1010650799 1720407430 10 Physicians LONG ROBERT 999999999 53 Kane 0 0 Emergency 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 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 0 908.14 0 0 0 0 0 0 908.14 0 0 1010650859 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.88 0 0 0 0 0 0 0 0 0 0 0 0 0 117.88 0 0 1010651006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26017.56 0 0 0 0 0 0 0 0 0 0 0 0 0 26017.56 0 0 1010651165 1831621325 10 Physicians HAMIEH LANA 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 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 0 241.76 0 0 0 0 0 0 241.76 0 0 1010651600 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 62.74 0 0 0 0 0 0 62.74 0 0 1010651858 1174875223 89 Physician Assistant Only(Encounter Only) SMITH AMY 625264163 63 Macon 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 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 0 466.66 0 0 0 0 0 0 466.66 0 0 1010651992 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1352.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.2 0 0 1010652299 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 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 0 156.49 0 0 0 0 0 0 156.49 0 0 1010652956 1558869958 16 Nurse Practitioners CLEVY-SCHNELLER TED 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 0 176 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 0 755.36 0 0 0 0 0 0 755.36 0 0 1010653035 1285110213 16 Nurse Practitioners CORCORAN NEVIN 999999999 91 Sangamon 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 0 142 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 5236.93 0 0 0 0 0 0 5236.93 0 0 1010653058 10 Physicians 109 Winnebago 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 0 218.97 0 0 0 0 0 0 218.97 0 0 1010653126 1295180347 10 Physicians TABOR RYAN M 999999999 200 Cook 0 0 Emergency Medicine 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 0 113 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 5398.67 0 0 0 0 0 0 5398.67 0 0 1010653554 1245324755 100 Family Support Program RTC RESOURCE TREATMENT CENTER 999999999 815 Indiana 0 0 0 11 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 2038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870348.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870348.28 0 0 1010653569 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3081.28 0 0 0 0 0 0 0 0 0 0 0 0 0 3081.28 0 0 1010654176 1831608991 25 Audiologists DONALDSON LAUREL K 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4081.95 4081.95 0 0 1010654558 1558880633 12 Optometrists HARRIS MARNI 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 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 0 449.85 0 0 0 0 0 0 449.85 0 0 1010654853 1003396219 16 Nurse Practitioners CALZONZI MARIA E 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1322.84 0 0 0 0 0 0 1322.84 0 0 1010655244 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010655412 1023564671 11 Dentists MANASOVSKA NATASA 999999999 200 Cook 0 0 General Dentistry 0 0 41 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4222.75 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 5351.8 0 0 1010655615 1053813055 16 Nurse Practitioners NIETO QUIROGA CHRISTINA 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 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 2208.89 0 0 0 0 0 0 2208.89 0 0 1010655667 1568858934 10 Physicians XU HAOLIANG 999999999 200 Cook 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 0 120 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 2979.35 0 0 0 0 0 0 0 0 2979.35 0 0 1010655808 1093080103 10 Physicians STEPHENSON MARA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 29 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349.59 0 492.94 0 0 0 0 0 0 842.53 0 0 1010655886 1366950099 22 Physical Therapists KINCAIDE KRISTIN N 999999999 89 Rock Island 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 0 105 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 1134.36 1134.36 0 0 1010656124 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1236.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1236.76 0 0 1010656263 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 4360.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4360.03 0 0 1010656305 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 1454.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1454.09 0 0 1010656870 1538479548 10 Physicians CASTELINO CAROL A 999999999 109 Winnebago 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9753.29 0 0 0 0 0 0 9753.29 0 0 1010656987 1821384710 10 Physicians KOBIERSKA MAGDALENA 999999999 57 Lake 0 0 Dermatology 0 0 0 0 0 0 0 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 0 103.12 0 0 0 0 0 0 103.12 0 0 1010656998 1316203367 10 Physicians KHAN MOHSEN 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 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 3087.58 0 0 0 0 0 0 3087.58 0 0 1010657010 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3190.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3190.88 0 0 1010657090 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 19785.35 0 0 0 0 0 0 0 0 0 0 0 0 0 19785.35 0 0 1010657151 1144519430 10 Physicians ADONGAY JOSEPH C 999999999 65 Madison 0 0 Colon - Rectal 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 0 271 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 12.59 0 0 0 0 0 0 12.59 0 0 1010657288 10 Physicians 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 87.08 0 0 0 0 0 0 87.08 0 0 1010657711 22 Physical Therapists 54 Kankakee 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 0 144.76 144.76 0 0 1010658377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24100.89 0 0 0 0 0 0 0 0 0 0 0 0 0 24100.89 0 0 1010658443 1972984698 10 Physicians WESSOL ELISE L 999999999 19 Champaign 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 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 2211.03 0 0 0 0 0 0 2211.03 0 0 1010658451 1003341363 91 Waiver service provider--Adults (DHS/DDD) WHITE JESSICA 999999999 30 DuPage 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63246.6 0 0 0 0 0 0 0 0 0 0 0 0 0 63246.6 0 0 1010658482 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 74.67 0 0 0 0 0 0 0 0 0 0 0 0 0 74.67 0 0 1010658556 1699246504 30 General Hospitals MANTENO DIALYSIS 999999999 54 Kankakee DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9440.98 0 0 0 0 0 9440.98 0 0 1010658975 1023499480 10 Physicians MOSENTHAL WILLIAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.44 0 106.68 0 0 0 0 0 0 112.12 0 0 1010658989 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16954.72 0 0 0 0 0 0 0 0 0 0 0 0 0 16954.72 0 0 1010659825 1639635972 16 Nurse Practitioners ANDES TAMMY 999999999 33 Effingham 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 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 41.27 0 0 0 0 0 0 41.27 0 0 1010660110 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 1010660132 1205283116 10 Physicians HARRIS ELIZABETH A 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 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 1294.67 0 0 0 0 0 0 1294.67 0 0 1010660258 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11064.02 0 0 0 0 0 0 0 0 0 0 0 0 0 11064.02 0 0 1010660337 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.37 0 0 0 0 0 0 26.37 0 0 1010660418 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5274.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5274.72 0 0 1010660794 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22840.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22840.64 0 0 1010660902 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1274.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1274.03 0 0 1010661089 1235491697 10 Physicians SMITH RYAN 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 0 171 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 6943.21 0 0 0 0 0 0 6943.21 0 0 1010661550 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16312.79 0 0 0 0 0 0 0 0 0 0 0 0 0 16312.79 0 0 1010661776 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 78.09 0 0 0 0 0 0 78.09 0 0 1010661993 1285977314 10 Physicians PONTARELLI KRISTINA N 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 3426.62 0 0 0 0 0 0 3426.62 0 0 1010662300 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10652.97 0 0 0 0 0 0 0 0 0 0 0 0 0 10652.97 0 0 1010662674 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25627.65 0 0 0 0 0 0 0 0 0 0 0 0 0 25627.65 0 0 1010662869 1548558950 89 Physician Assistant Only(Encounter Only) WILLIAMS NICKOLAS A 999999999 24 Coles 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 0 121 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 0 784.72 0 0 0 0 0 0 784.72 0 0 1010663031 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24129.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24129.2 0 0 1010663039 1740773555 89 Physician Assistant Only(Encounter Only) HEASLIP PATRICIA 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 0 131.56 0 0 0 0 0 0 131.56 0 0 1010663392 1427512748 16 Nurse Practitioners BUECHLER ANNE H 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 20.02 0 0 0 0 0 0 20.02 0 0 1010663647 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 35.27 0 0 0 0 0 0 0 0 0 0 0 0 0 35.27 0 0 1010663765 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 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 0 433.96 433.96 0 0 1010664108 10 Physicians 88 Richland 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 73.4 0 0 0 0 0 0 73.4 0 0 1010664126 1518199553 16 Nurse Practitioners SCHOLP CONSTANCE J 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 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 0 511.44 0 0 0 0 0 0 511.44 0 0 1010664360 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1774.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1774.52 0 0 1010664479 1609168681 10 Physicians GUPTA SHIPRA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4139.83 0 0 0 0 0 0 4139.83 0 0 1010664907 1164802609 10 Physicians SHAH ASHLEY A 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 0 326 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 2655.4 0 0 0 0 0 0 2655.4 0 0 1010664919 1457815425 16 Nurse Practitioners HOLLAND KIRBIE E 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 161.42 0 0 0 0 0 0 0 0 1429.64 0 0 0 0 0 0 1591.06 0 0 1010664925 1871087361 55 Early Intervention Services TIERNAN AIMEE M 999999999 65 Madison 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 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36514.91 0 0 0 0 0 0 36514.91 0 0 1010665147 1659863009 24 Speech Therapists BENSON BRONTE 999999999 71 McHenry 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 0 234 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 4851.37 4851.37 0 0 1010665282 1043643083 10 Physicians WINTHERS JONATHAN 999999999 30 DuPage 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 0 102 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 3887.14 0 0 0 0 0 0 3887.14 0 0 1010665581 1689948770 10 Physicians SUTPHEN SEAN A 999999999 200 Cook 0 0 Orthopedic Surgery 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 15 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.45 0 527.66 0 0 0 0 0 0 600.11 0 0 1010665723 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15437.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15437.49 0 0 1010665983 1336656537 16 Nurse Practitioners KOCH VICTORIA M 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 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 0 441.75 0 0 0 0 0 0 441.75 0 0 1010665988 1821512997 89 Physician Assistant Only(Encounter Only) ROSENBAUM MADELINE L 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 0 386.75 0 0 0 0 0 0 386.75 0 0 1010666202 1174006290 16 Nurse Practitioners LYONS MARY 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 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 61.76 0 0 0 0 0 0 61.76 0 0 1010666320 1437664109 16 Nurse Practitioners MOORE MELISA R 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 0 112 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 0 925.14 0 0 0 0 0 0 925.14 0 0 1010666664 1245632371 12 Optometrists AMIN PATHIK P 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 0 628.65 0 0 0 0 0 0 628.65 0 0 1010666723 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1051.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1051.86 0 0 1010666908 1265881981 10 Physicians GREENBERG JORDAN S 999999999 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 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 0 925.95 0 0 0 0 0 0 925.95 0 0 1010667325 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 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 0 207.84 207.84 0 0 1010667518 1205034410 10 Physicians WING DANIEL 999999999 89 Rock Island 0 0 Emergency 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 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 0 989.48 0 0 0 0 0 0 989.48 0 0 1010667529 91 Waiver service provider--Adults (DHS/DDD) 22 Clay 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113770.44 0 0 0 0 0 0 0 0 0 0 0 0 0 113770.44 0 0 1010667575 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 28851.01 0 0 0 0 0 0 0 0 0 0 0 0 0 28851.01 0 0 1010667989 1346244241 89 Physician Assistant Only(Encounter Only) SPRINKEL CHRISTOPHER A 999999999 91 Sangamon 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 0 121 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 1353.57 0 0 0 0 0 0 1353.57 0 0 1010668451 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25441.08 0 0 0 0 0 0 0 0 0 0 0 0 0 25441.08 0 0 1010668638 1184190290 91 Waiver service provider--Adults (DHS/DDD) PARKINSON SARAH 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 1705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66903.53 0 0 0 0 0 0 0 0 0 0 0 0 0 66903.53 0 0 1010668833 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2841.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2841.91 0 0 1010669043 1891134839 10 Physicians GITELIS SAMANTHA LYNN 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 0 782.85 0 0 0 0 0 0 782.85 0 0 1010669165 1932392032 28 Waiver service provider--Supportive living facility (HFS) "KENSINGTON, THE" 999999999 56 Knox 0 0 0 0 0 0 0 19 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 2128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167861.16 0 0 0 0 0 0 0 0 0 0 0 0 0 167861.16 0 0 1010669267 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 0 216 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 18432.27 0 0 0 0 0 0 0 0 0 0 0 0 0 18432.27 0 0 1010669404 1871931212 10 Physicians MEHTA CHRISTOPHER K 999999999 53 Kane 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11399.56 0 0 0 0 0 0 11399.56 0 0 1010669462 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11540.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11540.2 0 0 1010669528 1366952665 23 Occupational Therapists STULL CLAIRE C 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 152.32 0 0 0 0 0 586.95 739.27 0 0 1010669758 10 Physicians 200 Cook 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 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 0 492.62 0 0 0 0 0 0 0 0 492.62 0 0 1010670223 1851836696 86 Clinical Social Worker(Encounter Only) RYLATT JULIE 999999999 109 Winnebago 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 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39397.42 0 0 0 0 0 0 39397.42 0 0 1010670243 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 9634.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9634.8 0 0 1010670846 1427444967 10 Physicians CHAUDHRY ARSLAN T 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 0 226 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 3368.72 0 0 0 0 0 0 3368.72 0 0 1010670917 1568949329 36 Community mental health provider A SAFE HAVEN LLC 999999999 200 Cook 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 113.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9244.68 0 0 9358.56 0 0 1010671053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10403.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10403.18 0 0 1010671486 1255820619 16 Nurse Practitioners BURKHART AMY M 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 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 0 291.63 0 0 0 0 0 0 291.63 0 0 1010671510 1205305414 23 Occupational Therapists MATHIS KATELYN N 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211 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 15723.22 15723.22 0 0 1010671597 1912421678 24 Speech Therapists LOVGREN MARGARET 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49372.73 49372.73 0 0 1010671737 1649769746 65 Independent Diagnostic Testing Facility (IDTF) "ENVISION MEDICAL IMAGING, LLC" 999999999 200 Cook 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 0 188 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 8550.73 0 0 0 0 0 0 0 0 8550.73 0 0 1010672024 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20006.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20006.86 0 0 1010672157 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3382.57 0 0 0 0 0 0 0 0 0 0 0 0 0 3382.57 0 0 1010672189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 551.18 0 0 0 0 0 0 0 0 0 0 0 0 0 551.18 0 0 1010672408 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27393.17 0 0 0 0 0 0 0 0 0 0 0 0 0 27393.17 0 0 1010672505 1356755722 10 Physicians ADDANTE AMY 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 1 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123534.62 0 0 0 0 0 0 123534.62 0 0 1010672600 1649610064 10 Physicians LAHART ALEXANDRA C 999999999 30 DuPage 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 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 4365.08 0 0 0 0 0 0 4365.08 0 0 1010672743 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13364.28 0 0 0 0 0 0 0 0 0 0 0 0 0 13364.28 0 0 1010673269 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2112.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2112.33 0 0 1010673358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20725.74 0 0 0 0 0 0 0 0 0 0 0 0 0 20725.74 0 0 1010673683 1841784139 16 Nurse Practitioners ALVAREZ COURTNEY 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 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 0 468.04 0 0 0 0 0 0 468.04 0 0 1010673838 1669899159 10 Physicians THALHEIMER JASON 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 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 0 233.34 0 0 0 0 0 0 233.34 0 0 1010674189 1295140960 10 Physicians LAWLOR MEGAN 999999999 80 Peoria 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 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.12 0 1037.9 0 0 0 0 0 0 1107.02 0 0 1010674515 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7757.42 0 0 0 0 0 0 0 0 0 0 0 0 0 7757.42 0 0 1010674533 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16877.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16877.4 0 0 1010674743 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 16998.21 0 0 0 0 0 0 0 0 0 0 0 0 0 16998.21 0 0 1010674942 1295146587 10 Physicians HENKLE SARAH 999999999 200 Cook 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 6 0 73 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 8 0 134 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 8 0 134 0 0 0 0 0 0 0 0 0 248.44 0 0 0 0 0 0 63.21 0 6574.57 0 0 0 0 0 0 6886.22 0 0 1010675096 1154707024 10 Physicians JAIDEV PRAVEENA USHA 999999999 53 Kane 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6922.9 0 0 0 0 0 0 6922.9 0 0 1010675236 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22379.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22379.22 0 0 1010675276 1437326238 16 Nurse Practitioners SHARMA MADHU 999999999 54 Kankakee 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 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 0 825.47 0 0 0 0 0 0 825.47 0 0 1010675368 1104292275 10 Physicians KOTKAR KUNAL 999999999 91 Sangamon 0 0 Thoracic Surgery 0 0 0 0 0 0 0 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 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 5287.95 0 0 0 0 0 0 5287.95 0 0 1010675452 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 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 1010675617 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23815.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23815.7 0 0 1010675714 1306293626 10 Physicians GONZALEZ VICTORIA 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 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 1297.53 0 0 0 0 0 0 1297.53 0 0 1010676263 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 1010676371 1861905028 11 Dentists BUKHAR ALENA 999999999 200 Cook 0 0 General Dentistry 0 0 31 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 13561.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13561.9 0 0 1010676530 16 Nurse Practitioners 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010676581 1063878072 30 General Hospitals TINLEY PARK DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24291.24 0 0 0 0 0 24291.24 0 0 1010676777 1720490667 10 Physicians KHURRAM MUHAMMAD 999999999 53 Kane 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 0 177 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 1806.76 0 0 0 0 0 0 0 0 1806.76 0 0 1010676810 1427405075 63 Other Providers of Medical Equipment/Supplies (Non-registered) LIVING CENTERS INC 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 7042.01 0 0 0 0 0 0 7042.01 0 0 1010676952 1386995595 16 Nurse Practitioners NELSON KRISTINA 999999999 54 Kankakee 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 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 0 565.18 0 0 0 0 0 0 565.18 0 0 1010677125 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010677272 1245586775 10 Physicians ROSE JUSTIN A 999999999 80 Peoria 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 0 133 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 4666.69 0 0 0 0 0 0 4666.69 0 0 1010677278 1306310131 16 Nurse Practitioners RUCKMAN KAITLYN 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 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 1100.31 0 0 0 0 0 0 1100.31 0 0 1010677291 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 1010681346 1518463330 89 Physician Assistant Only(Encounter Only) ANNES NICOLE 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 0 220.55 0 0 0 0 0 0 220.55 0 0 1010681435 1689191033 16 Nurse Practitioners PIELA AMANDA L 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 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 78.09 0 0 0 0 0 0 78.09 0 0 1010681529 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 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 3.99 0 0 0 0 0 0 3.99 0 0 1010681692 88 Other behavior health professional 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 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 0 652.06 0 0 0 0 0 0 652.06 0 0 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0 0 0 0 0 170.66 0 0 1010686088 10 Physicians 200 Cook 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.16 0 0 0 0 0 0 141.16 0 0 1010686221 1922550433 91 Waiver service provider--Adults (DHS/DDD) JAUREGUI BETSY 999999999 91 Sangamon 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76917.6 0 0 0 0 0 0 0 0 0 0 0 0 0 76917.6 0 0 1010686385 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 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 62.97 62.97 0 0 1010686400 1083170278 16 Nurse Practitioners HATCHER BRANDY J 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 0 207 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 3084.06 0 0 0 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1010686929 1205344603 40 Federally Qualified Health Centers HOWARD BROWN HEALTH COUNSELING 999999999 200 Cook 0 0 0 43 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 14704.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14704.09 0 0 1010686962 10 Physicians 109 Winnebago 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 0 143.12 0 0 0 0 0 0 143.12 0 0 1010687151 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24266.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24266.37 0 0 1010687322 1114920048 30 General Hospitals UNITYPOINT MERITER 537151507 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 8 0 0 0 0 6 0 0 0 14 0 0 0 0 0 0 0 0 0 10 0 0 0 0 6 0 0 0 16 0 0 0 0 0 0 0 0 0 10 0 0 0 0 18 0 0 0 21 0 0 0 0 0 0 0 0 0 1471.81 0 0 0 0 7135.82 0 0 0 6836.26 0 0 0 0 0 15443.89 0 0 1010687396 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 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 1010687592 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 0 0 0 0 0 0 0 0 0 0 1010687716 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 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 21904.26 0 0 0 0 0 0 0 0 0 0 0 0 0 21904.26 0 0 1010687757 1720570799 60 Pharmacies "COMMUNITY, A WALGREENS PHARMAC" 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 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 1923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99691.93 0 0 0 99691.93 0 0 1010687827 1457709172 10 Physicians REHMAN JAMAAL A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586.84 0 0 0 0 0 0 0 0 586.84 0 0 1010687875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9551.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9551.26 0 0 1010687892 1760985436 60 Pharmacies CRX PHARMACY 999999999 200 Cook 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 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14858 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1617.28 0 0 0 1617.28 0 0 1010688044 1184914699 10 Physicians SHEFFER DOUGLAS W 999999999 41 Hamilton 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 0 142 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 0 996.29 0 0 0 0 0 0 996.29 0 0 1010688189 1528347937 16 Nurse Practitioners HOWELL SOO J 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 0 136 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 0 0 0 0 0 0 0 0 0 0 1010688411 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18760.7 0 0 0 0 0 0 0 0 0 0 0 0 0 18760.7 0 0 1010688480 1245747971 16 Nurse Practitioners ATANASOFF NICOLE 999999999 109 Winnebago 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 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11014.94 0 0 0 0 0 0 11014.94 0 0 1010688561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140.81 0 0 0 0 0 0 0 0 0 0 0 0 0 140.81 0 0 1010688830 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 0 0 0 0 0 0 0 0 0 0 1010688858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26179.8 0 0 0 0 0 0 0 0 0 0 0 0 0 26179.8 0 0 1010688949 1255712816 10 Physicians DESANTO CORI L 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 1776.94 0 0 0 0 0 0 1776.94 0 0 1010689168 1447728183 16 Nurse Practitioners MERCADO PAOLO 999999999 53 Kane 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 0 101 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 2882.54 0 0 0 0 0 0 2882.54 0 0 1010689456 1497286884 10 Physicians SHANAHAN CHRISTINE M 999999999 200 Cook 0 0 Internal Medicine 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 0 236.01 0 0 0 0 0 0 236.01 0 0 1010690281 1801158894 10 Physicians COHEN ANAT 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 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 6176.69 0 0 0 0 0 0 6176.69 0 0 1010690446 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16757.02 0 0 0 0 0 0 0 0 0 0 0 0 0 16757.02 0 0 1010690762 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 511.4 0 0 0 0 0 0 0 0 0 0 0 0 0 511.4 0 0 1010690783 1790272789 16 Nurse Practitioners BELL BRANDON K. 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 0 873.28 0 0 0 0 0 0 873.28 0 0 1010691338 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23899.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23899.04 0 0 1010691667 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 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 7666.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7666.7 0 0 1010691689 1306230370 10 Physicians QUARLES AARON R 999999999 200 Cook 0 0 Emergency Medicine 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 0 230 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 6426.86 0 0 0 0 0 0 6426.86 0 0 1010691714 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 0 169 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 14625.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14625.8 0 0 1010691814 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 0 157 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 11167.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11167.45 0 0 1010691918 1568622702 10 Physicians BERKES MARSCHALL B 999999999 24 Coles 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 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 11984.65 0 0 0 0 0 0 11984.65 0 0 1010692029 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24863.63 0 0 0 0 0 0 0 0 0 0 0 0 0 24863.63 0 0 1010692097 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19189.98 0 0 0 0 0 0 0 0 0 0 0 0 0 19189.98 0 0 1010692193 1588058580 10 Physicians GERBIE EMILY Y 999999999 200 Cook 0 0 Urology 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 5 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.84 0 410.66 0 0 0 0 0 0 423.5 0 0 1010692478 1619448461 16 Nurse Practitioners LACPLESIS KRISTINA M 999999999 109 Winnebago 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 0 104 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 3828.78 0 0 0 0 0 0 3828.78 0 0 1010692535 1396069191 89 Physician Assistant Only(Encounter Only) DUER CHARLOTTE 600162359 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 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 1563.39 0 0 0 0 0 0 1563.39 0 0 1010692730 1114332152 10 Physicians YEN EUGENE C 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 121 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 4694.31 0 0 0 0 0 0 4694.31 0 0 1010692929 1356860100 16 Nurse Practitioners KONIECZNY MARGARET 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.58 0 0 0 0 0 0 255.58 0 0 1010693046 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17419.6 0 0 0 0 0 0 0 0 0 0 0 0 0 17419.6 0 0 1010693262 1659809853 91 Waiver service provider--Adults (DHS/DDD) MEZA SANJUANA 999999999 200 Cook 0 0 0 0 0 0 0 15 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 3203.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3203.33 0 0 1010693296 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25047.02 0 0 0 0 0 0 0 0 0 0 0 0 0 25047.02 0 0 1010693377 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 0 126.42 0 0 0 0 0 0 126.42 0 0 1010693626 1316432420 11 Dentists ZHOU YANG 999999999 27 Dekalb 0 0 General Dentistry 0 0 256 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 1056 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 1056 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 32188.55 0 0 0 0 0 0 0 0 0 0 0 4139.85 0 0 0 0 36328.4 0 0 1010693776 1275037665 10 Physicians WALTON EMILY ANN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 6377.52 0 0 0 0 0 0 6413.47 0 0 1010694125 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 301.58 0 0 0 0 0 0 0 0 0 0 0 0 0 301.58 0 0 1010694211 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16792.05 0 0 0 0 0 0 0 0 0 0 0 0 0 16792.05 0 0 1010694590 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21214.1 0 0 0 0 0 0 0 0 0 0 0 0 0 21214.1 0 0 1010694618 4010694618 90 Waiver service provider--Elderly (DOA) DAYSPRING HEALTHCARE SERVICES 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 1809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169596.18 0 0 0 0 0 0 0 0 0 0 0 0 0 169596.18 0 0 1010694727 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 97.8 0 0 0 0 0 0 97.8 0 0 1010694814 12 Optometrists 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 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 42.06 0 0 0 0 42.06 0 0 1010695027 1376089136 91 Waiver service provider--Adults (DHS/DDD) OWSLEY TAMARA 999999999 200 Cook 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 2206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81116.33 0 0 0 0 0 0 0 0 0 0 0 0 0 81116.33 0 0 1010695037 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 1010695146 1902335391 12 Optometrists TANG TIFFANY H 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.7 0 58.56 0 0 0 0 127.26 0 0 1010695934 1972590719 16 Nurse Practitioners PRYKA MARY 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1010696566 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 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 4700.99 0 0 0 0 0 0 0 0 0 0 0 0 0 4700.99 0 0 1010696826 91 Waiver service provider--Adults (DHS/DDD) 78 Moultrie 0 0 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 22587.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22587.06 0 0 1010696952 1467654962 47 Local Education Agencies KNOX WARREN SPEC EDUC DISTRICT 614014855 56 Knox 0 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 6550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67579.8 0 67579.8 0 0 1010697089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29626.2 0 0 0 0 0 0 0 0 0 0 0 0 0 29626.2 0 0 1010697192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5054.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5054.94 0 0 1010697786 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 0 208 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 22294.59 0 0 0 0 0 0 0 0 0 0 0 0 0 22294.59 0 0 1010697799 1144790536 22 Physical Therapists LUCAS PAIGE 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 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 0 281.47 281.47 0 0 1010697803 1720444110 10 Physicians OIKEH ASIKHAME A 999999999 47 Jackson 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 0 176 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 5437.67 0 0 0 0 0 0 5437.67 0 0 1010697928 1154663441 10 Physicians PATEL MONA 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 3 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1871.41 0 0 0 0 0 0 1871.41 0 0 1010698029 1720513922 91 Waiver service provider--Adults (DHS/DDD) HARMONY HOUSE 999999999 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 4058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4058 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598978.77 0 0 0 0 0 0 0 0 0 0 0 0 0 598978.77 0 0 1010698122 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3139.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3139.9 0 0 1010698132 1346621505 10 Physicians LORTS STEPHANIE N 999999999 65 Madison 0 0 Pediatrics 0 0 0 39 0 0 0 0 0 0 13 0 53 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 13 0 74 0 0 0 0 0 0 0 0 0 4006.85 0 0 0 0 0 0 343.18 0 3720.29 0 0 0 0 0 0 8070.32 0 0 1010698157 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16337.42 0 0 0 0 0 0 0 0 0 0 0 0 0 16337.42 0 0 1010698216 1265931455 16 Nurse Practitioners HUTKOWSKI COURTNEY L 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 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 0 222.48 0 0 0 0 0 0 222.48 0 0 1010698244 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 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 1.14 0 0 0 0 0 0 1.14 0 0 1010698279 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 0 238 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 15358.12 0 0 0 0 0 0 0 0 0 0 0 0 0 15358.12 0 0 1010698312 1427324425 10 Physicians WABICH JAMIE B 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 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 2732.63 0 0 0 0 0 0 2732.63 0 0 1010698624 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23832.03 0 0 0 0 0 0 0 0 0 0 0 0 0 23832.03 0 0 1010698636 11 Dentists 53 Kane 0 0 General Dentistry 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.2 0 0 1010698709 1134633902 16 Nurse Practitioners OLALUSI JOSEPH O 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 1366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9543.41 0 0 0 0 0 0 9543.41 0 0 1010698784 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20483.57 0 0 0 0 0 0 0 0 0 0 0 0 0 20483.57 0 0 1010699048 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13279.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13279.37 0 0 1010699243 1124520424 60 Pharmacies CVS PHARMACY #10981 999999999 58 La Salle 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 1837 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86455.26 0 0 0 86455.26 0 0 1010699588 1245240456 22 Physical Therapists NAZAL FERDIE 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 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 0 705.93 705.93 0 0 1010699755 1255435996 10 Physicians LONG JULIE A 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 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 1576.1 0 0 0 0 0 0 1576.1 0 0 1010699785 1316334816 10 Physicians BRUCE LYDIA 999999999 200 Cook 0 0 Family Practice 0 0 0 10 0 0 0 0 0 0 0 0 22 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 0 916.65 0 0 0 0 0 0 0 0 727.6 0 0 0 0 0 0 1644.25 0 0 1010700132 1538681986 30 General Hospitals US RENAL CARE HICKORY HILLS DI 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 39 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 81.38 0 0 0 0 0 81.38 0 0 1010700287 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010700337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23175.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23175.64 0 0 1010700416 1366769945 10 Physicians VYAS BIMAL 999999999 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 674 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 866 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10160.11 0 378.21 0 0 0 0 0 0 10538.32 0 0 1010700487 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 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 56.17 56.17 0 0 1010700525 1255772471 16 Nurse Practitioners REILLY BRENDA A 999999999 53 Kane 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 0 199 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 9062.89 0 0 0 0 0 0 9062.89 0 0 1010701049 1215479621 16 Nurse Practitioners ABU-SAMRA LISA 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6850.07 0 0 0 0 0 0 6850.07 0 0 1010701072 1073651568 10 Physicians MCMURRY SARAH 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 1371.02 0 0 0 0 0 0 1371.02 0 0 1010701102 1508356098 48 Rural Health Clinics QUINCY MEDICAL GROUP KEOKUK AF 999999999 10 Adams 0 0 0 65 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7778.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7778.37 0 0 1010701330 1336503580 89 Physician Assistant Only(Encounter Only) RIDDELL TIMOTHY N 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 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 0 160.54 0 0 0 0 0 0 160.54 0 0 1010701605 1619461688 10 Physicians SO ROBIN C 999999999 200 Cook 0 0 Pediatrics 0 0 0 31 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1174.31 0 0 0 0 0 0 0 0 312.31 0 0 0 0 0 0 1486.62 0 0 1010701657 1255836326 16 Nurse Practitioners BATES 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 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 0 118.67 0 0 0 0 0 0 118.67 0 0 1010701816 1497199640 10 Physicians UEDA KEISUKE 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 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 1469.88 0 0 0 0 0 0 1469.88 0 0 1010701838 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 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 72.88 0 0 0 0 0 0 72.88 0 0 1010702024 1205331063 16 Nurse Practitioners ARAIZA MARY 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 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 0 245.65 0 0 0 0 0 0 245.65 0 0 1010702135 12 Optometrists 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.82 0 0 0 0 0 0 126.82 0 0 1010702280 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 0 217 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 14603.16 0 0 0 0 0 0 0 0 0 0 0 0 0 14603.16 0 0 1010702484 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25818.89 0 0 0 0 0 0 0 0 0 0 0 0 0 25818.89 0 0 1010702808 1154526739 10 Physicians MENDEL JESSICA N 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 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 0 151.16 0 0 0 0 0 0 151.16 0 0 1010702813 1811480908 10 Physicians RODRIGUEZ HERIBERTO 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 3 0 29 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 2.22 0 182.13 0 0 0 0 0 0 184.35 0 0 1010702819 1992146179 10 Physicians REHMAN ANIS 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.28 0 6364.58 0 0 0 0 0 0 6392.86 0 0 1010702913 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 165.7 0 0 0 0 0 0 237.6 0 0 1010702947 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26180.22 0 0 0 0 0 0 0 0 0 0 0 0 0 26180.22 0 0 1010703125 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15286.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15286.86 0 0 1010703225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23369.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23369.94 0 0 1010703315 12 Optometrists 57 Lake 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 214.95 0 0 0 0 0 0 214.95 0 0 1010703495 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26197.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 1010703578 1780061713 10 Physicians ELKHATIB OSAMA ZIAD 999999999 200 Cook 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 0 309 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 3118.87 0 0 0 0 0 0 3118.87 0 0 1010703613 91 Waiver service provider--Adults (DHS/DDD) 57 Lake 0 0 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 0 640.15 0 0 0 0 0 0 0 0 0 0 0 0 0 640.15 0 0 1010704016 1437577285 10 Physicians FANTUS SARAH 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 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 2116.37 0 0 0 0 0 0 2116.37 0 0 1010704139 1144663568 10 Physicians GRAY KATY 999999999 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 22 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.11 0 1018.09 0 0 0 0 0 0 1976.2 0 0 1010705103 1154816700 16 Nurse Practitioners JOHNSON CYNTHIA E 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 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 0 677.78 0 0 0 0 0 0 677.78 0 0 1010705188 1962924902 10 Physicians OREN NISA C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 284 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3339.94 0 60.8 0 0 0 0 0 0 3400.74 0 0 1010705296 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 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 90.27 0 0 0 0 0 0 90.27 0 0 1010705861 1427006402 10 Physicians LEE YVONNE C 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 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 22738.6 0 0 0 0 0 0 22738.6 0 0 1010706048 1255843272 16 Nurse Practitioners TRIGG ALLISON 999999999 91 Sangamon 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 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 2663.71 0 0 0 0 0 0 2663.71 0 0 1010706055 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10643.05 0 0 0 0 0 0 0 0 0 0 0 0 0 10643.05 0 0 1010706954 1982151049 22 Physical Therapists GWARDYS ADAM 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 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 0 841.84 841.84 0 0 1010707014 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 11041.94 0 0 0 0 0 0 0 0 0 0 0 0 0 11041.94 0 0 1010707094 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23422.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23422.6 0 0 1010707137 1427542471 16 Nurse Practitioners GBABIRI DEBRA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 1951.87 0 0 0 0 0 0 2016.17 0 0 1010707264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6756.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6756.2 0 0 1010707445 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23234.75 0 0 0 0 0 0 0 0 0 0 0 0 0 23234.75 0 0 1010707462 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17559.33 0 0 0 0 0 0 0 0 0 0 0 0 0 17559.33 0 0 1010707769 1518251347 10 Physicians POCIVAVSEK LUKA 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 4 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.52 0 7134.77 0 0 0 0 0 0 7155.29 0 0 1010707799 1336659838 16 Nurse Practitioners WASMUTH KELSY B 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 87.08 0 0 0 0 0 0 87.08 0 0 1010707915 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2626.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2626.8 0 0 1010707960 1871006239 60 Pharmacies NORTHWEST COMMUNITY PHARMACY 999999999 200 Cook 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 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30843.59 0 0 0 30843.59 0 0 1010707961 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010708098 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20056.96 0 0 0 0 0 0 0 0 0 0 0 0 0 20056.96 0 0 1010708174 1780071050 10 Physicians MOHAMMED FAYEZA 999999999 200 Cook 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 483.75 0 0 0 0 0 0 0 0 1759.3 0 0 0 0 0 0 2243.05 0 0 1010708265 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 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 16129.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16129.67 0 0 1010708316 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.93 0 0 0 0 0 0 29.93 0 0 1010708470 1225317464 10 Physicians KHAN MARIAM ALI 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 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 1789.24 0 0 0 0 0 0 1789.24 0 0 1010708579 16 Nurse Practitioners 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1010708842 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22882.65 0 0 0 0 0 0 0 0 0 0 0 0 0 22882.65 0 0 1010708946 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 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 15022.74 0 0 0 0 0 0 0 0 0 0 0 0 0 15022.74 0 0 1010709010 1336675933 10 Physicians ANGELOVA PETRA PETEVA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 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 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.47 0 739.05 0 0 0 0 0 0 750.52 0 0 1010709148 1295978526 10 Physicians ZAHEERULLAH MOHAMMAD 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.52 0 11014.06 0 0 0 0 0 0 11103.58 0 0 1010709205 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2226.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2226.42 0 0 1010709473 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 93.61 93.61 0 0 1010710037 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11454.21 0 0 0 0 0 0 0 0 0 0 0 0 0 11454.21 0 0 1010710225 1699940999 89 Physician Assistant Only(Encounter Only) BROWN STACEY 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 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 0 170.09 0 0 0 0 0 0 170.09 0 0 1010710270 1699273011 16 Nurse Practitioners DEAN TIFFANY 999999999 200 Cook 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 0 267 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 2998.76 0 0 0 0 0 0 2998.76 0 0 1010711088 1679050132 16 Nurse Practitioners GREEN ALICIA F 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 299.04 0 0 0 0 0 0 299.04 0 0 1010711120 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3432.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3432.51 0 0 1010711318 1891212718 60 Pharmacies CVS PHARMACY #17706 999999999 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3709 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3694.55 0 0 0 3694.55 0 0 1010711440 1376067736 89 Physician Assistant Only(Encounter Only) MCGRATH MEGHAN 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 82.74 0 0 0 0 0 0 82.74 0 0 1010711692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35936.43 0 0 0 0 0 0 0 0 0 0 0 0 0 35936.43 0 0 1010711802 1871755470 10 Physicians MITCHELL JOSHUA D 999999999 815 Indiana 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 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 0 276.34 0 0 0 0 0 0 276.34 0 0 1010711879 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6638.17 0 0 0 0 0 0 0 0 0 0 0 0 0 6638.17 0 0 1010711899 1023517109 16 Nurse Practitioners HUBBARD PAULA K 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 827.99 0 0 0 0 0 0 827.99 0 0 1010712165 1336678929 16 Nurse Practitioners GUSSWEIN AMANDA S 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 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 0 867.06 0 0 0 0 0 0 867.06 0 0 1010712777 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 9974.28 0 0 0 0 0 0 0 0 0 0 0 0 0 9974.28 0 0 1010712996 1679594055 10 Physicians GARG SANJAY 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 8 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 5 0 35 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 5 0 35 0 0 0 0 0 0 0 0 0 1340.92 0 0 0 0 0 0 78.4 0 1165.05 0 0 0 0 0 0 2584.37 0 0 1010713028 1417217415 10 Physicians STRANGE JEHU E 999999999 200 Cook 0 0 Family Practice 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339.9 0 1085.95 0 0 0 0 0 0 1425.85 0 0 1010713084 1447744438 10 Physicians LEVAULT KELSEY 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 8 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 64.3 0 0 0 0 0 0 0 0 227.04 0 0 0 0 0 0 291.34 0 0 1010713205 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 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 1010713289 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13748.46 0 0 0 0 0 0 0 0 0 0 0 0 0 13748.46 0 0 1010713536 1013394022 16 Nurse Practitioners BRUMLEVE LENA M 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 460.63 0 0 0 0 0 0 460.63 0 0 1010713626 1598137390 16 Nurse Practitioners KIRBY SHANNON 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 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 0 845.17 0 0 0 0 0 0 845.17 0 0 1010713784 1437286671 89 Physician Assistant Only(Encounter Only) WILLS AUTUMN C 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 0 494.86 0 0 0 0 0 0 494.86 0 0 1010713887 1255325320 10 Physicians PUZIO-BELL MICHELLE 999999999 200 Cook 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 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.31 0 1017.74 0 0 0 0 0 0 1069.05 0 0 1010714058 1629545892 16 Nurse Practitioners SHEEHY MARY 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 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 2537.46 0 0 0 0 0 0 2537.46 0 0 1010714370 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.8 0 0 0 0 0 0 0 0 0 0 0 0 0 162.8 0 0 1010714407 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29593.05 0 0 0 0 0 0 0 0 0 0 0 0 0 29593.05 0 0 1010714669 94 Waiver service provider--Children's support (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 0 209 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 19389.96 0 0 0 0 0 0 0 0 0 0 0 0 0 19389.96 0 0 1010714929 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9584.85 0 0 0 0 0 0 0 0 0 0 0 0 0 9584.85 0 0 1010715385 1689094948 10 Physicians HASHIMI SYED YAMIN 999999999 47 Jackson 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 0 207 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 3694.2 0 0 0 0 0 0 3694.2 0 0 1010715707 1255818258 16 Nurse Practitioners HAYES JUSTIN RAY 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 966.55 0 0 0 0 0 0 1036.07 0 0 1010716149 1295096154 10 Physicians FRAINT AVRAM 999999999 200 Cook 0 0 Neurology 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 4178.92 0 0 0 0 0 0 4178.92 0 0 1010716721 1689166456 11 Dentists ABUSHARARA BARA M 999999999 200 Cook 0 0 0 0 38 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 8820.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8820.06 0 0 1010716923 1043691165 11 Dentists VADLAMANI PRATHYUSHA 999999999 200 Cook 0 0 General Dentistry 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 1237.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237.16 0 0 1010717074 1558886861 16 Nurse Practitioners SEXTON MICHELLE 999999999 53 Kane 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 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 1927.26 0 0 0 0 0 0 1927.26 0 0 1010717163 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544.38 0 0 0 0 0 0 544.38 0 0 1010717174 1689196578 75 Department of Alcohol and Substance Abuse Provider SERENITY TREATMENT AND COUNSEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3011.65 0 0 3011.65 0 0 1010717600 1760993711 89 Physician Assistant Only(Encounter Only) WOJTOWICZ ELIZABETH 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 95.24 0 0 0 0 0 0 95.24 0 0 1010717714 10 Physicians 109 Winnebago 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 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.36 0 0 0 0 0 0 0 0 110.36 0 0 1010717739 1326546185 89 Physician Assistant Only(Encounter Only) WOODBRIDGE WHITNEY K 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 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 0 126.22 0 0 0 0 0 0 126.22 0 0 1010717841 1124533047 12 Optometrists YEE KIMBERLY 999999999 67 Marshall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1260.48 0 527.04 0 0 0 0 1787.52 0 0 1010718233 1790934297 10 Physicians YUN DURI 999999999 200 Cook 0 0 Dermatology 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 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 3953.25 0 0 0 0 0 0 3953.25 0 0 1010718325 1083132963 16 Nurse Practitioners SLOAN SARAH I 999999999 91 Sangamon 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 0 218 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 1242.25 0 0 0 0 0 0 1242.25 0 0 1010718357 1811480635 11 Dentists AZIMI MOHAMMAD MOEIN ZAVAREHEE 999999999 57 Lake 0 0 General Dentistry 0 0 80 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 14980.27 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 15732.97 0 0 1010718890 1023592524 16 Nurse Practitioners SPANGLER NICOLE 999999999 19 Champaign 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 0 104 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 5324.76 0 0 0 0 0 0 5324.76 0 0 1010718943 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23874.62 0 0 0 0 0 0 0 0 0 0 0 0 0 23874.62 0 0 1010719181 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010719253 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 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 0 0 0 0 1010719374 10 Physicians 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 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 40.69 0 0 0 0 0 0 40.69 0 0 1010719504 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 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 26980.74 0 0 0 0 0 0 0 0 0 0 0 0 0 26980.74 0 0 1010719661 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24992 0 0 0 0 0 0 0 0 0 0 0 0 0 24992 0 0 1010720179 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 1010720382 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29531.64 0 0 0 0 0 0 0 0 0 0 0 0 0 29531.64 0 0 1010720386 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 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 0 911.4 0 0 0 0 0 0 0 0 0 0 0 0 0 911.4 0 0 1010720487 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22844.91 0 0 0 0 0 0 0 0 0 0 0 0 0 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MAHANNAH JENNIFER S 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 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 0 283.98 0 0 0 0 0 0 283.98 0 0 1010739609 1649436783 89 Physician Assistant Only(Encounter Only) PENKALA APRIL 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 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 0 100.21 0 0 0 0 0 0 100.21 0 0 1010739631 1891052437 10 Physicians TYLER MATTHEW D 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 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 2022.02 0 0 0 0 0 0 2022.02 0 0 1010739804 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 20312.49 0 0 0 0 0 0 0 0 0 0 0 0 0 20312.49 0 0 1010739828 10 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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 16135.43 0 0 0 0 0 0 0 0 0 0 0 0 0 16135.43 0 0 1010742393 70 Ambulance Service Providers 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462.4 0 0 0 0 0 0 462.4 0 0 1010742501 1417399676 10 Physicians BYRNES KATHLEEN 999999999 53 Kane 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 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 1404.36 0 0 0 0 0 0 0 0 1404.36 0 0 1010742565 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 10367.63 0 0 0 0 0 0 0 0 0 0 0 0 0 10367.63 0 0 1010742606 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22936.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22936.9 0 0 1010742618 1851360820 89 Physician Assistant Only(Encounter Only) SCHEETZ GAYLE 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 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 0 415.77 0 0 0 0 0 0 415.77 0 0 1010742638 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 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 12193.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12193.72 0 0 1010742794 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25267.17 0 0 0 0 0 0 0 0 0 0 0 0 0 25267.17 0 0 1010743060 1992124218 10 Physicians VEADE ASHLEY E 999999999 65 Madison 0 0 Obstetric-Gynecology 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 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 21.57 0 131.96 0 0 0 0 0 0 153.53 0 0 1010743181 1144735978 11 Dentists CHUGHTAI ABDULLAH 999999999 89 Rock Island 0 0 General Dentistry 0 0 12 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 4 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2919.44 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 4424.84 0 0 1010743301 1215408968 16 Nurse Practitioners ROYER LADAWNA 999999999 70 McDonough 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 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 0 0 0 0 0 0 0 0 0 75.57 0 0 0 0 0 0 75.57 0 0 1010743762 1225548753 65 Independent Diagnostic Testing Facility (IDTF) HSHS SLEEP DISORDER CENTER SOU 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.04 0 0 0 0 0 0 0 0 62.04 0 0 1010743814 4010743814 91 Waiver service provider--Adults (DHS/DDD) LEE KARLA J 999999999 91 Sangamon 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9397.63 0 0 0 0 0 0 0 0 0 0 0 0 0 9397.63 0 0 1010743833 1326492620 10 Physicians PATEL JAY A 999999999 19 Champaign 0 0 Family Practice 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 0 102 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 2501.88 0 0 0 0 0 0 2501.88 0 0 1010743948 1841600194 10 Physicians SANDERS VANESSA R. 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 30 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.25 0 61 0 0 0 0 0 0 230.25 0 0 1010744177 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 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 2621.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2621.8 0 0 1010744618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17739.75 0 0 0 0 0 0 0 0 0 0 0 0 0 17739.75 0 0 1010744782 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010744796 1043660350 10 Physicians ZHU TINA T 999999999 30 DuPage 0 0 Internal 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 0 226 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 3473.02 0 0 0 0 0 0 3473.02 0 0 1010744842 1710333000 10 Physicians FISCHRE NOEL-MARIE C 999999999 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1829.18 0 0 0 0 0 0 1829.18 0 0 1010744890 1013258110 89 Physician Assistant Only(Encounter Only) MORRIS LATANYA D 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 0 419.28 0 0 0 0 0 0 419.28 0 0 1010745203 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22805.16 0 0 0 0 0 0 0 0 0 0 0 0 0 22805.16 0 0 1010745428 1578981544 10 Physicians KUMAR SMITA J 999999999 53 Kane 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 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 1161.86 0 0 0 0 0 0 1161.86 0 0 1010745499 1043604580 10 Physicians MARTUSIEWICZ MONIKA 999999999 200 Cook 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 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 4301.93 0 0 0 0 0 0 4301.93 0 0 1010745619 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010745823 1003324260 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 999999999 10 Adams 0 0 0 148 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 19314.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19314.61 0 0 1010745869 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6674.8 0 0 0 0 0 0 0 0 0 0 0 0 0 6674.8 0 0 1010746104 1013267194 10 Physicians GEORGE AMRUTHA MARY 999999999 109 Winnebago 0 0 Internal Medicine 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 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.97 0 1725.8 0 0 0 0 0 0 1727.77 0 0 1010746260 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 31.01 0 0 0 0 0 0 31.01 0 0 1010746275 1912428129 10 Physicians KLEIN SAMUEL E 999999999 200 Cook 0 0 Emergency 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 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 1675.99 0 0 0 0 0 0 1675.99 0 0 1010746305 1699120535 10 Physicians SHAIKH IMRAN 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 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 0 110.72 0 0 0 0 0 0 110.72 0 0 1010746605 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010746626 10 Physicians 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.19 0 0 0 0 0 0 25.19 0 0 1010746928 1457822199 33 Nursing Facilities ELEVATE CARE WAUKEGAN 999999999 57 Lake 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 0 375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074213.6 0 0 0 0 0 0 0 1074213.6 0 0 1010747343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11148.61 0 0 0 0 0 0 0 0 0 0 0 0 0 11148.61 0 0 1010747349 1336501238 10 Physicians SNIDER JOSEPHINE B 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 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 3329.47 0 0 0 0 0 0 3329.47 0 0 1010747383 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885.85 0 0 0 0 0 0 0 0 0 0 0 0 0 885.85 0 0 1010747390 1326302258 10 Physicians GILL RICK 999999999 200 Cook 0 0 Neurology 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 0 170 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 5002.2 0 0 0 0 0 0 5002.2 0 0 1010747659 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22792 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 1010747790 1104343599 16 Nurse Practitioners PATEL MONA J 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 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 1250.23 0 0 0 0 0 0 1250.23 0 0 1010747800 1891206892 16 Nurse Practitioners BARCLAY JULIE L 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 0 202.51 0 0 0 0 0 0 202.51 0 0 1010748204 1265475768 16 Nurse Practitioners BARNES LAURA 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 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 0 739.46 0 0 0 0 0 0 739.46 0 0 1010748297 1144622457 22 Physical Therapists SUNSERI ELIZABETH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 21614.3 21614.3 0 0 1010748407 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4324.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4324.81 0 0 1010748541 1942454624 16 Nurse Practitioners AMES VANESSA M 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 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 1419.88 0 0 0 0 0 0 1419.88 0 0 1010748549 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 58.4 0 0 0 0 0 0 58.4 0 0 1010749070 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.11 0 0 0 0 0 0 42.11 0 0 1010749233 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 283.17 0 0 0 0 0 0 0 0 0 0 0 0 0 283.17 0 0 1010749570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4832.87 0 0 0 0 0 0 0 0 0 0 0 0 0 4832.87 0 0 1010749621 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17155.05 0 0 0 0 0 0 0 0 0 0 0 0 0 17155.05 0 0 1010749864 1245672393 10 Physicians ONAJIN OLUWAKEMI 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 44 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.29 0 599.24 0 0 0 0 0 0 886.53 0 0 1010749894 1811242118 10 Physicians SWAMINARAYAN HARSHIL Y 999999999 19 Champaign 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 0 105 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 3169.48 0 0 0 0 0 0 3169.48 0 0 1010750064 1013008796 89 Physician Assistant Only(Encounter Only) HARPER CAROL M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 392.03 0 0 0 0 0 0 392.03 0 0 1010750198 1609294438 10 Physicians BROWN OLUWATENIOLA E 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 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 0 193.27 0 0 0 0 0 0 193.27 0 0 1010750569 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 0 233 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 16418.86 0 0 0 0 0 0 0 0 0 0 0 0 0 16418.86 0 0 1010750629 1669981916 16 Nurse Practitioners MANCINI STAMATINA 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 0 141 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 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0 0 422.4 0 0 0 0 0 0 692.44 0 0 1010754866 1003337817 10 Physicians GAY GABRIELLE D 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.4 0 0 0 0 0 0 2083.4 0 0 1010754882 1730634791 89 Physician Assistant Only(Encounter Only) SMYTH KELLY 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 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 46.45 0 0 0 0 0 0 46.45 0 0 1010754941 1750395851 10 Physicians GOLDHAGEN PAUL R 999999999 25 Crawford 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 24 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 2174.19 0 0 0 0 0 0 2174.19 0 0 1010755095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16883.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16883.66 0 0 1010755157 1902249543 10 Physicians BAUER JAMES 999999999 89 Rock Island 0 0 0 0 0 0 0 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 0 182.22 0 0 0 0 0 0 0 0 182.22 0 0 1010755208 1922481530 10 Physicians LOBUR THOMAS 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 0 326 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 8054.43 0 0 0 0 0 0 8054.43 0 0 1010755233 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 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 6926.04 0 0 0 0 0 0 0 0 0 0 0 0 0 6926.04 0 0 1010755368 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 719.92 0 0 0 0 0 0 719.92 0 0 1010756972 1447737499 16 Nurse Practitioners PEDDYCOART ALISON M 999999999 35 Ford 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 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 1876.44 0 0 0 0 0 0 1876.44 0 0 1010757120 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14467.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14467.86 0 0 1010757517 1609365014 16 Nurse Practitioners HENDERSON RACHEL C 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 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 1461.29 0 0 0 0 0 0 1461.29 0 0 1010757637 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 5505.73 0 0 0 0 0 0 0 0 0 0 0 0 0 5505.73 0 0 1010757668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.98 0 0 0 0 0 0 0 0 0 0 0 0 0 98.98 0 0 1010757840 1023438835 10 Physicians MAHMOUD SHAMSELDEEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 227 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 428 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11838.76 0 75.61 0 0 0 0 0 0 11914.37 0 0 1010757944 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 0 135.8 0 0 0 0 0 0 0 0 135.8 0 0 1010758125 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 0 201.01 0 0 0 0 0 0 201.01 0 0 1010758320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9094.55 0 0 0 0 0 0 0 0 0 0 0 0 0 9094.55 0 0 1010758373 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3168.2 0 0 0 0 0 0 0 0 0 0 0 0 0 3168.2 0 0 1010758547 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1544.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1544.52 0 0 1010758713 1043662612 10 Physicians PRATT ABDULLAH H 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4351.35 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0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4839.34 0 0 0 0 0 0 4839.34 0 0 1010759513 1760778880 10 Physicians SCIAMANNA CHRISTOPHER JARED 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 0 322 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 2401.83 0 0 0 0 0 0 2401.83 0 0 1010760043 1720428733 10 Physicians RANGRASS GOVIND 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 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 6861.71 0 0 0 0 0 0 6861.71 0 0 1010760142 98 Waiver service provider--TBI (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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12673.89 0 0 0 0 0 0 0 0 0 0 0 0 0 12673.89 0 0 1010760482 1538573258 55 Early Intervention Services PROJCESKI EMILY E 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 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78.95 0 0 0 0 0 0 78.95 0 0 1010761470 1174938690 10 Physicians KELLY MALLORY J. 999999999 80 Peoria 0 0 0 0 0 12 0 0 0 0 0 0 16 0 67 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 20 0 142 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 20 0 142 0 0 0 0 0 0 0 0 0 931.1 0 0 0 0 0 0 189.18 0 2602.88 0 0 0 0 0 0 3723.16 0 0 1010761857 1790226991 10 Physicians WADE FRANCIS 999999999 818 Kentucky 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 0 276.8 0 0 0 0 0 0 276.8 0 0 1010762055 1386059756 10 Physicians BOLLAMPALLY PREETAM R 999999999 103 Washington 0 0 Internal Medicine 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 0 535 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 4698.13 0 0 0 0 0 0 4698.13 0 0 1010762209 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12698.84 0 0 0 0 0 0 0 0 0 0 0 0 0 12698.84 0 0 1010762442 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1126.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1126.68 0 0 1010762526 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 0 0 0 0 0 0 0 0 0 0 1010762634 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16586.06 0 0 0 0 0 0 0 0 0 0 0 0 0 16586.06 0 0 1010762668 1093283780 16 Nurse Practitioners LAZARO RUDY C 999999999 30 DuPage 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 1072.23 0 0 0 0 0 0 1072.23 0 0 1010762746 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23894.81 0 0 0 0 0 0 0 0 0 0 0 0 0 23894.81 0 0 1010762790 1043691272 10 Physicians HULTEEN LAURA K 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 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 0 992.19 0 0 0 0 0 0 992.19 0 0 1010762802 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 52.6 0 0 0 0 0 0 52.6 0 0 1010763367 1710340633 10 Physicians NANEGRUNGSUNK DANOP 999999999 200 Cook 0 0 Anesthesiology 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 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 10812.47 0 0 0 0 0 0 10812.47 0 0 1010763720 10 Physicians 19 Champaign 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 87.08 0 0 0 0 0 0 87.08 0 0 1010764189 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010764328 1831247113 12 Optometrists HUNGERFORD TODD 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 0 358.69 0 0 0 0 0 0 358.69 0 0 1010764453 1689801680 63 Other Providers of Medical Equipment/Supplies (Non-registered) BRACE MAN P&O INC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2064.17 0 48508.04 0 0 0 0 50572.21 0 0 1010764571 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 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 4162.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4162.72 0 0 1010764592 22 Physical Therapists 40 Grundy 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 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 0 156.49 156.49 0 0 1010764602 1841726742 89 Physician Assistant Only(Encounter Only) DROEGE ASHLEY R 999999999 80 Peoria 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 0 196 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 4827.43 0 0 0 0 0 0 4827.43 0 0 1010764716 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13838.09 0 0 0 0 0 0 0 0 0 0 0 0 0 13838.09 0 0 1010764838 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 0 106 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 5285.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5285.3 0 0 1010764898 1033644497 30 General Hospitals FRESENIUS KIDNEY CARE CHICAGO 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 2093 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14490.37 0 0 0 0 0 14490.37 0 0 1010765126 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 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 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 1848.9 0 0 0 0 0 0 1854.07 0 0 1010765158 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22865.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22865.26 0 0 1010765191 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11971.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11971.31 0 0 1010765206 1245520568 10 Physicians BLANK SARAH B 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 48.4 0 429.5 0 0 0 0 0 0 477.9 0 0 1010765273 1306331673 22 Physical Therapists HILL JENNIFER L 999999999 10 Adams 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 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 0 806.02 806.02 0 0 1010765296 1881169183 16 Nurse Practitioners MOTULIAK LINDSAY 999999999 19 Champaign 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 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 2091.36 0 0 0 0 0 0 2091.36 0 0 1010765327 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6874.54 0 0 0 0 0 0 0 0 0 0 0 0 0 6874.54 0 0 1010765382 1225498751 16 Nurse Practitioners ROPP WHITNEY 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 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 2060.36 0 0 0 0 0 0 2060.36 0 0 1010765558 1912479247 16 Nurse Practitioners QUEARY JAMIE M 999999999 91 Sangamon 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 0 154 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 4836 0 0 0 0 0 0 4836 0 0 1010765894 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 6820.38 0 0 0 0 0 0 0 0 0 0 0 0 0 6820.38 0 0 1010766058 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010766283 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19470.88 0 0 0 0 0 0 0 0 0 0 0 0 0 19470.88 0 0 1010766914 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 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 0 128.9 128.9 0 0 1010766961 1679951727 10 Physicians CHATURVEDI HULIYAR RADHIKA 999999999 57 Lake 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 0 297 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 2316.27 0 0 0 0 0 0 2316.27 0 0 1010767005 1205101334 10 Physicians GNIADEK THOMAS J. 999999999 200 Cook 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 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 0 306.33 0 0 0 0 0 0 0 0 306.33 0 0 1010767094 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13356.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13356.35 0 0 1010767154 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4770.33 0 0 0 0 0 0 0 0 0 0 0 0 0 4770.33 0 0 1010767450 1134535693 10 Physicians SAMAHA ELIAS 999999999 80 Peoria 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 0 199 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 6265.91 0 0 0 0 0 0 6265.91 0 0 1010767612 1942696869 10 Physicians KHOSRAVANI ARIANA 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 4564.2 0 0 0 0 0 0 4564.2 0 0 1010767880 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 0 178 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 33017.27 0 0 0 0 0 0 0 0 0 0 0 0 0 33017.27 0 0 1010767990 1962867929 60 Pharmacies SHEFFIELD TELEPHARMACY 999999999 15 Bureau 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 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5880 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6503.57 0 0 0 6503.57 0 0 1010768023 1073080560 89 Physician Assistant Only(Encounter Only) HALL RACHEL C. 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 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 2211.25 0 0 0 0 0 0 2211.25 0 0 1010768204 1205191988 10 Physicians ORELLANA MARTINEZ CARMEN 999999999 64 Macoupin 0 0 Psychiatry 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 0 157 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 4863.59 0 0 0 0 0 0 4863.59 0 0 1010768223 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2283.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2283.28 0 0 1010768532 1821512815 16 Nurse Practitioners LANDON HEATHER 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 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 80.23 0 0 0 0 0 0 80.23 0 0 1010768888 1972867315 10 Physicians TANNENBAUM ANDREW D 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 245 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3258.06 0 1365.2 0 0 0 0 0 0 4623.26 0 0 1010769106 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19768.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19768.86 0 0 1010769133 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7674.96 0 0 0 0 0 0 0 0 0 0 0 0 0 7674.96 0 0 1010769134 10 Physicians 30 DuPage 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 47.62 0 0 0 0 0 0 47.62 0 0 1010769216 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22589.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22589.63 0 0 1010769243 1457734295 10 Physicians VAN HEUKELOM SETH 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 10 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.13 0 4835.99 0 0 0 0 0 0 5016.12 0 0 1010769277 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22971.66 0 0 0 0 0 0 0 0 0 0 0 0 0 22971.66 0 0 1010769293 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16177.61 0 0 0 0 0 0 0 0 0 0 0 0 0 16177.61 0 0 1010769416 1144727447 16 Nurse Practitioners SCHOENBECK ALEX C 999999999 72 McLean 0 0 0 0 0 0 0 0 0 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 0 557.74 0 0 0 0 0 0 557.74 0 0 1010769445 1851486559 10 Physicians ARNOLD PAUL M 999999999 19 Champaign 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 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 15916.14 0 0 0 0 0 0 15916.14 0 0 1010769749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13123.07 0 0 0 0 0 0 0 0 0 0 0 0 0 13123.07 0 0 1010769833 1831505106 10 Physicians NAGRA INDUPREET 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 0 208 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 7754.46 0 0 0 0 0 0 7754.46 0 0 1010770012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6492.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6492.33 0 0 1010770099 11 Dentists 107 Will 0 0 0 0 5 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 0 901.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901.5 0 0 1010770115 1750834628 10 Physicians AHMED WAHAJ 999999999 80 Peoria 0 0 Internal Medicine 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 0 424 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 8628.98 0 0 0 0 0 0 8628.98 0 0 1010770309 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22513.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22513.75 0 0 1010770393 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 50846.79 0 0 0 0 0 0 0 0 0 0 0 0 0 50846.79 0 0 1010770560 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12926.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12926.88 0 0 1010770740 1194179663 10 Physicians WU CATHERINE XINTONG 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 0 102 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 1981.79 0 0 0 0 0 0 1981.79 0 0 1010770749 10 Physicians 10 Adams 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.86 0 0 0 0 0 0 34.86 0 0 1010770825 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3548.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3548.56 0 0 1010770981 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 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 2645.4 2645.4 0 0 1010771065 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15972.25 0 0 0 0 0 0 0 0 0 0 0 0 0 15972.25 0 0 1010771282 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 0 0 0 0 0 0 0 0 0 0 1010771624 1184981490 10 Physicians BARLASKAR FERDOUS 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 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 0 609.34 0 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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 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 1010774113 1346760725 12 Optometrists ALEXOPOULOS DENISE D 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 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 2156.62 0 0 0 0 0 0 2156.62 0 0 1010775195 1770087769 10 Physicians PETERS ANDREW 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 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 0 286.99 0 0 0 0 0 0 286.99 0 0 1010775271 1841516234 10 Physicians PATRO MALGORZATA 999999999 200 Cook 0 0 Internal 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 0 393 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 3319.52 0 0 0 0 0 0 3319.52 0 0 1010775537 1336621572 33 Nursing Facilities ACCOLADE HC OF PAXTON ON PELLS 999999999 35 Ford 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 0 290 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842457.97 0 0 0 0 0 0 0 842457.97 0 0 1010775923 1386137693 10 Physicians GINN JASMINE 999999999 88 Richland 0 0 Emergency 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 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 1587.54 0 0 0 0 0 0 1587.54 0 0 1010775941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7693.33 0 0 0 0 0 0 0 0 0 0 0 0 0 7693.33 0 0 1010776393 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1188.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1188.44 0 0 1010776433 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26175.57 0 0 0 0 0 0 0 0 0 0 0 0 0 26175.57 0 0 1010776466 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010776702 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 0 393.95 0 0 0 0 0 0 393.95 0 0 1010776852 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6943.13 0 0 0 0 0 0 0 0 0 0 0 0 0 6943.13 0 0 1010777016 1073892253 10 Physicians SINGH NIMARTA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 553 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 856 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 856 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10905.66 0 525.84 0 0 0 0 0 0 11431.5 0 0 1010777056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4996.94 0 0 0 0 0 0 0 0 0 0 0 0 0 4996.94 0 0 1010777370 100 Family Support Program 19 Champaign 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144907.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144907.8 0 0 1010777451 1306326616 16 Nurse Practitioners SMITH TOMBI 999999999 109 Winnebago 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 0 103 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 2609.88 0 0 0 0 0 0 2609.88 0 0 1010777649 1023105566 30 General Hospitals INGALLS MEMORIAL HOSPITAL 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 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 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376959.56 0 0 0 0 0 0 0 0 0 376959.56 0 4530.46 1010777901 1184134462 16 Nurse Practitioners MCGEE SHANTA T 999999999 80 Peoria 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 0 153 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 33.22 0 0 0 0 0 0 0 0 1791.04 0 0 0 0 0 0 1824.26 0 0 1010777909 1417022161 10 Physicians MORAITES ELENI 999999999 19 Champaign 0 0 Dermatology 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 0 107 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 1643.57 0 0 0 0 0 0 1643.57 0 0 1010778037 10 Physicians 36 Franklin 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 1010778279 1821540782 16 Nurse Practitioners KUNCHERIA JOLLY 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 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 23.71 0 0 0 0 0 0 23.71 0 0 1010778288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13186.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13186.79 0 0 1010778816 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13333.74 0 0 0 0 0 0 0 0 0 0 0 0 0 13333.74 0 0 1010778949 1225556996 40 Federally Qualified Health Centers SIHF HEALTHCARE 999999999 96 St Clair 0 0 0 527 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1978 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1978 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111377.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111377.98 0 0 1010779107 1760980957 16 Nurse Practitioners TIPTON MAGDALENA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 400.15 0 0 0 0 0 0 400.15 0 0 1010779127 1437419413 10 Physicians SOLNIN ERIC J 999999999 200 Cook 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 0 330 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 1890.08 0 0 0 0 0 0 1890.08 0 0 1010779198 1558724617 10 Physicians RODRIGUEZ FERNANDEZ JORGE MARI 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 21 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 1668.29 0 0 0 0 0 0 1668.29 0 0 1010779247 1871907774 10 Physicians ALSARRAF ODAY 999999999 109 Winnebago 0 0 Psychiatry 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 0 191 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 7119.03 0 0 0 0 0 0 7119.03 0 0 1010779323 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 22915.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22915.2 0 0 1010779406 1376829010 89 Physician Assistant Only(Encounter Only) CRAWFORD AMANDA M 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 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 2361.42 0 0 0 0 0 0 2361.42 0 0 1010779765 1962788752 87 Psychologist(Encounter Only) STEPHENS JOANN 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 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 53.25 0 0 0 0 0 0 53.25 0 0 1010779806 1265845366 10 Physicians HUGHES PATRICK D 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 0 101 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 8127.98 0 0 0 0 0 0 8127.98 0 0 1010780324 1275789224 89 Physician Assistant Only(Encounter Only) KINCAID SARAH 999999999 19 Champaign 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 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 0 785.36 0 0 0 0 0 0 785.36 0 0 1010780344 10 Physicians 65 Madison 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 0 188.37 0 0 0 0 0 0 188.37 0 0 1010780554 1164990131 16 Nurse Practitioners CONNERS ARIEL G 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 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 1640.55 0 0 0 0 0 0 1640.55 0 0 1010780608 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23199 0 0 0 0 0 0 0 0 0 0 0 0 0 23199 0 0 1010781050 1831614809 16 Nurse Practitioners MESSMORE ANDREW W 999999999 91 Sangamon 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 0 116 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 3073.77 0 0 0 0 0 0 3073.77 0 0 1010781323 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27552.41 0 0 0 0 0 0 0 0 0 0 0 0 0 27552.41 0 0 1010781508 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 0 134 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 14743.84 0 0 0 0 0 0 0 0 0 0 0 0 0 14743.84 0 0 1010781526 12 Optometrists 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 46.45 0 0 0 0 0 0 46.45 0 0 1010781696 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 0 271 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 25126.43 0 0 0 0 0 0 0 0 0 0 0 0 0 25126.43 0 0 1010781740 1417119926 10 Physicians QURESHI KAMRAN U 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 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 0 825.55 0 0 0 0 0 0 825.55 0 0 1010781860 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 0 276.3 0 0 0 0 0 0 276.3 0 0 1010782020 1851786305 10 Physicians PATEL POOJA P 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 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 0 394.76 0 0 0 0 0 0 394.76 0 0 1010782048 1205345196 16 Nurse Practitioners HEMING LEAH R 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 253.17 0 0 0 0 0 0 253.17 0 0 1010782163 1982866737 10 Physicians MCGRATH BRIAN 999999999 200 Cook 0 0 Anesthesiology 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 5485.11 0 0 0 0 0 0 5485.11 0 0 1010782282 1285967141 10 Physicians BADIYAN SHAHED NICOLAS 999999999 200 Cook 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 0 114 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 1537.97 0 0 0 0 0 0 1537.97 0 0 1010782591 1528549474 16 Nurse Practitioners DUBORD CAROLINE H 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 93.59 0 0 0 0 0 0 93.59 0 0 1010782800 1912387531 10 Physicians EHSAN DUSTIN 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 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 1254.67 0 0 0 0 0 0 1254.67 0 0 1010782952 1568845360 10 Physicians NASR SHARIF 999999999 200 Cook 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 0 171 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 2875.56 0 0 0 0 0 0 0 0 2875.56 0 0 1010783541 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2658.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2658.03 0 0 1010783711 1003854530 10 Physicians DYER KAREN J 999999999 109 Winnebago 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 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 4963.44 0 0 0 0 0 0 4963.44 0 0 1010783842 1770960098 10 Physicians HUISINGA KRISTI K. 999999999 200 Cook 0 0 Pediatrics 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 2172.5 0 0 0 0 0 0 2172.5 0 0 1010784158 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 54313.65 0 0 0 0 0 0 0 0 0 0 0 0 0 54313.65 0 0 1010784364 1568944361 16 Nurse Practitioners ALLEN BRANDY J 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 0 273 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 0 718.19 0 0 0 0 0 0 718.19 0 0 1010784650 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 17346.31 0 0 0 0 0 0 0 0 0 0 0 0 0 17346.31 0 0 1010784716 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6491.85 0 0 0 0 0 0 0 0 0 0 0 0 0 6491.85 0 0 1010784924 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010784970 1245441815 60 Pharmacies THOREK MEMORIAL HOSPITAL 606133077 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 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14583.2 0 0 0 14583.2 0 0 1010785056 11 Dentists 200 Cook 0 0 General Dentistry 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 0 111.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.5 0 0 1010785486 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1596.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1596.86 0 0 1010785813 1316131196 10 Physicians VANUKURI RADHA 999999999 80 Peoria 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 0 280 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 5092.36 0 0 0 0 0 0 5092.36 0 0 1010785863 1831578335 24 Speech Therapists PUDRYCKI NANCY D 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 0 309 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 22056.32 22056.32 0 0 1010785935 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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0 0 0 6 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 172.61 0 0 0 0 0 0 0 0 6300.34 0 0 0 0 0 0 6472.95 0 0 1010787229 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 0 208.9 0 0 0 0 0 0 208.9 0 0 1010787330 1760770101 10 Physicians AGGARWAL BHUVNESH 999999999 91 Sangamon 0 0 Internal Medicine 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 1592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13186.11 0 0 0 0 0 0 13186.11 0 0 1010787342 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23896.45 0 0 0 0 0 0 0 0 0 0 0 0 0 23896.45 0 0 1010787423 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010787545 1013203561 10 Physicians HAMADAH ABDURRAHMAN M 999999999 200 Cook 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 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 0 189.56 0 0 0 0 0 0 189.56 0 0 1010787579 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 39.44 0 0 0 0 0 0 39.44 0 0 1010787945 1750741096 11 Dentists OMER AISHA 999999999 200 Cook 0 0 General Dentistry 0 0 14 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 4935.85 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 5688.55 0 0 1010788363 1902316250 33 Nursing Facilities APERION CARE MORTON VILLA 999999999 98 Tazewell 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 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505112.15 0 0 0 0 0 0 0 505112.15 0 0 1010788720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21479.14 0 0 0 0 0 0 0 0 0 0 0 0 0 21479.14 0 0 1010788735 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21469.89 0 0 0 0 0 0 0 0 0 0 0 0 0 21469.89 0 0 1010789378 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6583 0 0 0 0 0 0 0 0 0 0 0 0 0 6583 0 0 1010789738 1396909412 16 Nurse Practitioners JENKINS JENNIFER E 999999999 91 Sangamon 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 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 1049.75 0 0 0 0 0 0 1049.75 0 0 1010790398 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 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 0 122.06 0 0 0 0 0 0 122.06 0 0 1010790655 1396977328 10 Physicians AUFFENBERG GREGORY B 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.87 0 1554.64 0 0 0 0 0 0 1600.51 0 0 1010790818 1942606934 16 Nurse Practitioners FUNK MEGHANN E 999999999 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 43.54 0 0 1010791013 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 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 7861.93 0 0 0 0 0 0 0 0 0 0 0 0 0 7861.93 0 0 1010791059 1750870291 16 Nurse Practitioners MOROZ LORI 999999999 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 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 0 373.07 0 0 0 0 0 0 373.07 0 0 1010791785 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10449.65 0 0 0 0 0 0 0 0 0 0 0 0 0 10449.65 0 0 1010792214 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26557.48 0 0 0 0 0 0 0 0 0 0 0 0 0 26557.48 0 0 1010792517 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 1010793003 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 0 132 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 4632.16 0 0 0 0 0 0 0 0 0 0 0 0 0 4632.16 0 0 1010793416 1275898116 10 Physicians DINA PELE 999999999 91 Sangamon 0 0 Pediatrics 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 0 273 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 88883.61 0 0 0 0 0 0 88883.61 0 0 1010793798 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.01 0 0 0 0 0 0 12.01 0 0 1010794051 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13298.14 0 0 0 0 0 0 0 0 0 0 0 0 0 13298.14 0 0 1010794187 1104209931 10 Physicians BRINK MATTHEW 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.4 0 290.5 0 0 0 0 0 0 294.9 0 0 1010794221 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 22967.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22967.28 0 0 1010794305 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2360.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2360.6 0 0 1010794834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22827.67 0 0 0 0 0 0 0 0 0 0 0 0 0 22827.67 0 0 1010794982 1558413302 10 Physicians GUPTA RUCHI 999999999 91 Sangamon 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 0 164 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 4601.89 0 0 0 0 0 0 4601.89 0 0 1010795260 1568954105 36 Community mental health provider ENVISION UNLIMITED 999999999 200 Cook 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 1456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18640 0 0 1456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18640 0 0 53974.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1645094.91 0 0 1699069.16 0 0 1010795585 1831459759 10 Physicians BREAM ELISE N 999999999 89 Rock Island 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 446.32 0 0 0 0 0 0 0 0 131.01 0 0 0 0 0 0 577.33 0 0 1010795712 1417926619 86 Clinical Social Worker(Encounter Only) LOVELAND WILLIAM 999999999 77 Morgan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2086.11 0 0 0 0 0 0 2086.11 0 0 1010795714 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22082.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22082.5 0 0 1010795876 1760800809 10 Physicians BUDD ASHLEY NICOLE 999999999 200 Cook 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 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 1775.96 0 0 0 0 0 0 1775.96 0 0 1010795889 1669949848 89 Physician Assistant Only(Encounter Only) CRAWFORD ABBY 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 220.2 0 0 0 0 0 0 220.2 0 0 1010796072 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 95.24 0 0 0 0 0 0 95.24 0 0 1010796353 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.8 0 0 0 0 0 0 0 0 0 0 0 0 0 119.8 0 0 1010796909 1962698639 10 Physicians AL-ZUBEIDI DUHA N 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 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 0 815.77 0 0 0 0 0 0 815.77 0 0 1010796938 1972023570 10 Physicians BERG SARAH E 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2104.9 0 0 0 0 0 0 2104.9 0 0 1010797048 86 Clinical Social Worker(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 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 1308.1 0 0 0 0 0 0 1308.1 0 0 1010797275 1760932248 48 Rural Health Clinics COMMUNITY MEDICAL CLINIC OF AS 999999999 20 Christian 0 0 0 20 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 1828.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828.47 0 0 1010797324 1164659298 10 Physicians PHILIPP SARAH KATHLEEN 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6004.28 0 0 0 0 0 0 6004.28 0 0 1010797487 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 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 0 274.32 0 0 0 0 0 0 274.32 0 0 1010797785 1356846901 16 Nurse Practitioners FRANK TINA M 999999999 106 Whiteside 0 0 0 0 0 9 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 730.46 0 0 0 0 0 0 0 0 5340.31 0 0 0 0 0 0 6070.77 0 0 1010798076 1588983209 10 Physicians RIOS MORALES PEDRO J 999999999 65 Madison 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3995 0 0 0 0 0 0 3995 0 0 1010798200 1265826838 10 Physicians KUSMA JENNIFER D 999999999 200 Cook 0 0 Pediatrics 0 0 0 28 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 0 0 0 2098.76 0 0 0 0 0 0 12.33 0 1930.22 0 0 0 0 0 0 4041.31 0 0 1010798563 1700365962 89 Physician Assistant Only(Encounter Only) FLANAGAN ALEXANDRA 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 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 1010798613 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 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 0 933.1 0 0 0 0 0 0 0 0 0 0 0 0 0 933.1 0 0 1010798654 1467963561 16 Nurse Practitioners KARMANIAN ALISON 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 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 0 456.1 0 0 0 0 0 0 456.1 0 0 1010798681 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 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 87.19 0 0 0 0 0 0 87.19 0 0 1010798844 1447692223 16 Nurse Practitioners HAMMERSCHMIDT TIFFANY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1907.92 0 0 0 0 0 0 1907.92 0 0 1010799225 1548655749 10 Physicians COTTON RONALD 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264.31 0 0 0 0 0 0 264.31 0 0 1010799285 1699074104 10 Physicians ASHRAF RIDA 999999999 200 Cook 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 0 172 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 2321.68 0 0 0 0 0 0 2321.68 0 0 1010799398 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11818.07 0 0 0 0 0 0 0 0 0 0 0 0 0 11818.07 0 0 1010799501 1649786906 16 Nurse Practitioners RIDGEWAY AMBER N 999999999 91 Sangamon 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 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 0 370.67 0 0 0 0 0 0 370.67 0 0 1010799663 1740776129 11 Dentists ANKOLA SHAAN 999999999 200 Cook 0 0 General Dentistry 0 0 135 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 823 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 31111.91 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 32617.31 0 0 1010799704 1992724595 10 Physicians PHILLIPS TIMOTHY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.29 0 6552.46 0 0 0 0 0 0 6559.75 0 0 1010799848 1508373770 16 Nurse Practitioners HOLMES CHRISTY R 999999999 47 Jackson 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 0 917 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 917 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6149.55 0 0 0 0 0 0 6149.55 0 0 1010799889 1548652720 89 Physician Assistant Only(Encounter Only) KOWALCZYK KIMBERLY L 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 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 1356.12 0 0 0 0 0 0 1356.12 0 0 1010799916 4010799916 71 Medicar Provider CHOSEN 4 FAVOR LLC 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 3053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20913.16 0 0 0 0 0 0 20913.16 0 0 1010800505 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 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 0 356.57 0 0 0 0 0 0 356.57 0 0 1010800550 1659422517 89 Physician Assistant Only(Encounter Only) EPSTEIN DEBORAH S 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 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 0 654.04 0 0 0 0 0 0 654.04 0 0 1010800653 1134514763 10 Physicians FARNEY ROBERT 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2810.15 0 0 0 0 0 0 2810.15 0 0 1010800744 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 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 1252.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1252.56 0 0 1010800817 1184128753 10 Physicians KRAFT TAYLOR 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 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 1640.7 0 0 0 0 0 0 1640.7 0 0 1010800898 1912346248 10 Physicians PFENNIGER ANNA 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 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 0 844.14 0 0 0 0 0 0 844.14 0 0 1010801136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1785.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1785.36 0 0 1010801319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8977.07 0 0 0 0 0 0 0 0 0 0 0 0 0 8977.07 0 0 1010801356 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15814.48 0 0 0 0 0 0 0 0 0 0 0 0 0 15814.48 0 0 1010801494 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 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 80.07 0 0 0 0 0 0 80.07 0 0 1010801602 1952628646 10 Physicians WITT BRIAN D 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1139.9 0 0 0 0 0 0 1139.9 0 0 1010801651 1720170665 10 Physicians BRADY KEN 999999999 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 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 21448.04 0 0 0 0 0 0 21448.04 0 0 1010801762 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21969.18 0 0 0 0 0 0 0 0 0 0 0 0 0 21969.18 0 0 1010801818 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 1010801961 89 Physician Assistant Only(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.29 0 0 0 0 0 0 18.29 0 0 1010802071 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 14864.01 0 0 0 0 0 0 0 0 0 0 0 0 0 14864.01 0 0 1010802483 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6965.7 0 0 0 0 0 0 0 0 0 0 0 0 0 6965.7 0 0 1010802550 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26935.04 0 0 0 0 0 0 0 0 0 0 0 0 0 26935.04 0 0 1010802699 1578541470 89 Physician Assistant Only(Encounter Only) VAN ANROOY MARK 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.87 0 0 0 0 0 0 57.87 0 0 1010803035 1891261871 91 Waiver service provider--Adults (DHS/DDD) GRISHAM DANIEL R 999999999 91 Sangamon 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96887.86 0 0 0 0 0 0 0 0 0 0 0 0 0 96887.86 0 0 1010803451 1437651072 16 Nurse Practitioners CAFE ROBERT 999999999 57 Lake 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 0 266 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 10814.06 0 0 0 0 0 0 10814.06 0 0 1010803552 1871896571 10 Physicians MAHESHWARI ANSHU 999999999 80 Peoria 0 0 Pediatrics 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 0 123 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 15090.28 0 0 0 0 0 0 15090.28 0 0 1010804075 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21648.33 0 0 0 0 0 0 0 0 0 0 0 0 0 21648.33 0 0 1010804252 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 1010804587 1164665808 10 Physicians KRISHNAN SONIA 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 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 3151.79 0 0 0 0 0 0 3151.79 0 0 1010804731 1720563307 91 Waiver service provider--Adults (DHS/DDD) FISCHER KIMBERLEE 999999999 91 Sangamon 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78268.93 0 0 0 0 0 0 0 0 0 0 0 0 0 78268.93 0 0 1010804736 10 Physicians 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 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1010804773 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23162.37 0 0 0 0 0 0 0 0 0 0 0 0 0 23162.37 0 0 1010804816 86 Clinical Social Worker(Encounter Only) 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 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 1010804960 1245658004 10 Physicians BABA BERNADETTE 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 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 4860.31 0 0 0 0 0 0 4860.31 0 0 1010805104 1104392497 16 Nurse Practitioners KETHCART MICHELLE 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 90 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 26145.68 0 0 0 0 0 0 0 0 0 0 0 0 0 26145.68 0 0 1010805984 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 1010806197 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 0 163 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 13273.89 0 0 0 0 0 0 0 0 0 0 0 0 0 13273.89 0 0 1010806413 1336117928 10 Physicians NATESAN VISWANATH 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 8 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 428 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.05 0 3546.33 0 0 0 0 0 0 3650.38 0 0 1010806747 1023526035 33 Nursing Facilities UNIVERSITY NURSING AND REHABIL 999999999 65 Madison 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 0 154 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1798.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1798.55 0 0 1010807307 1972092716 16 Nurse Practitioners JIMENEZ KELSEY R 999999999 53 Kane 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 0 275 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 1166.73 0 0 0 0 0 0 1166.73 0 0 1010807403 1215176078 10 Physicians AVERY RYAN J 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 44 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1276.07 0 2247.68 0 0 0 0 0 0 3523.75 0 0 1010807483 1598201048 16 Nurse Practitioners KIMBLE YVETTE 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 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 1792.33 0 0 0 0 0 0 1792.33 0 0 1010807553 1649561374 87 Psychologist(Encounter Only) HEATH NICOLE M 999999999 200 Cook 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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 0 258 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 6613.75 0 0 0 0 0 0 0 0 0 0 0 0 0 6613.75 0 0 1010832168 1881855450 16 Nurse Practitioners TONRY JUDY M 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 56.4 0 0 0 0 0 0 0 0 1031.52 0 0 0 0 0 0 1087.92 0 0 1010832247 91 Waiver service provider--Adults (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 0 273 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 22816.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22816.42 0 0 1010832592 1386062636 10 Physicians PEREZ IRMA A 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 215 0 0 0 0 0 0 0 0 0 235.9 0 0 0 0 0 0 0 0 3589.59 0 0 0 0 0 0 3825.49 0 0 1010832623 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 0 261.7 0 0 0 0 0 0 261.7 0 0 1010832627 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 0 136 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 14793.79 0 0 0 0 0 0 0 0 0 0 0 0 0 14793.79 0 0 1010832961 1093206856 16 Nurse Practitioners HARNER KASEY D 999999999 90 Saline 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 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 0 783.91 0 0 0 0 0 0 783.91 0 0 1010833006 1427549393 16 Nurse Practitioners PATEL DEVIKA 999999999 53 Kane 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 9 0 0 0 0 0 0 0 0 0 1 0 0 0 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 1010833067 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010833180 1831671205 16 Nurse Practitioners MCDERMOTT TREVINO TRACY A. 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 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 1129.03 0 0 0 0 0 0 1129.03 0 0 1010833205 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 1209.73 0 0 0 0 0 0 1209.73 0 0 1010833732 1245539774 10 Physicians TRAN ERIN ELIZABETH 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 87 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4452.99 0 8484.43 0 0 0 0 0 0 12937.42 0 0 1010833894 1437234606 60 Pharmacies CVS PHARMACY 10553 604082028 107 Will 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 0 991 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31722 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51847.23 0 0 0 51847.23 0 0 1010834040 61 Independent Laboratories 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 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 2322.62 0 0 0 0 0 0 0 0 2322.62 0 0 1010834412 1699038885 10 Physicians PAPAGIANNOPOULOS DIMITRI 999999999 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 1259.15 0 0 0 0 0 0 1261.33 0 0 1010834533 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 13.46 0 0 0 0 0 0 13.46 0 0 1010835300 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010835784 1649613332 10 Physicians HORWITZ MARA 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 0 786.07 0 0 0 0 0 0 786.07 0 0 1010835802 1538542758 10 Physicians KANE ERIN E 999999999 63 Macon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.62 0 0 0 0 0 0 598.62 0 0 1010835822 1952745788 10 Physicians THRESS TYLER M 999999999 57 Lake 0 0 Urology 0 0 0 0 0 0 0 0 0 0 7 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.27 0 494.29 0 0 0 0 0 0 502.56 0 0 1010835905 1457766560 10 Physicians HERNANDEZ GUARIN LAURA N 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 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 2302.85 0 0 0 0 0 0 2302.85 0 0 1010835942 87 Psychologist(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 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 0 559.37 0 0 0 0 0 0 559.37 0 0 1010835958 11 Dentists 109 Winnebago 0 0 General Dentistry 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 51.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.15 0 0 1010836447 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 0 111 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 13336.82 0 0 0 0 0 0 0 0 0 0 0 0 0 13336.82 0 0 1010836523 1366838112 10 Physicians JOHNSON JESSICA A 999999999 19 Champaign 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 0 216 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 2699.88 0 0 0 0 0 0 2699.88 0 0 1010836525 1609385269 36 Community mental health provider LIFELINKS MENTAL HEALTH 999999999 88 Richland 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613 0 0 215.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45789.69 0 0 46005.21 0 0 1010836654 1164680393 10 Physicians PARHAR PREETI K 999999999 200 Cook 0 0 Radiation Oncology 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 0 170 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 1639.67 0 0 0 0 0 0 1639.67 0 0 1010836781 1548730609 100 Family Support Program "NEURORESTORATIVE, ILLINOIS" 999999999 200 Cook 0 0 0 9 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 1172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 814500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 814500 0 0 1010836787 1982724183 10 Physicians FAUMAN KAREN 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 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 5002.34 0 0 0 0 0 0 5002.34 0 0 1010836812 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23464.08 0 0 0 0 0 0 0 0 0 0 0 0 0 23464.08 0 0 1010836828 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 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 22.69 0 0 0 0 0 0 22.69 0 0 1010836921 10 Physicians 60 Lee 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.4 0 0 0 0 0 0 66.4 0 0 1010837153 1801310222 89 Physician Assistant Only(Encounter Only) OPPERMAN HANNAH 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1010837239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11191.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11191.47 0 0 1010837296 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581.31 0 0 0 0 0 0 0 0 0 0 0 0 0 581.31 0 0 1010837327 1184744625 51 Community Health Agencies - In home INDEPENDENCE HEALTH & THERAPY 600982265 71 McHenry 0 0 0 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 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 17116.44 0 0 0 0 0 0 0 0 0 0 0 0 17116.44 0 0 1010837330 1982972782 89 Physician Assistant Only(Encounter Only) STOUT ANDREA K 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 0 146.06 0 0 0 0 0 0 146.06 0 0 1010837634 1356786255 10 Physicians GARG RITU 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 0 214 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 2099.52 0 0 0 0 0 0 2099.52 0 0 1010838168 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20940.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20940.5 0 0 1010838259 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.25 0 0 0 0 0 0 63.25 0 0 1010838436 10 Physicians 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 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 0 633.82 0 0 0 0 0 0 633.82 0 0 1010838553 1033292024 16 Nurse Practitioners BOWER RONNIE N 999999999 818 Kentucky 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 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 0 955.68 0 0 0 0 0 0 955.68 0 0 1010838598 1588187397 16 Nurse Practitioners BLOODWORTH ANDREA N 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2006 0 0 0 0 0 0 2006 0 0 1010838737 1508336918 16 Nurse Practitioners MORRISROE LISABETH 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 470.26 0 0 0 0 0 0 470.26 0 0 1010839185 1508941667 60 Pharmacies CVS PHARMACY 10656 999999999 67 Marshall 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 0 297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5411.67 0 0 0 5411.67 0 0 1010839335 1538631114 16 Nurse Practitioners WAGNER SAMANTHA E 999999999 109 Winnebago 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 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 2303.59 0 0 0 0 0 0 2303.59 0 0 1010839336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.54 0 0 0 0 0 0 0 0 0 0 0 0 0 183.54 0 0 1010839405 1710362512 10 Physicians HENEN SARA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1806.6 0 0 0 0 0 0 1806.6 0 0 1010839580 1003368440 30 General Hospitals DIALYSIS CARE CENTER OLYMPIA F 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14518.83 0 0 0 0 0 14518.83 0 0 1010839635 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24839.22 0 0 0 0 0 0 0 0 0 0 0 0 0 24839.22 0 0 1010839674 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 0 416.46 0 0 0 0 0 0 416.46 0 0 1010839704 1396144879 10 Physicians ALDARWEESH FATIMA 999999999 30 DuPage 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 148 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788.84 0 0 0 0 0 0 0 0 788.84 0 0 1010839940 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 1010840403 1578995023 10 Physicians MAYNARD STEVEN M 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 818.5 0 0 0 0 0 0 818.5 0 0 1010840513 1467624528 10 Physicians HENSLEY JENNIFER 999999999 30 DuPage 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 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 32.76 0 0 0 0 0 0 32.76 0 0 1010840750 1407331184 89 Physician Assistant Only(Encounter Only) REYES DAVID 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 74.95 0 0 0 0 0 0 74.95 0 0 1010840802 1639697485 10 Physicians STRELZOW JASON 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 1 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 129 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 129 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 32.7 0 27837.39 0 0 0 0 0 0 27876.49 0 0 1010840837 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1279.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1279.63 0 0 1010841140 1548728165 23 Occupational Therapists WERBIE JESSICA J 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 0 133 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 9373.06 9373.06 0 0 1010841392 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23012.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23012.85 0 0 1010842116 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.55 0 0 0 0 0 0 54.55 0 0 1010842136 10 Physicians 91 Sangamon 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 88.97 0 0 0 0 0 0 0 0 88.97 0 0 1010842163 1164837985 10 Physicians SHIRAZI NIDA F 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 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 1339.16 0 0 0 0 0 0 1339.16 0 0 1010842248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 1010842374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20555.32 0 0 0 0 0 0 0 0 0 0 0 0 0 20555.32 0 0 1010842541 1538612650 11 Dentists HARVEY ANNA 999999999 200 Cook 0 0 Pedodontics 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10468.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10468.16 0 0 1010842764 1700382447 10 Physicians ASLAM AMBREEN DANISH 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 0 115 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 0 807.88 0 0 0 0 0 0 807.88 0 0 1010842956 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23724.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23724.78 0 0 1010843116 1457852683 16 Nurse Practitioners JANEK JOSHUA A 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 2121.48 0 0 0 0 0 0 2121.48 0 0 1010843234 1881171338 11 Dentists YASIN AREEB 999999999 35 Ford 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 275 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 10294.74 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 12176.49 0 0 1010843341 1891788055 13 Podiatrists HALINSKI CATHERINE 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 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 79.76 0 0 0 0 0 0 79.76 0 0 1010843559 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25362.5 0 0 0 0 0 0 0 0 0 0 0 0 0 25362.5 0 0 1010843634 1538336706 10 Physicians KUSMIREK JOANNA E 999999999 89 Rock Island 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 11 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.36 0 152.12 0 0 0 0 0 0 334.48 0 0 1010843661 1265579551 10 Physicians QANDEEL MONTHER S 999999999 30 DuPage 0 0 Radiology Diagnosis 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 1057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15177.65 0 0 0 0 0 0 0 0 15177.65 0 0 1010843766 1033693742 16 Nurse Practitioners MEMON AHMED H 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 0 222 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 3154.64 0 0 0 0 0 0 3154.64 0 0 1010843833 10 Physicians 200 Cook 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 16.62 0 0 0 0 0 0 0 0 16.62 0 0 1010843882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7560.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7560.18 0 0 1010844618 1407348527 11 Dentists RIZKALLA GEORGE 999999999 200 Cook 0 0 General Dentistry 0 0 22 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 2929.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2929.74 0 0 1010844662 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010844794 1184663742 10 Physicians GARG SHAMILA 999999999 80 Peoria 0 0 Internal Medicine 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 0 396 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 7258.36 0 0 0 0 0 0 7258.36 0 0 1010845143 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 0 109.26 0 0 0 0 0 0 109.26 0 0 1010845215 1396269700 16 Nurse Practitioners MAVIS AMANDA 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 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 0 955.85 0 0 0 0 0 0 955.85 0 0 1010845448 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11852.93 0 0 0 0 0 0 0 0 0 0 0 0 0 11852.93 0 0 1010845501 1174963458 10 Physicians ONA SIENA ELISA N 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 1 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.26 0 8446.55 0 0 0 0 0 0 8457.81 0 0 1010845614 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 1010845670 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23601.44 0 0 0 0 0 0 0 0 0 0 0 0 0 23601.44 0 0 1010845892 1437531811 10 Physicians ALI BASIL A 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 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 0 431.95 0 0 0 0 0 0 431.95 0 0 1010845955 1801337589 89 Physician Assistant Only(Encounter Only) PENNINGTON BRADLEY 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 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 0 350.14 0 0 0 0 0 0 350.14 0 0 1010846089 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 2815.49 0 0 0 0 0 0 2815.49 0 0 1010846505 1396240669 16 Nurse Practitioners MORIMOTO JUDY A 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 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 0 442.81 0 0 0 0 0 0 442.81 0 0 1010846854 1083180228 16 Nurse Practitioners SHEWALTER ANDREA M 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 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 0 268.7 0 0 0 0 0 0 268.7 0 0 1010846864 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26141.61 0 0 0 0 0 0 0 0 0 0 0 0 0 26141.61 0 0 1010847056 1134104037 10 Physicians KEDLAYA DIVAKARA 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 269.39 0 0 0 0 0 0 269.39 0 0 1010847106 1669888558 89 Physician Assistant Only(Encounter Only) CHANG JENNIFER 999999999 53 Kane 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 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 0 659.09 0 0 0 0 0 0 659.09 0 0 1010847259 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 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 2198.19 0 0 0 0 0 0 2198.19 0 0 1010847613 1386062776 10 Physicians OPOKU IFEANYIROCHUKWU G 999999999 19 Champaign 0 0 Obstetric-Gynecology 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 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 6398.5 0 0 0 0 0 0 6398.5 0 0 1010847622 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8881.26 0 0 0 0 0 0 0 0 0 0 0 0 0 8881.26 0 0 1010847727 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 0 445.15 0 0 0 0 0 0 445.15 0 0 1010847868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7676.78 0 0 0 0 0 0 0 0 0 0 0 0 0 7676.78 0 0 1010848131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3870.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3870.62 0 0 1010848133 1477816619 10 Physicians KATIB OMAR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 620 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 956 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9528.57 0 263.71 0 0 0 0 0 0 9792.28 0 0 1010848206 1265916753 16 Nurse Practitioners PATEL KRISHNA 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 0 268 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 5059.74 0 0 0 0 0 0 5059.74 0 0 1010848252 1891020913 89 Physician Assistant Only(Encounter Only) PATEL NISHA K 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 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 0 603.1 0 0 0 0 0 0 603.1 0 0 1010848636 1356306492 10 Physicians LAROW EDWARD 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 328 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2905.66 0 426.33 0 0 0 0 0 0 3331.99 0 0 1010848718 1164777223 10 Physicians BRIDEN KELLEIGH E 999999999 54 Kankakee 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 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 4868.78 0 0 0 0 0 0 4868.78 0 0 1010849119 1912394982 10 Physicians LEE VIVIAN H 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 183.73 0 0 0 0 0 0 183.73 0 0 1010849138 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24000.09 0 0 0 0 0 0 0 0 0 0 0 0 0 24000.09 0 0 1010849189 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15195.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15195.9 0 0 1010849380 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 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 4361.7 0 0 0 0 0 0 0 0 0 0 0 0 0 4361.7 0 0 1010849638 1710452065 16 Nurse Practitioners SMITH-COLBERT SHERRYL F 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 0 262 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 3811.77 0 0 0 0 0 0 3811.77 0 0 1010849871 1407341357 10 Physicians FORSYTH ALEX 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 0 223.16 0 0 0 0 0 0 223.16 0 0 1010850110 1114476835 24 Speech Therapists RODHEIM HANNAH J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 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 12486.18 12486.18 0 0 1010850384 1861913980 16 Nurse Practitioners WAN ROSEANN M 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 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 0 671.09 0 0 0 0 0 0 671.09 0 0 1010850404 1457799595 10 Physicians FRAZIER REBECCA S 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 0 147 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 0 531.18 0 0 0 0 0 0 531.18 0 0 1010850523 1447769724 16 Nurse Practitioners MUTTER WAYLAND J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 661.36 0 0 0 0 0 0 661.36 0 0 1010850643 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 23864.98 0 0 0 0 0 0 0 0 0 0 0 0 0 23864.98 0 0 1010850673 1962660753 10 Physicians MACBEAN ULUNNA K 999999999 91 Sangamon 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 3326.22 0 0 0 0 0 0 3326.22 0 0 1010850764 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 42.14 0 0 0 0 0 0 42.14 0 0 1010850981 4010850981 90 Waiver service provider--Elderly (DOA) KELLY HOME HEALTH CARE INC 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 1219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94681.86 0 0 0 0 0 0 0 0 0 0 0 0 0 94681.86 0 0 1010851868 1376905307 10 Physicians SCIGACZ ANNA 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 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 0 170.78 0 0 0 0 0 0 170.78 0 0 1010852005 1386871069 10 Physicians SAINT LINDSEY 999999999 91 Sangamon 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 14 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 27224.22 0 0 0 0 0 0 27224.22 0 0 1010852221 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283.54 0 0 0 0 0 0 0 0 0 0 0 0 0 283.54 0 0 1010852256 1154837698 55 Early Intervention Services EASTER SEALS CFC #8 606436316 200 Cook 0 0 1026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690405.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690405.18 0 0 1010852285 1073016929 11 Dentists ANKIREDDY DEEPIKA 999999999 200 Cook 0 0 General Dentistry 0 0 258 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1584 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1584 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 40805.83 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 41558.53 0 0 1010852288 1740754829 16 Nurse Practitioners SMITH KENDRA 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 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 0 427.27 0 0 0 0 0 0 427.27 0 0 1010852338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8902.09 0 0 0 0 0 0 0 0 0 0 0 0 0 8902.09 0 0 1010852470 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26605.59 0 0 0 0 0 0 0 0 0 0 0 0 0 26605.59 0 0 1010852810 1841552411 10 Physicians SHEFFIELD ABRAHAM M 999999999 10 Adams 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 0 114 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 3022.47 0 0 0 0 0 0 3022.47 0 0 1010853606 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 1010854000 1366444184 89 Physician Assistant Only(Encounter Only) ENTER JACK 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 0 104.36 0 0 0 0 0 0 104.36 0 0 1010854094 1659372506 10 Physicians DESAI SAMIR B 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294.41 0 79400.58 0 0 0 0 0 0 79694.99 0 0 1010854118 1518466895 91 Waiver service provider--Adults (DHS/DDD) TURNER ABBEY G 999999999 200 Cook 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 1414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61323.6 0 0 0 0 0 0 0 0 0 0 0 0 0 61323.6 0 0 1010854121 1124281647 10 Physicians MEHTA SHAIL 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 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 1504.11 0 0 0 0 0 0 1504.11 0 0 1010854215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 22540.7 0 0 0 0 0 0 0 0 0 0 0 0 0 22540.7 0 0 1010854738 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19828.29 0 0 0 0 0 0 0 0 0 0 0 0 0 19828.29 0 0 1010854896 1215342670 10 Physicians PHAM DUNG 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 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 5004.26 0 0 0 0 0 0 5004.26 0 0 1010855115 62 Opticians / Optical Companies 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 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 16.9 0 0 0 0 16.9 0 0 1010855229 1760968721 16 Nurse Practitioners KAESTNER ELYSE K. 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 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 0 685.74 0 0 0 0 0 0 685.74 0 0 1010855560 1184096646 25 Audiologists HAWKINS WHITNEY M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 428.69 428.69 0 0 1010855627 1164904553 16 Nurse Practitioners MCCLELLAN ALYSSA 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 0 772.73 0 0 0 0 0 0 772.73 0 0 1010855741 1184113318 16 Nurse Practitioners SCHLUPP JESSICA 999999999 80 Peoria 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 0 209 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 1143.15 0 0 0 0 0 0 1143.15 0 0 1010855780 1952492472 16 Nurse Practitioners HAWKINS BRENDA K 999999999 91 Sangamon 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 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 443.38 0 0 0 0 0 0 520.22 0 0 1010856089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2423.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2423.11 0 0 1010856167 1053899385 91 Waiver service provider--Adults (DHS/DDD) ROMAN JORGE L 999999999 91 Sangamon 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71092.95 0 0 0 0 0 0 0 0 0 0 0 0 0 71092.95 0 0 1010856232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2913.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2913.84 0 0 1010856548 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 13194.28 0 0 0 0 0 0 0 0 0 0 0 0 0 13194.28 0 0 1010856656 1467847384 10 Physicians SAAVEDRA JASMINE 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 375.84 0 0 0 0 0 0 375.84 0 0 1010856811 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24997.65 0 0 0 0 0 0 0 0 0 0 0 0 0 24997.65 0 0 1010856928 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 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 0 189.07 189.07 0 0 1010856969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19399.8 0 0 0 0 0 0 0 0 0 0 0 0 0 19399.8 0 0 1010857100 1205108727 16 Nurse Practitioners BURKHALTER ALEXIS M 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 0 426.03 0 0 0 0 0 0 426.03 0 0 1010857319 1801191994 10 Physicians FOORSOV VICTOR A 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 9 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.92 0 1619.28 0 0 0 0 0 0 1761.2 0 0 1010857396 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 74.87 0 0 0 0 0 0 74.87 0 0 1010857549 1285143545 16 Nurse Practitioners SAHBAZ KENAN 999999999 42 Hancock 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 0 241 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 2159.43 0 0 0 0 0 0 2159.43 0 0 1010857554 1477755916 10 Physicians LU KURT Q 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 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 0 199.47 0 0 0 0 0 0 199.47 0 0 1010857572 1982182424 16 Nurse Practitioners DALEY NICOLE 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Practitioners MINSER JULIE A 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 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 0 768.21 0 0 0 0 0 0 768.21 0 0 1010858145 1982960480 10 Physicians KILANI JYOTSNA 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 1361.75 0 0 0 0 0 0 1361.75 0 0 1010858330 1780128876 24 Speech Therapists KISTENFEGER KELSEY 999999999 58 La Salle 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 0 152 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 9472.06 9472.06 0 0 1010858644 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48140.74 0 0 0 0 0 0 0 0 0 0 0 0 0 48140.74 0 0 1010858773 1821284266 16 Nurse Practitioners SELF ANN M 999999999 91 Sangamon 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 0 651.7 0 0 0 0 0 0 651.7 0 0 1010858778 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26377.38 0 0 0 0 0 0 0 0 0 0 0 0 0 26377.38 0 0 1010859124 1184064057 10 Physicians HARTMAN JEREMY A 999999999 81 Perry 0 0 Orthopedic Surgery 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 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 33.01 0 324.89 0 0 0 0 0 0 357.9 0 0 1010859411 1245711027 60 Pharmacies CHICAGO HEALTHMART PHARMACY 999999999 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11895 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15073.73 0 0 0 15073.73 0 0 1010859434 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22896.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22896.54 0 0 1010859719 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 0 118 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 6878.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6878.9 0 0 1010859887 1477098978 60 Pharmacies MARIANOS PHARMACY 8543 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.54 0 0 0 2691.54 0 0 1010860122 1033406228 10 Physicians JASIM SINA A 999999999 97 Stephenson 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 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 0 262.87 0 0 0 0 0 0 262.87 0 0 1010860150 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13599.51 0 0 0 0 0 0 0 0 0 0 0 0 0 13599.51 0 0 1010860223 1003292624 10 Physicians GUBA MOHAMMED L 999999999 47 Jackson 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 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4412.46 0 0 0 0 0 0 4412.46 0 0 1010860343 1649754433 91 Waiver service provider--Adults (DHS/DDD) AMBROSE LAUREN M 999999999 91 Sangamon 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98433.03 0 0 0 0 0 0 0 0 0 0 0 0 0 98433.03 0 0 1010860362 1851668164 91 Waiver service provider--Adults (DHS/DDD) DIAZ NATALIE 999999999 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 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 6552.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6552.4 0 0 1010860545 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 27437.16 0 0 0 0 0 0 0 0 0 0 0 0 0 27437.16 0 0 1010860756 1013438795 89 Physician Assistant Only(Encounter Only) SURMAN ALEXANDRA L 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 0 313.46 0 0 0 0 0 0 313.46 0 0 1010860878 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5757.81 0 0 0 0 0 0 0 0 0 0 0 0 0 5757.81 0 0 1010860897 1467971333 30 General Hospitals FRESENIUS MEDICAL CARE OF ILLI 999999999 96 St Clair 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 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1659 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6079.18 0 0 0 0 0 6079.18 0 0 1010861038 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 17134.98 0 0 0 0 0 0 0 0 0 0 0 0 0 17134.98 0 0 1010861114 1265960959 10 Physicians KASS JESSICA L 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 0 211 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 2195.97 0 0 0 0 0 0 2195.97 0 0 1010861245 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19172.5 0 0 0 0 0 0 0 0 0 0 0 0 0 19172.5 0 0 1010861284 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 30.54 0 0 0 0 0 0 30.54 0 0 1010861840 89 Physician Assistant Only(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 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 50.68 0 0 0 0 0 0 50.68 0 0 1010862305 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 1010862329 1538556774 10 Physicians DADABO JOSEPH GREGORY 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 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 0 328.28 0 0 0 0 0 0 328.28 0 0 1010862330 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 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 16683.22 0 0 0 0 0 0 0 0 0 0 0 0 0 16683.22 0 0 1010862350 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 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 1010862612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14702.06 0 0 0 0 0 0 0 0 0 0 0 0 0 14702.06 0 0 1010862841 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 0 156 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 14813.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14813.5 0 0 1010863002 10 Physicians 96 St Clair 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 6.4 0 0 0 0 0 0 6.4 0 0 1010863116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22148.34 0 0 0 0 0 0 0 0 0 0 0 0 0 22148.34 0 0 1010863424 1942685037 10 Physicians MISHRA PRAKASH 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 0 330 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 11068.63 0 0 0 0 0 0 11068.63 0 0 1010863683 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 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 14723.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14723.45 0 0 1010864037 1306236013 10 Physicians O''CONNOR MATTHEW 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 0 506.6 0 0 0 0 0 0 506.6 0 0 1010864094 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23240.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23240.7 0 0 1010864405 1235634775 10 Physicians EDWARDS TYLER D 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 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 0 783.91 0 0 0 0 0 0 783.91 0 0 1010864756 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 2024.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2024.9 0 0 1010864868 16 Nurse Practitioners 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 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 1010865011 1598907545 16 Nurse Practitioners MOLDREM MICHELE D 999999999 75 Monroe 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 0 204 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 0 817.42 0 0 0 0 0 0 817.42 0 0 1010865081 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14391.52 0 0 0 0 0 0 0 0 0 0 0 0 0 14391.52 0 0 1010865120 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 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 0 765.88 765.88 0 0 1010865338 1831579945 10 Physicians IQBAL UMAIR 999999999 63 Macon 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 0 123 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 12034.87 0 0 0 0 0 0 12034.87 0 0 1010865524 1457825481 89 Physician Assistant Only(Encounter Only) WORTHINGTON ASHLEY A 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 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 47.08 0 0 0 0 0 0 47.08 0 0 1010865655 1811370273 10 Physicians BAUMGARTNER DESIREE C 999999999 88 Richland 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 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 0 253.52 0 0 0 0 0 0 253.52 0 0 1010865774 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 0 201.99 0 0 0 0 0 0 201.99 0 0 1010866007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1264.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1264.78 0 0 1010866127 1427476456 10 Physicians JIANG LINDA Y 999999999 200 Cook 0 0 Neurology 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 0 242 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 3129.65 0 0 0 0 0 0 3129.65 0 0 1010866599 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5596.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5596.6 0 0 1010866617 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17570.07 0 0 0 0 0 0 0 0 0 0 0 0 0 17570.07 0 0 1010866628 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 168.58 0 0 0 0 0 0 198.06 0 0 1010867547 1073812467 16 Nurse Practitioners SPITLER JEFFREY 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 0 815.59 0 0 0 0 0 0 815.59 0 0 1010867805 1376936997 10 Physicians HAMMER ZACHARY S 999999999 200 Cook 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 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 2255.45 0 0 0 0 0 0 2255.45 0 0 1010867829 1750393328 16 Nurse Practitioners AFRICANO THOMAS 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 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 0 127.74 0 0 0 0 0 0 127.74 0 0 1010868009 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 99.24 0 0 0 0 0 0 99.24 0 0 1010868124 1801273016 10 Physicians OBERWETTER JACOB R. 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 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 0 987.66 0 0 0 0 0 0 987.66 0 0 1010868265 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 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 25386.66 0 0 0 0 0 0 0 0 0 0 0 0 0 25386.66 0 0 1010868367 1326243171 10 Physicians SHAH TEJAS R 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 24 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.76 0 9940.47 0 0 0 0 0 0 10020.23 0 0 1010868478 1073859401 89 Physician Assistant Only(Encounter Only) GREEN KRISTIAN A 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 281.94 0 0 0 0 0 0 281.94 0 0 1010868519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 765.16 0 0 0 0 0 0 0 0 0 0 0 0 0 765.16 0 0 1010868617 1346751997 16 Nurse Practitioners TURNBULL DANIELLE N 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 717.01 0 0 0 0 0 0 731.61 0 0 1010868810 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 1010869038 1871911891 10 Physicians SHAH CHIRAG K 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 3 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 5135.97 0 0 0 0 0 0 5135.97 0 0 1010869638 1255698445 10 Physicians VARGAS ALEJANDRO 999999999 200 Cook 0 0 Neurology 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 0 181 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 5647.28 0 0 0 0 0 0 5647.28 0 0 1010869659 1073779088 89 Physician Assistant Only(Encounter Only) APILADO RON-GRAN P 999999999 200 Cook 0 0 0 0 0 69 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 164 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 6204.67 0 0 0 0 0 0 0 0 3419.7 0 0 0 0 0 0 9624.37 0 0 1010869882 1528595576 10 Physicians GRABER EMILY ERIN 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 4 0 43 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 9 0 87 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 9 0 87 0 0 0 0 0 0 0 0 0 237.7 0 0 0 0 0 0 262.09 0 5769.15 0 0 0 0 0 0 6268.94 0 0 1010869908 1306990080 10 Physicians GOYAL VIJAY L 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 7 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 812 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 812 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.3 0 144341.17 0 0 0 0 0 0 144844.47 0 0 1010869973 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 676.9 0 0 0 0 0 0 0 0 0 0 0 0 0 676.9 0 0 1010870118 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 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 4042.71 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.71 0 0 1010870169 1982198354 11 Dentists MIRZA TAHA 999999999 107 Will 0 0 0 0 232 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1194 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1194 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 33236.14 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 35117.89 0 0 1010870262 1376022244 16 Nurse Practitioners HOHENADEL JENNIFER 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 0 327 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 3072.07 0 0 0 0 0 0 3072.07 0 0 1010870587 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15311.19 0 0 0 0 0 0 0 0 0 0 0 0 0 15311.19 0 0 1010870784 1619362761 10 Physicians PHAN AMANDA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1989.65 0 0 0 0 0 0 1989.65 0 0 1010870793 1447360037 16 Nurse Practitioners TRZUPEK IRENE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.37 0 0 0 0 0 0 552.37 0 0 1010871296 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 9949.22 0 0 0 0 0 0 0 0 0 0 0 0 0 9949.22 0 0 1010871403 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 1930.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1930.95 0 0 1010871599 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 322.16 0 0 0 0 0 0 0 0 0 0 0 0 0 322.16 0 0 1010871818 1962853010 91 Waiver service provider--Adults (DHS/DDD) LEWANDOWSKI ROBERT M 999999999 30 DuPage 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 1106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139016.07 0 0 0 0 0 0 0 0 0 0 0 0 0 139016.07 0 0 1010871820 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 0 206 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 21810.59 0 0 0 0 0 0 0 0 0 0 0 0 0 21810.59 0 0 1010872167 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 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 10546.16 0 0 0 0 0 0 0 0 0 0 0 0 0 10546.16 0 0 1010872186 1063940005 10 Physicians SIDDIQUI SAADUDDIN M 999999999 200 Cook 0 0 Emergency 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 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 1497.91 0 0 0 0 0 0 1497.91 0 0 1010872284 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 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 0 364.06 0 0 0 0 0 0 364.06 0 0 1010872670 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.42 0 0 0 0 0 0 0 0 0 0 0 0 0 282.42 0 0 1010872726 75 Department of Alcohol and Substance Abuse Provider 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 316.62 0 0 316.62 0 0 1010872827 1780022905 10 Physicians MAHMOOD ALI 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 66.4 0 0 0 0 0 0 66.4 0 0 1010872865 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 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 7555.13 0 0 0 0 0 0 0 0 0 0 0 0 0 7555.13 0 0 1010872959 1588145312 16 Nurse Practitioners SHERRILL ASHLEY B 999999999 91 Sangamon 0 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0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331 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 23756.59 0 0 0 0 0 0 0 0 0 0 0 0 0 23756.59 0 0 1010873999 1467894527 10 Physicians PARVEEN SANOBER 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.31 0 6821.92 0 0 0 0 0 0 6834.23 0 0 1010874228 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 15591.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15591.7 0 0 1010874285 1003323288 16 Nurse Practitioners WALDEN ELIZABETH 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 0 196.39 0 0 0 0 0 0 196.39 0 0 1010874331 1891053716 10 Physicians ARK JACOB T 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 8 0 36 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 6.62 0 941 0 0 0 0 0 0 947.62 0 0 1010874501 1831422740 16 Nurse Practitioners CARNEY COLEEN A 999999999 53 Kane 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 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 455.66 0 0 0 0 0 0 560.62 0 0 1010874504 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8039.11 0 0 0 0 0 0 0 0 0 0 0 0 0 8039.11 0 0 1010874579 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14529.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14529.9 0 0 1010874679 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 0 147.26 0 0 0 0 0 0 147.26 0 0 1010874872 1851658579 10 Physicians DESAI RAVI 999999999 30 DuPage 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 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.76 0 0 0 0 0 0 1995.76 0 0 1010875065 1164860557 10 Physicians KSHETRAPAL ANISHA 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 984.09 0 0 0 0 0 0 984.09 0 0 1010875096 1366860215 10 Physicians CUEVA SHIRLEY 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 3179.94 0 0 0 0 0 0 3179.94 0 0 1010875251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32321.28 0 0 0 0 0 0 0 0 0 0 0 0 0 32321.28 0 0 1010875429 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4197.3 0 0 0 0 0 0 0 0 0 0 0 0 0 4197.3 0 0 1010875430 1164794533 16 Nurse Practitioners BROWNING ERIN 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 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 0 252.12 0 0 0 0 0 0 252.12 0 0 1010875448 89 Physician Assistant Only(Encounter Only) 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.53 0 0 0 0 0 0 118.53 0 0 1010875727 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.5 0 0 0 0 0 0 0 0 0 0 0 0 0 146.5 0 0 1010875810 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 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 0 873.37 0 0 0 0 0 0 0 0 0 0 0 0 0 873.37 0 0 1010876032 1467737320 89 Physician Assistant Only(Encounter Only) ABRAMOVSKE TONI 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 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 0 753.24 0 0 0 0 0 0 753.24 0 0 1010876158 1003072547 10 Physicians MEHDI ASAD 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1887 0 0 0 0 0 0 1887 0 0 1010876165 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 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 2712.49 0 0 0 0 0 0 0 0 0 0 0 0 0 2712.49 0 0 1010876261 1881138329 89 Physician Assistant Only(Encounter Only) NIGG BENJAMIN J 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 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1010876659 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 35.4 0 0 0 0 0 0 35.4 0 0 1010876992 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13926.68 0 0 0 0 0 0 0 0 0 0 0 0 0 13926.68 0 0 1010877005 1083906838 10 Physicians WEMHOFF MICHAEL P 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 7457.69 0 0 0 0 0 0 7457.69 0 0 1010877242 1902210859 10 Physicians ABUISNEINEH FIDA 999999999 200 Cook 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 128.6 0 0 0 0 0 0 0 0 566.6 0 0 0 0 0 0 695.2 0 0 1010877731 1801258629 13 Podiatrists BRISSEY NICHOLAS C 999999999 109 Winnebago 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 0 208 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 1850.85 0 0 0 0 0 0 1850.85 0 0 1010877739 1104372952 16 Nurse Practitioners BLANKS AMY M. 999999999 30 DuPage 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 0 710.42 0 0 0 0 0 0 710.42 0 0 1010878173 1801833066 86 Clinical Social Worker(Encounter Only) BRUCE-BOEHLER WILLIAM D 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 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 0 504.43 0 0 0 0 0 0 504.43 0 0 1010878355 1295249498 61 Independent Laboratories AQSA LAB INC 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 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 0 259.08 0 0 0 0 0 0 0 0 259.08 0 0 1010878576 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 0 100.68 0 0 0 0 0 0 100.68 0 0 1010878653 1265788483 10 Physicians SUBER LADOUGLAS J 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 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 3428.2 0 0 0 0 0 0 3428.2 0 0 1010878703 1477831550 16 Nurse Practitioners TOBIN BRITTANY L 999999999 60 Lee 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 0 222 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 1709.01 0 0 0 0 0 0 1709.01 0 0 1010878910 71 Medicar Provider 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 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 0 467.3 0 0 0 0 0 0 467.3 0 0 1010879158 1295262582 89 Physician Assistant Only(Encounter Only) GOULD CATHERINE 999999999 81 Perry 0 0 0 0 0 0 0 0 0 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 1382.08 0 0 0 0 0 0 1382.08 0 0 1010879399 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 47.62 0 0 0 0 0 0 47.62 0 0 1010879493 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 1010879644 1073907341 10 Physicians GANDHI SHWETA H 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 0 151 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 2240.49 0 0 0 0 0 0 2240.49 0 0 1010879899 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7127.27 0 0 0 0 0 0 0 0 0 0 0 0 0 7127.27 0 0 1010880256 1659880094 16 Nurse Practitioners ROYSE MICHELLE F 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 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 0 616.9 0 0 0 0 0 0 616.9 0 0 1010880329 1275024523 16 Nurse Practitioners FORT LA TEISHA N 999999999 90 Saline 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 0 934.4 0 0 0 0 0 0 934.4 0 0 1010880563 1891156444 16 Nurse Practitioners ADAMS MERCHANT 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 1464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2056.33 0 0 0 0 0 0 2056.33 0 0 1010880618 1700208980 10 Physicians QASEEM MUHAMMAD K 999999999 91 Sangamon 0 0 Internal Medicine 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 0 468 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 11024.59 0 0 0 0 0 0 11024.59 0 0 1010880680 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2185.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.33 0 0 1010881235 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 1010881272 1619136942 10 Physicians NEVREKAR DIPTI 999999999 98 Tazewell 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 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 0 362.94 0 0 0 0 0 0 0 0 362.94 0 0 1010881409 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3778.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3778.67 0 0 1010881992 1215322714 10 Physicians STEWART DANIELLE 999999999 89 Rock Island 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 895.96 0 0 0 0 0 0 895.96 0 0 1010882173 10 Physicians 89 Rock Island 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 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 1010882238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48789.4 0 0 0 0 0 0 0 0 0 0 0 0 0 48789.4 0 0 1010882351 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 4112.94 0 0 0 0 0 0 0 0 0 0 0 0 0 4112.94 0 0 1010882535 1881107613 16 Nurse Practitioners PATEL ANGELI S 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 0 379.26 0 0 0 0 0 0 379.26 0 0 1010882821 1194227827 36 Community mental health provider "CHESTNUT HEALTH SYSTEMS, INC" 999999999 72 McLean 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 0 801.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11664.44 0 0 12465.56 0 0 1010882968 1518472463 16 Nurse Practitioners HARTY REBECCA 999999999 107 Will 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 0 133 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 4628.21 0 0 0 0 0 0 4628.21 0 0 1010883072 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 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 37880.16 0 0 0 0 0 0 0 0 0 0 0 0 0 37880.16 0 0 1010883105 1376998187 10 Physicians KAST ANNA ELISABETH 999999999 200 Cook 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 0 136 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 2632.46 0 0 0 0 0 0 2632.46 0 0 1010883180 1164836433 10 Physicians NJIE ABDOULIE 999999999 200 Cook 0 0 Emergency 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 0 148 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 4820.42 0 0 0 0 0 0 4820.42 0 0 1010883770 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9875.25 0 0 0 0 0 0 0 0 0 0 0 0 0 9875.25 0 0 1010883985 1750778924 10 Physicians SOTO CHERVIN CAROLINA 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 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 62.74 0 0 0 0 0 0 62.74 0 0 1010884063 1699950535 16 Nurse Practitioners WATKINS SUMMER 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 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 1557.78 0 0 0 0 0 0 1557.78 0 0 1010884086 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.97 0 0 0 0 0 0 0 0 88.97 0 0 1010884407 1558878439 16 Nurse Practitioners WALL SARA 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 0 119 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 17999.59 0 0 0 0 0 0 17999.59 0 0 1010884663 1639100878 12 Optometrists PETKOVIC MILA 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 0 245.11 0 0 0 0 0 0 245.11 0 0 1010885401 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.39 0 0 0 0 0 0 0 0 0 0 0 0 0 46.39 0 0 1010885406 1942784509 70 Ambulance Service Providers UNITED MEDICAL RESPONSE LLC 999999999 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1048389.73 0 0 0 0 0 0 1048389.73 0 0 1010885620 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 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 15.25 0 0 0 0 0 0 15.25 0 0 1010886091 1558789826 10 Physicians ALTER RANAAN Y 999999999 30 DuPage 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 69.17 0 0 0 0 0 0 69.17 0 0 1010886308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17352.58 0 0 0 0 0 0 0 0 0 0 0 0 0 17352.58 0 0 1010886383 1396961363 16 Nurse Practitioners SHELTON AMANDA 999999999 49 Jefferson 0 0 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 0 137 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 6290.07 0 0 0 0 0 0 6395.03 0 0 1010886392 1508159146 10 Physicians MUNICH STEPHAN A 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 10 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.25 0 14660.84 0 0 0 0 0 0 14698.09 0 0 1010886454 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 0 172.95 0 0 0 0 0 0 172.95 0 0 1010886741 1437609377 89 Physician Assistant Only(Encounter Only) WALKER CLAY 999999999 101 Wabash 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 0 111 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 1797.72 0 0 0 0 0 0 1797.72 0 0 1010886760 1649534231 10 Physicians FLEETWOOD VIDYARATNA 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 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 1039.97 0 0 0 0 0 0 1039.97 0 0 1010886897 1740544329 10 Physicians CHENG WAYLAND 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 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 1915.58 0 0 0 0 0 0 1915.58 0 0 1010887391 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1280.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1280.14 0 0 1010887684 1831432343 10 Physicians MCMILLIN JOHN R 999999999 91 Sangamon 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 0 187 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 7988.18 0 0 0 0 0 0 7988.18 0 0 1010887931 1780128512 48 Rural Health Clinics MANITO MEDICAL ASSOCIATES 999999999 68 Mason 0 0 0 91 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13151.26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13151.26 0 0 1010888764 1184064099 10 Physicians BEHAR ALEX 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 3 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.81 0 1743.55 0 0 0 0 0 0 1832.36 0 0 1010889188 1386971018 89 Physician Assistant Only(Encounter Only) ECHEVARRIA DONNA C 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 0 174 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 1354.28 0 0 0 0 0 0 1354.28 0 0 1010889357 1295966786 89 Physician Assistant Only(Encounter Only) ROBINSON ABIGAIL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 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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 0 203 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 0 427.83 0 0 0 0 0 0 427.83 0 0 1010890362 1891976866 10 Physicians WALSH SARAH N 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.2 0 0 0 0 0 0 0 0 186.2 0 0 1010890430 30 General Hospitals 109 Winnebago 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 780 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8012.83 0 0 0 0 0 8012.83 0 0 1010890823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28526.47 0 0 0 0 0 0 0 0 0 0 0 0 0 28526.47 0 0 1010890836 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10448.44 0 0 0 0 0 0 0 0 0 0 0 0 0 10448.44 0 0 1010890875 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14222.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14222.88 0 0 1010891185 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010891218 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1010891332 1306263561 10 Physicians THOMPSON ANDREW 999999999 57 Lake 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 14 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 24.44 0 0 0 0 0 0 24.44 0 0 1010891490 1104082320 10 Physicians KHAN FAROOQ A 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 7 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 732 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2492.37 0 0 0 0 0 0 2492.37 0 0 1010891546 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 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 1010891645 1225531577 16 Nurse Practitioners DIZON GINA 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 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 6295.12 0 0 0 0 0 0 6295.12 0 0 1010891746 1184979551 10 Physicians BUTT BILAL 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 0 176 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 5867.3 0 0 0 0 0 0 5867.3 0 0 1010891953 1225356033 10 Physicians YING WANG 999999999 200 Cook 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 0 223 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 2376.46 0 0 0 0 0 0 2376.46 0 0 1010892222 1386188068 30 General Hospitals ADVOCATE CHRIST MEDICAL CENTER 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 71 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 494 0 0 0 0 0 0 0 0 0 0 27212.2 0 0 0 0 0 0 0 94890.04 0 0 0 0 0 0 0 0 0 122102.24 0 0 1010892233 1295149409 10 Physicians HAAMID AMEERA 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 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 4256.61 0 0 0 0 0 0 4256.61 0 0 1010892290 1457871006 10 Physicians WILSON TIMOTHY 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 0 473.5 0 0 0 0 0 0 473.5 0 0 1010892426 1194040634 10 Physicians BUCKLEY LUCAS 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 533 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3737.26 0 2803.17 0 0 0 0 0 0 6540.43 0 0 1010892986 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16342.27 0 0 0 0 0 0 0 0 0 0 0 0 0 16342.27 0 0 1010893813 1053805895 16 Nurse Practitioners KOMSRI ANDREA 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 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 78.09 0 0 0 0 0 0 78.09 0 0 1010894099 1013114453 10 Physicians ANDELIN CLARK O 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 16 0 45 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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 1010896590 10 Physicians 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1.66 0 0 1010896619 1568814432 16 Nurse Practitioners HARMON AMY A 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 5575.76 0 0 0 0 0 0 5575.76 0 0 1010896797 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 0 147.66 0 0 0 0 0 0 147.66 0 0 1010896980 1659759553 10 Physicians HERRIN THOMAS 999999999 89 Rock Island 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 34 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579.99 0 173.21 0 0 0 0 0 0 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Physicians PETERSON MATTHEW 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 199 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4408.45 0 372.53 0 0 0 0 0 0 4780.98 0 0 1010906131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5217.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5217.58 0 0 1010906440 1821318353 10 Physicians BOWEN DIANA K 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 6 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.07 0 11508.75 0 0 0 0 0 0 11563.82 0 0 1010907013 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23996.72 0 0 0 0 0 0 0 0 0 0 0 0 0 23996.72 0 0 1010907548 1871075002 16 Nurse Practitioners MOHRMANN ALEXANDER M. 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 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 0 241.1 0 0 0 0 0 0 241.1 0 0 1010907679 1366986184 16 Nurse Practitioners FREEDMAN LYNN C 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 2059.91 0 0 0 0 0 0 2059.91 0 0 1010907690 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.81 0 0 0 0 0 0 33.81 0 0 1010908012 1326511882 75 Department of Alcohol and Substance Abuse Provider FAMILY GUIDANCE CENTERS - BRAN 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 199 0 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1010913723 1518253640 10 Physicians STELLE LACEY M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 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 24.74 0 1875.42 0 0 0 0 0 0 1900.16 0 0 1010913777 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 0 0 0 0 0 0 0 2 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 49052.32 0 0 0 0 0 0 0 0 0 0 0 0 0 49052.32 0 0 1010913972 1083131999 89 Physician Assistant Only(Encounter Only) TRAN NGUYEN H 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 0 384 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 1659.07 0 0 0 0 0 0 1659.07 0 0 1010914408 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1551.44 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 316.33 0 0 1010920938 1134650997 48 Rural Health Clinics CARMI FAMILY MEDICINE 999999999 105 White 0 0 0 59 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8568.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8568.1 0 0 1010921003 1437413598 10 Physicians GRIFFITH JENNIFER 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1359.71 0 0 0 0 0 0 1359.71 0 0 1010921010 1649355660 60 Pharmacies CVS PHARMACY 10761 999999999 107 Will 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 1198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38838 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87559.23 0 0 0 87559.23 0 0 1010921042 1760448120 89 Physician Assistant Only(Encounter Only) BROWN VALERIE G 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 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 0 352.19 0 0 0 0 0 0 352.19 0 0 1010921064 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 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 0 716.11 0 0 0 0 0 0 716.11 0 0 1010921166 1538650403 55 Early Intervention Services HOLSTEN LEAH 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 6276.69 0 0 0 0 0 0 6276.69 0 0 1010921326 1447795695 16 Nurse Practitioners MICHLER LAURA 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 184.83 0 0 0 0 0 0 184.83 0 0 1010921717 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 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 0 295.84 0 0 0 0 0 0 295.84 0 0 1010922945 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.08 0 0 0 0 0 0 0 0 56.08 0 0 1010923097 1801854732 10 Physicians BLOSS MICHAEL F 999999999 89 Rock Island 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 55 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2467.09 0 60.71 0 0 0 0 0 0 2527.8 0 0 1010923447 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 78.09 0 0 0 0 0 0 78.09 0 0 1010923569 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6922.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6922.11 0 0 1010923651 1336388586 10 Physicians KOPP FABIOLLA S 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10110.67 0 0 0 0 0 0 10110.67 0 0 1010923886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26617.59 0 0 0 0 0 0 0 0 0 0 0 0 0 26617.59 0 0 1010924135 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.33 0 0 0 0 0 0 93.33 0 0 1010924170 1366720245 10 Physicians KIM ERIN D 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 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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 0 0 0 0 0 0 0 0 0 0 1010925524 1376038166 16 Nurse Practitioners WIENKES BRITTANY L 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 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 63.34 0 0 0 0 0 0 63.34 0 0 1010925693 1013951912 10 Physicians EVANS-BECKMAN LINDA C 999999999 200 Cook 0 0 Family Practice 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 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 0 0 95.24 0 0 0 0 0 0 200.2 0 0 1010925894 1174818454 10 Physicians REDONDO RAQUEL 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 831.05 0 0 0 0 0 0 831.05 0 0 1010925903 1881972305 10 Physicians BRINDISE RENATA 999999999 200 Cook 0 0 Dermatology 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 1934.42 0 0 0 0 0 0 1934.42 0 0 1010926113 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 18.76 0 0 0 0 0 0 18.76 0 0 1010926400 1982087433 10 Physicians GOMEZ MARIA V 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 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 0 566.08 0 0 0 0 0 0 566.08 0 0 1010926441 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1010926490 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 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 8511.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8511.97 0 0 1010926521 1649789082 16 Nurse Practitioners LANNERT KELLY 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 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 0 456.18 0 0 0 0 0 0 456.18 0 0 1010926751 1518279231 10 Physicians KENFACK EVE E 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4625.36 0 0 0 0 0 0 4625.36 0 0 1010926975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28697.95 0 0 0 0 0 0 0 0 0 0 0 0 0 28697.95 0 0 1010926979 1588104194 16 Nurse Practitioners TATE REBECCA 999999999 24 Coles 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 1720.12 0 0 0 0 0 0 1720.12 0 0 1010927090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2308.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2308.99 0 0 1010927139 55 Early Intervention Services 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 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 3069.47 0 0 0 0 0 0 3069.47 0 0 1010927514 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11020.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11020.45 0 0 1010927664 1760831465 11 Dentists ZIELINSKI MATTHEW 999999999 200 Cook 0 0 General Dentistry 0 0 5 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2002.48 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 2755.18 0 0 1010927818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18659.87 0 0 0 0 0 0 0 0 0 0 0 0 0 18659.87 0 0 1010927996 61 Independent Laboratories 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010928084 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 1010928221 1235575739 11 Dentists CYGAN GREGORY A 999999999 30 DuPage 0 0 General Dentistry 0 0 81 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 11328.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11328.94 0 0 1010928550 1174030381 23 Occupational Therapists SHUMATE KRISTIAN E 999999999 200 Cook 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 0 241 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 16801.78 16801.78 0 0 1010928672 97 Waiver service provider--Children's residential (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 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 0 787.02 0 0 0 0 0 0 0 0 0 0 0 0 0 787.02 0 0 1010928812 1457870131 25 Audiologists FAZIL TAYLER R 999999999 65 Madison 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 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 1402.95 1402.95 0 0 1010929000 1598277907 89 Physician Assistant Only(Encounter Only) LINDBERG MALLORY 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 89.73 0 0 0 0 0 0 89.73 0 0 1010929114 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22971.08 0 0 0 0 0 0 0 0 0 0 0 0 0 22971.08 0 0 1010929222 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21618.61 0 0 0 0 0 0 0 0 0 0 0 0 0 21618.61 0 0 1010929537 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4167.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4167.37 0 0 1010929546 1326480385 10 Physicians HUO SIYA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.4 0 3240.33 0 0 0 0 0 0 3287.73 0 0 1010929594 1659697100 10 Physicians LIU JAY 999999999 53 Kane 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 0 254 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 3403.42 0 0 0 0 0 0 3403.42 0 0 1010929618 1093297111 55 Early Intervention Services SATO COLLEEN 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 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26971.63 0 0 0 0 0 0 26971.63 0 0 1010929761 55 Early Intervention Services 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 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 2715.72 0 0 0 0 0 0 2715.72 0 0 1010929801 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10383.89 0 0 0 0 0 0 0 0 0 0 0 0 0 10383.89 0 0 1010929816 1053823591 33 Nursing Facilities ACCOLADE PAXTON SENIOR LIVING 999999999 35 Ford 0 0 1 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 185 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 3911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555706.38 0 0 0 0 0 0 0 555706.38 0 0 1010930069 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 0 0 0 0 0 0 0 0 0 0 1010930087 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34569.49 0 0 0 0 0 0 0 0 0 0 0 0 0 34569.49 0 0 1010930296 1003141995 89 Physician Assistant Only(Encounter Only) GERSHTEYN MARINA 999999999 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 0 605 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 2227.88 0 0 0 0 0 0 2227.88 0 0 1010930649 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 0 163 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 15160.08 0 0 0 0 0 0 0 0 0 0 0 0 0 15160.08 0 0 1010930830 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 1937.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1937.3 0 0 1010931323 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21937.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21937.3 0 0 1010931560 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14064.73 0 0 0 0 0 0 0 0 0 0 0 0 0 14064.73 0 0 1010931666 1720493406 10 Physicians CHARSHAFIAN STEPHANIE K 999999999 200 Cook 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 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2904.61 0 0 0 0 0 0 2904.61 0 0 1010931718 1427420397 16 Nurse Practitioners STOTT AMY S 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 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 0 242.68 0 0 0 0 0 0 242.68 0 0 1010931956 1235492372 10 Physicians DURAKOVIC NEDIM 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.79 0 0 0 0 0 0 311.79 0 0 1010932402 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 1010932624 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15524.63 0 0 0 0 0 0 0 0 0 0 0 0 0 15524.63 0 0 1010932630 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24824.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24824.8 0 0 1010932910 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24363.67 0 0 0 0 0 0 0 0 0 0 0 0 0 24363.67 0 0 1010933122 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 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 24.25 0 0 0 0 0 0 24.25 0 0 1010933186 1114402518 16 Nurse Practitioners GEISS MICHELLE D 999999999 77 Morgan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 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 1669.06 0 0 0 0 0 0 1669.06 0 0 1010933766 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010934654 1104310457 10 Physicians SHEPHERD JULIE 999999999 91 Sangamon 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 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 0 263.95 0 0 0 0 0 0 263.95 0 0 1010934966 1699264101 16 Nurse Practitioners CLARKE RENAE 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 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 0 493.66 0 0 0 0 0 0 493.66 0 0 1010935619 1174938369 10 Physicians GURBA KATHARINE N. 999999999 89 Rock Island 0 0 Anesthesiology 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 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 0 885.08 0 0 0 0 0 0 885.08 0 0 1010935850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 49087.61 0 0 0 0 0 0 0 0 0 0 0 0 0 49087.61 0 0 1010936018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 966.53 0 0 0 0 0 0 0 0 0 0 0 0 0 966.53 0 0 1010936045 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 0 251.1 0 0 0 0 0 0 251.1 0 0 1010936187 1114435559 16 Nurse Practitioners LANTZ CAROL J 999999999 91 Sangamon 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 0 105 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 0 104.96 0 0 0 0 0 0 0 0 2544.9 0 0 0 0 0 0 2649.86 0 0 1010936909 1366822975 10 Physicians SHAH IMARI P 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 425.26 0 0 0 0 0 0 0 0 2129.66 0 0 0 0 0 0 2554.92 0 0 1010937090 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 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 1010937116 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18904 0 0 0 0 0 0 0 0 0 0 0 0 0 18904 0 0 1010937262 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21066.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21066.32 0 0 1010937431 1730548330 16 Nurse Practitioners ELLINGER REBEKAH 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 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 2891.46 0 0 0 0 0 0 2891.46 0 0 1010937500 1871895110 10 Physicians DONTHAMSETTI VIKRANT 999999999 200 Cook 0 0 Ophthalmology 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 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14950.92 0 0 0 0 0 0 14950.92 0 0 1010937649 1881910396 10 Physicians VANVRANCKEN MICHAEL J 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 60 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 824.05 0 70.74 0 0 0 0 0 0 894.79 0 0 1010937650 1891282760 86 Clinical Social Worker(Encounter Only) GUTIERREZ JESSE S 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 0 0 0 0 0 0 0 0 0 1010937695 1780845230 86 Clinical Social Worker(Encounter Only) AMADI RITA 999999999 91 Sangamon 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 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70904.02 0 0 0 0 0 0 70904.02 0 0 1010937842 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 7624.61 0 0 0 0 0 0 0 0 0 0 0 0 0 7624.61 0 0 1010937872 1639438997 10 Physicians JEDD ANTHONY 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 640 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11354.67 0 1379.55 0 0 0 0 0 0 12734.22 0 0 1010939021 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399.1 0 0 0 0 0 0 399.1 0 0 1010939231 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 31.01 0 0 0 0 0 0 31.01 0 0 1010939288 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 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 17.95 0 0 0 0 0 0 17.95 0 0 1010939887 1093070302 10 Physicians SHAFQAT HAMMAD 999999999 47 Jackson 0 0 Internal Medicine 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 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2931.52 0 0 0 0 0 0 2931.52 0 0 1010940016 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 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 1410.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1410.5 0 0 1010940133 1003299082 89 Physician Assistant Only(Encounter Only) KENNEY MARY KATHERINE 999999999 63 Macon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 5591.5 0 0 0 0 0 0 5676.12 0 0 1010940541 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 0 786.23 0 0 0 0 0 0 0 0 0 0 0 0 0 786.23 0 0 1010940673 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 218.69 218.69 0 0 1010940814 1386123354 33 Nursing Facilities GROVE OF ST CHARLES 999999999 53 Kane 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 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760599.59 0 0 0 0 0 0 0 760599.59 0 0 1010940895 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 854.87 854.87 0 0 1010941159 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 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 22.68 0 0 0 0 0 0 22.68 0 0 1010941164 1245636026 16 Nurse Practitioners NICHOLSON KIMBERLY 999999999 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885.53 0 0 0 0 0 0 885.53 0 0 1010941169 1962845891 86 Clinical Social Worker(Encounter Only) LECHNIAK HOLLY N 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 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 0 367.2 0 0 0 0 0 0 367.2 0 0 1010941582 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.48 0 0 0 0 0 0 0 0 0 0 0 0 0 161.48 0 0 1010941710 1013473305 16 Nurse Practitioners BUCKMAN LAURIE 999999999 106 Whiteside 0 0 0 0 0 2 0 0 0 0 0 0 0 0 57 0 0 0 0 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 0 131 0 0 0 0 0 0 0 0 0 100.25 0 0 0 0 0 0 0 0 10111.09 0 0 0 0 0 0 10211.34 0 0 1010941718 1841252426 89 Physician Assistant Only(Encounter Only) POOLE LAUREL 999999999 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 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 0 337.61 0 0 0 0 0 0 337.61 0 0 1010941818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7333.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7333.85 0 0 1010942001 1730592668 10 Physicians ALONSO VANESSA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.14 0 752.96 0 0 0 0 0 0 759.1 0 0 1010942233 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24966.12 0 0 0 0 0 0 0 0 0 0 0 0 0 24966.12 0 0 1010942383 10 Physicians 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.47 0 0 0 0 0 0 0 0 42.47 0 0 1010942844 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18338.53 0 0 0 0 0 0 0 0 0 0 0 0 0 18338.53 0 0 1010942960 1104142777 10 Physicians RAY KRISTINE L 999999999 80 Peoria 0 0 0 0 0 44 0 0 0 0 0 0 22 0 75 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 26 0 94 0 0 0 0 0 0 0 0 0 109 0 0 0 0 0 0 26 0 94 0 0 0 0 0 0 0 0 0 4081.69 0 0 0 0 0 0 368.29 0 4182.49 0 0 0 0 0 0 8632.47 0 0 1010942964 1205335320 12 Optometrists SALIM SARAH R 999999999 80 Peoria 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 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 0 759.53 0 0 0 0 0 0 759.53 0 0 1010943029 1508038019 10 Physicians REESE CHANDA L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 833.1 0 0 0 0 0 0 833.1 0 0 1010943088 1124509773 89 Physician Assistant Only(Encounter Only) CONNOLLY SARA B. 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 1369.89 0 0 0 0 0 0 1369.89 0 0 1010943229 1033650395 10 Physicians NICKELS MARGARET 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 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 0 354.34 0 0 0 0 0 0 354.34 0 0 1010943259 10 Physicians 200 Cook 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 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 8040.71 0 0 0 0 0 0 8040.71 0 0 1010943324 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010943344 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 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 0 846.56 0 0 0 0 0 0 0 0 0 0 0 0 0 846.56 0 0 1010943357 1538664941 10 Physicians DYER ALEXANDRA JULIAN 999999999 200 Cook 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 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 1616.03 0 0 0 0 0 0 1616.03 0 0 1010943409 1457766297 10 Physicians LUCHTEFELD STEPHEN 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 1 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6076.25 0 0 0 0 0 0 6076.25 0 0 1010943657 1770901134 10 Physicians GARRITY JOSEPH 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 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 24.3 0 0 0 0 0 0 0 0 24.3 0 0 1010943784 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 6.14 0 0 0 0 0 0 6.14 0 0 1010943966 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 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 0 197.56 197.56 0 0 1010944061 1811156219 10 Physicians TRUEBLOOD ANDREW C 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 14 0 0 0 0 0 0 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 22.2 0 434.39 0 0 0 0 0 0 456.59 0 0 1010944068 1558625251 10 Physicians CASINI ANTHONY J 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 0 202 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 4133.2 0 0 0 0 0 0 4133.2 0 0 1010944169 1366685794 10 Physicians ESKANDARI FARZAN 999999999 106 Whiteside 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 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 288 0 0 1010944244 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 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 0 159.13 0 0 0 0 0 0 159.13 0 0 1010944368 1922571397 16 Nurse Practitioners CYRIER KRISTIN M 999999999 54 Kankakee 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 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 0 905.35 0 0 0 0 0 0 905.35 0 0 1010945019 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 0 0 0 0 0 0 0 0 0 0 1010945079 1306208228 10 Physicians SIMAK NATALIE 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 3388.49 0 0 0 0 0 0 3388.49 0 0 1010945170 1134560030 10 Physicians WILKINS NANCY M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 75 0 5 0 0 0 0 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 98 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469.95 0 0 0 0 0 0 0 0 469.95 0 0 1010945578 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19408.54 0 0 0 0 0 0 0 0 0 0 0 0 0 19408.54 0 0 1010945876 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23418.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23418.78 0 0 1010946091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20396.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20396.44 0 0 1010946194 1548600125 10 Physicians ALSTON WHITNEY 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 19 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.94 0 4571.47 0 0 0 0 0 0 4662.41 0 0 1010946282 1639640238 89 Physician Assistant Only(Encounter Only) DAY MEGHAN K 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 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 0 358.8 0 0 0 0 0 0 358.8 0 0 1010946304 1881894707 10 Physicians RIZZARI AMANDA 999999999 24 Coles 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1914.39 0 0 0 0 0 0 1914.39 0 0 1010946332 1174787535 86 Clinical Social Worker(Encounter Only) BOYLAND DANA 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.48 0 0 0 0 0 0 248.48 0 0 1010946863 1558846741 23 Occupational Therapists REHKEMPER CORI A 999999999 91 Sangamon 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 0 130 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 10089.53 10089.53 0 0 1010947361 1104937622 10 Physicians HANLON MATTHEW SCOTT 999999999 200 Cook 0 0 Family Practice 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.43 0 1106 0 0 0 0 0 0 1116.43 0 0 1010947488 1659626554 10 Physicians MAUZO SHAKUNTALA H 999999999 68 Mason 0 0 Clinical Pathology 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 0 118 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 0 616.13 0 0 0 0 0 0 0 0 616.13 0 0 1010947630 1407339765 16 Nurse Practitioners WEAVER ADRIANE 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 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 0 852.53 0 0 0 0 0 0 852.53 0 0 1010947708 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12328.92 0 0 0 0 0 0 0 0 0 0 0 0 0 12328.92 0 0 1010947736 1689696304 60 Pharmacies CVS PHARMACY 17031 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 3336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.75 0 0 0 311.75 0 0 1010948078 1174919831 10 Physicians HOPKINS JOSEPH B 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 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 0 540.04 0 0 0 0 0 0 540.04 0 0 1010948388 1346613718 16 Nurse Practitioners GALLOWAY CHRISTOPHER 999999999 107 Will 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 0 193 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 2786.97 0 0 0 0 0 0 2786.97 0 0 1010948742 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3880.55 0 0 0 0 0 0 0 0 0 0 0 0 0 3880.55 0 0 1010949139 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 14310.2 0 0 0 0 0 0 0 0 0 0 0 0 0 14310.2 0 0 1010949196 1770947368 16 Nurse Practitioners ENRIQUEZ JOSE 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 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2046.43 0 0 0 0 0 0 2046.43 0 0 1010949513 1083140966 12 Optometrists WILSON MICHAEL K 999999999 103 Washington 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 689.38 0 0 0 0 0 0 689.38 0 0 1010949674 1194106351 10 Physicians SCHROEDER KATHLEEN J R 999999999 53 Kane 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 282.78 0 0 0 0 0 0 0 0 562.24 0 0 0 0 0 0 845.02 0 0 1010949841 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 191.67 0 0 0 0 0 0 191.67 0 0 1010949913 1134481054 10 Physicians ALMARDINI NOUR 999999999 80 Peoria 0 0 Clinical Pathology 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 0 134 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 0 798.95 0 0 0 0 0 0 0 0 798.95 0 0 1010949934 1356833255 11 Dentists ILYAS IRFANA S 999999999 200 Cook 0 0 0 0 14 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 2000.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2000.75 0 0 1010950194 1720563075 16 Nurse Practitioners SPETTER ASHLEY 999999999 108 Williamson 0 0 0 0 0 25 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 2582.41 0 0 0 0 0 0 0 0 1224.66 0 0 0 0 0 0 3807.07 0 0 1010950566 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 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 0 446.63 446.63 0 0 1010950597 1427379221 10 Physicians GLASS DIANNE H 999999999 30 DuPage 0 0 Obstetric-Gynecology 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 653.87 0 0 0 0 0 0 656.05 0 0 1010950680 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23569.37 0 0 0 0 0 0 0 0 0 0 0 0 0 23569.37 0 0 1010950992 1073036000 11 Dentists ROSALES DANIEL 999999999 200 Cook 0 0 General Dentistry 0 0 30 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 3395.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3395.21 0 0 1010951166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 42435.2 0 0 0 0 0 0 0 0 0 0 0 0 0 42435.2 0 0 1010951665 1245772284 75 Department of Alcohol and Substance Abuse Provider HEALTHCARE ALTERNATIVE SYSTEMS 999999999 200 Cook 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 0 306 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 20091.31 0 0 20091.31 0 0 1010951805 1649783440 11 Dentists ABBASI HENNA 999999999 200 Cook 0 0 Maxillofacial Surgery 0 0 27 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 6659.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6659.35 0 0 1010951895 1972764819 10 Physicians MCDONOUGH TIFFANI 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 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 5889.63 0 0 0 0 0 0 5889.63 0 0 1010952217 1275896300 10 Physicians DODICK TODD ANTHONY 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1097.19 0 0 0 0 0 0 1097.19 0 0 1010952392 1144562216 10 Physicians RHEE MARY H 999999999 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 7376.04 0 0 0 0 0 0 7388.06 0 0 1010952414 1891175915 10 Physicians FUGAR SETRI 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 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 83.23 0 0 0 0 0 0 83.23 0 0 1010952533 1750870051 16 Nurse Practitioners STEELE ALECIA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 2953.55 0 0 0 0 0 0 2953.55 0 0 1010952614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7637.72 0 0 0 0 0 0 0 0 0 0 0 0 0 7637.72 0 0 1010952693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13134.21 0 0 0 0 0 0 0 0 0 0 0 0 0 13134.21 0 0 1010952887 1295254993 16 Nurse Practitioners WELLNITZ ARYN LYNN 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 64.4 0 0 0 0 0 0 0 0 683.49 0 0 0 0 0 0 747.89 0 0 1010952962 1376024240 20 Registered nurse WOLD AMBER 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4070.67 0 0 0 0 0 0 4070.67 0 0 1010953206 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15396.28 0 0 0 0 0 0 0 0 0 0 0 0 0 15396.28 0 0 1010953724 1700309812 11 Dentists CHIM PANHAVUT 999999999 30 DuPage 0 0 General Dentistry 0 0 118 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 14593.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14593.81 0 0 1010953892 1649623935 11 Dentists ABU SABAA ALAA H 999999999 200 Cook 0 0 0 0 43 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 9710.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9710.17 0 0 1010954046 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.4 0 0 0 0 0 0 0 0 0 0 0 0 0 43.4 0 0 1010954113 1073995684 10 Physicians WRAIKAT MOTAZ R 999999999 47 Jackson 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 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9576.68 0 0 0 0 0 0 9576.68 0 0 1010954126 1336339381 10 Physicians BERI ABHIMANYU 999999999 54 Kankakee 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 233 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 453 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3907.83 0 0 0 0 0 0 3907.83 0 0 1010954192 1205340080 16 Nurse Practitioners MINNION-KLYCE ERICA 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 58.13 0 0 0 0 0 0 58.13 0 0 1010954208 86 Clinical Social Worker(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 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 1010954410 1033536057 10 Physicians DAVIS CAROLYN 999999999 200 Cook 0 0 Obstetric-Gynecology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 25.65 0 0 0 0 0 0 61.6 0 0 1010954454 4010954454 90 Waiver service provider--Elderly (DOA) LAWNDALE CHRISTIAN HEALTH CENT 999999999 200 Cook 0 0 0 0 0 0 0 7 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 3487.17 0 0 0 0 0 0 0 0 0 0 0 0 0 3487.17 0 0 1010954606 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 2711.85 0 0 0 0 0 0 0 0 0 0 0 0 0 2711.85 0 0 1010955220 1497140727 10 Physicians MOINUDDIN SUNNAN 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 0 271 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 4524.2 0 0 0 0 0 0 4524.2 0 0 1010955564 1396238937 40 Federally Qualified Health Centers IMAN YOUTH AND FAMILY HEALTH C 999999999 200 Cook 0 0 0 15 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 3754.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3754.79 0 0 1010955696 1730672395 10 Physicians KANAKARAJ MUTHURAJ 999999999 47 Jackson 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 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 2734.52 0 0 0 0 0 0 2734.52 0 0 1010955726 1841768660 16 Nurse Practitioners GRAYSON-CANTY PATRICIA 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 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 0 529.48 0 0 0 0 0 0 529.48 0 0 1010955746 1255644555 10 Physicians PENESETTI SUNIL 999999999 200 Cook 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 0 118 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 2051.13 0 0 0 0 0 0 2051.13 0 0 1010956010 1467409508 89 Physician Assistant Only(Encounter Only) COGNAC GREGG 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 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 1557.56 0 0 0 0 0 0 1557.56 0 0 1010956066 1144790791 60 Pharmacies MERCYHEALTH PHARMACY - RIVERSI 999999999 13 Boone 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 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54006.83 0 0 0 54006.83 0 0 1010956105 1558830851 16 Nurse Practitioners EDSALL COURTNEY D 999999999 80 Peoria 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 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1025.81 0 0 0 0 0 0 1057.96 0 0 1010956304 1689125817 24 Speech Therapists MERCIER OLIVIA E 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 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 4395.2 4395.2 0 0 1010956409 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7201.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7201.97 0 0 1010956876 1427557446 16 Nurse Practitioners EKBERG AMY N 999999999 109 Winnebago 0 0 0 0 0 2 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 161.46 0 0 0 0 0 0 0 0 2875.9 0 0 0 0 0 0 3037.36 0 0 1010957280 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16537.57 0 0 0 0 0 0 0 0 0 0 0 0 0 16537.57 0 0 1010957394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21548.75 0 0 0 0 0 0 0 0 0 0 0 0 0 21548.75 0 0 1010958310 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 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 0 947.57 0 0 0 0 0 0 947.57 0 0 1010958390 91 Waiver service provider--Adults (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 0 674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135196.98 0 0 0 0 0 0 0 0 0 0 0 0 0 135196.98 0 0 1010958679 1669877502 89 Physician Assistant Only(Encounter Only) VASQUEZ ALYSSA K 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 0 236.91 0 0 0 0 0 0 236.91 0 0 1010958793 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11817.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11817.6 0 0 1010958996 1245775998 16 Nurse Practitioners NATALE JAMIE 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 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 0 419.31 0 0 0 0 0 0 419.31 0 0 1010959155 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 17.21 0 0 0 0 0 0 17.21 0 0 1010959212 1598077760 10 Physicians SALAM MAAMOUN 999999999 24 Coles 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757.25 0 0 0 0 0 0 757.25 0 0 1010959263 1881102325 16 Nurse Practitioners KARABINOS KATE LYNNE 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 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 0 673.01 0 0 0 0 0 0 673.01 0 0 1010959425 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16325.08 0 0 0 0 0 0 0 0 0 0 0 0 0 16325.08 0 0 1010959601 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 0 126 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 15661.36 0 0 0 0 0 0 0 0 0 0 0 0 0 15661.36 0 0 1010959781 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 295.52 0 0 0 0 0 0 0 0 0 0 0 0 0 295.52 0 0 1010960014 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 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 30.41 0 0 0 0 0 0 30.41 0 0 1010960026 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 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 0 102.27 0 0 0 0 0 0 102.27 0 0 1010960208 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 31.01 0 0 0 0 0 0 31.01 0 0 1010960373 1043674138 16 Nurse Practitioners HUSHKA ELIZABETH 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 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 0 624.72 0 0 0 0 0 0 624.72 0 0 1010960417 1811415342 16 Nurse Practitioners DAVIS EMILY 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 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 0 242.85 0 0 0 0 0 0 242.85 0 0 1010960469 1912160151 10 Physicians GOEL RUCHIKA 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 0 106 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 1425.84 0 0 0 0 0 0 1425.84 0 0 1010960529 1689167298 11 Dentists BRIKHA MARIE 999999999 200 Cook 0 0 General Dentistry 0 0 52 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 6855.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6855.2 0 0 1010960642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8773 0 0 0 0 0 0 0 0 0 0 0 0 0 8773 0 0 1010961009 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 0 104 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 4296.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4296.6 0 0 1010961030 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.45 0 0 0 0 0 0 50.45 0 0 1010961055 1003323254 16 Nurse Practitioners BAUTISTA GAY 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 0 144 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 2069.35 0 0 0 0 0 0 2069.35 0 0 1010961403 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 0 238 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 17438.08 0 0 0 0 0 0 0 0 0 0 0 0 0 17438.08 0 0 1010961569 1922397462 10 Physicians VIVAR KARINA L. 999999999 200 Cook 0 0 Dermatology 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 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 3455.19 0 0 0 0 0 0 3455.19 0 0 1010961819 1255826137 10 Physicians JOSEPH AMY 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 53.15 0 0 0 0 0 0 4.4 0 155.05 0 0 0 0 0 0 212.6 0 0 1010962289 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18360.19 0 0 0 0 0 0 0 0 0 0 0 0 0 18360.19 0 0 1010962389 1356683734 10 Physicians BRENT JONATHAN B 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 0 238.79 0 0 0 0 0 0 238.79 0 0 1010962681 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12293.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12293.05 0 0 1010962856 1851826507 16 Nurse Practitioners WILEY ARIELLE J. 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 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 1870.54 0 0 0 0 0 0 1870.54 0 0 1010962880 1336534288 10 Physicians PATEL NITI 999999999 200 Cook 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 0 327 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 3803.45 0 0 0 0 0 0 3803.45 0 0 1010962924 1316391410 10 Physicians DAVIS JESSIKA 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 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 0 767.34 0 0 0 0 0 0 767.34 0 0 1010962949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12398.59 0 0 0 0 0 0 0 0 0 0 0 0 0 12398.59 0 0 1010963096 1861904187 75 Department of Alcohol and Substance Abuse Provider PIATT COUNTY MENTAL HEALTH CEN 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785.42 0 0 1785.42 0 0 1010963212 1487636569 10 Physicians WIGBOLDY JAY F 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 1 908 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1461 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1461 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.54 16299.41 0 258.77 0 0 0 0 0 0 16563.72 0 0 1010963400 1508374505 16 Nurse Practitioners RADOSEVICH ERIN 999999999 30 DuPage 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 0 107 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 0 374.4 0 0 0 0 0 0 374.4 0 0 1010963469 1063977627 16 Nurse Practitioners REES ASHLEY N 999999999 91 Sangamon 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 0 174 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 1632.11 0 0 0 0 0 0 1632.11 0 0 1010963692 1194050500 89 Physician Assistant Only(Encounter Only) HASSAN KATY Y 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 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 0 401.5 0 0 0 0 0 0 401.5 0 0 1010963954 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1010964611 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 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 32.26 0 0 0 0 0 0 32.26 0 0 1010964698 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39257.34 0 0 0 0 0 0 0 0 0 0 0 0 0 39257.34 0 0 1010964723 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7757.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7757.64 0 0 1010964769 1932513751 10 Physicians GOLDFARB MIKHAIL 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 61.76 0 0 0 0 0 0 61.76 0 0 1010965447 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 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 16291.06 0 0 0 0 0 0 0 0 0 0 0 0 0 16291.06 0 0 1010965448 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.15 0 0 0 0 0 0 4.15 0 0 1010965573 1629417290 10 Physicians TWU JONATHAN 999999999 200 Cook 0 0 0 0 0 0 0 0 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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 0 300.07 0 0 0 0 0 300.07 0 0 1010974766 10 Physicians 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 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 0 478.79 0 0 0 0 0 0 478.79 0 0 1010975036 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1010975314 1164956918 16 Nurse Practitioners VALENTINE SHANITA M 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 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 6959.23 0 0 0 0 0 0 6959.23 0 0 1010975316 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2910.28 0 0 0 0 0 0 2910.28 0 0 1010976311 1023527207 25 Audiologists SEPER ERIC 999999999 30 DuPage 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 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 0 160.46 160.46 0 0 1010976745 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 3174.11 0 0 0 0 0 0 0 0 0 0 0 0 0 3174.11 0 0 1010976818 1376921361 10 Physicians FLETCHER PETER J 999999999 200 Cook 0 0 Emergency 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 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 0 326.4 0 0 0 0 0 0 326.4 0 0 1010976849 1447670260 10 Physicians SEMENOVA YELENA B 999999999 200 Cook 0 0 Psychiatry 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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MEDICINE LABS LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2767 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2767 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36606.63 0 0 0 0 0 0 0 0 36606.63 0 0 1010981343 1659786150 13 Podiatrists TABOR DIANA K 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 0 650.36 0 0 0 0 0 0 650.36 0 0 1010981356 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37107.25 0 0 0 0 0 0 0 0 0 0 0 0 0 37107.25 0 0 1010981380 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 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 0 508.2 508.2 0 0 1010981646 1619427069 16 Nurse Practitioners SHAH HETA 999999999 53 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29.48 0 0 0 0 0 0 29.48 0 0 1010988711 1023512118 55 Early Intervention Services CHRZANOWSKA AGNIESZKA 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 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 4446.89 0 0 0 0 0 0 4446.89 0 0 1010988830 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3176.98 0 0 0 0 0 0 0 0 0 0 0 0 0 3176.98 0 0 1010989057 1992295596 16 Nurse Practitioners OLIVER CLAIRE E 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 0 109 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 1855.77 0 0 0 0 0 0 1855.77 0 0 1010989064 1902379621 16 Nurse Practitioners HUSSEY VONNISE R 999999999 200 Cook 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 0 122 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 1732.84 0 0 0 0 0 0 1732.84 0 0 1010989192 1750316774 10 Physicians MAISH MARY 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 0 483.43 0 0 0 0 0 0 483.43 0 0 1010989282 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 0 212.58 0 0 0 0 0 0 212.58 0 0 1010989450 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13278.73 0 0 0 0 0 0 0 0 0 0 0 0 0 13278.73 0 0 1010989469 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 749.21 0 0 0 0 0 0 0 0 0 0 0 0 0 749.21 0 0 1010989575 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12657.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12657.05 0 0 1010989628 1639573710 10 Physicians SADATH HALEEMA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 5 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.5 0 851.21 0 0 0 0 0 0 1117.71 0 0 1010989718 1386156040 24 Speech Therapists RODRIGUEZ ROMO MARIA X 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 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 6396.76 6396.76 0 0 1010989955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 25632.86 0 0 0 0 0 0 0 0 0 0 0 0 0 25632.86 0 0 1010990208 1649693441 89 Physician Assistant Only(Encounter Only) FLAHERTY KATHERINE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.13 0 0 0 0 0 0 116.13 0 0 1010990231 4010990231 90 Waiver service provider--Elderly (DOA) GOODHOPE HEALTHCARE AND HOME H 999999999 71 McHenry 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 3206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374128.95 0 0 0 0 0 0 0 0 0 0 0 0 0 374128.95 0 0 1010990569 1639686835 16 Nurse Practitioners REISING SARAH L. 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 0 488.39 0 0 0 0 0 0 488.39 0 0 1010990571 1710211503 10 Physicians BORJA CACHO DANIEL 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 0 104 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 0 184.93 0 0 0 0 0 0 184.93 0 0 1010990591 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 0 125.36 0 0 0 0 0 0 125.36 0 0 1010990611 1760973762 91 Waiver service provider--Adults (DHS/DDD) MORTON MIRANDA T 999999999 30 DuPage 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155250.6 0 0 0 0 0 0 0 0 0 0 0 0 0 155250.6 0 0 1010990862 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23110.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23110.5 0 0 1010991263 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3890.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3890.92 0 0 1010991385 1003347071 10 Physicians BOWERS JOHN NATHAN 999999999 53 Kane 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 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 0 370.72 0 0 0 0 0 0 370.72 0 0 1010991683 1538521794 10 Physicians LOKE DANA ELIZABETH 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3819.88 0 0 0 0 0 0 3819.88 0 0 1010992010 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16882.41 0 0 0 0 0 0 0 0 0 0 0 0 0 16882.41 0 0 1010992042 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14464.72 0 0 0 0 0 0 0 0 0 0 0 0 0 14464.72 0 0 1010992463 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 83.7 0 0 0 0 0 0 83.7 0 0 1010992513 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 78.09 0 0 0 0 0 0 78.09 0 0 1010992588 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4047.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4047.31 0 0 1010992678 1063598068 60 Pharmacies CVS PHARMACY 10736 609543913 54 Kankakee 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 0 621 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12326.52 0 0 0 12326.52 0 0 1010993061 1396084794 10 Physicians COHEN JASON E 999999999 200 Cook 0 0 Urology 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.51 0 1346.48 0 0 0 0 0 0 1352.99 0 0 1010993905 1255443412 10 Physicians WAGNER STEPHEN P 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 580.77 0 0 0 0 0 0 580.77 0 0 1010994348 1538647318 55 Early Intervention Services WOLVERTON LYNDSEY E 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 3654.42 0 0 0 0 0 0 3654.42 0 0 1010994438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1010994558 1528421021 10 Physicians NEUMANN KAITLYN E 999999999 200 Cook 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 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 1415.51 0 0 0 0 0 0 1415.51 0 0 1010994616 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 81.59 0 0 0 0 0 0 81.59 0 0 1010995135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.03 0 0 0 0 0 0 0 0 0 0 0 0 0 82.03 0 0 1010995159 1972771160 36 Community mental health provider PILLARS COMMUNITY HEALTH 999999999 200 Cook 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 678 0 0 78545.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60258.78 0 0 138804.31 0 0 1010995181 1043622632 10 Physicians TAYEBALY SUMRA 999999999 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 27 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1604.03 0 874.99 0 0 0 0 0 0 2479.02 0 0 1010995468 1124547500 55 Early Intervention Services HUGHES CHAZVON L 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 0 171 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 10019.38 0 0 0 0 0 0 10019.38 0 0 1010995629 1427539279 89 Physician Assistant Only(Encounter Only) CASHEN ROBERT 999999999 200 Cook 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 0 229 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 8465.11 0 0 0 0 0 0 8465.11 0 0 1010995757 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3871.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3871.85 0 0 1010995988 1962798397 10 Physicians PARK JAE YOON 999999999 88 Richland 0 0 Internal Medicine 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 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7627.29 0 0 0 0 0 0 7627.29 0 0 1010996084 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 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 0 204.06 0 0 0 0 0 0 204.06 0 0 1010996267 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1010996382 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 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 0 706.44 0 0 0 0 0 0 0 0 0 0 0 0 0 706.44 0 0 1010996553 1447545447 10 Physicians MILLER DANIEL W 999999999 200 Cook 0 0 Obstetric-Gynecology 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 17 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 835.89 0 6259.1 0 0 0 0 0 0 7094.99 0 0 1010996678 1992159206 10 Physicians DALEY MICHAEL N 999999999 53 Kane 0 0 Emergency Medicine 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 0 175 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 5647.17 0 0 0 0 0 0 5647.17 0 0 1010997061 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4550.27 0 0 0 0 0 0 0 0 0 0 0 0 0 4550.27 0 0 1010997131 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25041.8 0 0 0 0 0 0 0 0 0 0 0 0 0 25041.8 0 0 1010997188 1104338425 70 Ambulance Service Providers "AIR EVAC EMS, INC." 999999999 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 9828.79 0 0 0 0 0 0 9828.79 0 0 1010997242 1477062172 16 Nurse Practitioners ROGERS CHERYL 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.48 0 0 0 0 0 0 33.48 0 0 1010997253 1053663641 89 Physician Assistant Only(Encounter Only) OLIVER SARAH 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 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 0 128.25 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 238120.83 0 0 0 0 0 0 0 0 0 0 0 0 0 238120.83 0 0 1010999250 1235290883 89 Physician Assistant Only(Encounter Only) DISANTO RICHARD 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 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 0 626.83 0 0 0 0 0 0 626.83 0 0 1010999515 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 1010999595 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 42.14 0 0 0 0 0 0 42.14 0 0 1010999626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6617.59 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 0 366.56 366.56 0 0 1011009652 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 0 165 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 15063.07 0 0 0 0 0 0 0 0 0 0 0 0 0 15063.07 0 0 1011009655 1760978688 10 Physicians HASSANIEH IHAB 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 0 145.97 0 0 0 0 0 0 145.97 0 0 1011010064 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 46689.88 0 0 0 0 0 0 0 0 0 0 0 0 0 46689.88 0 0 1011010625 1477840833 10 Physicians SUN YIFEI A 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 8 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 195 0 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0 0 0 0 0 34 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 0 403.12 0 0 0 0 0 0 403.12 0 0 1011014064 1427376425 10 Physicians SMITH ZACHARY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 6 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.02 0 1453.9 0 0 0 0 0 0 1455.92 0 0 1011014461 1972878080 10 Physicians SYED MAARIA 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 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 0 640.25 0 0 0 0 0 0 640.25 0 0 1011014475 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14060.22 0 0 0 0 0 0 0 0 0 0 0 0 0 14060.22 0 0 1011014489 1023448230 16 Nurse Practitioners SOBOLEWSKI REBEKKAH 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 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 0 113.75 0 0 0 0 0 0 113.75 0 0 1011014656 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 47.62 0 0 0 0 0 0 47.62 0 0 1011014705 23 Occupational Therapists 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 369.07 369.07 0 0 1011014786 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 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 56 0 0 1011014799 1982099651 10 Physicians COLTON KATHARINE 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1011015398 91 Waiver service provider--Adults (DHS/DDD) 80 Peoria 0 0 0 0 0 0 0 2 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 21851.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21851.9 0 0 1011015506 1063952620 16 Nurse Practitioners CLEVENGER MELISSA B 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 21 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 38.64 0 0 0 0 0 0 0 0 581.43 0 0 0 0 0 0 620.07 0 0 1011015629 1417112483 10 Physicians NELSON CHRISTOPHER D 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 0 549.52 0 0 0 0 0 0 549.52 0 0 1011015794 1366735680 23 Occupational Therapists BEHM CHRISTEN 999999999 89 Rock Island 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 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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 0 333 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 21851.67 0 0 0 0 0 0 0 0 0 0 0 0 0 21851.67 0 0 1011023536 1619324399 55 Early Intervention Services MAYFIELD WHITNEY C. 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 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 2587.12 0 0 0 0 0 0 2587.12 0 0 1011023555 1932674322 16 Nurse Practitioners GEORGE ASHLEIGH 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 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 0 209.37 0 0 0 0 0 0 209.37 0 0 1011024069 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 0 236.9 0 0 0 0 0 0 236.9 0 0 1011024082 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 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 6764.97 0 0 0 0 0 0 0 0 0 0 0 0 0 6764.97 0 0 1011024131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 43056.84 0 0 0 0 0 0 0 0 0 0 0 0 0 43056.84 0 0 1011024397 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 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 13123.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13123.79 0 0 1011024413 1518080605 10 Physicians MUSHTAQ SAULAT 999999999 200 Cook 0 0 Internal Medicine 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.52 0 300.66 0 0 0 0 0 0 557.18 0 0 1011024519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8449 0 0 0 0 0 0 0 0 0 0 0 0 0 8449 0 0 1011024721 1497224943 16 Nurse Practitioners MATHEW JAIMI P. 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 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 0 193.36 0 0 0 0 0 0 193.36 0 0 1011025031 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38104.45 0 0 0 0 0 0 0 0 0 0 0 0 0 38104.45 0 0 1011025240 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22527.72 0 0 0 0 0 0 0 0 0 0 0 0 0 22527.72 0 0 1011025304 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.75 0 0 0 0 0 0 106.75 0 0 1011025351 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4277.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4277.81 0 0 1011025442 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 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 0 759.74 0 0 759.74 0 0 1011025569 1891203956 86 Clinical Social Worker(Encounter Only) SMITH BEVERLY A 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 0 207 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 4333.77 0 0 0 0 0 0 4333.77 0 0 1011025583 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 5 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 17245.6 0 0 17245.6 0 0 1011025925 1962744797 10 Physicians AVANTS KELSIE 999999999 200 Cook 0 0 Pediatrics 0 0 0 13 0 0 0 0 0 0 2 0 68 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 2 0 138 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 2 0 138 0 0 0 0 0 0 0 0 0 948.86 0 0 0 0 0 0 6.3 0 6346.96 0 0 0 0 0 0 7302.12 0 0 1011026194 1144513359 10 Physicians KASS HOUT TAREQ 999999999 30 DuPage 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 10 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135.68 0 16177.64 0 0 0 0 0 0 16313.32 0 0 1011026269 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5915.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5915.52 0 0 1011026270 1932607835 16 Nurse Practitioners WHITLATCH ASHLEY 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 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 1444.48 0 0 0 0 0 0 1444.48 0 0 1011027082 1134100134 60 Pharmacies CVS SPECIALTY 600562151 200 Cook 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 1317 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3871720.44 0 0 0 3871720.44 0 0 1011027257 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12327.86 0 0 0 0 0 0 0 0 0 0 0 0 0 12327.86 0 0 1011027308 1396065884 10 Physicians YUN HONG JUN 999999999 200 Cook 0 0 Internal Medicine 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 0 248 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 3323.38 0 0 0 0 0 0 3323.38 0 0 1011027331 1396057972 10 Physicians TEKIPPE MICHAEL J 999999999 200 Cook 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 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 5078.1 0 0 0 0 0 0 5078.1 0 0 1011027405 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 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 1913.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1913.95 0 0 1011027615 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22598.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22598.58 0 0 1011027619 1649782269 16 Nurse Practitioners CARLSON ELLEN 999999999 108 Williamson 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 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 0 661.97 0 0 0 0 0 0 661.97 0 0 1011027695 1386110674 43 Encounter rate clinic COOK COUNTY HEALTH PROFESSIONA 999999999 200 Cook 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 5673.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5673.5 0 0 1011028083 1578914248 10 Physicians BRUINSMA MONIQUE W 999999999 61 Livingston 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 0 438.8 0 0 0 0 0 0 438.8 0 0 1011028290 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20152.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20152.8 0 0 1011028422 1811419245 40 Federally Qualified Health Centers CRUSADER COMMUNITY HEALTH SOUT 610802579 109 Winnebago 0 0 0 18 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2958.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2958.55 0 0 1011028491 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 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 0 424.28 424.28 0 0 1011028618 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2044.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2044.05 0 0 1011028632 91 Waiver service provider--Adults (DHS/DDD) 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 0 245 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 13667.06 0 0 0 0 0 0 0 0 0 0 0 0 0 13667.06 0 0 1011028749 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 0 195 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 16589.63 0 0 0 0 0 0 0 0 0 0 0 0 0 16589.63 0 0 1011028975 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 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 32983.4 0 0 0 0 0 0 0 0 0 0 0 0 0 32983.4 0 0 1011029054 1093206245 91 Waiver service provider--Adults (DHS/DDD) LANG LAUREN M 999999999 30 DuPage 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119497.7 0 0 0 0 0 0 0 0 0 0 0 0 0 119497.7 0 0 1011029653 1871003335 90 Waiver service provider--Elderly (DOA) CENTER FOR SENIORS 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 2814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183851.44 0 0 0 0 0 0 0 0 0 0 0 0 0 183851.44 0 0 1011030075 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3418.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3418.8 0 0 1011030088 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25089.26 0 0 0 0 0 0 0 0 0 0 0 0 0 25089.26 0 0 1011030475 1558701664 10 Physicians AMATUL HABEEB S 999999999 30 DuPage 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 0 151 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 0 724.48 0 0 0 0 0 0 724.48 0 0 1011030563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22142.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22142.47 0 0 1011030571 1114277688 13 Podiatrists ZORGER RACHEL 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 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 0 194.29 0 0 0 0 0 0 194.29 0 0 1011030579 1215317599 10 Physicians DEVISSER MICHAEL 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 3005.33 0 0 0 0 0 0 3005.33 0 0 1011030946 1235360553 10 Physicians HANSEN KATHERINE E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 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 0 0 166.28 0 0 0 0 0 0 166.28 0 0 1011031166 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 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 97.3 0 0 0 0 0 0 97.3 0 0 1011031445 1982063624 89 Physician Assistant Only(Encounter Only) SPENCER KACI J 999999999 80 Peoria 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 0 172 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 0 652.99 0 0 0 0 0 0 652.99 0 0 1011031714 1952560443 89 Physician Assistant Only(Encounter Only) KLAUSTERMEIER JACOB 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 40.45 0 0 0 0 0 0 40.45 0 0 1011031977 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24435.18 0 0 0 0 0 0 0 0 0 0 0 0 0 24435.18 0 0 1011031985 1376044933 89 Physician Assistant Only(Encounter Only) PARRIS GRETCHEN A 999999999 80 Peoria 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 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.81 0 0 0 0 0 0 130.81 0 0 1011032174 1003227117 10 Physicians SABHERWAL NARYAN S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 815 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.48 0 42501.85 0 0 0 0 0 0 42585.33 0 0 1011032249 1477811610 10 Physicians DODD KENNETH W 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 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 0 293.95 0 0 0 0 0 0 293.95 0 0 1011032304 21 Licensed Practical Nurses 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 0 0 0 0 0 0 0 0 0 0 1011032350 1144736026 24 Speech Therapists BALTRISIS BRIANNA J 999999999 54 Kankakee 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 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 3374.24 3374.24 0 0 1011032558 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1953.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1953.6 0 0 1011032893 1134268121 10 Physicians PAPPU SUGUNA 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 0 176.37 0 0 0 0 0 0 176.37 0 0 1011033650 1497267207 89 Physician Assistant Only(Encounter Only) BLAIR JESSICA D 999999999 15 Bureau 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 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 1040.23 0 0 0 0 0 0 1040.23 0 0 1011033688 1073994851 10 Physicians SCHWARTZ CHARLES 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 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 0 940.74 0 0 0 0 0 0 940.74 0 0 1011033967 1174906515 10 Physicians DOSHETTY RAKESH V 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 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 0 599.28 0 0 0 0 0 0 599.28 0 0 1011034036 1962914317 11 Dentists PATEL ARSHITA 999999999 89 Rock Island 0 0 General Dentistry 0 0 68 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 11393.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11393.16 0 0 1011034223 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 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 1286.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1286.12 0 0 1011034355 1760770671 10 Physicians LOTT MELISA L 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 40 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1979.66 0 2461.07 0 0 0 0 0 0 4440.73 0 0 1011034424 40 Federally Qualified Health Centers 815 Indiana 0 0 0 5 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 1621.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1621.73 0 0 1011034501 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23989.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.35 0 0 1011034546 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1070.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1070.19 0 0 1011034669 1467947655 10 Physicians PHILIBERT MEGAN ELIZABETH 999999999 47 Jackson 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 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 0 236.82 0 0 0 0 0 0 236.82 0 0 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Physicians 47 Jackson 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 0 0 0 0 0 0 0 0 0 0 0 0 1011039836 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 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 0 354.47 354.47 0 0 1011040238 1154866374 16 Nurse Practitioners ANDERSON MOLLY 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 33.22 0 0 0 0 0 0 0 0 632.15 0 0 0 0 0 0 665.37 0 0 1011040672 1790203057 10 Physicians PEREZ GUTIERREZ ROSARIO 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 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 6841.6 0 0 0 0 0 0 6841.6 0 0 1011040679 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 67.22 0 0 0 0 0 0 67.22 0 0 1011040782 1609059740 10 Physicians HAIDAR GEORGES M 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 1 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493.78 0 0 0 0 0 0 493.78 0 0 1011041222 1396235933 16 Nurse Practitioners SCHOLLENBERGER AMY 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 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 1143.76 0 0 0 0 0 0 1143.76 0 0 1011041389 1710477526 16 Nurse Practitioners DZUBUR ELVIRA 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 0 704.55 0 0 0 0 0 0 704.55 0 0 1011041806 86 Clinical Social Worker(Encounter Only) 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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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 23813.57 0 0 0 0 0 0 0 0 0 0 0 0 0 23813.57 0 0 1011044103 1780080846 22 Physical Therapists CARLSON ADAM M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 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 1837.46 1837.46 0 0 1011044256 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23913.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23913.4 0 0 1011044275 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216.43 0 0 0 0 0 0 216.43 0 0 1011044320 1164496097 10 Physicians PIERRE-JEROME FRANTZ 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 1 757 0 167 0 0 0 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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 23101.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23101.32 0 0 1011059566 1841554078 10 Physicians MARTIN TAMIKA L. 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 2.6 0 101.23 0 0 0 0 0 0 103.83 0 0 1011059583 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.93 90.93 0 0 1011059717 1649651811 10 Physicians BALDI BROOKE B 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 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 2678.52 0 0 0 0 0 0 2678.52 0 0 1011060059 91 Waiver service provider--Adults (DHS/DDD) 60 Lee 0 0 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 18561 0 0 0 0 0 0 0 0 0 0 0 0 0 18561 0 0 1011060090 1679091474 89 Physician Assistant Only(Encounter Only) GUEBERT COURTNEY 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 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 0 808.97 0 0 0 0 0 0 808.97 0 0 1011060134 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 0 0 0 0 0 0 0 0 0 0 1011060393 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 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 1011060525 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 1011060534 1134357189 10 Physicians HARP MELHEM H 999999999 10 Adams 0 0 Family Practice 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 2298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9681.7 0 0 0 0 0 0 9681.7 0 0 1011060651 1780191437 56 School Based / Linked Health Clinics MMG IN SCHOOL HEALTH PEORIA HI 999999999 80 Peoria 0 0 0 7 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450.55 0 325.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 776.5 0 0 1011060706 1750818522 16 Nurse Practitioners EYERS KAYCEE 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 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 0 954.9 0 0 0 0 0 0 954.9 0 0 1011060766 1710460951 47 Local Education Agencies ELGIN MATH AND SCIENCE ACADEMY 999999999 53 Kane 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 0 0 0 176.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5567.29 0 5743.58 0 0 1011060856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9893.56 0 0 0 0 0 0 0 0 0 0 0 0 0 9893.56 0 0 1011060875 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6293.93 0 0 0 0 0 0 0 0 0 0 0 0 0 6293.93 0 0 1011060922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31873.54 0 0 0 0 0 0 0 0 0 0 0 0 0 31873.54 0 0 1011061674 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 0 113.26 0 0 0 0 0 0 113.26 0 0 1011061937 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 54460.79 0 0 0 0 0 0 0 0 0 0 0 0 0 54460.79 0 0 1011061949 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 79.26 79.26 0 0 1011062373 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 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 28311.09 0 0 0 0 0 0 0 0 0 0 0 0 0 28311.09 0 0 1011062445 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 5662.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5662.8 0 0 1011062688 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 0 147 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 14346.75 0 0 0 0 0 0 0 0 0 0 0 0 0 14346.75 0 0 1011062887 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 0 121 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 15091.56 0 0 0 0 0 0 0 0 0 0 0 0 0 15091.56 0 0 1011063846 1669763983 10 Physicians PANT MAMTA 999999999 200 Cook 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 0 284 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 3355.67 0 0 0 0 0 0 0 0 3355.67 0 0 1011064126 55 Early Intervention Services 109 Winnebago 0 0 0 0 0 0 0 0 0 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 3289.23 0 0 0 0 0 0 3289.23 0 0 1011064173 1194935494 10 Physicians OIKONOMOU IOANNIS 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 0 103 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 2244.39 0 0 0 0 0 0 2244.39 0 0 1011064344 1225543580 89 Physician Assistant Only(Encounter Only) VALENTE MITCHELL 999999999 200 Cook 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 0 121 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 5601.64 0 0 0 0 0 0 5601.64 0 0 1011064675 1245727197 16 Nurse Practitioners SCOTT RICHARD L 999999999 58 La Salle 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 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 1506.51 0 0 0 0 0 0 1506.51 0 0 1011064753 10 Physicians 107 Will 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 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 1011064764 1952779696 89 Physician Assistant Only(Encounter Only) WALTON HALEY 999999999 200 Cook 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 0 115 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 1377.72 0 0 0 0 0 0 1377.72 0 0 1011064771 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24403.72 0 0 0 0 0 0 0 0 0 0 0 0 0 24403.72 0 0 1011064802 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5594.06 0 0 0 0 0 0 0 0 0 0 0 0 0 5594.06 0 0 1011065232 1538401112 10 Physicians LUND EMILY B 999999999 30 DuPage 0 0 Dermatology 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 33 0 0 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 7.16 0 344.4 0 0 0 0 0 0 351.56 0 0 1011065337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23003.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23003.64 0 0 1011065608 1144737123 16 Nurse Practitioners CAMPO TARA A 999999999 54 Kankakee 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 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 1423.55 0 0 0 0 0 0 1423.55 0 0 1011065702 1659461606 16 Nurse Practitioners FINK MARY 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 236.62 0 0 0 0 0 0 236.62 0 0 1011065922 1710146576 10 Physicians BAEWER DAVID V 999999999 53 Kane 0 0 Clinical Pathology 0 0 0 0 0 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 0 340.58 0 0 0 0 0 0 0 0 340.58 0 0 1011065995 1659877439 63 Other Providers of Medical Equipment/Supplies (Non-registered) ASHLEY MEDICAL SUPPLY 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 0 150 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 12750.58 0 0 0 0 0 0 12750.58 0 0 1011066086 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 14.57 0 0 0 0 0 0 14.57 0 0 1011066422 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.6 0 0 0 0 0 0 0 0 0 0 0 0 0 328.6 0 0 1011066563 4011066563 89 Physician Assistant Only(Encounter Only) VIGILANTE ALEXANDRA 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 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 0 897.14 0 0 0 0 0 0 897.14 0 0 1011067224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6553.52 0 0 0 0 0 0 0 0 0 0 0 0 0 6553.52 0 0 1011067239 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 0 540.51 0 0 0 0 0 0 0 0 0 0 0 0 0 540.51 0 0 1011067243 1043795388 23 Occupational Therapists CAPONERA GIANNA 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 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 3775.05 3775.05 0 0 1011067553 1811499114 75 Department of Alcohol and Substance Abuse Provider GATEWAY JACKSONVILLE 999999999 77 Morgan 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 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182490.88 0 0 182490.88 0 0 1011067669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16389.34 0 0 0 0 0 0 0 0 0 0 0 0 0 16389.34 0 0 1011067947 1275783557 89 Physician Assistant Only(Encounter Only) OYERINDE OLAWUNMI 999999999 80 Peoria 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 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 3345.51 0 0 0 0 0 0 3345.51 0 0 1011067979 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 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 0 336.24 336.24 0 0 1011068181 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352.57 0 0 0 0 0 0 0 0 0 0 0 0 0 352.57 0 0 1011068244 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1822.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1822.76 0 0 1011068348 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 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 9986.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9986.34 0 0 1011068389 1568846343 16 Nurse Practitioners CARLSON STEVEN 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 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 0 100.18 0 0 0 0 0 0 100.18 0 0 1011068428 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1684.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1684.19 0 0 1011068432 10 Physicians 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 39.86 0 0 0 0 0 0 39.86 0 0 1011068461 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23253.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23253.2 0 0 1011068489 1255786489 70 Ambulance Service Providers TRANSCARE MEDICAL TRANSPORT 999999999 90 Saline 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 1398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83670.43 0 0 0 0 0 0 83670.43 0 0 1011068516 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 0 0 0 0 0 0 0 0 0 0 1011068663 1265827075 10 Physicians PATEL NIKKI 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 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 4088.01 0 0 0 0 0 0 4088.01 0 0 1011068789 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 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 0 214.09 214.09 0 0 1011068842 1952618316 16 Nurse Practitioners GOMEZ MELJUN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11861.12 0 0 0 0 0 0 11861.12 0 0 1011068958 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 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 2271.06 0 0 0 0 0 0 0 0 0 0 0 0 0 2271.06 0 0 1011069294 1700351442 16 Nurse Practitioners JACKATEY SUZIE F 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 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 1406.1 0 0 0 0 0 0 1406.1 0 0 1011069380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3724.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3724.09 0 0 1011069490 1336384460 10 Physicians AKHTAR MUHAMMAD S 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.38 0 2778.53 0 0 0 0 0 0 2788.91 0 0 1011069761 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10676.37 0 0 0 0 0 0 0 0 0 0 0 0 0 10676.37 0 0 1011069775 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 45457.07 0 0 0 0 0 0 0 0 0 0 0 0 0 45457.07 0 0 1011069959 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3496.66 0 0 0 0 0 0 0 0 0 0 0 0 0 3496.66 0 0 1011070139 1568717627 10 Physicians MUSLEHUDDIN RUQAYYAH 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 25 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 385.27 0 1719.38 0 0 0 0 0 0 2104.65 0 0 1011070463 1710407531 10 Physicians DUBE AMANDA REIS 999999999 54 Kankakee 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 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 1501.2 0 0 0 0 0 0 1501.2 0 0 1011070466 1659886679 11 Dentists BHOW AASHNA S 999999999 53 Kane 0 0 0 0 381 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 2257 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 2257 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 82057.96 0 0 0 0 0 0 0 0 0 0 0 5268.9 0 0 0 0 87326.86 0 0 1011070546 1275544777 60 Pharmacies KIRBY PHARMACY 624012425 33 Effingham 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 0 741 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33520.64 0 0 0 33520.64 0 0 1011070751 1295099406 10 Physicians CHILLURU VAMSI KRISHNA 999999999 47 Jackson 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 0 126 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 0 636.52 0 0 0 0 0 0 636.52 0 0 1011070813 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.6 0 0 0 0 0 0 33.6 0 0 1011071010 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.07 0 0 0 0 0 0 0 0 0 0 0 0 0 231.07 0 0 1011071051 1528141116 10 Physicians ABATE KELLY 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.14 0 0 0 0 0 0 124.14 0 0 1011071054 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1011071086 1407348337 16 Nurse Practitioners SIMS BRENDA N 999999999 71 McHenry 0 0 0 0 0 7 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 521.15 0 0 0 0 0 0 0 0 1551.88 0 0 0 0 0 0 2073.03 0 0 1011071219 1558833699 16 Nurse Practitioners RAMIREZ MARYBELL 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 0 198.64 0 0 0 0 0 0 198.64 0 0 1011071287 1912476599 16 Nurse Practitioners STOWERS JENNA N. 999999999 53 Kane 0 0 0 0 0 4 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 552.81 0 0 0 0 0 0 0 0 1812.83 0 0 0 0 0 0 2365.64 0 0 1011071497 1093873671 89 Physician Assistant Only(Encounter Only) ZHAO LILY L 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 1308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257.12 0 0 0 0 0 0 257.12 0 0 1011071542 1780196766 16 Nurse Practitioners DRAYTON KRISTINA 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 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 1191.89 0 0 0 0 0 0 1191.89 0 0 1011072219 1922340397 10 Physicians COHEN THEODORE M 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 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 1836.97 0 0 0 0 0 0 1836.97 0 0 1011072241 86 Clinical Social Worker(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 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 0 666.6 0 0 0 0 0 0 666.6 0 0 1011072327 1104200625 89 Physician Assistant Only(Encounter Only) KETCHUM ALYSSA B 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 0 196.59 0 0 0 0 0 0 196.59 0 0 1011072871 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16013.81 0 0 0 0 0 0 0 0 0 0 0 0 0 16013.81 0 0 1011073199 1821528621 89 Physician Assistant Only(Encounter Only) PIERCE-SAVOIE PAULA L 999999999 47 Jackson 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 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2937.88 0 0 0 0 0 0 2937.88 0 0 1011073381 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13346.18 0 0 0 0 0 0 0 0 0 0 0 0 0 13346.18 0 0 1011073411 1417399320 10 Physicians WEIMHOLT CODY 999999999 53 Kane 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 0 119 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 1430.53 0 0 0 0 0 0 0 0 1430.53 0 0 1011073472 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16510.81 0 0 0 0 0 0 0 0 0 0 0 0 0 16510.81 0 0 1011073668 1992787915 10 Physicians CHO TRACEY A 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 109.35 0 0 0 0 0 0 109.35 0 0 1011073800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7900.02 0 0 0 0 0 0 0 0 0 0 0 0 0 7900.02 0 0 1011074085 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24090.77 0 0 0 0 0 0 0 0 0 0 0 0 0 24090.77 0 0 1011074345 1952307886 10 Physicians REESE STERLING S 999999999 106 Whiteside 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 0 191 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 1417.82 0 0 0 0 0 0 1417.82 0 0 1011074416 1871011635 16 Nurse Practitioners STRALOW ANGELA 999999999 106 Whiteside 0 0 0 0 0 1 0 0 0 0 0 0 0 0 9 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 84.62 0 0 0 0 0 0 0 0 379.32 0 0 0 0 0 0 463.94 0 0 1011074482 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24571.66 0 0 0 0 0 0 0 0 0 0 0 0 0 24571.66 0 0 1011074504 1164871786 23 Occupational Therapists HAMSTRA BRIANNE E 999999999 106 Whiteside 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 0 134 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 2283.17 2283.17 0 0 1011075084 1215341938 10 Physicians LEAVITT TRENT D 999999999 80 Peoria 0 0 0 0 0 4 0 0 0 0 0 0 2 0 49 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 4 0 82 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 4 0 82 0 0 0 0 0 0 0 0 0 429.51 0 0 0 0 0 0 19.24 0 3152.52 0 0 0 0 0 0 3601.27 0 0 1011075253 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 1011075565 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 680.23 0 0 0 0 0 0 0 0 0 0 0 0 0 680.23 0 0 1011075875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4873.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4873.02 0 0 1011075902 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.76 0 0 0 0 0 0 0 0 54.76 0 0 1011075966 1841709862 16 Nurse Practitioners YANTIS BRYCE 999999999 19 Champaign 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 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 0 895.38 0 0 0 0 0 0 895.38 0 0 1011076057 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2289.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2289.35 0 0 1011076064 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 38.39 0 0 0 0 0 0 38.39 0 0 1011076235 1972573780 10 Physicians MEHROTRA SUSHI 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 7 0 38 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 61 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 61 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 149.17 0 1624 0 0 0 0 0 0 1805.32 0 0 1011076481 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19722.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19722.38 0 0 1011076938 1912169319 10 Physicians ROHENA LUIS 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 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 0 781.83 0 0 0 0 0 0 781.83 0 0 1011076954 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 13697.61 0 0 0 13697.61 0 0 1011077384 1003317389 89 Physician Assistant Only(Encounter Only) SALMON KRISTIN 999999999 50 Jersey 0 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0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7122.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7122.5 0 0 1011077892 1083125348 16 Nurse Practitioners FROMM CHERYL L 999999999 108 Williamson 0 0 0 0 0 2 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 24 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 35.27 0 0 0 0 0 0 0 0 1112.57 0 0 0 0 0 0 1147.84 0 0 1011078177 1467961482 16 Nurse Practitioners KIELY KATHERINE 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 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 2300.79 0 0 0 0 0 0 2300.79 0 0 1011078282 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18151.08 0 0 0 0 0 0 0 0 0 0 0 0 0 18151.08 0 0 1011078400 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252.3 0 0 0 0 0 0 252.3 0 0 1011078513 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.5 0 0 0 0 0 0 5.5 0 0 1011078575 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 0 552.47 0 0 0 0 0 0 0 0 0 0 0 0 0 552.47 0 0 1011078742 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 25077.63 0 0 0 0 0 0 0 0 0 0 0 0 0 25077.63 0 0 1011078944 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 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 12877.31 0 0 0 0 0 0 0 0 0 0 0 0 0 12877.31 0 0 1011078996 1538480181 10 Physicians CHAN DAVID M 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 0 126 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 7808.71 0 0 0 0 0 0 7808.71 0 0 1011079080 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15982.62 0 0 0 0 0 0 0 0 0 0 0 0 0 15982.62 0 0 1011079114 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1011079380 1184065898 12 Optometrists NESBITT DANIELLE J 999999999 55 Kendall 0 0 0 0 0 0 0 0 0 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 0 507.22 0 0 0 0 0 0 507.22 0 0 1011079508 1891210647 16 Nurse Practitioners PATEL PRATIXA 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 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 0 697.99 0 0 0 0 0 0 697.99 0 0 1011079980 1003142704 10 Physicians IGLESIAS ANTONIO 999999999 200 Cook 0 0 Neurology 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 0 267 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 5501.21 0 0 0 0 0 0 5501.21 0 0 1011079985 1891176772 10 Physicians MOHAMMED DEENA H 999999999 57 Lake 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 0 109 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 4756.67 0 0 0 0 0 0 4756.67 0 0 1011080320 1871834424 24 Speech Therapists SCHLINDWEIN KAREN M 999999999 80 Peoria 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 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 8361.22 8361.22 0 0 1011080697 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17461.64 0 0 0 0 0 0 0 0 0 0 0 0 0 17461.64 0 0 1011080870 1447792866 11 Dentists HAMOUD DUAA 999999999 200 Cook 0 0 General Dentistry 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3356.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3356.3 0 0 1011081296 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.36 0 0 0 0 0 0 173.36 0 0 1011081608 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30290.85 0 0 0 0 0 0 0 0 0 0 0 0 0 30290.85 0 0 1011081823 1851812788 89 Physician Assistant Only(Encounter Only) SEFTON JESSICA 999999999 200 Cook 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 0 156 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 5021.53 0 0 0 0 0 0 5021.53 0 0 1011082011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1044.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1044.74 0 0 1011082257 1275823296 10 Physicians JACOBS KRISTIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 225 0 0 0 0 0 0 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 2.6 0 3739.4 0 0 0 0 0 0 3742 0 0 1011082367 1376084707 10 Physicians MERVAK COLIN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1424.69 0 0 0 0 0 0 1424.69 0 0 1011082596 1346769171 16 Nurse Practitioners MARSH SARAH E 999999999 97 Stephenson 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 0 119 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 5033.31 0 0 0 0 0 0 5033.31 0 0 1011082654 30 General Hospitals 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1011082701 1417472887 16 Nurse Practitioners LYNCH KIMBERLY E 999999999 30 DuPage 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 0 128 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 0 406.52 0 0 0 0 0 0 406.52 0 0 1011082731 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26790.26 0 0 0 0 0 0 0 0 0 0 0 0 0 26790.26 0 0 1011082777 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1937.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1937.04 0 0 1011082931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22913.71 0 0 0 0 0 0 0 0 0 0 0 0 0 22913.71 0 0 1011082990 1265930127 89 Physician Assistant Only(Encounter Only) BANYS OLGA 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 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 0 250.62 0 0 0 0 0 0 250.62 0 0 1011082992 1407365174 16 Nurse Practitioners LEON GABRIELA 999999999 71 McHenry 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 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 2142.23 0 0 0 0 0 0 2142.23 0 0 1011083148 1760900799 16 Nurse Practitioners LUBA ABRAHAM YOHANNES 999999999 200 Cook 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23069.79 0 0 0 0 0 0 23069.79 0 0 1011083416 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4921.63 0 0 0 0 0 0 0 0 0 0 0 0 0 4921.63 0 0 1011083420 1588955066 10 Physicians AMIN JAIMIN P 999999999 200 Cook 0 0 Internal Medicine 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 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3521.13 0 0 0 0 0 0 3521.13 0 0 1011083455 86 Clinical Social Worker(Encounter Only) 92 Schuyler 0 0 0 0 0 0 0 0 0 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 1011083901 1760973234 16 Nurse Practitioners THOMPSON ANGELICA 999999999 102 Warren 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 32.15 0 0 0 0 0 0 0 0 128.87 0 0 0 0 0 0 161.02 0 0 1011084025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1051.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1051.15 0 0 1011084132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19736.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19736.3 0 0 1011084262 1043694045 10 Physicians LASALA JULIETA 999999999 200 Cook 0 0 Family 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 0 275 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 5388.29 0 0 0 0 0 0 5388.29 0 0 1011084425 86 Clinical Social Worker(Encounter Only) 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 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 0 106.75 0 0 0 0 0 0 106.75 0 0 1011084530 1942728506 60 Pharmacies THE MEDICINE SHOPPE PHARMACY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3525.83 0 0 0 3525.83 0 0 1011084696 1811491236 10 Physicians VUONG WHITNEY 999999999 200 Cook 0 0 0 0 0 1 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 18 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 38.55 0 0 0 0 0 0 0 0 396.97 0 0 0 0 0 0 435.52 0 0 1011085118 1871818385 10 Physicians BHATHEJA SAMIT 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 544.65 0 0 0 0 0 0 544.65 0 0 1011085174 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35629.47 0 0 0 0 0 0 0 0 0 0 0 0 0 35629.47 0 0 1011085177 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9517.5 0 0 0 0 0 0 0 0 0 0 0 0 0 9517.5 0 0 1011085213 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23360.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23360.83 0 0 1011085556 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23427.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23427.69 0 0 1011085805 1609392091 16 Nurse Practitioners HARDWICK TAMARA M 999999999 91 Sangamon 0 0 0 0 0 18 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 1820.04 0 0 0 0 0 0 0 0 1862.96 0 0 0 0 0 0 3683 0 0 1011086572 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 297.25 0 0 0 0 0 0 0 0 0 0 0 0 0 297.25 0 0 1011086597 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.3 0 0 0 0 0 0 51.3 0 0 1011086658 1851596720 10 Physicians WOOD RYAN 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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 0 333 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 24490.61 0 0 0 0 0 0 0 0 0 0 0 0 0 24490.61 0 0 1011087132 1700142395 10 Physicians MAHAJAN SANDEEP 999999999 53 Kane 0 0 Internal 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 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 1995.98 0 0 0 0 0 0 1995.98 0 0 1011087192 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 0 0 0 0 0 0 0 0 0 0 1011087200 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7394.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7394.85 0 0 1011087406 1477060895 16 Nurse Practitioners ZETTLER JEFFERY A 999999999 200 Cook 0 0 0 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0 0 0 0 0 0 0 0 0 5224.78 0 0 1011091733 1548656838 10 Physicians NANDYALA ANISHA 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 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 0 353.31 0 0 0 0 0 0 353.31 0 0 1011091907 1679967202 10 Physicians LINDERER RENA 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 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 12975.01 0 0 0 0 0 0 12975.01 0 0 1011092280 1376047035 16 Nurse Practitioners TAYLOR ANTIONETTE L. 999999999 24 Coles 0 0 0 0 0 0 0 0 0 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 0 508.93 0 0 0 0 0 0 508.93 0 0 1011092284 1093218836 16 Nurse Practitioners HOUSEHOLDER ROBYN A. 999999999 30 DuPage 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 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 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0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.93 186.93 0 0 1011095752 1942595129 10 Physicians CHAPIN CATHERINE 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 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 3307 0 0 0 0 0 0 3307 0 0 1011095962 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12342.54 0 0 0 0 0 0 0 0 0 0 0 0 0 12342.54 0 0 1011096136 1750677621 10 Physicians PATEL COOKE SHEENA 999999999 200 Cook 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 0 109 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 1159.96 0 0 0 0 0 0 1159.96 0 0 1011096151 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 23941 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34446.32 0 0 0 34446.32 0 0 1011096929 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8286.52 0 0 0 0 0 0 0 0 0 0 0 0 0 8286.52 0 0 1011097278 1487105649 30 General Hospitals O'FALLON DIALYSIS 999999999 96 St Clair DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 1369 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14665.01 0 0 0 0 0 14665.01 0 0 1011097465 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8593.05 0 0 0 0 0 0 0 0 0 0 0 0 0 8593.05 0 0 1011097628 1508123787 10 Physicians TAZEH NGII N 999999999 30 DuPage 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 687.7 0 0 0 0 0 0 689.88 0 0 1011097923 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2901.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.84 0 0 1011098448 1699213496 16 Nurse Practitioners FOUNTAIN LAURA J 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 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 0 555.49 0 0 0 0 0 0 555.49 0 0 1011098493 1427547538 30 General Hospitals HOLY CROSS HOSPITAL 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 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 0 123 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 253159.01 0 0 0 0 0 0 0 0 0 253159.01 0 0 1011098620 1295140309 10 Physicians PARK PAUL J 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1583.72 0 0 0 0 0 0 1583.72 0 0 1011098732 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 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 91.25 91.25 0 0 1011098945 1891290276 55 Early Intervention Services DUNLAP JENNIFER P 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 9254.13 0 0 0 0 0 0 9254.13 0 0 1011099114 1043442544 89 Physician Assistant Only(Encounter Only) DUSAK MEGAN 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 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 1104.69 0 0 0 0 0 0 1104.69 0 0 1011099360 1215128400 10 Physicians SAMRA MANPREET 999999999 200 Cook 0 0 Internal Medicine 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 0 107 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 88.03 0 0 0 0 0 0 88.03 0 0 1011099491 1134605439 16 Nurse Practitioners MUYLEART LYNDSIE 999999999 30 DuPage 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 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6612.88 0 0 0 0 0 0 6612.88 0 0 1011099608 4011099608 91 Waiver service provider--Adults (DHS/DDD) YANDEL HANNAH G 999999999 200 Cook 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 491 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45537.4 0 0 0 0 0 0 0 0 0 0 0 0 0 45537.4 0 0 1011099752 1871951210 55 Early Intervention Services DIAZ ISABEL 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 0 138 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 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 0 646.29 0 0 0 0 0 0 646.29 0 0 1011100105 1609393966 16 Nurse Practitioners PYTLINSKI JEANETTE S 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 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 0 543.62 0 0 0 0 0 0 543.62 0 0 1011100216 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1011100221 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25625.63 0 0 0 0 0 0 0 0 0 0 0 0 0 25625.63 0 0 1011100290 1982853750 10 Physicians HICKS TAYLOR D 999999999 80 Peoria 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 13 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.83 0 39539.3 0 0 0 0 0 0 39602.13 0 0 1011100354 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011100430 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 46.45 0 0 0 0 0 0 46.45 0 0 1011100474 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2132.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2132.29 0 0 1011100530 1881179430 16 Nurse Practitioners SCHADLER CRAIG 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 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 0 350.32 0 0 0 0 0 0 350.32 0 0 1011100710 1093132284 10 Physicians SITA ELIZABETH E 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2655.7 0 0 0 0 0 0 2655.7 0 0 1011100835 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24913.3 0 0 0 0 0 0 0 0 0 0 0 0 0 24913.3 0 0 1011100870 1245729458 55 Early Intervention Services TIGGES LYNN T 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 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 18034.11 0 0 0 0 0 0 18034.11 0 0 1011100951 1518200468 10 Physicians BRADKE AMANDA 999999999 200 Cook 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 0 212 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 2446.99 0 0 0 0 0 0 2446.99 0 0 1011101237 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11875.72 0 0 0 0 0 0 0 0 0 0 0 0 0 11875.72 0 0 1011101287 1043352677 10 Physicians NELSON KAREN M 999999999 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 2351.5 0 0 0 0 0 0 2437.15 0 0 1011101598 1972777126 10 Physicians RAVAL MEHUL 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 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 4736.64 0 0 0 0 0 0 4736.64 0 0 1011101853 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1051.83 0 0 0 0 0 0 1051.83 0 0 1011102445 1245602093 16 Nurse Practitioners KINAHAN KAREN 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 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 0 185.96 0 0 0 0 0 0 185.96 0 0 1011102597 1629552229 100 Family Support Program ONARGA ACADEMY 999999999 46 Iroquois 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 1224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462329.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462329.64 0 0 1011102853 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23392.61 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.61 0 0 1011103090 1275036303 16 Nurse Practitioners WRIGHT LARONDA 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 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 0 525.93 0 0 0 0 0 0 525.93 0 0 1011103157 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21461.31 0 0 0 0 0 0 0 0 0 0 0 0 0 21461.31 0 0 1011103700 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25596.6 0 0 0 0 0 0 0 0 0 0 0 0 0 25596.6 0 0 1011103754 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 21846.88 0 0 0 0 0 0 0 0 0 0 0 0 0 21846.88 0 0 1011103849 1699934471 10 Physicians FAYN YEKATERINA 999999999 25 Crawford 0 0 Internal Medicine 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 0 430 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 2595.67 0 0 0 0 0 0 2595.67 0 0 1011103907 1568877678 10 Physicians KHAN ASMA S 999999999 80 Peoria 0 0 Pediatrics 0 0 0 39 0 0 0 0 0 0 9 0 44 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 10 0 64 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 10 0 64 0 0 0 0 0 0 0 0 0 4295.52 0 0 0 0 0 0 196.72 0 2187.37 0 0 0 0 0 0 6679.61 0 0 1011104113 1972084796 89 Physician Assistant Only(Encounter Only) ASATURIAN SARAH E 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 12.39 0 0 0 0 0 0 12.39 0 0 1011104240 1629489323 10 Physicians HOWARTH DT R 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 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5504.49 0 0 0 0 0 0 5504.49 0 0 1011104315 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21634.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21634.9 0 0 1011104332 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17503.37 0 0 0 0 0 0 0 0 0 0 0 0 0 17503.37 0 0 1011104395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26330.38 0 0 0 0 0 0 0 0 0 0 0 0 0 26330.38 0 0 1011104763 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 0 694.4 0 0 0 0 0 0 0 0 0 0 0 0 0 694.4 0 0 1011104867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3703.15 0 0 0 0 0 0 0 0 0 0 0 0 0 3703.15 0 0 1011105475 1780875898 12 Optometrists JASPER JANNA F 999999999 100 Vermilion 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 0 341 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 4686.14 0 0 0 0 0 0 4686.14 0 0 1011105902 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23650.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23650.83 0 0 1011106079 1588058606 10 Physicians KANNAN JACQUELINE L 999999999 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 13 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742.32 0 0 0 0 0 0 742.32 0 0 1011106266 1881122893 12 Optometrists SCHERER KELLY K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2333.31 0 6477.52 0 0 0 0 8810.83 0 0 1011106581 1588857718 10 Physicians WAANDERS ANGELA J. 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 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 1853.74 0 0 0 0 0 0 1853.74 0 0 1011106773 1649535782 10 Physicians EBERSOLE JOHN WARREN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1307 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2112 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2112 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9978.55 0 401.51 0 0 0 0 0 0 10380.06 0 0 1011107232 1568957637 30 General Hospitals GLEN DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 1158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576.54 0 0 0 0 0 576.54 0 0 1011107272 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22068.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22068.9 0 0 1011107334 1962778522 10 Physicians MCWILLIAMS LUCAS M 999999999 200 Cook 0 0 Pediatrics 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 0 105 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 5387.62 0 0 0 0 0 0 5387.62 0 0 1011107426 1013178235 10 Physicians ULLAH ASHFAQ 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 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 0 114.67 0 0 0 0 0 0 114.67 0 0 1011107732 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 7023.92 0 0 0 0 0 0 0 0 0 0 0 0 0 7023.92 0 0 1011107924 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11397.83 0 0 0 0 0 0 0 0 0 0 0 0 0 11397.83 0 0 1011108121 1316254287 16 Nurse Practitioners ROHER STACY A 999999999 91 Sangamon 0 0 0 0 0 5 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 360.88 0 0 0 0 0 0 0 0 2573.48 0 0 0 0 0 0 2934.36 0 0 1011108583 1275037400 10 Physicians KNAZEE LAUREN 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 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 0 379.26 0 0 0 0 0 0 379.26 0 0 1011108790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21851.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21851.9 0 0 1011108833 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35536.43 0 0 0 0 0 0 0 0 0 0 0 0 0 35536.43 0 0 1011108933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35057.26 0 0 0 0 0 0 0 0 0 0 0 0 0 35057.26 0 0 1011109301 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 1011109802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3418.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3418.8 0 0 1011109810 10 Physicians 107 Will 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 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 0.98 0 0 0 0 0 0 0.98 0 0 1011110242 1053894238 16 Nurse Practitioners FRIELDS ABIGAYL 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 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 0 113.37 0 0 0 0 0 0 113.37 0 0 1011110505 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 418.06 0 0 0 0 0 0 0 0 0 0 0 0 0 418.06 0 0 1011110587 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8109.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8109.5 0 0 1011110656 1871824987 89 Physician Assistant Only(Encounter Only) RODRIGUEZ EMILY 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 3.91 0 0 0 0 0 0 3.91 0 0 1011110705 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 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 0 353.79 0 0 0 0 0 0 353.79 0 0 1011110726 1477010031 16 Nurse Practitioners SALAZAR CYNTHIA 999999999 15 Bureau 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 0 270 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 27705.38 0 0 0 0 0 0 27705.38 0 0 1011110809 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6439.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6439.11 0 0 1011111272 1508337056 16 Nurse Practitioners LOGAN LAURA 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 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 1161.59 0 0 0 0 0 0 1161.59 0 0 1011111478 1336431667 10 Physicians KAWADRY SURAYA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.78 0 0 0 0 0 0 506.78 0 0 1011111499 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 5 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 7559.28 7559.28 0 0 1011111517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1077.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1077.21 0 0 1011111685 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9306.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9306.78 0 0 1011111954 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20617.78 0 0 0 0 0 0 0 0 0 0 0 0 0 20617.78 0 0 1011112091 1629432091 10 Physicians GROSS NICHOLAS 999999999 30 DuPage 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 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 0 376.91 0 0 0 0 0 0 376.91 0 0 1011112185 1639478969 10 Physicians PET GILLIAN 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 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 5054.86 0 0 0 0 0 0 5054.86 0 0 1011112624 1497268965 16 Nurse Practitioners BAUGHER DANA 999999999 91 Sangamon 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 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 0 937.84 0 0 0 0 0 0 937.84 0 0 1011112889 1114390788 16 Nurse Practitioners EYDELMAN KATHERINE 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 0 108.63 0 0 0 0 0 0 108.63 0 0 1011113056 1952717902 10 Physicians GRANADILLO DE LUQUE JORGE L 999999999 109 Winnebago 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 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 0 543.54 0 0 0 0 0 0 543.54 0 0 1011113194 1457892606 10 Physicians NEAL CHRISTOPHER 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 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 0 817.74 0 0 0 0 0 0 817.74 0 0 1011113456 1407381387 12 Optometrists DONTHAMSETTI NAMRATA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459.73 0 838.6 0 0 0 0 1298.33 0 0 1011113489 1972044311 10 Physicians BRUTON LUCAS 999999999 200 Cook 0 0 0 0 0 14 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 731.02 0 0 0 0 0 0 0 0 2499.29 0 0 0 0 0 0 3230.31 0 0 1011113886 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 3580.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3580.62 0 0 1011113902 1619442555 21 Licensed Practical Nurses JOHNSON MALINDA 999999999 200 Cook 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 1516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6150.81 0 0 0 0 0 0 6150.81 0 0 1011114191 1801258462 10 Physicians BERGREN RYAN K 999999999 200 Cook 0 0 Psychiatry 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 2600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33173.1 0 0 0 0 0 0 33173.1 0 0 1011114194 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 0 223.3 0 0 0 0 0 0 223.3 0 0 1011114225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18298.72 0 0 0 0 0 0 0 0 0 0 0 0 0 18298.72 0 0 1011114366 1760725469 10 Physicians WITEK NATALIE P 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 0 129 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 1342.03 0 0 0 0 0 0 1342.03 0 0 1011114437 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 0 0 0 0 0 0 0 0 0 0 1011114547 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 81.59 0 0 0 0 0 0 81.59 0 0 1011114549 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12286.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12286.1 0 0 1011114645 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 29.53 0 0 0 0 0 0 29.53 0 0 1011114825 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18111.66 0 0 0 0 0 0 0 0 0 0 0 0 0 18111.66 0 0 1011114964 1154896520 24 Speech Therapists CORNWELL LAUREN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 238 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 16448.74 16448.74 0 0 1011114967 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 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 1011115002 1659862266 16 Nurse Practitioners ADINDU NGOZIKA 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 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 77.46 0 0 0 0 0 0 77.46 0 0 1011115089 1578977500 10 Physicians LUND JOHN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9418.36 0 0 0 0 0 0 9418.36 0 0 1011115121 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6544 0 0 0 0 0 0 0 0 0 0 0 0 0 6544 0 0 1011115164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15716.04 0 0 0 0 0 0 0 0 0 0 0 0 0 15716.04 0 0 1011115169 1629562608 10 Physicians MCCARTIN MICHAEL P 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 0 507.04 0 0 0 0 0 0 507.04 0 0 1011115484 1386061380 10 Physicians BHAT ADITHYA DEVADAS 999999999 91 Sangamon 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 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 2056.66 0 0 0 0 0 0 2056.66 0 0 1011115746 10 Physicians 109 Winnebago 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 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 0 201 0 0 0 0 0 0 201 0 0 1011115897 1568780625 10 Physicians JAZAERLY TAREK 999999999 97 Stephenson 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 0 168 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 0 766.76 0 0 0 0 0 0 0 0 766.76 0 0 1011116009 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011116071 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150.02 0 0 0 0 0 0 150.02 0 0 1011116135 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 58.34 0 0 0 0 0 0 58.34 0 0 1011116278 1174045462 16 Nurse Practitioners NOLAN KINSEY 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 0 118 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 0 962.93 0 0 0 0 0 0 962.93 0 0 1011116310 1720427040 13 Podiatrists MESHULAM ERIC H 999999999 60 Lee 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 0 120 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 1853.46 0 0 0 0 0 0 1853.46 0 0 1011116316 1881162774 16 Nurse Practitioners ROCHA CAITLIN 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 31.01 0 0 0 0 0 0 31.01 0 0 1011116783 1063956456 16 Nurse Practitioners MEEHAN MEGAN 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 0 517.1 0 0 0 0 0 0 517.1 0 0 1011116785 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 7949.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7949.97 0 0 1011116866 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 1011117034 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011117311 1336572544 10 Physicians RAJU SIVASHANMUGAM 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Nurse Practitioners LIEBBE WILLIAM 999999999 89 Rock Island 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 0 222 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 12218.15 0 0 0 0 0 0 12218.15 0 0 1011118297 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18331.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18331.28 0 0 1011118402 1619421047 22 Physical Therapists MOCTEZUMA KRISTIN T 999999999 200 Cook 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 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 0 675.09 675.09 0 0 1011118428 1750792081 89 Physician Assistant Only(Encounter Only) MCGRATH BRIDGET A 999999999 30 DuPage 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 0 196 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 1422.21 0 0 0 0 0 0 1422.21 0 0 1011118784 1114932589 10 Physicians BRUNNER NOEMI 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 748 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1237 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15520.49 0 12.08 0 0 0 0 0 0 15532.57 0 0 1011119689 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 0 224 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 24466.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24466.7 0 0 1011120026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1011120088 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 4170.41 0 0 0 0 0 0 0 0 0 0 0 0 0 4170.41 0 0 1011120205 1467992669 16 Nurse Practitioners ONGBUECO MAREADEL B 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 0 102 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 1271.16 0 0 0 0 0 0 1271.16 0 0 1011120240 1457358202 60 Pharmacies ELMWOOD TELEPHARMACY 615297963 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 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 0 658 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378.31 0 0 0 378.31 0 0 1011120302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10167.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10167.02 0 0 1011120672 1295255487 11 Dentists OLUYEMI MOROLAYO 999999999 200 Cook 0 0 General Dentistry 0 0 110 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 21670.86 0 0 0 0 0 0 0 0 0 0 0 1855.4 0 0 0 0 23526.26 0 0 1011121181 1447612551 10 Physicians GOKHALE PRIYANKA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 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 44.67 0 9887.71 0 0 0 0 0 0 9932.38 0 0 1011121279 1144704172 16 Nurse Practitioners KNOLL JESSICA 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 349.55 0 0 0 0 0 0 0 0 1396.97 0 0 0 0 0 0 1746.52 0 0 1011121316 1881074441 10 Physicians GUPTA MOHIT 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.68 0 798.51 0 0 0 0 0 0 873.19 0 0 1011121777 1649657602 10 Physicians POON BRIAN C 999999999 53 Kane 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 0 449 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 4161.36 0 0 0 0 0 0 4161.36 0 0 1011121921 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23381.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23381.7 0 0 1011122072 1649763855 22 Physical Therapists SILVERMAN LAUREN M 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 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 6254.48 6254.48 0 0 1011122379 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31956.13 0 0 0 0 0 0 0 0 0 0 0 0 0 31956.13 0 0 1011122459 1417343567 10 Physicians ZINCONE RACHEL 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 4730.28 0 0 0 0 0 0 4730.28 0 0 1011122735 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 0 203.57 0 0 0 0 0 0 203.57 0 0 1011122773 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 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 1844.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1844.5 0 0 1011122873 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5307.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5307.9 0 0 1011122967 1093246621 10 Physicians DAYAL ARJUN 999999999 53 Kane 0 0 Dermatology 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 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 424.29 0 0 0 0 0 0 429.46 0 0 1011123224 1487093092 87 Psychologist(Encounter Only) ARMSTRONG KERRIE M 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 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 0 924.64 0 0 0 0 0 0 924.64 0 0 1011123288 1861791261 10 Physicians DRAPER KAREN V 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 4 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.01 0 3116.8 0 0 0 0 0 0 3216.81 0 0 1011123289 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 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 12428.67 0 0 0 0 0 0 0 0 0 0 0 0 0 12428.67 0 0 1011123350 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327.78 0 0 0 0 0 0 327.78 0 0 1011123626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8630.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8630.68 0 0 1011123830 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3248.86 0 0 0 0 0 0 0 0 0 0 0 0 0 3248.86 0 0 1011124056 1407825722 10 Physicians DALI SAMMI M 999999999 53 Kane 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 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 0 203.28 0 0 0 0 0 0 203.28 0 0 1011124276 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1448.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1448.92 0 0 1011124426 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22860.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22860.58 0 0 1011124440 1871909382 13 Podiatrists SAYEED RASHAD A 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 0 412 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 5902.14 0 0 0 0 0 0 5902.14 0 0 1011124475 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13319.64 0 0 0 0 0 0 0 0 0 0 0 0 0 13319.64 0 0 1011124560 1578081790 16 Nurse Practitioners JARVIS LAURA R 999999999 80 Peoria 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 39 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 907.3 0 0 0 0 0 0 939.45 0 0 1011124646 1164938882 16 Nurse Practitioners STEWART KARIE E 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 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 4557.88 0 0 0 0 0 0 4557.88 0 0 1011124760 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2275.86 0 0 0 0 0 0 0 0 0 0 0 0 0 2275.86 0 0 1011125377 1841767977 16 Nurse Practitioners REINHART KATELYN 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 1710 0 0 0 0 0 0 1806.6 0 0 1011125548 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 0 126 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 18273.57 0 0 0 0 0 0 0 0 0 0 0 0 0 18273.57 0 0 1011125748 1184166613 16 Nurse Practitioners JOHN SMITHA K 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 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 0 142.81 0 0 0 0 0 0 142.81 0 0 1011125932 1932695251 89 Physician Assistant Only(Encounter Only) BEVOLO ANDREA 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1011126137 1013259647 10 Physicians ROBINSON MELISSA 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 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 0 679.83 0 0 0 0 0 0 679.83 0 0 1011126409 1255851796 86 Clinical Social Worker(Encounter Only) CRAFT LINDA ANN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2093.68 0 0 0 0 0 0 2093.68 0 0 1011126558 1760657381 10 Physicians WEINREICH HEATHER 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 0 117 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 5223.99 0 0 0 0 0 0 5223.99 0 0 1011126834 1790070746 10 Physicians QUADRI SYEDA A 999999999 80 Peoria 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 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 0 894.75 0 0 0 0 0 0 894.75 0 0 1011127313 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 1011127447 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 8785.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8785.97 0 0 1011127467 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 0 151.16 0 0 0 0 0 0 151.16 0 0 1011127545 1336639269 16 Nurse Practitioners COLEMAN BRITTNEY M 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 0 679.14 0 0 0 0 0 0 679.14 0 0 1011127823 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 0 455.4 0 0 0 0 0 0 455.4 0 0 1011127824 1275054801 42 Waiver service provider--MFTD (HFS) ALMOST HOME KIDS AT OSF HEALTH 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 1835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1743250 0 0 0 0 0 0 1743250 0 0 1011127879 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16068.33 0 0 0 0 0 0 0 0 0 0 0 0 0 16068.33 0 0 1011128047 1548674476 10 Physicians HOFFER BRANDON A 999999999 80 Peoria 0 0 Emergency Medicine 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 0 178 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 5569.76 0 0 0 0 0 0 5569.76 0 0 1011128407 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 84.28 0 0 0 0 0 0 84.28 0 0 1011128627 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 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 2761.19 2761.19 0 0 1011128675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15183.42 0 0 0 0 0 0 0 0 0 0 0 0 0 15183.42 0 0 1011129193 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23398.47 0 0 0 0 0 0 0 0 0 0 0 0 0 23398.47 0 0 1011129461 4011129461 71 Medicar Provider SUITABLE TRANSPORTATION 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 4074.5 0 0 0 0 0 0 4074.5 0 0 1011129525 1265939623 16 Nurse Practitioners PIERRE GAELLE 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 1464.22 0 0 0 0 0 0 1464.22 0 0 1011129535 1902310642 16 Nurse Practitioners SHAIN JULIE 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 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 0 893.6 0 0 0 0 0 0 893.6 0 0 1011129626 1205345949 16 Nurse Practitioners RAUT NITA 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 0 124 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 1807.68 0 0 0 0 0 0 1807.68 0 0 1011129852 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19573.89 0 0 0 0 0 0 0 0 0 0 0 0 0 19573.89 0 0 1011130268 1679093454 10 Physicians TARRAN JOSEPH 999999999 30 DuPage 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 0 132 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 4347.73 0 0 0 0 0 0 4347.73 0 0 1011130422 1306344585 16 Nurse Practitioners DAVIS MEREDITH P 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 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 0 557.34 0 0 0 0 0 0 557.34 0 0 1011130438 1649558289 10 Physicians CHAUDHRY SALMAN I 999999999 200 Cook 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 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 16248.17 0 0 0 0 0 0 16248.17 0 0 1011130473 4011130473 90 Waiver service provider--Elderly (DOA) ILLINOIS HOME CARE SPECIALISTS 999999999 30 DuPage 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294178.56 0 0 0 0 0 0 0 0 0 0 0 0 0 294178.56 0 0 1011131017 1497292692 60 Pharmacies MARIANO'S PHARMACY #8542 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1579 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3147.48 0 0 0 3147.48 0 0 1011131247 10 Physicians 80 Peoria 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 0 0 0 0 0 0 0 0 0 0 1011131343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7075.81 0 0 0 0 0 0 0 0 0 0 0 0 0 7075.81 0 0 1011131859 1265926745 11 Dentists SREEKANTAM BHARATH VASMI KRISH 999999999 80 Peoria 0 0 0 0 195 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 999 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 32728.93 0 0 0 0 0 0 0 0 0 0 0 8279.7 0 0 0 0 41008.63 0 0 1011131892 1780826784 10 Physicians VOELKEL ANTHONY J 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Physicians RAJI ZAINAB 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 166 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 2 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5187.61 0 0 0 0 0 0 5187.61 0 0 1011134144 1568915361 10 Physicians SEARES MARIE JENNIFER B 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.21 0 0 0 0 0 0 170.21 0 0 1011134226 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7421.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7421.4 0 0 1011134282 1366909491 23 Occupational Therapists IOVINO KELLI 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 416 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 25148.74 25148.74 0 0 1011134371 1780950386 10 Physicians ASTRUG LAUREN TEPFER 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 0 119 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 18535.84 0 0 0 0 0 0 18535.84 0 0 1011134483 1942567698 10 Physicians KUKLINSKI CADENCE A 999999999 33 Effingham 0 0 Pediatrics 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 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 4104.29 0 0 0 0 0 0 4104.29 0 0 1011134760 1093288797 48 Rural Health Clinics GRAHAM MEDICAL GROUP ELMWOOD 999999999 80 Peoria 0 0 0 73 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5940.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5940.6 0 0 1011134770 1952661936 10 Physicians FLETCHER KATHRYN L 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 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 1459.74 0 0 0 0 0 0 1459.74 0 0 1011134771 1942767280 16 Nurse Practitioners WETZEL DANIELLE R 999999999 53 Kane 0 0 0 0 0 83 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 7979.46 0 0 0 0 0 0 0 0 835.75 0 0 0 0 0 0 8815.21 0 0 1011134884 10 Physicians 200 Cook 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 39.86 0 0 0 0 0 0 39.86 0 0 1011134910 1780025601 10 Physicians ARANAKE-CHRISINGER AMRITA 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1732.44 0 0 0 0 0 0 1732.44 0 0 1011134912 1043744964 10 Physicians HAN JOSIAH 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 0 150 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 5410.6 0 0 0 0 0 0 5410.6 0 0 1011134935 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24738.11 0 0 0 0 0 0 0 0 0 0 0 0 0 24738.11 0 0 1011134938 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 1011135054 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18152.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18152.25 0 0 1011135320 1396237459 11 Dentists SABBAR ALI 999999999 200 Cook 0 0 General Dentistry 0 0 85 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 12897.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12897.07 0 0 1011135489 1447284963 10 Physicians LEONARD RONALD L 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413.45 0 0 0 0 0 0 0 0 1413.45 0 0 1011136319 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 62.74 0 0 0 0 0 0 62.74 0 0 1011136594 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20301 0 0 0 0 0 0 0 0 0 0 0 0 0 20301 0 0 1011136603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23818.42 0 0 0 0 0 0 0 0 0 0 0 0 0 23818.42 0 0 1011136611 1962454645 10 Physicians CHANG SCOTT C 999999999 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 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 0 243.67 0 0 0 0 0 0 0 0 243.67 0 0 1011136758 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25388.45 0 0 0 0 0 0 0 0 0 0 0 0 0 25388.45 0 0 1011136823 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 6954.78 0 0 0 0 0 0 0 0 0 0 0 0 0 6954.78 0 0 1011137013 12 Optometrists 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.35 0 0 0 0 0 0 8.35 0 0 1011137160 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 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 0 147.04 0 0 0 0 0 0 147.04 0 0 1011137200 1578710281 89 Physician Assistant Only(Encounter Only) WHITMAN ROBERT E 999999999 91 Sangamon 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 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 0 604.36 0 0 0 0 0 0 604.36 0 0 1011137291 1154779627 22 Physical Therapists JONFF JONFF M 999999999 96 St Clair 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 0 216 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 1588.53 1588.53 0 0 1011137313 1841705639 16 Nurse Practitioners OLSON HOLLY J 999999999 200 Cook 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 0 109 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 2868.04 0 0 0 0 0 0 2868.04 0 0 1011137397 10 Physicians 200 Cook 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 0 113.6 0 0 0 0 0 0 113.6 0 0 1011137529 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8871.99 0 0 0 0 0 0 0 0 0 0 0 0 0 8871.99 0 0 1011137549 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1319.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1319.09 0 0 1011137627 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 0 124 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 8313.27 0 0 0 0 0 0 0 0 0 0 0 0 0 8313.27 0 0 1011137761 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0 0 0 0 314.42 0 0 0 0 0 0 314.42 0 0 1011138548 1992289599 16 Nurse Practitioners LIAUW DEVI GUNAWAN 999999999 200 Cook 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 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 187814.21 0 0 0 0 0 0 187814.21 0 0 1011138575 1992090468 10 Physicians LARSON ALEXANDRA L 999999999 80 Peoria 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 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 0 683.92 0 0 0 0 0 0 0 0 683.92 0 0 1011138581 1609286327 86 Clinical Social Worker(Encounter Only) HERNAN MARY K 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 106.5 0 0 0 0 0 0 106.5 0 0 1011138881 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011138932 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 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 27220.85 0 0 0 0 0 0 0 0 0 0 0 0 0 27220.85 0 0 1011139094 1497135065 10 Physicians MILLER TANNER M 999999999 88 Richland 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 10 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292.57 0 833.94 0 0 0 0 0 0 1126.51 0 0 1011139220 1952721391 10 Physicians MONTANA CYNTHIA 999999999 30 DuPage 0 0 Ophthalmology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160.16 0 643.61 0 0 0 0 0 0 803.77 0 0 1011139535 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 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0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1045.92 0 0 0 0 0 0 1045.92 0 0 1011140533 1912447467 60 Pharmacies HALLMARK PHARMACY 999999999 30 DuPage 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 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8988 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1577.77 0 0 0 1577.77 0 0 1011140694 1417025859 10 Physicians CHAN DENISE 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 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 6177.86 0 0 0 0 0 0 6177.86 0 0 1011140751 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.86 72.86 0 0 1011141554 55 Early Intervention Services 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 4470.27 0 0 0 0 0 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0 0 0 0 0 2270.15 0 0 1011141803 1306194071 10 Physicians GUZMAN VINASCO LUIS F 999999999 200 Cook 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 0 381 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 3299.2 0 0 0 0 0 0 3299.2 0 0 1011141995 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 0 0 0 0 0 0 0 0 0 0 1011142177 1427311646 10 Physicians MIKHAEIL DEMO YARA 999999999 200 Cook 0 0 Neurology 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 0 134 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 1971.52 0 0 0 0 0 0 1971.52 0 0 1011142352 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13423.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13423.93 0 0 1011142396 1932620820 10 Physicians LANKA LAVANYA 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 0 0 0 0 0 0 0 0 0 0 1011142952 1770996050 10 Physicians DOMINIQUE OMAR L 999999999 47 Jackson 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 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 1060.46 0 0 0 0 0 0 1060.46 0 0 1011143325 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 19853.96 0 0 0 0 0 0 0 0 0 0 0 0 0 19853.96 0 0 1011143610 1588070031 10 Physicians AL-KHAFAJI KHALID A. J. 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 0 202 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 1528.97 0 0 0 0 0 0 1528.97 0 0 1011143954 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 0 239 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 23125.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23125.69 0 0 1011144093 1952831646 10 Physicians HARRIS CHRISTOPHER 999999999 30 DuPage 0 0 Emergency Medicine 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 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 1584.46 0 0 0 0 0 0 1584.46 0 0 1011144099 1245640838 10 Physicians LAMSAL PARINA 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 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 0 783.13 0 0 0 0 0 0 783.13 0 0 1011144211 1093895849 10 Physicians PARDO-ISAAC HELENE 999999999 200 Cook 0 0 Anesthesiology 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 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 1286.34 0 0 0 0 0 0 1286.34 0 0 1011144355 1053793174 10 Physicians NGUYEN RICHARD D. 999999999 24 Coles 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 0 288 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 3421.3 0 0 0 0 0 0 3421.3 0 0 1011144800 10 Physicians 109 Winnebago 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 0 251.67 0 0 0 0 0 0 251.67 0 0 1011145013 1356754451 10 Physicians BRENNAN STEVEN K 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 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 4875.02 0 0 0 0 0 0 4875.02 0 0 1011145094 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.57 0 0 0 0 0 0 39.57 0 0 1011145298 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7247.22 0 0 0 0 0 0 0 0 0 0 0 0 0 7247.22 0 0 1011145534 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 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 2601.14 2601.14 0 0 1011145758 1861968273 16 Nurse Practitioners GOLDEN COLLEEN M 999999999 30 DuPage 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 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 0 793.96 0 0 0 0 0 0 793.96 0 0 1011146040 1255865853 60 Pharmacies WALMART PHARMACY 10-2425 999999999 65 Madison 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 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16229.88 0 0 0 16229.88 0 0 1011146266 1518368026 89 Physician Assistant Only(Encounter Only) AREKAT LOAI 999999999 91 Sangamon 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 0 126 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 6183.91 0 0 0 0 0 0 6183.91 0 0 1011147358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4797.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4797.96 0 0 1011147381 1598156705 16 Nurse Practitioners SHEFFIELD AMY R 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 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 2542.66 0 0 0 0 0 0 2542.66 0 0 1011147397 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4747.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4747.84 0 0 1011147527 1205348133 16 Nurse Practitioners LORENZO KATY 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 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 0 680.05 0 0 0 0 0 0 680.05 0 0 1011147539 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23483.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23483.9 0 0 1011147562 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.54 0 0 0 0 0 0 0 0 0 0 0 0 0 180.54 0 0 1011147659 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2051.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2051.28 0 0 1011147715 1437492675 89 Physician Assistant Only(Encounter Only) GLADCHENKO NICOLE M 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 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 0 646.14 0 0 0 0 0 0 646.14 0 0 1011147866 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22861.19 0 0 0 0 0 0 0 0 0 0 0 0 0 22861.19 0 0 1011148034 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17322.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17322.42 0 0 1011148180 40 Federally Qualified Health Centers 200 Cook 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 0 717.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717.45 0 0 1011148379 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23315.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23315.96 0 0 1011148380 1649701954 10 Physicians HATCHER MEGAN WHITLEY 999999999 200 Cook 0 0 Family 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 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 0 609.7 0 0 0 0 0 0 609.7 0 0 1011148507 1336554799 10 Physicians FIDAI SHIRAZ 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 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 61 0 0 0 0 0 0 0 0 61 0 0 1011148806 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.76 1509.76 0 0 1011148935 1912167669 10 Physicians YOO LAWRENCE 999999999 53 Kane 0 0 Internal Medicine 0 0 0 1 0 0 0 0 0 0 2 0 23 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 43 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 43 0 0 0 0 0 0 0 0 0 51.73 0 0 0 0 0 0 7.3 0 1495.38 0 0 0 0 0 0 1554.41 0 0 1011148995 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 2020.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2020.2 0 0 1011149153 1396235792 89 Physician Assistant Only(Encounter Only) MEGALLY AMALIA 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 0 120.07 0 0 0 0 0 0 120.07 0 0 1011149202 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21511.69 0 0 0 0 0 0 0 0 0 0 0 0 0 21511.69 0 0 1011149522 11 Dentists 30 DuPage 0 0 General Dentistry 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 0 171.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171.9 0 0 1011150016 1700882602 13 Podiatrists LACEY MICHAEL GEORGE 999999999 57 Lake 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 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 37.22 0 0 0 0 0 0 37.22 0 0 1011150244 1912262726 10 Physicians KUMAR VINEET R 999999999 200 Cook 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 0 261 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 6047.82 0 0 0 0 0 0 6047.82 0 0 1011150247 1033278387 87 Psychologist(Encounter Only) GARMAN DEBORAH W 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 863.23 0 0 0 0 0 0 863.23 0 0 1011150308 1568807618 10 Physicians SCOTT SIEBENALER MARY K 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 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 4464.77 0 0 0 0 0 0 4464.77 0 0 1011150321 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 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 0 169.21 0 0 0 0 0 0 169.21 0 0 1011150643 1194723312 16 Nurse Practitioners LOAR RICKI S 999999999 96 St Clair 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 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 2042.49 0 0 0 0 0 0 2042.49 0 0 1011151028 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 25.81 0 0 0 0 0 0 25.81 0 0 1011151031 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 4608.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4608.84 0 0 1011151045 1376067165 16 Nurse Practitioners HENSCHLER DEBORAH A 999999999 53 Kane 0 0 0 0 0 14 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 1144.61 0 0 0 0 0 0 0 0 2675.58 0 0 0 0 0 0 3820.19 0 0 1011151224 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23948.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23948.4 0 0 1011151350 1487940961 10 Physicians NANGLE SARAH ELIZABETH MARY 999999999 19 Champaign 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 0 320 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 3713.8 0 0 0 0 0 0 3713.8 0 0 1011151374 1316112717 10 Physicians NORRIS MARLAINA 999999999 57 Lake 0 0 Emergency 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 2 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.67 0 8594.96 0 0 0 0 0 0 8647.63 0 0 1011151376 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15506.82 0 0 0 0 0 0 0 0 0 0 0 0 0 15506.82 0 0 1011151804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9015.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9015.69 0 0 1011151819 1750683603 55 Early Intervention Services RIOS ROBIN 999999999 53 Kane 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 0 982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 982 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55915.15 0 0 0 0 0 0 55915.15 0 0 1011151823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22397.17 0 0 0 0 0 0 0 0 0 0 0 0 0 22397.17 0 0 1011151948 1437318318 10 Physicians KIMREY SABRINA L. 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 13 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 4408.93 0 0 0 0 0 0 4408.93 0 0 1011152036 1598166787 89 Physician Assistant Only(Encounter Only) SPAHR CLARE M 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 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 1479.61 0 0 0 0 0 0 1479.61 0 0 1011152192 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10739.94 0 0 0 0 0 0 0 0 0 0 0 0 0 10739.94 0 0 1011152288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7291.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7291.2 0 0 1011152603 1831670942 16 Nurse Practitioners JOHNSON KAREN 999999999 200 Cook 0 0 0 0 0 15 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 1448 0 0 0 0 0 0 0 0 2803.32 0 0 0 0 0 0 4251.32 0 0 1011152623 1821504069 60 Pharmacies CVS PHARMACY #17733 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1939.04 0 0 0 1939.04 0 0 1011152702 1790204725 24 Speech Therapists DEPPE LAUREN E 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 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 24472.61 24472.61 0 0 1011152712 1255814679 16 Nurse Practitioners DORMANEN MICHELLE R 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 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 34.28 0 0 0 0 0 0 0 0 288.19 0 0 0 0 0 0 322.47 0 0 1011153154 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1011153392 1366949224 16 Nurse Practitioners HNILICKA KAYLA M. 999999999 80 Peoria 0 0 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 80 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 1949.91 0 0 0 0 0 0 2014.21 0 0 1011153497 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 50156.8 0 0 0 0 0 0 0 0 0 0 0 0 0 50156.8 0 0 1011153514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15948.17 0 0 0 0 0 0 0 0 0 0 0 0 0 15948.17 0 0 1011153650 91 Waiver service provider--Adults (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 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 19441.37 0 0 0 0 0 0 0 0 0 0 0 0 0 19441.37 0 0 1011154108 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6022.82 0 0 0 0 0 0 0 0 0 0 0 0 0 6022.82 0 0 1011154128 1568973956 16 Nurse Practitioners HULET JESSICA S 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 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 1208.08 0 0 0 0 0 0 1208.08 0 0 1011154306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22928.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22928.5 0 0 1011154309 1417086679 89 Physician Assistant Only(Encounter Only) CORNWITH JAIMIE 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 0 146 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 0 660.43 0 0 0 0 0 0 660.43 0 0 1011154515 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.27 0 0 0 0 0 0 87.27 0 0 1011154865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 969.98 0 0 0 0 0 0 0 0 0 0 0 0 0 969.98 0 0 1011154954 1497221840 23 Occupational Therapists PERKINS ALLISON L 999999999 61 Livingston 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 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 5781.03 5781.03 0 0 1011155319 1215068531 60 Pharmacies WESTWOOD PHARMACY CLINICAL SER 999999999 848 Virginia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 2575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7416.46 0 0 0 7416.46 0 0 1011155327 1720594195 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNITYPOINT AT HOME 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1510.02 0 0 0 0 0 0 1510.02 0 0 1011155369 1790216323 10 Physicians SALAZAR ADUM JUAN PABLO 999999999 200 Cook 0 0 Internal Medicine 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 518.65 0 0 0 0 0 0 524.95 0 0 1011156026 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 13.55 0 0 0 0 0 0 13.55 0 0 1011156058 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7933.62 0 0 0 0 0 0 0 0 0 0 0 0 0 7933.62 0 0 1011156249 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7303.52 0 0 0 0 0 0 0 0 0 0 0 0 0 7303.52 0 0 1011156254 1275060154 16 Nurse Practitioners TRIPP JOLINN 999999999 10 Adams 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 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 1191.5 0 0 0 0 0 0 1191.5 0 0 1011156481 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.99 2597.99 0 0 1011156648 1740650860 39 Hospice ALC PALLIATIVE AND HOSPICE CAR 999999999 30 DuPage 0 0 0 0 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30537.96 0 0 0 0 0 0 0 0 0 0 0 30537.96 0 0 1011156668 1801378229 16 Nurse Practitioners POLLACK EMILYN A 999999999 109 Winnebago 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 0 138 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 5128.03 0 0 0 0 0 0 5128.03 0 0 1011156776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12736.25 0 0 0 0 0 0 0 0 0 0 0 0 0 12736.25 0 0 1011156881 1841795374 16 Nurse Practitioners RIGSBY CAROLYN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 340.59 0 0 0 0 0 0 340.59 0 0 1011157114 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 4449.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4449.34 0 0 1011157175 1669951000 55 Early Intervention Services OWENS TAYLER R 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 7164.14 0 0 0 0 0 0 7164.14 0 0 1011157682 1144730904 16 Nurse Practitioners REZO SILVIJA 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 0 335.27 0 0 0 0 0 0 335.27 0 0 1011157855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23726.74 0 0 0 0 0 0 0 0 0 0 0 0 0 23726.74 0 0 1011157928 16 Nurse Practitioners 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.44 0 0 0 0 0 0 42.44 0 0 1011157932 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1738.17 0 0 0 0 0 0 0 0 0 0 0 0 0 1738.17 0 0 1011158312 1912495391 16 Nurse Practitioners VIJ NIKHIL 999999999 107 Will 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 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.49 0 0 0 0 0 0 4524.49 0 0 1011158395 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23890.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23890.9 0 0 1011159055 1841586526 10 Physicians QIN-NELSON LING A 999999999 200 Cook 0 0 Internal 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 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 0 835.56 0 0 0 0 0 0 835.56 0 0 1011159609 1720552482 16 Nurse Practitioners MULROE JENNA Q 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 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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 0 208.9 0 0 0 0 0 0 208.9 0 0 1011161173 86 Clinical Social Worker(Encounter Only) 62 Logan 0 0 0 0 0 0 0 0 0 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 1011161257 1093100240 10 Physicians MURTHY NEVIN 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 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 0 377.51 0 0 0 0 0 0 377.51 0 0 1011161372 1477049435 57 Home Nursing Agency ZEE'S HEALTHCARE LLC 999999999 57 Lake 0 0 0 0 0 0 0 6 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1544 1567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1544 1567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611959.19 126519.28 0 0 0 0 0 0 0 0 0 0 0 0 738478.47 0 0 1011161393 1508064619 10 Physicians CANKURTARAN CEYLAN Z 999999999 200 Cook 0 0 Radiology Diagnosis 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 0 337 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 9873.77 0 0 0 0 0 0 0 0 9873.77 0 0 1011161585 1972879625 10 Physicians KANNER LAUREN 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 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 0 456.52 0 0 0 0 0 0 456.52 0 0 1011161641 1528354438 10 Physicians JONES HEATHER A 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 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 0 585.52 0 0 0 0 0 0 585.52 0 0 1011161965 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23557.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23557.96 0 0 1011162246 1144583030 10 Physicians AZEEM MOHAMMED 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Physicians SIMMS ANDREW T. 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 0 151 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 3863.57 0 0 0 0 0 0 3863.57 0 0 1011171355 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 10359.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10359.8 0 0 1011172081 86 Clinical Social Worker(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 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 0 432.02 0 0 0 0 0 0 432.02 0 0 1011172237 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 174 0 0 1011172307 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20831.72 0 0 0 0 0 0 0 0 0 0 0 0 0 20831.72 0 0 1011172536 16 Nurse Practitioners 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 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 0 173.51 0 0 0 0 0 0 173.51 0 0 1011172867 1093228652 16 Nurse Practitioners TENEZACA MARCIA C 999999999 200 Cook 0 0 0 0 0 9 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 619.94 0 0 0 0 0 0 0 0 615.41 0 0 0 0 0 0 1235.35 0 0 1011172944 1043714165 16 Nurse Practitioners DE LA TORRE MATTHEW R 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 0 121 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 2600.34 0 0 0 0 0 0 2600.34 0 0 1011173076 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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Richland 0 0 0 753 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2831 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2831 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63245.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63245.21 0 0 1011182051 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.49 0 0 0 0 0 0 0 0 11.49 0 0 1011182104 10 Physicians 65 Madison 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 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 0 170.92 0 0 0 0 0 0 170.92 0 0 1011182434 1659642940 16 Nurse Practitioners HOEMAN ERIN M 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 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 0 589.69 0 0 0 0 0 0 589.69 0 0 1011182634 1548674575 10 Physicians MACGREGOR CAITLIN AISLING 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 6 0 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MITCHELL BRIANA R 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 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 69.42 0 0 0 0 0 0 69.42 0 0 1011185944 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 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 0 200.97 0 0 0 0 0 0 200.97 0 0 1011185979 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 45.82 0 0 0 0 0 0 45.82 0 0 1011186106 1225553803 16 Nurse Practitioners DAVIS KELLY A 999999999 79 Ogle 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 0 269 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 3082.77 0 0 0 0 0 0 3082.77 0 0 1011186157 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 47.77 0 0 0 0 0 0 47.77 0 0 1011186400 1730576216 10 Physicians QUAYYUM MOHIUDDIN 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 0 167 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 3362.41 0 0 0 0 0 0 3362.41 0 0 1011186821 1932427754 10 Physicians AHMED WASSIA KHAJA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.35 0 2879.25 0 0 0 0 0 0 2944.6 0 0 1011186840 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 2408.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2408.69 0 0 1011186871 1447732953 16 Nurse Practitioners WEBB LUCAS C 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 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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 0 756.92 0 0 0 0 0 0 756.92 0 0 1011187931 1699221960 10 Physicians OKYNE EDWIN 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 24 0 0 0 0 0 0 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 0 0 118.17 0 0 0 0 0 0 118.17 0 0 1011188379 1609326743 11 Dentists ALSIBAIE LINA 999999999 30 DuPage 0 0 General Dentistry 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10509.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10509.1 0 0 1011188534 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24733.38 0 0 0 0 0 0 0 0 0 0 0 0 0 24733.38 0 0 1011188745 1679984843 10 Physicians HUSSAIN ASIYA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.5 0 1145.44 0 0 0 0 0 0 1166.94 0 0 1011188807 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 0 125 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 8868.53 0 0 0 0 0 0 0 0 0 0 0 0 0 8868.53 0 0 1011189282 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18188.83 0 0 0 0 0 0 0 0 0 0 0 0 0 18188.83 0 0 1011189327 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 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 53.25 0 0 0 0 0 0 53.25 0 0 1011189479 1154800969 60 Pharmacies COUNTY MARKET PHARMACY 226 999999999 91 Sangamon 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 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8817.54 0 0 0 8817.54 0 0 1011189520 1356650972 16 Nurse Practitioners SARTORI CHRISTINA E 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 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 0 832.02 0 0 0 0 0 0 832.02 0 0 1011189880 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 0 310 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 23140.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23140.48 0 0 1011190265 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19308.08 0 0 0 0 0 0 0 0 0 0 0 0 0 19308.08 0 0 1011190362 1376652370 89 Physician Assistant Only(Encounter Only) JAMES KAAMILYA 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 0 681 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 2287.56 0 0 0 0 0 0 2287.56 0 0 1011190927 1558514398 25 Audiologists HILLEBRAND AMANDA K 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1299.69 1299.69 0 0 1011191259 1972981009 10 Physicians RIGERT ERIN M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 1 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4263.81 0 0 0 0 0 0 4263.81 0 0 1011191426 1659683993 10 Physicians PARK KELLY 999999999 107 Will 0 0 Dermatology 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 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 0 0 93.44 0 0 0 0 0 0 93.44 0 0 1011191509 1578058244 11 Dentists POISSON PAIGE 999999999 200 Cook 0 0 General Dentistry 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9196.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9196.15 0 0 1011191802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23980.44 0 0 0 0 0 0 0 0 0 0 0 0 0 23980.44 0 0 1011191869 1811320856 10 Physicians KOLEKAR CHARU 999999999 47 Jackson 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 0 249 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 3392.51 0 0 0 0 0 0 3392.51 0 0 1011192032 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23433.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23433.85 0 0 1011192203 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 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 1011192313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5789.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5789.58 0 0 1011192314 1801235734 10 Physicians HERST BRIAN S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 10 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.36 0 2875.52 0 0 0 0 0 0 2896.88 0 0 1011192639 10 Physicians 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.48 0 0 0 0 0 0 129.48 0 0 1011192743 1801376744 16 Nurse Practitioners PROBST MORGAN 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 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 1178.84 0 0 0 0 0 0 1178.84 0 0 1011192861 1720001894 10 Physicians MACLAUGHLAN SHANNON 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 4523.12 0 0 0 0 0 0 4523.12 0 0 1011192959 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25103.76 0 0 0 0 0 0 0 0 0 0 0 0 0 25103.76 0 0 1011193013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1227.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1227.86 0 0 1011193496 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1011193536 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24993.87 0 0 0 0 0 0 0 0 0 0 0 0 0 24993.87 0 0 1011193902 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 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 1011194007 1376658864 10 Physicians LOWE KEVIN M 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 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 0 0 597.39 0 0 0 0 0 0 597.39 0 0 1011194112 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1011194376 1538695127 36 Community mental health provider TRILOGY INC 999999999 200 Cook 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 1492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 1492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 846 0 0 110476.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82784.65 0 0 193261.46 0 0 1011194472 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 353.05 0 0 0 0 0 0 353.05 0 0 1011194575 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 0 346.2 0 0 0 0 0 0 346.2 0 0 1011194650 1528215852 25 Audiologists BEQUETTE CAROLYN A 999999999 60 Lee 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 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 0 108.91 108.91 0 0 1011194737 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 379.26 0 0 0 0 0 0 0 0 0 0 0 0 0 379.26 0 0 1011194846 55 Early Intervention Services 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 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 0 641.44 0 0 0 0 0 0 641.44 0 0 1011195003 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3645.42 0 0 0 0 0 0 0 0 0 0 0 0 0 3645.42 0 0 1011195073 1912264896 10 Physicians REMIKER ALLISON 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 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 2998.01 0 0 0 0 0 0 2998.01 0 0 1011195089 1972824159 10 Physicians VELASQUEZ MONICA G 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 3598.67 0 0 0 0 0 0 3600.85 0 0 1011195100 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 32.15 0 0 0 0 0 0 32.15 0 0 1011195262 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14619.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14619.44 0 0 1011195890 1184190613 16 Nurse Practitioners FEHR SHELBY L 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 2 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 66 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 1062.16 0 0 0 0 0 0 1140.03 0 0 1011195892 1538689864 89 Physician Assistant Only(Encounter Only) FROEMING AMANDA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.99 0 0 0 0 0 0 78.99 0 0 1011196290 1760972715 16 Nurse Practitioners ALEXANDER CARRIE M 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 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 1155.51 0 0 0 0 0 0 1155.51 0 0 1011196291 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6976.52 0 0 0 0 0 0 0 0 0 0 0 0 0 6976.52 0 0 1011196351 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9120.86 0 0 0 0 0 0 0 0 0 0 0 0 0 9120.86 0 0 1011196378 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011197006 1225523103 10 Physicians BRITSKA SOLOMIYA 999999999 200 Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 1 0 20 0 0 0 0 0 0 0 0 0 268.29 0 0 0 0 0 0 5.17 0 598.61 0 0 0 0 0 0 872.07 0 0 1011197047 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1011197288 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 0 309.56 0 0 0 0 0 0 0 0 0 0 0 0 0 309.56 0 0 1011197396 1801151949 10 Physicians JACOBS NEKAIYA S. 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 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 4241.31 0 0 0 0 0 0 4241.31 0 0 1011197625 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 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 1608.51 0 0 0 0 0 0 1608.51 0 0 1011197758 1457884827 16 Nurse Practitioners LESTER PEGGY J 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 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 0 256.57 0 0 0 0 0 0 256.57 0 0 1011197859 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22246.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22246.64 0 0 1011197956 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 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 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 0 377.23 0 0 0 0 0 0 377.23 0 0 1011198919 1326486515 10 Physicians POPP SWITZER MARYNA J 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 651 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5841.95 0 0 0 0 0 0 5841.95 0 0 1011198985 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 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 6265.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6265.77 0 0 1011199359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25009.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25009.2 0 0 1011199433 1962841684 10 Physicians RICHESON ASHLEY L 999999999 24 Coles 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 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 1011199601 1306242318 89 Physician Assistant Only(Encounter Only) ABO MEGAN H 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 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 0 659.83 0 0 0 0 0 0 659.83 0 0 1011199707 10 Physicians 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 0 169.24 0 0 0 0 0 0 169.24 0 0 1011199868 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12459.55 0 0 0 0 0 0 0 0 0 0 0 0 0 12459.55 0 0 1011200128 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 78.09 0 0 1011200820 10 Physicians 98 Tazewell 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 2768.37 0 0 0 0 0 0 2768.37 0 0 1011201163 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40516.39 0 0 0 0 0 0 0 0 0 0 0 0 0 40516.39 0 0 1011201366 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 10202.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10202.84 0 0 1011201605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4824.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4824.72 0 0 1011201989 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 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 0 220.73 0 0 0 0 0 0 220.73 0 0 1011202059 1194254722 33 Nursing Facilities ASBURY COURT NURSING & REHAB 999999999 200 Cook 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 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196032.35 0 0 0 0 0 0 0 196032.35 0 0 1011202275 30 General Hospitals 815 Indiana ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.28 0 0 0 0 0 75.28 0 0 1011202397 1124584651 16 Nurse Practitioners VANCARDO EVELYN K 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 320.01 0 0 0 0 0 0 320.01 0 0 1011202444 1144664913 10 Physicians MARLOW KATHRYN 999999999 47 Jackson 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 329.84 0 0 0 0 0 0 329.84 0 0 1011202510 1487129318 16 Nurse Practitioners JAEGLE KATE E 999999999 80 Peoria 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 0 192 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 3019.75 0 0 0 0 0 0 3019.75 0 0 1011202882 1053883140 16 Nurse Practitioners BOWERS ERIN 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 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 0 359.09 0 0 0 0 0 0 359.09 0 0 1011202922 1922369669 10 Physicians PATEL NEERAJ M. 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 3 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.1 0 10866.64 0 0 0 0 0 0 10964.74 0 0 1011203093 1902195829 10 Physicians KLINGBEIL LINDSEY R 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 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 0 257.17 0 0 0 0 0 0 257.17 0 0 1011203111 1295034759 10 Physicians DAWOOD ALTAF 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 0 261 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 5967.1 0 0 0 0 0 0 5967.1 0 0 1011203250 1508359399 10 Physicians CHOU ARTHUR SUEN-YEU 999999999 91 Sangamon 0 0 Emergency Medicine 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 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 1757.14 0 0 0 0 0 0 1757.14 0 0 1011203425 1316462021 22 Physical Therapists MOLLOY KAILEY H 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1024.13 1024.13 0 0 1011203603 1417131772 10 Physicians WAHEED SALMAN 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 0 287 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 3926.75 0 0 0 0 0 0 3926.75 0 0 1011203921 1811240187 10 Physicians BAJWA VIKRAM S 999999999 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7970.94 0 0 0 0 0 0 7970.94 0 0 1011204217 1033408489 10 Physicians HART DEIRDRE M 999999999 96 St Clair 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3766.86 0 0 0 0 0 0 3766.86 0 0 1011204402 1164773743 16 Nurse Practitioners WEISS MEAGAN MURPHY 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 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 1546.46 0 0 0 0 0 0 1546.46 0 0 1011204463 1730422965 10 Physicians MALIK MARIAM A 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 81 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2107.64 0 10.06 0 0 0 0 0 0 2117.7 0 0 1011204912 1376092429 91 Waiver service provider--Adults (DHS/DDD) FULTS MEGAN R 999999999 91 Sangamon 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 2341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106551.4 0 0 0 0 0 0 0 0 0 0 0 0 0 106551.4 0 0 1011205336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1120.77 0 0 0 0 0 0 0 0 0 0 0 0 0 1120.77 0 0 1011205522 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 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 13280.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13280.4 0 0 1011205676 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11208.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11208.62 0 0 1011205745 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 0 0 0 0 0 0 0 0 0 0 1011205792 1285020669 10 Physicians LAI JASON 999999999 91 Sangamon 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 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 0 371.29 0 0 0 0 0 0 371.29 0 0 1011206058 1750899431 16 Nurse Practitioners ROGGEMAN CAROL L 999999999 200 Cook 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 0 169 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 6019.2 0 0 0 0 0 0 6019.2 0 0 1011206829 1104358951 89 Physician Assistant Only(Encounter Only) TERWELP ELIZABETH J 999999999 10 Adams 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 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 0 202.66 0 0 0 0 0 0 202.66 0 0 1011206863 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011206877 1073850491 16 Nurse Practitioners MCCURTAIN KELLY 999999999 53 Kane 0 0 0 0 0 20 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 2323.5 0 0 0 0 0 0 0 0 746.62 0 0 0 0 0 0 3070.12 0 0 1011207179 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10582.35 0 0 0 0 0 0 0 0 0 0 0 0 0 10582.35 0 0 1011207376 1295227569 10 Physicians GIESWEIN JOEL 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 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 2314.34 0 0 0 0 0 0 2314.34 0 0 1011207544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14945.04 0 0 0 0 0 0 0 0 0 0 0 0 0 14945.04 0 0 1011207761 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3471.83 0 0 0 0 0 0 0 0 0 0 0 0 0 3471.83 0 0 1011207878 1114491875 48 Rural Health Clinics WABASH GENERAL HOSPITAL PRIMAR 999999999 101 Wabash 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7576.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7576.8 0 0 1011208155 1548788854 16 Nurse Practitioners MARR EMMA 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 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 0 426.06 0 0 0 0 0 0 426.06 0 0 1011208626 1871069443 16 Nurse Practitioners LEE JULIA 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 0 311.71 0 0 0 0 0 0 311.71 0 0 1011208647 1194123679 16 Nurse Practitioners FORNER JUDI K 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 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 0 500.39 0 0 0 0 0 0 500.39 0 0 1011208648 1689772956 89 Physician Assistant Only(Encounter Only) MARINOVIC DEBRA 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 95.33 0 0 0 0 0 0 95.33 0 0 1011208794 1609860782 89 Physician Assistant Only(Encounter Only) GREGORY MARTINDILL 999999999 19 Champaign 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 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 0 140.3 0 0 0 0 0 0 140.3 0 0 1011208845 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 668.1 0 0 0 0 0 0 0 0 0 0 0 0 0 668.1 0 0 1011208959 1053726547 10 Physicians NORIEGA KRISTIN 999999999 200 Cook 0 0 Internal Medicine 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 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 1880.25 0 0 0 0 0 0 1880.25 0 0 1011209137 1528441078 10 Physicians BIJLANI RAHUL 999999999 92 Schuyler 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 0 156 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 0 0 0 0 0 0 0 0 0 0 1011209221 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27973.14 0 0 0 0 0 0 0 0 0 0 0 0 0 27973.14 0 0 1011209411 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16915.47 0 0 0 0 0 0 0 0 0 0 0 0 0 16915.47 0 0 1011209532 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 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 2696.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2696.15 0 0 1011209571 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7164.23 0 0 0 0 0 0 0 0 0 0 0 0 0 7164.23 0 0 1011209791 1841789583 89 Physician Assistant Only(Encounter Only) BHAYANI SHEELA 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 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1011210115 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1758.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1758.24 0 0 1011210229 1306315817 89 Physician Assistant Only(Encounter Only) BALUKA STEPHANIE Z 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 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 0 247.22 0 0 0 0 0 0 247.22 0 0 1011210614 4011210614 90 Waiver service provider--Elderly (DOA) GOODHOPE HEALTHCARE AND HOME H 999999999 71 McHenry 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253002.36 0 0 0 0 0 0 0 0 0 0 0 0 0 253002.36 0 0 1011210628 1811303217 89 Physician Assistant Only(Encounter Only) MAGOON KELLY 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 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 0 524.65 0 0 0 0 0 0 524.65 0 0 1011210840 10 Physicians 200 Cook 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.77 0 0 0 0 0 0 202.77 0 0 1011211050 1427354075 10 Physicians GHANI SOFIA 999999999 200 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Nurse Practitioners GUMMADI NIKITA 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 0 406 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 2715.68 0 0 0 0 0 0 2715.68 0 0 1011211384 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 871.49 0 0 0 0 0 0 0 0 0 0 0 0 0 871.49 0 0 1011211552 1669762795 10 Physicians DAMARLA VIJAY K 999999999 80 Peoria 0 0 Internal Medicine 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 64 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479.02 0 86445.3 0 0 0 0 0 0 86924.32 0 0 1011212504 10 Physicians 24 Coles 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 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 78.63 0 0 0 0 0 0 78.63 0 0 1011212875 92 Waiver service 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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 23707.75 0 0 0 0 0 0 0 0 0 0 0 0 0 23707.75 0 0 1011213303 1669931945 16 Nurse Practitioners COZZI KRISTIN 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 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 0 130.24 0 0 0 0 0 0 130.24 0 0 1011213465 1245519487 10 Physicians ROSADO BARRERAS LYMARIE 999999999 19 Champaign 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 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 9453.2 0 0 0 0 0 0 9453.2 0 0 1011213962 1437696663 10 Physicians MARCHESE EDWARD 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 0 122 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 7174.66 0 0 0 0 0 0 7174.66 0 0 1011214008 1942738166 16 Nurse Practitioners MATHEW CHARY 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 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 0 192.34 0 0 0 0 0 0 192.34 0 0 1011214036 1215342902 10 Physicians SHARMA SHIVANI 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 0 176 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 10234.34 0 0 0 0 0 0 10234.34 0 0 1011214842 1396246401 16 Nurse Practitioners MALE SHANNON K 999999999 30 DuPage 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 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 1027.74 0 0 0 0 0 0 1027.74 0 0 1011215460 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 80.23 0 0 0 0 0 0 80.23 0 0 1011215758 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 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10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1990.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1990.39 0 0 1011216589 4011216589 89 Physician Assistant Only(Encounter Only) REED MESHIA 629486334 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 66.8 0 0 0 0 0 0 66.8 0 0 1011216599 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 1011216894 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12110.41 0 0 0 0 0 0 0 0 0 0 0 0 0 12110.41 0 0 1011217025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23459.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23459.4 0 0 1011217220 1184979700 10 Physicians GUENETTE ALEXIS N 999999999 53 Kane 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 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 1011217372 1013020452 87 Psychologist(Encounter Only) CARNAZZO JOEL 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 1295 0 0 0 0 0 0 1295 0 0 1011217772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39621.03 0 0 0 0 0 0 0 0 0 0 0 0 0 39621.03 0 0 1011217788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26183.75 0 0 0 0 0 0 0 0 0 0 0 0 0 26183.75 0 0 1011217832 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5576.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5576.9 0 0 1011218100 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 31.01 0 0 0 0 0 0 31.01 0 0 1011218258 16 Nurse Practitioners 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 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 0 118.74 0 0 0 0 0 0 118.74 0 0 1011218561 1235694894 89 Physician Assistant Only(Encounter Only) BELL JOSHUA 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534.08 0 0 0 0 0 0 534.08 0 0 1011218719 1902069537 10 Physicians TRAN BENSON D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 34 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.26 0 21.07 0 0 0 0 0 0 548.33 0 0 1011218870 1942786249 12 Optometrists ANDERSON ALYSSA K 999999999 89 Rock Island 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 0 695.35 0 0 0 0 0 0 695.35 0 0 1011218886 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 667.48 0 0 0 0 0 0 0 0 0 0 0 0 0 667.48 0 0 1011218928 1720596166 16 Nurse Practitioners MENDEZ LETICIA 999999999 30 DuPage 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 46 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 3819.19 0 0 1011219698 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 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 1277.79 1277.79 0 0 1011220000 1720423312 10 Physicians AL-SARAF AMMAR A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 977 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1563 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1563 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24662.45 0 1191.94 0 0 0 0 0 0 25854.39 0 0 1011220712 1063993731 16 Nurse Practitioners AVILA LILIA E 999999999 109 Winnebago 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 0 120 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 0 854.57 0 0 0 0 0 0 854.57 0 0 1011220909 1972916658 10 Physicians VASENINA VALENTINA 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 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 1523.78 0 0 0 0 0 0 1523.78 0 0 1011221329 1083123038 16 Nurse Practitioners PETERS KEVIN M 999999999 53 Kane 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 0 0 0 0 130 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 298.16 0 0 0 0 0 0 0 0 3381.87 0 0 0 0 0 0 3680.03 0 0 1011221408 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 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 1036.17 0 0 0 0 0 0 0 0 0 0 0 0 0 1036.17 0 0 1011221450 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.31 0 0 0 0 0 0 0 0 0 0 0 0 0 21.31 0 0 1011221577 1932699345 16 Nurse Practitioners YI YEYIN 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 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 82.54 0 0 0 0 0 0 82.54 0 0 1011221931 70 Ambulance Service Providers 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 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 0 450.98 0 0 0 0 0 0 450.98 0 0 1011221954 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 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 5461.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5461.2 0 0 1011222110 1164798088 10 Physicians GRIFFITHS HEIDI 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 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 0 613.76 0 0 0 0 0 0 613.76 0 0 1011222307 1780159046 16 Nurse Practitioners GODSIL HEATHER M 999999999 31 Edgar 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 26 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 581.62 0 0 0 0 0 0 651.14 0 0 1011222468 1679076673 16 Nurse Practitioners SIEG SARAH 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 0 628.76 0 0 0 0 0 0 628.76 0 0 1011222476 1184870818 10 Physicians GOLDMAN KARA 999999999 200 Cook 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 16 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1080.72 0 134.44 0 0 0 0 0 0 1215.16 0 0 1011222551 1063919348 89 Physician Assistant Only(Encounter Only) KHAN AIMAN M 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 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 0 821.31 0 0 0 0 0 0 821.31 0 0 1011222613 1962960393 16 Nurse Practitioners MCALLISTER JESSICA L 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 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 1176.19 0 0 0 0 0 0 1176.19 0 0 1011222764 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 0 313 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 17487.1 0 0 0 0 0 0 0 0 0 0 0 0 0 17487.1 0 0 1011222811 1700391448 16 Nurse Practitioners SAINI VIKAS 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 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 3253.08 0 0 0 0 0 0 3253.08 0 0 1011223425 1124025416 10 Physicians SALTZMAN MELVIN B 999999999 96 St Clair 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 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 0 373.62 0 0 0 0 0 0 373.62 0 0 1011223827 1588155956 16 Nurse Practitioners TRUJILLO-CASTELLANOS LAURA 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 0 106 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 0 835.53 0 0 0 0 0 0 835.53 0 0 1011224475 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1128.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1128.8 0 0 1011224496 1124004908 10 Physicians HEMBY ROY S 999999999 30 DuPage 0 0 Emergency 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 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 2425.03 0 0 0 0 0 0 2425.03 0 0 1011224538 16 Nurse Practitioners 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 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 0 132.47 0 0 0 0 0 0 132.47 0 0 1011224764 1578039707 16 Nurse Practitioners HALL TINA 999999999 97 Stephenson 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 0 187 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 1151.56 0 0 0 0 0 0 1151.56 0 0 1011224799 1154810265 16 Nurse Practitioners FARRER BRIAN 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968.86 0 0 0 0 0 0 968.86 0 0 1011224875 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23451.84 0 0 0 0 0 0 0 0 0 0 0 0 0 23451.84 0 0 1011225012 1477040467 89 Physician Assistant Only(Encounter Only) VAN DYKEN RACHEL 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 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 0 111.89 0 0 0 0 0 0 111.89 0 0 1011226064 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23893.87 0 0 0 0 0 0 0 0 0 0 0 0 0 23893.87 0 0 1011226165 1982159612 10 Physicians SAAD HALA 999999999 107 Will 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 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 0 266.4 0 0 0 0 0 0 266.4 0 0 1011226290 1538623772 91 Waiver service provider--Adults (DHS/DDD) SMITH MACKINZEE I 999999999 91 Sangamon 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 0 548 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 77342.18 0 0 0 0 0 0 0 0 0 0 0 0 0 77342.18 0 0 1011226314 1689056103 10 Physicians DE ANDA HEATHER H 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.66 0 392.92 0 0 0 0 0 0 398.58 0 0 1011226633 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 553.35 0 0 0 0 0 0 0 0 0 0 0 0 0 553.35 0 0 1011226638 1790191385 16 Nurse Practitioners ROLDAN MILTON 999999999 108 Williamson 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 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 1122.39 0 0 0 0 0 0 1122.39 0 0 1011226835 1710343314 16 Nurse Practitioners DAYOLA ANNABELLE 999999999 200 Cook 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 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1293.44 0 0 0 0 0 0 1293.44 0 0 1011227050 1629572649 16 Nurse Practitioners SCHULTZ MICHELLE L 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 0 213 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 0 839.8 0 0 0 0 0 0 839.8 0 0 1011227072 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26881.02 0 0 0 0 0 0 0 0 0 0 0 0 0 26881.02 0 0 1011227369 1346395308 86 Clinical Social Worker(Encounter Only) KARELA SARAH 603021507 200 Cook 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 0 411 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 35169.13 0 0 0 0 0 0 35169.13 0 0 1011227634 1093132235 10 Physicians SIPAHI SEVGI 999999999 200 Cook 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1231.41 0 0 0 0 0 0 1231.41 0 0 1011227663 1730446915 10 Physicians MOZER ANTHONY BORAH 999999999 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 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 4177.78 0 0 0 0 0 0 4177.78 0 0 1011227871 1518329481 10 Physicians PONCZEK JACQUELINE W 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 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 3034.66 0 0 0 0 0 0 3034.66 0 0 1011228034 1326431446 10 Physicians SARAO PARAMINDER 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 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 0 128.98 0 0 0 0 0 0 128.98 0 0 1011228543 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 0 132 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 17464.06 0 0 0 0 0 0 0 0 0 0 0 0 0 17464.06 0 0 1011228606 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19277.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19277.46 0 0 1011228619 1124522719 10 Physicians YU CHEONG M 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 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 0 867.07 0 0 0 0 0 0 867.07 0 0 1011228818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3235.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3235.88 0 0 1011229070 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11374.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11374.12 0 0 1011229117 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1859.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1859.99 0 0 1011229537 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 217.76 0 0 0 0 0 0 0 0 0 0 0 0 0 217.76 0 0 1011229567 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16635.72 0 0 0 0 0 0 0 0 0 0 0 0 0 16635.72 0 0 1011229619 1417998774 10 Physicians PRITCHARD RONALD 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 125 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340.1 0 68.88 0 0 0 0 0 0 408.98 0 0 1011229680 1710425699 16 Nurse Practitioners PATEL NISHA { 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 0 142 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 2962.98 0 0 0 0 0 0 2962.98 0 0 1011230055 1396185161 10 Physicians KUSNEZOV NICHOLAS A 999999999 19 Champaign 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 1021.47 0 0 0 0 0 0 1021.47 0 0 1011230072 1306200340 10 Physicians WEI DANIEL 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 0 173 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 2039.37 0 0 0 0 0 0 2039.37 0 0 1011230121 4011230121 71 Medicar Provider CONNECT TRANSIT 999999999 72 McLean 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 5055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28725.24 0 0 0 0 0 0 28725.24 0 0 1011230400 1417067521 90 Waiver service provider--Elderly (DOA) LIFECARE HOME HEALTH & IN HOME 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 0 816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84408.87 0 0 0 0 0 0 0 0 0 0 0 0 0 84408.87 0 0 1011230727 10 Physicians 80 Peoria 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 0 0 0 0 0 0 0 0 0 0 1011230910 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 1011231153 1861993776 91 Waiver service provider--Adults (DHS/DDD) HENDERSON SHACOBY S. 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 0 833 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 97284.27 0 0 0 0 0 0 0 0 0 0 0 0 0 97284.27 0 0 1011231283 1376051789 16 Nurse Practitioners GREGORY CLAYTON T 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 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 0 648.75 0 0 0 0 0 0 648.75 0 0 1011231284 1508200775 10 Physicians OSTER ANDREW 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 4908.99 0 0 0 0 0 0 4908.99 0 0 1011231560 1396194569 10 Physicians SIFUENTES MELISSA 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 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 0 643.64 0 0 0 0 0 0 643.64 0 0 1011231629 1700267028 10 Physicians KRULL CAITLIN R 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 0 120 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 3253.28 0 0 0 0 0 0 3253.28 0 0 1011231653 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7644.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7644.4 0 0 1011231812 1710372941 10 Physicians STOKAR EVAN 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 24 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.42 0 473.86 0 0 0 0 0 0 522.28 0 0 1011232005 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 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 1325.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1325.44 0 0 1011232196 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 47.62 0 0 0 0 0 0 47.62 0 0 1011232347 1558850545 60 Pharmacies CORNERSTONE PHARMACY 999999999 200 Cook 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 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899.09 0 0 0 899.09 0 0 1011232592 1457497802 10 Physicians LAZARIDIS CHRISTOS 999999999 200 Cook 0 0 Neurology 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 0 196 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 13282.78 0 0 0 0 0 0 13282.78 0 0 1011232950 1790157600 55 Early Intervention Services WARISI SAMEERA 606563606 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 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30371.28 0 0 0 0 0 0 30371.28 0 0 1011233006 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23235.24 0 0 0 0 0 0 0 0 0 0 0 0 0 23235.24 0 0 1011233271 1700834348 10 Physicians KIEHN KATHRYN A 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 0 165 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 27775.34 0 0 0 0 0 0 27775.34 0 0 1011233570 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 21796.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21796.47 0 0 1011234020 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 21552.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21552.32 0 0 1011234060 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30282.52 0 0 0 0 0 0 0 0 0 0 0 0 0 30282.52 0 0 1011234062 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 23798.73 0 0 0 0 0 0 0 0 0 0 0 0 0 23798.73 0 0 1011234653 1295819381 16 Nurse Practitioners FLATT KARA D 999999999 47 Jackson 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 0 116 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 1509.66 0 0 0 0 0 0 1509.66 0 0 1011234693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15664.55 0 0 0 0 0 0 0 0 0 0 0 0 0 15664.55 0 0 1011234874 1649697889 10 Physicians WRIGHT ZACHARY W 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2233.65 0 0 0 0 0 0 2233.65 0 0 1011235635 1285144360 33 Nursing Facilities APERION CARE WEST CHICAGO 999999999 30 DuPage 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 0 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8026 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1090157.16 0 0 0 0 0 0 0 1090157.16 0 0 1011235676 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11919.17 0 0 0 0 0 0 0 0 0 0 0 0 0 11919.17 0 0 1011235716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3236.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3236.08 0 0 1011235836 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22828.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22828.4 0 0 1011235939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19564.36 0 0 0 0 0 0 0 0 0 0 0 0 0 19564.36 0 0 1011236159 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.34 0 0 0 0 0 0 78.34 0 0 1011236184 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1162.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.29 0 0 1011236977 1982040986 10 Physicians KAPLAN DAVID 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 370.15 0 0 0 0 0 0 370.15 0 0 1011237142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49577.97 0 0 0 0 0 0 0 0 0 0 0 0 0 49577.97 0 0 1011237633 1972920395 10 Physicians DEBURGHGRAEVE CORY 999999999 200 Cook 0 0 Anesthesiology 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 0 108 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 39453.37 0 0 0 0 0 0 39453.37 0 0 1011237834 1629598578 10 Physicians PATEL AXI R 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 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 27.89 0 0 0 0 0 0 27.89 0 0 1011237843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19281.65 0 0 0 0 0 0 0 0 0 0 0 0 0 19281.65 0 0 1011238287 1982081378 16 Nurse Practitioners BONZANI SAMANTHA 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 656.18 0 0 0 0 0 0 656.18 0 0 1011238386 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 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 0 261.24 0 0 0 0 0 0 261.24 0 0 1011238474 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 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 0 371.62 0 0 0 0 0 0 371.62 0 0 1011238520 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 32.25 0 0 0 0 0 0 32.25 0 0 1011238738 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 49.22 0 0 0 0 0 0 49.22 0 0 1011238857 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313.75 0 0 0 0 0 0 0 0 0 0 0 0 0 313.75 0 0 1011239181 1790293744 91 Waiver service provider--Adults (DHS/DDD) FIRST ZION HOMES 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 0 779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108329.97 0 0 0 0 0 0 0 0 0 0 0 0 0 108329.97 0 0 1011239453 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3867.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3867.6 0 0 1011239539 1891205720 16 Nurse Practitioners STAWICKI NICOLE 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 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 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0 1011240641 1699787150 10 Physicians YUNYONGYING PETE 999999999 19 Champaign 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 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 1858.8 0 0 0 0 0 0 1858.8 0 0 1011240662 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 0 126.99 0 0 0 0 0 0 126.99 0 0 1011240957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17290.53 0 0 0 0 0 0 0 0 0 0 0 0 0 17290.53 0 0 1011240975 1144545849 10 Physicians PATEL PRACHI 999999999 200 Cook 0 0 General Practice 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.88 0 0 0 0 0 0 68.88 0 0 1011241278 1750719894 70 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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 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 0 600.01 0 0 0 0 0 0 600.01 0 0 1011244265 1154852275 10 Physicians THAKKAR DHWANIL 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1559.17 0 0 0 0 0 0 1559.17 0 0 1011244276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3691.02 0 0 0 0 0 0 0 0 0 0 0 0 0 3691.02 0 0 1011245759 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 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 1011246552 1356738561 10 Physicians GOESE DAVID 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 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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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6210.86 0 0 0 6210.86 0 0 1011247652 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 1011247847 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 1011247876 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 0 670.95 0 0 0 0 0 0 670.95 0 0 1011247929 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2957.51 0 0 0 0 0 0 0 0 0 0 0 0 0 2957.51 0 0 1011248212 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 0 217 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 19280.43 0 0 0 0 0 0 0 0 0 0 0 0 0 19280.43 0 0 1011248267 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16108.78 0 0 0 0 0 0 0 0 0 0 0 0 0 16108.78 0 0 1011248462 1730690942 16 Nurse Practitioners ALEXANDER ELIZABETH 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 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 0 657.08 0 0 0 0 0 0 657.08 0 0 1011248503 1306221346 10 Physicians LEE ERIC 999999999 200 Cook 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 0 260 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 1176.4 0 0 0 0 0 0 1176.4 0 0 1011248790 1255844288 16 Nurse Practitioners ABANCO FRANCISCO 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 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 1865.96 0 0 0 0 0 0 1865.96 0 0 1011248861 33 Nursing Facilities 30 DuPage 0 0 0 0 0 0 0 0 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 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46944.7 0 0 0 0 0 0 0 46944.7 0 0 1011249061 1225501356 16 Nurse Practitioners STREETER MIYAKO 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 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 0 674.44 0 0 0 0 0 0 674.44 0 0 1011249103 1669816807 10 Physicians GEBHARDT BRIAN J 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.39 0 720.83 0 0 0 0 0 0 727.22 0 0 1011249130 1902193873 10 Physicians PATEL AMAR 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 242 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6282.68 0 85.46 0 0 0 0 0 0 6368.14 0 0 1011249131 1952782955 10 Physicians ELUGBADEBO JOYCE E 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 0 257.62 0 0 0 0 0 0 257.62 0 0 1011249403 1982835740 89 Physician Assistant Only(Encounter Only) SCHILZ STACY 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 0 121 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 2261.19 0 0 0 0 0 0 2261.19 0 0 1011249458 1023498029 10 Physicians KANABAR SHREYA P 999999999 30 DuPage 0 0 0 0 0 62 0 0 0 0 0 0 28 0 84 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 43 0 121 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 43 0 121 0 0 0 0 0 0 0 0 0 5503.37 0 0 0 0 0 0 902.42 0 6090.89 0 0 0 0 0 0 12496.68 0 0 1011249774 1952795254 10 Physicians VANDREVALA MALCOLM M 999999999 200 Cook 0 0 Psychiatry 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 0 107 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 9167.77 0 0 0 0 0 0 9167.77 0 0 1011250330 1194210393 16 Nurse Practitioners HOLTON JARED 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 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 0 567.81 0 0 0 0 0 0 567.81 0 0 1011250440 1396248464 16 Nurse Practitioners JONES AMBER K 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 112.11 0 0 0 0 0 0 0 0 1417.52 0 0 0 0 0 0 1529.63 0 0 1011250806 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17933.32 0 0 0 0 0 0 0 0 0 0 0 0 0 17933.32 0 0 1011250816 1407202427 16 Nurse Practitioners MCINTYRE SANDRA L 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3018.59 0 0 0 0 0 0 3018.59 0 0 1011250969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12039.06 0 0 0 0 0 0 0 0 0 0 0 0 0 12039.06 0 0 1011251031 1083657514 10 Physicians RAO ANIL G 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 787 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1283 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15161.55 0 2691 0 0 0 0 0 0 17852.55 0 0 1011251431 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24425.52 0 0 0 0 0 0 0 0 0 0 0 0 0 24425.52 0 0 1011251652 1235653908 16 Nurse Practitioners BLANTON AMANDA J 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 86.13 0 0 0 0 0 0 86.13 0 0 1011252049 1437656097 89 Physician Assistant Only(Encounter Only) FRANCIS KELLIE A 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 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 0 781.94 0 0 0 0 0 0 781.94 0 0 1011252152 1477947075 10 Physicians VARMA SELINA 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 1420.25 0 0 0 0 0 0 1420.25 0 0 1011252757 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 0 138 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 11533.21 0 0 0 0 0 0 0 0 0 0 0 0 0 11533.21 0 0 1011252971 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 0 192 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 17027.93 0 0 0 0 0 0 0 0 0 0 0 0 0 17027.93 0 0 1011252973 1205302015 16 Nurse Practitioners TAYLOR WARD 999999999 200 Cook 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 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71620.59 0 0 0 0 0 0 71620.59 0 0 1011253092 1467978049 89 Physician Assistant Only(Encounter Only) MIRABITO JON 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 114.82 0 0 0 0 0 0 114.82 0 0 1011253220 1154676781 12 Optometrists SHIEKH SEHER 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 520.71 0 0 0 0 0 0 520.71 0 0 1011253335 1003315706 16 Nurse Practitioners BRYANT DANIELLE 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 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 3479.5 0 0 0 0 0 0 3479.5 0 0 1011253443 1235365594 10 Physicians ROMMEL JENNEE 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 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 0 279.72 0 0 0 0 0 0 279.72 0 0 1011253522 1982794236 86 Clinical Social Worker(Encounter Only) SINGER ALAN F 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 940.96 0 0 0 0 0 0 940.96 0 0 1011253534 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31639.68 0 0 0 0 0 0 0 0 0 0 0 0 0 31639.68 0 0 1011253645 1750837043 30 General Hospitals ANGEL CARE CENTER LLC 999999999 81 Perry DIALYSIS Outpatient dialysis centers. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 194 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 4183 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408.95 0 0 0 0 0 408.95 0 0 1011253709 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17524.71 0 0 0 0 0 0 0 0 0 0 0 0 0 17524.71 0 0 1011253880 1164963468 10 Physicians GIROD-SALGADO SOFIA 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 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 0 809.97 0 0 0 0 0 0 809.97 0 0 1011253914 1912307992 63 Other Providers of Medical Equipment/Supplies (Non-registered) PRESQUE ISLE MEDICAL TECHNOLOG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 40700.28 0 0 0 0 40700.28 0 0 1011253940 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 0 291.94 291.94 0 0 1011254090 1871042937 75 Department of Alcohol and Substance Abuse Provider SINNISSIPPI CENTERS INC 610531461 17 Carroll 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 0 157 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 9035.41 0 0 9035.41 0 0 1011254095 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21483 0 0 0 0 0 0 0 0 0 0 0 0 0 21483 0 0 1011254220 1801215231 10 Physicians TENNILL ROBERT 999999999 91 Sangamon 0 0 Emergency 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 0 142 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 3744.67 0 0 0 0 0 0 3744.67 0 0 1011254290 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22230.34 0 0 0 0 0 0 0 0 0 0 0 0 0 22230.34 0 0 1011255033 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20331.06 0 0 0 0 0 0 0 0 0 0 0 0 0 20331.06 0 0 1011255053 1831244409 87 Psychologist(Encounter Only) CORSICA JOYCE 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 0 175 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 2587.15 0 0 0 0 0 0 2587.15 0 0 1011255110 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.99 0 0 0 0 0 0 93.99 0 0 1011255184 1821474958 89 Physician Assistant Only(Encounter Only) SHUMNY ANNICA 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 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 1306.34 0 0 0 0 0 0 1306.34 0 0 1011255483 16 Nurse Practitioners 200 Cook 0 0 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 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 0 104.96 0 0 0 0 0 0 0 0 51.3 0 0 0 0 0 0 156.26 0 0 1011255563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19733.7 0 0 0 0 0 0 0 0 0 0 0 0 0 19733.7 0 0 1011256058 1477818714 10 Physicians ANDREOLI JESSICA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 22 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.2 0 4218.66 0 0 0 0 0 0 4346.86 0 0 1011256260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36880.58 0 0 0 0 0 0 0 0 0 0 0 0 0 36880.58 0 0 1011256741 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1383.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.96 0 0 1011256794 1790190221 10 Physicians NEEDLEMAN ROBERT 999999999 53 Kane 0 0 Emergency Medicine 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 0 148 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 6530.69 0 0 0 0 0 0 6530.69 0 0 1011257338 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24273.48 0 0 0 0 0 0 0 0 0 0 0 0 0 24273.48 0 0 1011257531 1003021916 89 Physician Assistant Only(Encounter Only) LARVA JEREMY 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 0 148.31 0 0 0 0 0 0 148.31 0 0 1011257566 1710384219 60 Pharmacies ROSENS-MORSEVIEW PHARMACY 999999999 200 Cook 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 10181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69542.14 0 0 0 69542.14 0 0 1011257610 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14354.99 0 0 0 0 0 0 0 0 0 0 0 0 0 14354.99 0 0 1011257647 1285108621 48 Rural Health Clinics HEARTLAND WOMEN'S HEALTHCARE L 999999999 108 Williamson 0 0 0 274 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 941 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 941 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30968.03 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30968.03 0 0 1011257989 1780159996 16 Nurse Practitioners VOGT JESSICA 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 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 0 630.39 0 0 0 0 0 0 630.39 0 0 1011258552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25780.03 0 0 0 0 0 0 0 0 0 0 0 0 0 25780.03 0 0 1011258745 86 Clinical Social Worker(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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011258889 1134487234 10 Physicians AL RAWI SUMAYA A 999999999 200 Cook 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 0 106 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 1607.85 0 0 0 0 0 0 0 0 1607.85 0 0 1011259138 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 7526.24 0 0 0 0 0 0 0 0 0 0 0 0 0 7526.24 0 0 1011259474 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3855.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3855.06 0 0 1011259793 1801970017 60 Pharmacies PRAIRIE MEDICAL PHARMACY 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 4534 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1920.83 0 0 25245.05 0 0 0 27165.88 0 0 1011260520 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9650.16 0 0 0 0 0 0 0 0 0 0 0 0 0 9650.16 0 0 1011260599 1760897334 13 Podiatrists RUFF JAKE G 999999999 37 Fulton 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 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 1567.62 0 0 0 0 0 0 1567.62 0 0 1011260619 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4477.13 0 0 0 0 0 0 0 0 0 0 0 0 0 4477.13 0 0 1011260625 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17997.98 0 0 0 0 0 0 0 0 0 0 0 0 0 17997.98 0 0 1011260809 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 12.74 0 0 0 0 0 0 12.74 0 0 1011260824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19392.39 0 0 0 0 0 0 0 0 0 0 0 0 0 19392.39 0 0 1011261013 1033400957 10 Physicians SAMMARCO ANNE 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 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 1069.37 0 0 0 0 0 0 1069.37 0 0 1011261028 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22109.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22109.04 0 0 1011261043 1811334931 10 Physicians CRAWFORD ALLISON L 999999999 30 DuPage 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 0 146 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 1324.14 0 0 0 0 0 0 1324.14 0 0 1011261111 1053725374 10 Physicians TRIEBES LINDY A 999999999 200 Cook 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 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 2384.34 0 0 0 0 0 0 2384.34 0 0 1011261122 1497135750 10 Physicians ABRAHAM HRUDYA 999999999 80 Peoria 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 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 0 867.57 0 0 0 0 0 0 867.57 0 0 1011261681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26639.87 0 0 0 0 0 0 0 0 0 0 0 0 0 26639.87 0 0 1011261714 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23002 0 0 0 0 0 0 0 0 0 0 0 0 0 23002 0 0 1011261785 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 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 0 695.29 695.29 0 0 1011261812 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18836.04 0 0 0 0 0 0 0 0 0 0 0 0 0 18836.04 0 0 1011261835 1710476205 11 Dentists KIM JEE SUN 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 0 167 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 10287.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10287.1 0 0 1011261863 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5786.22 0 0 0 0 0 0 0 0 0 0 0 0 0 5786.22 0 0 1011262729 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19993.44 0 0 0 0 0 0 0 0 0 0 0 0 0 19993.44 0 0 1011263066 1295176261 16 Nurse Practitioners POGATCHNIK LAURA 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 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 0 319.27 0 0 0 0 0 0 319.27 0 0 1011263178 1477010874 16 Nurse Practitioners PIEPER JENNIFER D 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1710.66 0 0 0 0 0 0 1710.66 0 0 1011263419 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 49.16 0 0 0 0 0 0 49.16 0 0 1011263423 1609366061 16 Nurse Practitioners COLLINSWORTH ERIN L 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 2 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 155.74 0 0 0 0 0 0 0 0 1471.05 0 0 0 0 0 0 1626.79 0 0 1011263922 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9947.28 0 0 0 0 0 0 0 0 0 0 0 0 0 9947.28 0 0 1011263955 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011264056 1659790350 16 Nurse Practitioners SPANGLER KEVIN 999999999 80 Peoria 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 94 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 899.72 0 0 0 0 0 0 931.87 0 0 1011264082 1568917607 55 Early Intervention Services CREVISTON KAYCI 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 12878.68 0 0 0 0 0 0 12878.68 0 0 1011264283 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 47.62 0 0 0 0 0 0 47.62 0 0 1011264400 1437631835 16 Nurse Practitioners BAIDOO LAUREN S 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 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 3121.12 0 0 0 0 0 0 3121.12 0 0 1011264502 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22649.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22649.13 0 0 1011264630 1619457728 16 Nurse Practitioners LINDSTROM ALLISON 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 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 1092.63 0 0 0 0 0 0 1092.63 0 0 1011264774 89 Physician Assistant Only(Encounter Only) 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 1011264799 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 18 0 0 0 0 0 0 18 0 0 1011265223 1730476474 89 Physician Assistant Only(Encounter Only) FLORENTINO KATHLEEN 953586411 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 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 1559.48 0 0 0 0 0 0 1559.48 0 0 1011265395 1265847941 10 Physicians KIRK SPENCER S 999999999 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 4 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.57 0 595.68 0 0 0 0 0 0 620.25 0 0 1011265537 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19832.34 0 0 0 0 0 0 0 0 0 0 0 0 0 19832.34 0 0 1011265563 1457646135 10 Physicians KUNAPAREDDY GIRISH 999999999 200 Cook 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 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.26 0 929.75 0 0 0 0 0 0 944.01 0 0 1011265621 1871908723 10 Physicians ANZUETO GABRIEL 999999999 30 DuPage 0 0 0 0 0 8 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 533.24 0 0 0 0 0 0 0 0 5284.41 0 0 0 0 0 0 5817.65 0 0 1011265773 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13237 0 0 0 0 0 0 0 0 0 0 0 0 0 13237 0 0 1011266843 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 0 519.56 0 0 0 0 0 0 519.56 0 0 1011267051 1326428103 10 Physicians OLSON GREGORY R 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 0 217 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 2657.12 0 0 0 0 0 0 2657.12 0 0 1011267188 1275041097 16 Nurse Practitioners JOHNSON NICOLE 999999999 91 Sangamon 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 0 121 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 3449.57 0 0 0 0 0 0 3449.57 0 0 1011267211 1558858910 16 Nurse Practitioners WELCH AREE L 999999999 30 DuPage 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 0 135 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 0 177.96 0 0 0 0 0 0 177.96 0 0 1011267291 1275011132 16 Nurse Practitioners MILOJEVIC HOLLY 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 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 0 679.46 0 0 0 0 0 0 679.46 0 0 1011267337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22726.88 0 0 0 0 0 0 0 0 0 0 0 0 0 22726.88 0 0 1011267384 1073021762 16 Nurse Practitioners ALCOCK CASSANDRA 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 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 1193.33 0 0 0 0 0 0 1193.33 0 0 1011267455 1245705193 20 Registered nurse DEAN KATLYN 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 0 903.46 0 0 0 0 0 0 903.46 0 0 1011267457 55 Early Intervention Services 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 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 4547 0 0 0 0 0 0 4547 0 0 1011267889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12094.41 0 0 0 0 0 0 0 0 0 0 0 0 0 12094.41 0 0 1011268267 1124441753 10 Physicians MELAMED MATTHEW J 999999999 200 Cook 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 1392.69 0 0 0 0 0 0 1392.69 0 0 1011268390 1902397078 89 Physician Assistant Only(Encounter Only) ABRAHAM REBECCA 999999999 200 Cook 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 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 0 475.85 0 0 0 0 0 0 475.85 0 0 1011268681 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16437.88 0 0 0 0 0 0 0 0 0 0 0 0 0 16437.88 0 0 1011268941 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 7132.14 0 0 0 0 0 0 0 0 0 0 0 0 0 7132.14 0 0 1011269091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24349.78 0 0 0 0 0 0 0 0 0 0 0 0 0 24349.78 0 0 1011269234 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14973.94 0 0 0 0 0 0 0 0 0 0 0 0 0 14973.94 0 0 1011269278 1437598414 10 Physicians KEENEY MATTHEW 999999999 53 Kane 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 0 299 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 1833.81 0 0 0 0 0 0 0 0 1833.81 0 0 1011269466 1659890069 22 Physical Therapists CHEEK NICOLE L 999999999 108 Williamson 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 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 0 859.99 859.99 0 0 1011269806 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10931.14 0 0 0 0 0 0 0 0 0 0 0 0 0 10931.14 0 0 1011269895 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 36.15 0 0 0 0 0 0 36.15 0 0 1011269963 1154620680 10 Physicians ROSE FATEEMA 999999999 53 Kane 0 0 Pediatrics 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.24 0 2437.61 0 0 0 0 0 0 2437.85 0 0 1011270528 1013443993 16 Nurse Practitioners DONLEY THERESA 999999999 107 Will 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 0 146 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 0 314.52 0 0 0 0 0 0 314.52 0 0 1011270842 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.3 0 0 0 0 0 0 133.3 0 0 1011270854 1225074511 10 Physicians PORTER MICHAEL J 999999999 200 Cook 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2654.05 0 0 0 0 0 0 2654.05 0 0 1011271085 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6803.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6803.55 0 0 1011272452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4238.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4238.81 0 0 1011272564 1558789255 10 Physicians KIM ANDY T 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 5 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8348.35 0 0 0 0 0 0 8348.35 0 0 1011272586 1285628511 10 Physicians ROOD RICHARD P 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 0 850.44 0 0 0 0 0 0 850.44 0 0 1011272776 1477828523 10 Physicians MEHTA AMAR S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 62 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1986.07 0 1143.96 0 0 0 0 0 0 3130.03 0 0 1011272853 1396262879 86 Clinical Social Worker(Encounter Only) PEZESHKI NICHOLE N 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 0 183 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 3554.33 0 0 0 0 0 0 3554.33 0 0 1011272882 1700230034 10 Physicians CZESTOCHOWSKI STEFAN P 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 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 0 214.98 0 0 0 0 0 0 214.98 0 0 1011272962 71 Medicar Provider 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 40.74 0 0 0 0 0 0 40.74 0 0 1011272982 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 1011273193 1760565477 10 Physicians WESLEY BETSY E 999999999 200 Cook 0 0 Emergency Medicine 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 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 4590.03 0 0 0 0 0 0 4590.03 0 0 1011273528 1326434994 10 Physicians BAXI CHIRAYU N 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 0 247 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 4952.44 0 0 0 0 0 0 4952.44 0 0 1011273695 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 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 1947.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1947.53 0 0 1011273763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 740.74 0 0 0 0 0 0 0 0 0 0 0 0 0 740.74 0 0 1011273766 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011274308 1306264478 10 Physicians NADKARNI NEIL A 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 11484.76 0 0 0 0 0 0 11484.76 0 0 1011274310 1659560571 89 Physician Assistant Only(Encounter Only) BUNTING ERIC A 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 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 0 317.56 0 0 0 0 0 0 317.56 0 0 1011274493 1033684170 16 Nurse Practitioners STEINKAMP KOURTNEY L 999999999 19 Champaign 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 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 0 441.66 0 0 0 0 0 0 441.66 0 0 1011274841 1396243515 89 Physician Assistant Only(Encounter Only) ZAYAT RACHEL 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 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 0 572.71 0 0 0 0 0 0 572.71 0 0 1011274855 1235454968 10 Physicians RIGAMER MARGARET 999999999 200 Cook 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 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7755.71 0 0 0 0 0 0 7755.71 0 0 1011275399 1427221407 63 Other Providers of Medical Equipment/Supplies (Non-registered) WASHINGTON UNIVERSITY - DEPT. 631101032 826 Missouri 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.51 0 1572.79 0 0 0 0 1582.3 0 0 1011275746 1477919918 89 Physician Assistant Only(Encounter Only) SMOLINSKI ANDREA 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 49.22 0 0 0 0 0 0 49.22 0 0 1011275883 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 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 29191.37 0 0 0 0 0 0 0 0 0 0 0 0 0 29191.37 0 0 1011275911 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1331.27 0 0 0 0 0 0 1331.27 0 0 1011276067 91 Waiver service provider--Adults (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 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 0 531.3 0 0 0 0 0 0 0 0 0 0 0 0 0 531.3 0 0 1011276346 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15973.76 0 0 0 0 0 0 0 0 0 0 0 0 0 15973.76 0 0 1011276369 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12147.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12147.72 0 0 1011276533 10 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 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 0 551.6 0 0 0 0 0 0 551.6 0 0 1011276814 1629595053 16 Nurse Practitioners REGAN PAUL 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 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 0 379.89 0 0 0 0 0 0 379.89 0 0 1011276948 1053761288 10 Physicians GREENSTEIN DANIEL 999999999 200 Cook 0 0 Emergency Medicine 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 345.14 0 0 0 0 0 0 366.46 0 0 1011277177 1225392970 10 Physicians KROMREY DAVID MARK 999999999 71 McHenry 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 527 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 769 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9070.72 0 502.98 0 0 0 0 0 0 9573.7 0 0 1011277502 1871004838 16 Nurse Practitioners WIACEK BRIDGET 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 1152.25 0 0 0 0 0 0 1152.25 0 0 1011277671 1811338726 10 Physicians IQBAL ASIMA 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 5 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3029.75 0 0 0 0 0 0 3029.75 0 0 1011277849 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 0 178.9 0 0 0 0 0 0 178.9 0 0 1011278166 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 1011278598 1992737563 10 Physicians BEHRENS JENNIFER T 999999999 82 Piatt 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 0 135 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 6023.76 0 0 0 0 0 0 6023.76 0 0 1011278652 1518300425 10 Physicians KATSIS JAMES M 999999999 200 Cook 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 0 307 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 6561.27 0 0 0 0 0 0 6561.27 0 0 1011278940 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.12 0 0 0 0 0 0 0 0 0 0 0 0 0 65.12 0 0 1011279001 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1011279259 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.52 0 0 0 0 0 0 47.52 0 0 1011279265 1821446006 10 Physicians CHOTTINER MARK C 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 5 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.12 0 6403.29 0 0 0 0 0 0 6475.41 0 0 1011279463 1346623667 10 Physicians CAIL AUSTIN J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.07 0 0 0 0 0 0 0 0 155.07 0 0 1011279550 1710405899 89 Physician Assistant Only(Encounter Only) SUVITTAYASIRI KANYADA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 5078.26 0 0 0 0 0 0 5151.66 0 0 1011279713 1467961748 16 Nurse Practitioners LITHILA AMBER 999999999 10 Adams 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 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 1578.68 0 0 0 0 0 0 1578.68 0 0 1011279812 1578033551 33 Nursing Facilities "GROVE OF BERWYN, THE" 999999999 200 Cook 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 0 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 923115.29 0 0 0 0 0 0 0 923115.29 0 0 1011279861 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15184.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15184.81 0 0 1011280083 1013134469 10 Physicians HUMBURG BURT 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 0 470.61 0 0 0 0 0 0 470.61 0 0 1011280320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19272.66 0 0 0 0 0 0 0 0 0 0 0 0 0 19272.66 0 0 1011280805 1063970051 22 Physical Therapists ACKERT NATHAN 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 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 2727.2 2727.2 0 0 1011281057 1164817722 10 Physicians BERG DANIEL P 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 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 0 296.44 0 0 0 0 0 0 296.44 0 0 1011281701 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 78.09 0 0 0 0 0 0 78.09 0 0 1011281876 1083094106 10 Physicians KHATOON AYESHA 999999999 30 DuPage 0 0 Emergency Medicine 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 0 241 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 10750.63 0 0 0 0 0 0 10750.63 0 0 1011282027 1023436995 10 Physicians JUVINALL DOUGLAS R 999999999 80 Peoria 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 0 112 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 1493.64 0 0 0 0 0 0 1493.64 0 0 1011282868 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 16038.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16038.66 0 0 1011282959 1215402045 24 Speech Therapists POWLES HALEY 999999999 91 Sangamon 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 0 178 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 13178.64 13178.64 0 0 1011282975 1639634876 86 Clinical Social Worker(Encounter Only) PEREZ CARMEN 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 0 250 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 0 913.07 0 0 0 0 0 0 913.07 0 0 1011283057 1558750430 10 Physicians ZESSIS NICHOLAS R 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 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 2818.5 0 0 0 0 0 0 2818.5 0 0 1011283083 1548548134 10 Physicians BAVARO JOSEPH B 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 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 4558.6 0 0 0 0 0 0 4558.6 0 0 1011283206 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 930.23 0 0 0 0 0 0 930.23 0 0 1011283340 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26125.78 0 0 0 0 0 0 0 0 0 0 0 0 0 26125.78 0 0 1011283545 1093112963 89 Physician Assistant Only(Encounter Only) TANEJA SEVINA 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 0 159 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 1013.7 0 0 0 0 0 0 1013.7 0 0 1011284097 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12110.21 0 0 0 0 0 0 0 0 0 0 0 0 0 12110.21 0 0 1011284159 1659864445 16 Nurse Practitioners ROUSE ERICA L 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 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 0 279.73 0 0 0 0 0 0 279.73 0 0 1011284286 1417474511 16 Nurse Practitioners WUEBBELS KAYLA B 999999999 65 Madison 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 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 0 809.2 0 0 0 0 0 0 809.2 0 0 1011284455 10 Physicians 87 Randolph 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 1011284456 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25296.9 0 0 0 0 0 0 0 0 0 0 0 0 0 25296.9 0 0 1011284486 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828.9 0 0 0 0 0 0 828.9 0 0 1011284704 1053897504 91 Waiver service provider--Adults (DHS/DDD) YOUNG JENNA A 999999999 91 Sangamon 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109176.21 0 0 0 0 0 0 0 0 0 0 0 0 0 109176.21 0 0 1011284971 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22820.49 0 0 0 0 0 0 0 0 0 0 0 0 0 22820.49 0 0 1011285149 1508377532 89 Physician Assistant Only(Encounter Only) STRAND MEGHAN 606118709 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 0 106 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 0 358.65 0 0 0 0 0 0 358.65 0 0 1011285180 87 Psychologist(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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.31 0 0 0 0 0 0 129.31 0 0 1011285407 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 0 114 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 18919.68 0 0 0 0 0 0 0 0 0 0 0 0 0 18919.68 0 0 1011285588 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 0 179.35 0 0 0 0 0 0 179.35 0 0 1011285638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5209.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5209.29 0 0 1011285718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12836.78 0 0 0 0 0 0 0 0 0 0 0 0 0 12836.78 0 0 1011285895 1508210188 10 Physicians WYMAN TIMOTHY 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 0 227 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 5699.16 0 0 0 0 0 0 5699.16 0 0 1011286368 1154760619 86 Clinical Social Worker(Encounter Only) MORTENSEN PATRICIA L 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 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 1380.31 0 0 0 0 0 0 1380.31 0 0 1011286467 1487910865 10 Physicians NELSON JESSICA LAUREN 999999999 51 Jo Daviess 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 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 1777.16 0 0 0 0 0 0 1777.16 0 0 1011286720 1780175778 16 Nurse Practitioners SPERRY AMBER E 999999999 91 Sangamon 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 0 100 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 3024.81 0 0 0 0 0 0 3024.81 0 0 1011287041 1376046060 55 Early Intervention Services ZALOUM KIRSTIN A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 5216.8 0 0 0 0 0 0 5216.8 0 0 1011287060 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 84.28 0 0 0 0 0 0 84.28 0 0 1011287216 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20951.94 0 0 0 0 0 0 0 0 0 0 0 0 0 20951.94 0 0 1011287222 1780187260 23 Occupational Therapists DEBRABANDER KRISTA A 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 0 148 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 10514.04 10514.04 0 0 1011287254 1104294875 16 Nurse Practitioners KIDANDI TANYA 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 0 150 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 1127.66 0 0 0 0 0 0 1127.66 0 0 1011287459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18956.41 0 0 0 0 0 0 0 0 0 0 0 0 0 18956.41 0 0 1011287702 1982803532 10 Physicians YACOUB EMAD N 999999999 57 Lake 0 0 0 0 0 0 0 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 0 159.56 0 0 0 0 0 0 0 0 159.56 0 0 1011287716 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 1316.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.6 0 0 1011287728 1316201320 10 Physicians PARKER WILLIAM 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 0 102 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 2551.08 0 0 0 0 0 0 2551.08 0 0 1011288563 1265581391 22 Physical Therapists PARAGAS BHERNEE 999999999 53 Kane 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 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 0 562.94 562.94 0 0 1011288851 1467934893 16 Nurse Practitioners WATTS SUZANNE L 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 0 131 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 4663.77 0 0 0 0 0 0 4663.77 0 0 1011288853 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 0 245.6 0 0 0 0 0 0 245.6 0 0 1011288868 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1685.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1685.38 0 0 1011289137 1700365137 16 Nurse Practitioners BERTRAM STEPHANIE L 999999999 109 Winnebago 0 0 0 0 0 14 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 887.71 0 0 0 0 0 0 0 0 3296.25 0 0 0 0 0 0 4183.96 0 0 1011289314 1710392170 10 Physicians BISO SYLVIA M 999999999 200 Cook 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 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 0 191.5 0 0 0 0 0 0 191.5 0 0 1011289413 1356844526 60 Pharmacies PHARMACY PLUS INC 999999999 64 Macoupin 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 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7610 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6450.91 0 0 0 6450.91 0 0 1011289635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20073.24 0 0 0 0 0 0 0 0 0 0 0 0 0 20073.24 0 0 1011290333 1023497823 63 Other Providers of Medical Equipment/Supplies (Non-registered) CENTEGRA HOME MEDICAL EQUIPMEN 999999999 71 McHenry 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 0 357 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 11888.43 0 0 0 0 0 0 11888.43 0 0 1011290687 1780044263 16 Nurse Practitioners KRASNOPOLSKIY IEVGENIIA 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 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 0 161.84 0 0 0 0 0 0 161.84 0 0 1011290734 92 Waiver service provider--Disability (DHS/DRS) 30 DuPage 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82845.4 0 0 0 0 0 0 0 0 0 0 0 0 0 82845.4 0 0 1011291468 1891260667 16 Nurse Practitioners CALENDO REBECCA 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 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 0 337.12 0 0 0 0 0 0 337.12 0 0 1011291654 1427477843 10 Physicians STRNAD BENJAMIN S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 119 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2880.24 0 294.11 0 0 0 0 0 0 3174.35 0 0 1011291996 1730606583 89 Physician Assistant Only(Encounter Only) RUSHING LEANN 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 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 0 109.64 0 0 0 0 0 0 109.64 0 0 1011292214 1285998237 10 Physicians AFSHARI MITRA 999999999 200 Cook 0 0 Neurology 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 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 0 834.24 0 0 0 0 0 0 834.24 0 0 1011292301 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 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 4678.77 0 0 0 0 0 0 0 0 0 0 0 0 0 4678.77 0 0 1011292671 16 Nurse Practitioners 18 Cass 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011293074 89 Physician Assistant Only(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 23.46 0 0 0 0 0 0 23.46 0 0 1011293237 1902373301 89 Physician Assistant Only(Encounter Only) HOSKING MEGAN E 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 422.44 0 0 0 0 0 0 422.44 0 0 1011293981 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24037.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24037.42 0 0 1011294288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4405.01 0 0 0 0 0 0 0 0 0 0 0 0 0 4405.01 0 0 1011294346 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23410.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 1011294440 1861811523 10 Physicians LUDMER NICHOLAS G 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 9 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.15 0 6486.57 0 0 0 0 0 0 6711.72 0 0 1011294456 1609274760 16 Nurse Practitioners WESTFALL JENNIFER M 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 93.03 0 0 0 0 0 0 93.03 0 0 1011294508 1508302373 91 Waiver service provider--Adults (DHS/DDD) O'CONNOR MAUREEN 999999999 96 St Clair 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 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111436 0 0 0 0 0 0 0 0 0 0 0 0 0 111436 0 0 1011295376 1588614002 48 Rural Health Clinics MEMORIAL MEDICAL CENTER CARTHA 623213551 42 Hancock 0 0 0 793 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3538 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3538 0 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84259.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84259.66 0 0 1011295762 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23392.57 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.57 0 0 1011295765 1083183677 16 Nurse Practitioners SNYDER SANDRA E 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 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 0 279.29 0 0 0 0 0 0 279.29 0 0 1011295779 1609357045 11 Dentists CASTELLANOS VIVIAN 999999999 200 Cook 0 0 General Dentistry 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1372.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1372.27 0 0 1011295974 23 Occupational Therapists 65 Madison 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 0 261.3 261.3 0 0 1011296055 4011296055 72 Taxicabs and Livery Companies GOLDWELL ENTERPRISE GROUP INC 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 2098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11536.92 0 0 0 0 0 0 11536.92 0 0 1011296252 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 1011296900 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 54774.33 0 0 0 0 0 0 0 0 0 0 0 0 0 54774.33 0 0 1011296964 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.2 0 0 0 0 0 0 146.2 0 0 1011297575 1871039875 16 Nurse Practitioners MASTERSON MICHELLE 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 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 0 362.54 0 0 0 0 0 0 362.54 0 0 1011297708 1235683798 46 Ambulatory Surgical Treatment Centers ASSOCIATED SURGICAL CENTER 999999999 200 Cook 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 0 269 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 10842.81 0 0 0 0 0 10842.81 0 0 1011297852 1558743138 10 Physicians NAKASHIMA-MORAN PATRICK V 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 7 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.31 0 338.64 0 0 0 0 0 0 352.95 0 0 1011297865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3992.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3992.75 0 0 1011297898 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 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 1603.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1603.58 0 0 1011297899 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.27 0 0 0 0 0 0 87.27 0 0 1011298019 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16398.69 0 0 0 0 0 0 0 0 0 0 0 0 0 16398.69 0 0 1011298374 1013397967 16 Nurse Practitioners BURNLEY KATHERINE ANNE 999999999 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 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 0 112.65 0 0 0 0 0 0 112.65 0 0 1011298661 1265870695 10 Physicians BENNIS STACEY 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 1 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1001.89 0 0 0 0 0 0 1001.89 0 0 1011298813 1760733182 16 Nurse Practitioners CLAWSON STEPHANIE 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 98.44 0 0 0 0 0 0 98.44 0 0 1011299084 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 23907.18 0 0 0 0 0 0 0 0 0 0 0 0 0 23907.18 0 0 1011307644 1780038430 10 Physicians WILLE JOHN THOMAS 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 0 204 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 1186.12 0 0 0 0 0 0 1186.12 0 0 1011307671 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16708.89 0 0 0 0 0 0 0 0 0 0 0 0 0 16708.89 0 0 1011307702 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 1011307876 1801395249 89 Physician Assistant Only(Encounter Only) MARCONI ZWEIG ANGELICA 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 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0 0 0 0 0 0 0 0 0 0 336.39 0 0 0 0 0 0 336.39 0 0 1011308961 1932249521 10 Physicians EVANS JAMES 999999999 200 Cook 0 0 Emergency 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 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 0 653.21 0 0 0 0 0 0 653.21 0 0 1011309024 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8470.21 0 0 0 0 0 0 0 0 0 0 0 0 0 8470.21 0 0 1011309178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8210.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8210.2 0 0 1011309190 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19926.75 0 0 0 0 0 0 0 0 0 0 0 0 0 19926.75 0 0 1011309310 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 3052.82 0 0 0 0 0 0 0 0 0 0 0 0 0 3052.82 0 0 1011309601 1386124618 16 Nurse Practitioners AKUFFO AKUA 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 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 28.2 0 0 0 0 0 0 28.2 0 0 1011310316 1629516455 16 Nurse Practitioners GALLOWAY TARA 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 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 0 733.34 0 0 0 0 0 0 733.34 0 0 1011310716 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 69.67 0 0 0 0 0 0 69.67 0 0 1011310796 1811449176 91 Waiver service provider--Adults (DHS/DDD) LOPEZ GRISELDA 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 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81269.59 0 0 0 0 0 0 0 0 0 0 0 0 0 81269.59 0 0 1011310855 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7098.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7098.36 0 0 1011310951 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19040.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19040.91 0 0 1011311042 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 0 177 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 8496 0 0 0 0 0 0 0 0 0 0 0 0 0 8496 0 0 1011311225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 608.21 0 0 0 0 0 0 0 0 0 0 0 0 0 608.21 0 0 1011311663 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34234.75 0 0 0 0 0 0 0 0 0 0 0 0 0 34234.75 0 0 1011311962 1467975243 11 Dentists IBRAHIM MAGDI T 999999999 200 Cook 0 0 General Dentistry 0 0 65 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 454 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 22935.7 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 24817.45 0 0 1011312249 1902383953 36 Community mental health provider HELP LLC CHICAGO CLINIC 999999999 200 Cook 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 1275.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7700.7 0 0 8975.86 0 0 1011312393 1568934941 16 Nurse Practitioners SABAS LAURIE 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 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 0 194.88 0 0 0 0 0 0 194.88 0 0 1011312511 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24213 0 0 0 0 0 0 0 0 0 0 0 0 0 24213 0 0 1011312769 1992117816 10 Physicians HAAG ADAM M. 999999999 200 Cook 0 0 Emergency Medicine 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 0 112 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 4224.81 0 0 0 0 0 0 4224.81 0 0 1011313025 1609293935 10 Physicians ARNOLDS DAVID 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 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 1666.43 0 0 0 0 0 0 1666.43 0 0 1011313124 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3385.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3385.72 0 0 1011313268 1326488065 10 Physicians GOODMANSON NICHOLAS W 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 0 132 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 1875.3 0 0 0 0 0 0 1875.3 0 0 1011313648 1235615279 16 Nurse Practitioners HASSON ANTHONY MICHAEL 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 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 1725.9 0 0 0 0 0 0 1725.9 0 0 1011313863 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6905 0 0 0 0 0 0 0 0 0 0 0 0 0 6905 0 0 1011314051 1396011763 10 Physicians BADRELDIN NEVERT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 37 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1067.18 0 5778.95 0 0 0 0 0 0 6846.13 0 0 1011314101 1861848871 10 Physicians RAUBE LEE D 999999999 80 Peoria 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 0 125 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 5276.66 0 0 0 0 0 0 5276.66 0 0 1011314555 1467960104 16 Nurse Practitioners FRAZIER DAVID M. 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 0 749.82 0 0 0 0 0 0 749.82 0 0 1011314774 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 0 146.33 0 0 0 0 0 0 146.33 0 0 1011315520 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 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 1171.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1171.8 0 0 1011315789 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 0 335.87 0 0 0 0 0 0 0 0 0 0 0 0 0 335.87 0 0 1011315799 1184968646 89 Physician Assistant Only(Encounter Only) KAVLIE LAURA 999999999 24 Coles 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 0 117 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 4911.29 0 0 0 0 0 0 4911.29 0 0 1011316404 1144787599 55 Early Intervention Services CARTER KAYLA N. 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 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 5159.5 0 0 0 0 0 0 5159.5 0 0 1011316701 1023512001 10 Physicians VOLKELMA KEVIN A 999999999 200 Cook 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 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 0 104.96 0 0 0 0 0 0 0 0 503.23 0 0 0 0 0 0 608.19 0 0 1011317006 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 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 5636.31 0 0 0 0 0 0 0 0 0 0 0 0 0 5636.31 0 0 1011317101 1891995593 11 Dentists VALLADARES ALEJANDRO 999999999 200 Cook 0 0 Maxillofacial Surgery 0 0 25 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 1676.11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1676.11 0 0 1011317339 1912391558 10 Physicians WU LINDA X 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 0 304.77 0 0 0 0 0 0 304.77 0 0 1011317348 1457762395 10 Physicians MAGEE ANDREA LYNN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 19 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145.67 0 917.93 0 0 0 0 0 0 1063.6 0 0 1011317896 1306285051 10 Physicians AL HALABI SHADI 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 0 101 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 1110.21 0 0 0 0 0 0 1110.21 0 0 1011318001 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 0 240 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 23199 0 0 0 0 0 0 0 0 0 0 0 0 0 23199 0 0 1011318086 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11505.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11505.8 0 0 1011318740 1386159028 16 Nurse Practitioners RICCIARDI ASHLEY 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 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 1256.97 0 0 0 0 0 0 1256.97 0 0 1011318858 1437481934 89 Physician Assistant Only(Encounter Only) ROSE PATRICIA 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 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 10.82 0 0 0 0 0 0 10.82 0 0 1011319009 1457627465 10 Physicians PATEL ALOK M 999999999 53 Kane 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 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 2399.18 0 0 0 0 0 0 2399.18 0 0 1011319223 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 2848.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2848.64 0 0 1011319310 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 0 123 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 14863.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14863.64 0 0 1011319402 1134230766 16 Nurse Practitioners HANSEN KENDRA G 999999999 54 Kankakee 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 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 925 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4113.3 0 0 0 0 0 0 4113.3 0 0 1011319466 1962727750 10 Physicians LOCKWOOD GINA M 522421009 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.79 0 345.05 0 0 0 0 0 0 354.84 0 0 1011319575 1447759550 11 Dentists CHONG RORY A 999999999 200 Cook 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 0 169.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.5 0 0 1011319660 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 0 234 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 13551.43 0 0 0 0 0 0 0 0 0 0 0 0 0 13551.43 0 0 1011319894 1437608130 55 Early Intervention Services WILLIAMS MONICA 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 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 877 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49869 0 0 0 0 0 0 49869 0 0 1011319928 1881602043 87 Psychologist(Encounter Only) MEYER-COX THERESE M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1011320200 1982016499 10 Physicians LIPON AMANDA 999999999 91 Sangamon 0 0 Emergency Medicine 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 0 122 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 5213.14 0 0 0 0 0 0 5213.14 0 0 1011320213 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011320292 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2860.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2860.14 0 0 1011320785 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17091.13 0 0 0 0 0 0 0 0 0 0 0 0 0 17091.13 0 0 1011320885 1063856979 10 Physicians FREEDMAN RYAN LEONARD 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 0 130 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 4828.09 0 0 0 0 0 0 4828.09 0 0 1011321031 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 1011321177 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16750.76 0 0 0 0 0 0 0 0 0 0 0 0 0 16750.76 0 0 1011321424 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9589.85 0 0 0 0 0 0 0 0 0 0 0 0 0 9589.85 0 0 1011321584 1619414034 16 Nurse Practitioners PARRACK LAURA 999999999 91 Sangamon 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 0 112 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 2304.7 0 0 0 0 0 0 2304.7 0 0 1011321688 89 Physician Assistant Only(Encounter Only) 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1011321725 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2523.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2523.15 0 0 1011322457 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 0 156 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 24768.84 0 0 0 0 0 0 0 0 0 0 0 0 0 24768.84 0 0 1011322473 1952531311 10 Physicians LUGO-COLON HECTOR A 999999999 40 Grundy 0 0 Clinical Pathology 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 0 130 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 0 780.22 0 0 0 0 0 0 0 0 780.22 0 0 1011322512 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 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 0 324.23 0 0 0 0 0 0 324.23 0 0 1011322629 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8490.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8490.73 0 0 1011322683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258.36 0 0 0 0 0 0 0 0 0 0 0 0 0 258.36 0 0 1011322959 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9218.01 0 0 0 0 0 0 0 0 0 0 0 0 0 9218.01 0 0 1011323226 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.08 0 0 0 0 0 0 87.08 0 0 1011323423 1548524770 10 Physicians NAYANI ARCHANA 999999999 91 Sangamon 0 0 Radiation Oncology 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 0 236 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 6193.75 0 0 0 0 0 0 6193.75 0 0 1011323666 1194986950 89 Physician Assistant Only(Encounter Only) DOBROVEANU AMY B 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 46.3 0 0 0 0 0 0 46.3 0 0 1011323725 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 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30766.26 0 0 0 0 0 0 0 0 0 0 0 0 0 30766.26 0 0 1011323773 1962898759 10 Physicians LIN ALEXANDER JUSTIN 999999999 80 Peoria 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 6 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 0 315.17 0 0 0 0 0 0 315.17 0 0 1011323942 1699871038 87 Psychologist(Encounter Only) MERRIMAN 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 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 0 112.53 0 0 0 0 0 0 112.53 0 0 1011323949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8327.31 0 0 0 0 0 0 0 0 0 0 0 0 0 8327.31 0 0 1011324094 1952812182 89 Physician Assistant Only(Encounter Only) POWERS MACKENZIE 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 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 0 277.45 0 0 0 0 0 0 277.45 0 0 1011324169 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 0 100 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 23816 0 0 0 0 0 0 0 0 0 0 0 0 0 23816 0 0 1011324248 10 Physicians 200 Cook 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 32.86 0 0 0 0 0 0 32.86 0 0 1011324557 1043408313 86 Clinical Social Worker(Encounter Only) LEE STACY 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 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 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0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27312.1 0 0 0 0 0 0 0 0 0 0 0 0 0 27312.1 0 0 1011325208 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 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 0 857.01 0 0 0 0 0 0 857.01 0 0 1011325236 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 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 10071.87 0 0 0 0 0 0 0 0 0 0 0 0 0 10071.87 0 0 1011325325 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 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 9244.44 0 0 0 0 0 0 0 0 0 0 0 0 0 9244.44 0 0 1011325663 1730654922 91 Waiver service provider--Adults (DHS/DDD) BRACHBILL KAYLA 999999999 91 Sangamon 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116587.2 0 0 0 0 0 0 0 0 0 0 0 0 0 116587.2 0 0 1011325942 1902054463 86 Clinical Social Worker(Encounter Only) VOSS MARLA 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 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 0 231.94 0 0 0 0 0 0 231.94 0 0 1011326118 1649678806 86 Clinical Social Worker(Encounter Only) BONARIRGO TINA 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 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 0 234.96 0 0 0 0 0 0 234.96 0 0 1011326188 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14937.94 0 0 0 0 0 0 0 0 0 0 0 0 0 14937.94 0 0 1011326244 1750628483 16 Nurse Practitioners PALOMBO CHRISTOPHER 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 21.91 0 0 0 0 0 0 21.91 0 0 1011326427 10 Physicians 89 Rock Island 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 0 320.16 0 0 0 0 0 0 320.16 0 0 1011326445 1700226206 10 Physicians SORGELOOS ALIESJE G 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 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 5705.92 0 0 0 0 0 0 5705.92 0 0 1011326533 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3451.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3451.74 0 0 1011326838 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 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 0 197.37 197.37 0 0 1011326847 1609293695 10 Physicians TSOU PEI YUAN 999999999 200 Cook 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 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 2359.4 0 0 0 0 0 0 2359.4 0 0 1011327323 10 Physicians 30 DuPage 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 0 104 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 1300.55 0 0 0 0 0 0 1300.55 0 0 1011327594 1619350212 11 Dentists PASS LAUREN 999999999 80 Peoria 0 0 General Dentistry 0 0 16 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 10800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10800 0 0 1011327617 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22743.16 0 0 0 0 0 0 0 0 0 0 0 0 0 22743.16 0 0 1011327740 1508341181 16 Nurse Practitioners EVANS KELLY S 999999999 65 Madison 0 0 0 0 0 4 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 58 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 398.86 0 0 0 0 0 0 0 0 620.69 0 0 0 0 0 0 1019.55 0 0 1011327810 1073097069 16 Nurse Practitioners RAMSLAND SARAH 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 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 0 221.13 0 0 0 0 0 0 221.13 0 0 1011328379 1659790137 10 Physicians VISUTH KELVIN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 736 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21840.16 0 79.51 0 0 0 0 0 0 21919.67 0 0 1011328422 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 31.01 0 0 0 0 0 0 31.01 0 0 1011328517 1013350446 10 Physicians CENIK BASAR 999999999 91 Sangamon 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4951.96 0 0 0 0 0 0 4951.96 0 0 1011328635 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.74 0 0 0 0 0 0 237.74 0 0 1011328818 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 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 1011329074 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3725.29 0 0 0 0 0 0 0 0 0 0 0 0 0 3725.29 0 0 1011329605 1588133003 16 Nurse Practitioners WHEELER CHRISTEL G 999999999 63 Macon 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 0 106 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 3122.55 0 0 0 0 0 0 3122.55 0 0 1011329610 1639608409 89 Physician Assistant Only(Encounter Only) ELINSKI KRISTIN 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 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 56.71 0 0 0 0 0 0 56.71 0 0 1011329874 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1011329881 1699282475 63 Other Providers of Medical Equipment/Supplies (Non-registered) INTEGRATED HOMECARE SERVICES 999999999 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 0 980.15 0 0 0 0 0 0 980.15 0 0 1011329884 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 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 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277.65 0 0 0 277.65 0 0 1011330691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24603.77 0 0 0 0 0 0 0 0 0 0 0 0 0 24603.77 0 0 1011330919 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.69 0 0 0 0 0 0 1.69 0 0 1011331020 1669909644 22 Physical Therapists ZICH BETHANY 618203909 19 Champaign 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 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 0 393.81 393.81 0 0 1011331069 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 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 0 168.53 168.53 0 0 1011331128 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22270.24 0 0 0 0 0 0 0 0 0 0 0 0 0 22270.24 0 0 1011331156 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 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 0 523.04 523.04 0 0 1011331482 1215388137 16 Nurse Practitioners NINA TRISILLA N 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 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 0 455.57 0 0 0 0 0 0 455.57 0 0 1011331553 1457745911 10 Physicians MCCRORY EMERY 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 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 4107.99 0 0 0 0 0 0 4107.99 0 0 1011331788 1053371021 10 Physicians CHILDERS TRACEY W 999999999 80 Peoria 0 0 Otolaryngology 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 0 297 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 7289.62 0 0 0 0 0 0 7289.62 0 0 1011331808 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 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 6033.17 0 0 0 0 0 0 0 0 0 0 0 0 0 6033.17 0 0 1011332052 89 Physician Assistant Only(Encounter Only) 63 Macon 0 0 0 0 0 0 0 0 0 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 42.96 0 0 0 0 0 0 42.96 0 0 1011332086 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 15506.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15506.7 0 0 1011332220 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 47.62 0 0 0 0 0 0 47.62 0 0 1011332242 1477050631 12 Optometrists BRADY BRITTNEY M 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 0 163 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 2054.99 0 0 0 0 0 0 2054.99 0 0 1011332356 1174029615 16 Nurse Practitioners MCLELAND HEATHER 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 0 0 0 0 0 0 0 0 0 0 1011332791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 233.82 0 0 0 0 0 0 0 0 0 0 0 0 0 233.82 0 0 1011333114 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23446.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23446.85 0 0 1011333127 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 81.59 0 0 0 0 0 0 81.59 0 0 1011333252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23220.99 0 0 0 0 0 0 0 0 0 0 0 0 0 23220.99 0 0 1011333296 1841539772 10 Physicians NEUGARTEN CARTER J 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 0 164 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 2306.34 0 0 0 0 0 0 2306.34 0 0 1011333414 1366989899 22 Physical Therapists JONES MARGARET 999999999 89 Rock Island 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 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 0 820.94 820.94 0 0 1011333429 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 95.52 0 0 0 0 0 0 0 0 0 0 0 0 0 95.52 0 0 1011333615 1558743559 10 Physicians WOODRUFF JENNIFER L 999999999 200 Cook 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 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 3304.22 0 0 0 0 0 0 3304.22 0 0 1011333672 1417277930 89 Physician Assistant Only(Encounter Only) LYNCH ERIKA 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 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 0 254.67 0 0 0 0 0 0 254.67 0 0 1011333926 1821454729 16 Nurse Practitioners WILLIS ANGELA 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 0 365.78 0 0 0 0 0 0 365.78 0 0 1011334026 1134634116 30 General Hospitals LAKE BEHAVIORAL HOSPITAL 999999999 57 Lake DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 21 0 0 0 0 0 0 0 681 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 0 2781 0 0 0 0 0 0 0 0 0 0 15254.87 0 0 0 0 0 0 0 405486.87 0 0 0 0 0 0 0 0 0 420741.74 0 20520 1011334139 1104325091 89 Physician Assistant Only(Encounter Only) OYLER JENNIFER 999999999 65 Madison 0 0 0 0 0 7 0 0 0 0 0 0 0 0 39 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 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 1472.32 0 0 0 0 0 0 1472.32 0 0 1011334860 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37874.85 0 0 0 0 0 0 0 0 0 0 0 0 0 37874.85 0 0 1011335230 1831656248 89 Physician Assistant Only(Encounter Only) KRUG AMANDA 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 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 0 184.71 0 0 0 0 0 0 184.71 0 0 1011335269 1710321310 10 Physicians WANG RUIDI 999999999 19 Champaign 0 0 Ophthalmology 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 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.88 0 7067.93 0 0 0 0 0 0 7072.81 0 0 1011335275 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 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 0 861.53 0 0 0 0 0 0 861.53 0 0 1011335366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1399.65 0 0 0 0 0 0 0 0 0 0 0 0 0 1399.65 0 0 1011335388 1932284833 10 Physicians OWENS DAVID 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 49 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.35 0 48.24 0 0 0 0 0 0 338.59 0 0 1011335449 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6437.69 0 0 0 0 0 0 0 0 0 0 0 0 0 6437.69 0 0 1011335652 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15592.17 0 0 0 0 0 0 0 0 0 0 0 0 0 15592.17 0 0 1011335713 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1373.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1373.68 0 0 1011335803 1356624035 16 Nurse Practitioners WANYANA CHRISTINE 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 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 1285.74 0 0 0 0 0 0 1285.74 0 0 1011335968 1922559673 16 Nurse Practitioners OVERCASH MEGAN 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 23.76 0 0 0 0 0 0 23.76 0 0 1011336011 1982932711 89 Physician Assistant Only(Encounter Only) FRITCHER ANNE M 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 0 176 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 5661.47 0 0 0 0 0 0 5661.47 0 0 1011336016 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 0 132 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 15526.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15526.35 0 0 1011336585 1518426220 16 Nurse Practitioners COLEMAN DAVID C. 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 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 2154.84 0 0 0 0 0 0 2154.84 0 0 1011336776 1578913943 10 Physicians DAO ANTHONY T 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 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 0 356.58 0 0 0 0 0 0 356.58 0 0 1011336834 1477020345 16 Nurse Practitioners HALL MARVA 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 0 195 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 3312.41 0 0 0 0 0 0 3312.41 0 0 1011336955 1437666294 16 Nurse Practitioners NICHOLS JOHN R. 999999999 24 Coles 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 0 172 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 3446.09 0 0 0 0 0 0 3446.09 0 0 1011337161 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13151.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13151.63 0 0 1011337456 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 804.71 0 0 0 0 0 0 0 0 0 0 0 0 0 804.71 0 0 1011337471 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.09 0 0 0 0 0 0 61.09 0 0 1011337764 1649560079 10 Physicians RAHMANDAR MARIA 999999999 200 Cook 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 28 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 28 0 0 0 0 0 0 0 0 0 153.73 0 0 0 0 0 0 9.87 0 1562.39 0 0 0 0 0 0 1725.99 0 0 1011338220 1982048435 10 Physicians KOCHANEK MALGORZATA 999999999 200 Cook 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 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6719.55 0 0 0 0 0 0 6719.55 0 0 1011338572 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 7725.56 0 0 0 0 0 0 0 0 0 0 0 0 0 7725.56 0 0 1011339122 1871095109 16 Nurse Practitioners THOMAS ELMIRA 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 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 0 654.81 0 0 0 0 0 0 654.81 0 0 1011339262 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 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 0 119.16 0 0 0 0 0 0 119.16 0 0 1011339374 4011339374 90 Waiver service provider--Elderly (DOA) GOODHOPE HEALTHCARE AND HOME H 999999999 71 McHenry 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82408.95 0 0 0 0 0 0 0 0 0 0 0 0 0 82408.95 0 0 1011339381 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16990.83 0 0 0 0 0 0 0 0 0 0 0 0 0 16990.83 0 0 1011339425 1528579372 16 Nurse Practitioners STAMPS CRYSTAL J 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 1202.15 0 0 0 0 0 0 1202.15 0 0 1011339483 1467992651 30 General Hospitals FRESENIUS KIDNEY CARE EVERGREE 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19253.9 0 0 0 0 0 19253.9 0 0 1011340101 1962959296 46 Ambulatory Surgical Treatment Centers RUSH COPLEY SURGICENTER 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1068.92 0 0 0 0 0 1068.92 0 0 1011340348 1659787893 10 Physicians KANITSCH STEPHANIE M 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 29 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1481.16 0 7417.59 0 0 0 0 0 0 8898.75 0 0 1011340357 4011340357 91 Waiver service provider--Adults (DHS/DDD) ETHERIDGE STEPHANY 999999999 91 Sangamon 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29990.18 0 0 0 0 0 0 0 0 0 0 0 0 0 29990.18 0 0 1011340752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8632.21 0 0 0 0 0 0 0 0 0 0 0 0 0 8632.21 0 0 1011340792 1952690182 10 Physicians OCHOA CHRISTOPHER D 999999999 200 Cook 0 0 Internal Medicine 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 0 297 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 3654.18 0 0 0 0 0 0 3654.18 0 0 1011340931 1619464336 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 47 Jackson 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 0 223.07 0 0 0 0 0 0 0 0 223.07 0 0 1011341171 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 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 0 124.54 0 0 0 0 0 0 124.54 0 0 1011341194 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33526.69 0 0 0 0 0 0 0 0 0 0 0 0 0 33526.69 0 0 1011341200 1760896633 10 Physicians AKHTAR ZOHAIB 999999999 47 Jackson 0 0 Internal Medicine 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 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4770.4 0 0 0 0 0 0 4770.4 0 0 1011341736 1376080788 24 Speech Therapists POMIJE NATALIE J 999999999 30 DuPage 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26625.44 26625.44 0 0 1011341872 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12450.27 0 0 0 0 0 0 0 0 0 0 0 0 0 12450.27 0 0 1011342013 1982012621 10 Physicians SAGI JAHNAVI 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 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 0 450.8 0 0 0 0 0 0 450.8 0 0 1011342309 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 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 33821.38 0 0 0 0 0 0 0 0 0 0 0 0 0 33821.38 0 0 1011342658 16 Nurse Practitioners 19 Champaign 0 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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 0 258 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 18955 0 0 0 0 0 0 18955 0 0 1011343977 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 0 126 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 5959.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5959.8 0 0 1011344023 1528449014 10 Physicians CUI MICHAEL X 999999999 200 Cook 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 0 256 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 1408.18 0 0 0 0 0 0 1408.18 0 0 1011344033 1306208517 10 Physicians GANDHI KUMAR RAJESH 999999999 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 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 2765.45 0 0 0 0 0 0 2765.45 0 0 1011344112 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 0 172 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 17347.82 0 0 0 0 0 0 0 0 0 0 0 0 0 17347.82 0 0 1011344248 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 74.87 0 0 0 0 0 0 74.87 0 0 1011344708 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22678.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22678.35 0 0 1011344748 1295710580 30 General Hospitals MACNEAL HOSPITAL 604023429 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 2 0 0 0 2123 0 0 0 0 880 0 0 0 1921 0 0 0 0 0 2 0 0 0 2756 0 0 0 0 999 0 0 0 4216 0 0 0 0 0 2 0 0 0 2760 0 0 0 0 4465 0 0 0 4684 0 0 0 0 0 2.69 0 0 0 527686.42 0 0 0 0 2508451.2 0 0 0 540832.16 0 0 0 0 0 3576972.47 0 0 1011344808 1326380841 10 Physicians DONNAN MICHAEL D 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 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 0 594.14 0 0 0 0 0 0 594.14 0 0 1011344924 1619447745 89 Physician Assistant Only(Encounter Only) HAGER MIRA E 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 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 0 445.04 0 0 0 0 0 0 445.04 0 0 1011344978 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4477 0 0 0 0 0 0 0 0 0 0 0 0 0 4477 0 0 1011345006 1326590860 16 Nurse Practitioners ANASKI DONNA R 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 0 379.24 0 0 0 0 0 0 379.24 0 0 1011345138 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22429.12 0 0 0 0 0 0 0 0 0 0 0 0 0 22429.12 0 0 1011345171 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 667.48 0 0 0 0 0 0 0 0 0 0 0 0 0 667.48 0 0 1011345251 1477997369 10 Physicians HOLADAY CLINTON 999999999 80 Peoria 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 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 3968.4 0 0 0 0 0 0 3968.4 0 0 1011345276 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 7399.53 0 0 0 0 0 0 0 0 0 0 0 0 0 7399.53 0 0 1011345650 1467891317 10 Physicians RANA SHALINI 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771.53 0 0 0 0 0 0 771.53 0 0 1011346196 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1059.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1059.48 0 0 1011346623 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3354.93 0 0 0 0 0 0 0 0 0 0 0 0 0 3354.93 0 0 1011346625 1194015503 10 Physicians SZAFRAN APRIL A 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1289.19 0 0 0 0 0 0 1289.19 0 0 1011346908 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 0 0 0 0 0 0 0 0 0 0 1011347738 1730529132 10 Physicians VIJ AVIRAL 999999999 200 Cook 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 0 115 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 0 314.01 0 0 0 0 0 0 314.01 0 0 1011347786 1649778382 63 Other Providers of Medical Equipment/Supplies (Non-registered) BOSTON ORTHOTICS & PROSTHETICS 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 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 8316.84 0 0 0 0 8316.84 0 0 1011347828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5580.35 0 0 0 0 0 0 0 0 0 0 0 0 0 5580.35 0 0 1011347856 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 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 90.73 0 0 0 0 0 0 90.73 0 0 1011348015 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 64.23 0 0 0 0 0 0 64.23 0 0 1011348675 12 Optometrists 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 14 0 0 1011348918 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11990.29 0 0 0 0 0 0 0 0 0 0 0 0 0 11990.29 0 0 1011349282 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 0 319.8 0 0 0 0 0 0 0 0 0 0 0 0 0 319.8 0 0 1011349363 1063831956 10 Physicians SHAH NILAY S 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 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 0 361.93 0 0 0 0 0 0 361.93 0 0 1011349418 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12547.77 0 0 0 0 0 0 0 0 0 0 0 0 0 12547.77 0 0 1011349426 1578975421 13 Podiatrists SANCHEZ PATRICK JOHN 606313222 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 0 310 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 1488.37 0 0 0 0 0 0 1488.37 0 0 1011349825 1891231577 22 Physical Therapists RUMPZA JUSTIN 999999999 89 Rock Island 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 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 0 652.51 652.51 0 0 1011350403 12 Optometrists 27 Dekalb 0 0 0 0 0 0 0 0 0 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 95.61 0 0 0 0 0 0 95.61 0 0 1011350484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14347.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14347.53 0 0 1011350486 55 Early Intervention Services 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 1196.48 0 0 0 0 0 0 1196.48 0 0 1011350573 1528517406 87 Psychologist(Encounter Only) BRADLEY LAUREN 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 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 0 225.91 0 0 0 0 0 0 225.91 0 0 1011350598 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15524.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15524.18 0 0 1011350605 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24930.72 0 0 0 0 0 0 0 0 0 0 0 0 0 24930.72 0 0 1011350641 1457766602 10 Physicians SOLIZ MAY 999999999 200 Cook 0 0 0 0 0 12 0 0 0 0 0 0 2 0 79 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 3 0 164 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 3 0 164 0 0 0 0 0 0 0 0 0 980.11 0 0 0 0 0 0 12.52 0 1506.42 0 0 0 0 0 0 2499.05 0 0 1011350691 1518995299 10 Physicians DAVIS JAMES A 999999999 51 Jo Daviess 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.99 0 0 0 0 0 0 130.99 0 0 1011350791 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22405.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22405.35 0 0 1011350801 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23726.86 0 0 0 0 0 0 0 0 0 0 0 0 0 23726.86 0 0 1011350924 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12018.92 0 0 0 0 0 0 0 0 0 0 0 0 0 12018.92 0 0 1011351013 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 23951.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23951.95 0 0 1011351111 1861756371 10 Physicians MATROVA ELZA GUEORGUIEVA 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 21 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 0 125.4 0 0 0 0 0 0 0 0 125.4 0 0 1011351172 1063940823 89 Physician Assistant Only(Encounter Only) BLANEY DANIEL 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 87.19 0 0 0 0 0 0 87.19 0 0 1011351578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12551.45 0 0 0 0 0 0 0 0 0 0 0 0 0 12551.45 0 0 1011351691 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 0 0 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 6625.96 0 0 0 0 0 0 0 0 0 0 0 0 0 6625.96 0 0 1011352239 1538676424 16 Nurse Practitioners PARKHE AMIT 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 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 80.99 0 0 0 0 0 0 80.99 0 0 1011352260 1316443625 16 Nurse Practitioners BOWLES WHITNEY 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 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 1441.7 0 0 0 0 0 0 1441.7 0 0 1011352363 1710418223 10 Physicians KAKUMANU RUTH CHRISTINA 999999999 200 Cook 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 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 5027.09 0 0 0 0 0 0 5027.09 0 0 1011352665 1922448976 10 Physicians BESMER SHERRI 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679.56 0 0 0 0 0 0 0 0 679.56 0 0 1011352875 1780991133 12 Optometrists ALUMBAUGH KIMBERLY D 624540658 25 Crawford 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 41 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579.94 0 413.37 0 0 0 0 993.31 0 0 1011352992 4011352992 10 Physicians PINEDA JOWELLA R 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 213.4 0 0 0 0 0 0 213.4 0 0 1011353007 1053823534 23 Occupational Therapists PROBST BROOKE 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 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 885.74 885.74 0 0 1011353034 1396734430 10 Physicians VRLA ROLF F 999999999 815 Indiana 0 0 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 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759.72 0 21.07 0 0 0 0 0 0 780.79 0 0 1011353226 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 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 12.12 0 0 0 0 0 0 12.12 0 0 1011353866 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 6084.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6084.79 0 0 1011353897 1497103030 86 Clinical Social Worker(Encounter Only) RAMSEY ROBYN 999999999 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 977.01 0 0 0 0 0 0 977.01 0 0 1011353907 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25291.73 0 0 0 0 0 0 0 0 0 0 0 0 0 25291.73 0 0 1011354061 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27341.3 0 0 0 0 0 0 0 0 0 0 0 0 0 27341.3 0 0 1011354429 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32752.78 0 0 0 0 0 0 0 0 0 0 0 0 0 32752.78 0 0 1011354494 1205323763 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.22 0 0 0 0 0 0 0 0 130.22 0 0 1011354513 1568978013 11 Dentists GOYAL RINKLE 999999999 107 Will 0 0 0 0 109 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 12569.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12569.92 0 0 1011354892 1598207375 16 Nurse Practitioners VARUGHESE SHENCY 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 9 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 154.71 0 0 0 0 0 0 0 0 357.3 0 0 0 0 0 0 512.01 0 0 1011355515 1265792469 10 Physicians QUYYUM ASIF 999999999 80 Peoria 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 0 125 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 4532.81 0 0 0 0 0 0 4532.81 0 0 1011355518 1144709569 16 Nurse Practitioners RYNEARSON JAMIE R 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 33 0 0 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RICHARD ADAMS 999999999 200 Cook 0 0 Emergency Medicine 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 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2864.4 0 0 0 0 0 0 2864.4 0 0 1011385808 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1011386072 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 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 3036.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3036.22 0 0 1011388169 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12128.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12128.6 0 0 1011395961 1396867685 10 Physicians USANETASHVILI NINO 999999999 200 Cook 0 0 Internal Medicine 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 0 297 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 4707.7 0 0 0 0 0 0 4707.7 0 0 1011396429 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.03 0 0 0 0 0 0 3.03 0 0 1011401829 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11110.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11110.1 0 0 1011404450 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 160.59 160.59 0 0 1011411570 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 9262.88 0 0 0 0 0 0 0 0 0 0 0 0 0 9262.88 0 0 1011411604 1104274968 10 Physicians REGAN JOHN E 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 0 200 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 3853.05 0 0 0 0 0 0 3853.05 0 0 1011416164 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 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 1718.56 1718.56 0 0 1011418216 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 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 0 251.26 251.26 0 0 1011422684 1427291210 10 Physicians AHMED AISHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 17727.88 0 0 0 0 0 0 0 0 0 0 0 0 0 17727.88 0 0 1011435600 1699233825 86 Clinical Social Worker(Encounter Only) MARESKI HOLLY 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 0 213 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 11887.97 0 0 0 0 0 0 11887.97 0 0 1011437390 1154984979 16 Nurse Practitioners SLEDGE JENNIFER R 999999999 19 Champaign 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 0 258 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 7491.96 0 0 0 0 0 0 7491.96 0 0 1011440529 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 0 126 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 10419.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10419.2 0 0 1011441129 1124585716 22 Physical Therapists BROWN LINSEY 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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 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 0 379.5 0 0 0 0 0 0 379.5 0 0 1011464641 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.83 0 0 0 0 0 0 23.83 0 0 1011472055 4011472055 72 Taxicabs and Livery Companies HIGHMIND MEDICAL SUPPORT INCOR 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 1494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12975.53 0 0 0 0 0 0 12975.53 0 0 1011474726 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 0 107.74 0 0 0 0 0 0 107.74 0 0 1011475215 1992839872 100 Family Support Program WOODWARD ACADEMY 999999999 816 Iowa 0 0 0 10 0 0 0 0 0 0 0 0 0 0 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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 0 448.42 0 0 0 0 0 0 448.42 0 0 1011490823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19482.1 0 0 0 0 0 0 0 0 0 0 0 0 0 19482.1 0 0 1011491574 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 26712.97 0 0 0 0 0 0 0 0 0 0 0 0 0 26712.97 0 0 1011497866 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15315.3 0 0 0 0 0 0 0 0 0 0 0 0 0 15315.3 0 0 1011498565 1255895546 16 Nurse Practitioners CUMMINGS REBECCA 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 28 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 754.97 0 0 0 0 0 0 787.12 0 0 1011498645 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17391.11 0 0 0 0 0 0 0 0 0 0 0 0 0 17391.11 0 0 1011500744 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 0 574.57 574.57 0 0 1011501757 1619434602 89 Physician Assistant Only(Encounter Only) PATEL ROSHNI K 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 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 0 434.97 0 0 0 0 0 0 434.97 0 0 1011506288 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 4860.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4860.02 0 0 1011506698 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9873.5 0 0 0 0 0 0 0 0 0 0 0 0 0 9873.5 0 0 1011506763 1508323197 22 Physical Therapists VOS REBECCA 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 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 0 766.41 766.41 0 0 1011509276 1053804443 48 Rural Health Clinics "SIU PHYSICIANS & SURGEONS, INC" 999999999 77 Morgan 0 0 0 36 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4787.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4787.9 0 0 1011510682 1194280313 23 Occupational Therapists CURRY KELSEY 999999999 97 Stephenson 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 0 306 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 24274.43 24274.43 0 0 1011512749 1003376856 70 Ambulance Service Providers CITY OF LOVES PARK 999999999 109 Winnebago 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 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320372.92 0 0 0 0 0 0 320372.92 0 0 1011514316 91 Waiver service provider--Adults (DHS/DDD) 92 Schuyler 0 0 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 1811.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1811.95 0 0 1011523557 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24500 0 0 0 0 0 0 0 0 0 0 0 0 0 24500 0 0 1011525226 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446.32 446.32 0 0 1011526431 1881179018 60 Pharmacies HEALTHFIRST PHARMACY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 55335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2305.57 0 0 35178.24 0 0 0 37483.81 0 0 1011527315 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18295.55 0 0 0 0 0 0 0 0 0 0 0 0 0 18295.55 0 0 1011530685 1053796383 89 Physician Assistant Only(Encounter Only) ZINTAK GRACE 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 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 0 499.31 0 0 0 0 0 0 499.31 0 0 1011533283 1629176789 10 Physicians BAUGHMAN STEVEN M 999999999 53 Kane 0 0 Urology 0 0 0 0 0 0 0 0 0 0 9 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.54 0 5013.62 0 0 0 0 0 0 5091.16 0 0 1011535252 1578029013 16 Nurse Practitioners PANEK MICHELLE K 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 0 101 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 0 547.93 0 0 0 0 0 0 547.93 0 0 1011535389 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 1011543155 1306372164 10 Physicians KOHLI NEHA 999999999 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 19 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 1415.33 0 0 0 0 0 0 1415.33 0 0 1011546245 1225415458 13 Podiatrists LANDERS SABRINA 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 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 0 191.14 0 0 0 0 0 0 191.14 0 0 1011550025 1275911067 10 Physicians HARARI ELIZABETH 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 5019.79 0 0 0 0 0 0 5019.79 0 0 1011550742 57 Home Nursing Agency 107 Will 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 678 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181213.64 10848 0 0 0 0 0 0 0 0 0 0 0 0 192061.64 0 0 1011550912 1861965873 16 Nurse Practitioners CARNES KATHRYN E 999999999 91 Sangamon 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 0 117 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 3579.78 0 0 0 0 0 0 3657.65 0 0 1011553221 1538722202 16 Nurse Practitioners DEVOUS KATHY S 999999999 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 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 0 126.02 0 0 0 0 0 0 126.02 0 0 1011557968 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.4 0 0 0 0 0 0 0 0 0 0 0 0 0 260.4 0 0 1011559574 1922560481 16 Nurse Practitioners HARRISON ALYSSA S 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 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3647.1 0 0 0 0 0 0 3647.1 0 0 1011560326 1841515137 10 Physicians DEEN ZAHRA 999999999 30 DuPage 0 0 Internal Medicine 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 0 778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7759.07 0 0 0 0 0 0 7759.07 0 0 1011563672 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 47.62 0 0 0 0 0 0 47.62 0 0 1011564186 1245720820 61 Independent Laboratories DAVITA LABS 999999999 810 Florida 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 5171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54700.3 0 0 0 0 0 0 0 0 54700.3 0 0 1011570840 1346803103 16 Nurse Practitioners DINH JANIE 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 0 104.39 0 0 0 0 0 0 104.39 0 0 1011571912 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22948.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22948.25 0 0 1011576338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2417.48 0 0 0 0 0 0 0 0 0 0 0 0 0 2417.48 0 0 1011580329 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 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 0 102.27 0 0 0 0 0 0 102.27 0 0 1011580447 1841753043 16 Nurse Practitioners COUSINS KATI L 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 0 151.16 0 0 0 0 0 0 151.16 0 0 1011580759 1467895813 10 Physicians WELBEL RACHEL 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 234 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 8527.69 0 0 0 0 0 0 8527.69 0 0 1011581760 1053873232 23 Occupational Therapists WALLAERT CHELSEA L 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 0 105 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 7827.57 7827.57 0 0 1011583638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10449.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10449.5 0 0 1011584865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3235.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3235.6 0 0 1011586454 1982603098 10 Physicians UJAYLI ALAA 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 0 112 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 1732.62 0 0 0 0 0 0 1732.62 0 0 1011587174 1346542289 89 Physician Assistant Only(Encounter Only) SODAGAR MARINA 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 0 130 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 1835.05 0 0 0 0 0 0 1835.05 0 0 1011587919 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11639.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11639.23 0 0 1011588284 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22979.7 0 0 0 0 0 0 0 0 0 0 0 0 0 22979.7 0 0 1011600178 1376958215 10 Physicians FOONG KAP SUM 999999999 80 Peoria 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 0 146 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 3828.94 0 0 0 0 0 0 3828.94 0 0 1011600262 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26931.96 0 0 0 0 0 0 0 0 0 0 0 0 0 26931.96 0 0 1011600492 1487124707 40 Federally Qualified Health Centers ESPERANZA HEALTH CENTERS 999999999 200 Cook 0 0 0 1932 0 535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9199 0 1346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9199 0 1346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589243.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589243.67 0 0 1011601255 1760941132 16 Nurse Practitioners BOERSMA SARAH 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 0 117 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 1347.25 0 0 0 0 0 0 1347.25 0 0 1011604135 12 Optometrists 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 1011611305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7963.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7963.64 0 0 1011616551 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28262.48 0 0 0 0 0 0 0 0 0 0 0 0 0 28262.48 0 0 1011620105 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4023.15 0 0 0 0 0 0 0 0 0 0 0 0 0 4023.15 0 0 1011623888 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 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 0 182.82 0 0 0 0 0 0 182.82 0 0 1011626678 1093274912 16 Nurse Practitioners CRABTREE ALICIA J 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 636.27 0 0 0 0 0 0 636.27 0 0 1011628846 1578027918 89 Physician Assistant Only(Encounter Only) HAZLETT RICHARD A 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 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 0 653.84 0 0 0 0 0 0 653.84 0 0 1011629711 1295121358 10 Physicians DYMALA ANNA M 999999999 80 Peoria 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 14 0 74 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 17 0 156 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 17 0 156 0 0 0 0 0 0 0 0 0 199.15 0 0 0 0 0 0 56.17 0 1523.63 0 0 0 0 0 0 1778.95 0 0 1011630404 1699245662 60 Pharmacies CVS PHARMACY #10889 999999999 107 Will 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 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14866.86 0 0 0 14866.86 0 0 1011631999 1679991160 10 Physicians HEIBER GABRIEL J 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 0 137 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 2314 0 0 0 0 0 0 2314 0 0 1011647775 1427365501 10 Physicians PUNJ SHWETA 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 0 150 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 0 833.82 0 0 0 0 0 0 833.82 0 0 1011647925 1336267749 10 Physicians ROMANO-KEELER JOANN 999999999 200 Cook 0 0 Pediatrics 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 0 103 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 35685.78 0 0 0 0 0 0 35685.78 0 0 1011661113 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 0 369.5 0 0 0 0 0 0 369.5 0 0 1011662725 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 23190.02 0 0 0 0 0 0 0 0 0 0 0 0 0 23190.02 0 0 1011664656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2950.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2950.7 0 0 1011666012 1083065262 10 Physicians LOGAN MICHAEL P 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 0 104 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 4038.62 0 0 0 0 0 0 4038.62 0 0 1011671390 1285192385 16 Nurse Practitioners WINNER KATHERINE M 999999999 91 Sangamon 0 0 0 0 0 5 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 400.79 0 0 0 0 0 0 0 0 1159.86 0 0 0 0 0 0 1560.65 0 0 1011671755 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.27 0 0 0 0 0 0 0 0 0 0 0 0 0 233.27 0 0 1011673957 1780146225 55 Early Intervention Services BEDARD JESSICA A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 12040.53 0 0 0 0 0 0 12040.53 0 0 1011675840 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28591.62 0 0 0 0 0 0 0 0 0 0 0 0 0 28591.62 0 0 1011678139 1265985576 16 Nurse Practitioners CLIFTON RHONDA D 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 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 1478.86 0 0 0 0 0 0 1478.86 0 0 1011678854 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 47.77 0 0 0 0 0 0 47.77 0 0 1011681592 1538384409 10 Physicians KHAMIS LINA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 310.02 0 0 0 0 0 0 310.02 0 0 1011681808 1407246663 10 Physicians MACKEY ROSEWELL V 999999999 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 394 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3072.73 0 2303.44 0 0 0 0 0 0 5376.17 0 0 1011684749 1033524715 10 Physicians CEPEDA VICTOR H 999999999 47 Jackson 0 0 Internal Medicine 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 0 187 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 3420.18 0 0 0 0 0 0 3420.18 0 0 1011693147 24 Speech Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1311.57 1311.57 0 0 1011697464 1881153815 16 Nurse Practitioners ANZALONE TIFFANY 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 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 1117.08 0 0 0 0 0 0 1117.08 0 0 1011698132 1457916124 89 Physician Assistant Only(Encounter Only) NOVAK JACLYN 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 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 1946.74 0 0 0 0 0 0 1946.74 0 0 1011703315 1124513080 16 Nurse Practitioners BIESZCZAD MONICA L 999999999 200 Cook 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 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8209.22 0 0 0 0 0 0 8209.22 0 0 1011713469 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.25 0 0 0 0 0 0 53.25 0 0 1011713792 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48417.11 0 0 0 0 0 0 0 0 0 0 0 0 0 48417.11 0 0 1011714156 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 1011716811 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21205.38 0 0 0 0 0 0 0 0 0 0 0 0 0 21205.38 0 0 1011721506 1316408776 22 Physical Therapists DRENNAN JENNIFER A 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 0 879.77 879.77 0 0 1011724115 1912429051 16 Nurse Practitioners RIZZO ERIN L 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 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 13.68 0 0 0 0 0 0 13.68 0 0 1011724862 1386866853 10 Physicians KUMAR RAMAN 999999999 80 Peoria 0 0 Colon - Rectal Surgery 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3432.07 0 0 0 0 0 0 3432.07 0 0 1011725440 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1132.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.74 0 0 1011728627 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23704.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23704.8 0 0 1011733035 1336538982 10 Physicians HEIFERMAN MICHAEL 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 23 0 0 0 0 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 97.65 0 7794.35 0 0 0 0 0 0 7892 0 0 1011734281 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 16578.87 0 0 0 0 0 0 0 0 0 0 0 0 0 16578.87 0 0 1011739593 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22189.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22189.64 0 0 1011740083 1922575752 33 Nursing Facilities SOUTH HOLLAND MANOR HLTH REHAB 999999999 200 Cook 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 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 712652.04 0 0 0 0 0 0 0 712652.04 0 0 1011740665 1619222502 10 Physicians JOHANNS TANNER M 631600352 53 Kane 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 0 160 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 24905.49 0 0 0 0 0 0 24905.49 0 0 1011742076 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 0 129.34 129.34 0 0 1011746281 1801165436 16 Nurse Practitioners GIESE SHERYL 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 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 2556.14 0 0 0 0 0 0 2556.14 0 0 1011746597 1790247476 40 Federally Qualified Health Centers PRIMECARE BELMONT CRAGIN 999999999 200 Cook 0 0 0 562 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2329 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2329 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152674.78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152674.78 0 0 1011747150 1619092095 89 Physician Assistant Only(Encounter Only) LADENDORF KEITH 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 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 0 299.8 0 0 0 0 0 0 299.8 0 0 1011747821 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.7 0 0 0 0 0 0 194.7 0 0 1011750887 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 0 175.8 0 0 0 0 0 0 175.8 0 0 1011753359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15903.93 0 0 0 0 0 0 0 0 0 0 0 0 0 15903.93 0 0 1011763255 1295297737 16 Nurse Practitioners BESSER TASHA R 999999999 80 Peoria 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 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 0 808.66 0 0 0 0 0 0 808.66 0 0 1011765487 1750460481 89 Physician Assistant Only(Encounter Only) ANDERSON CLARK 999999999 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 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 0 508.86 0 0 0 0 0 0 508.86 0 0 1011773691 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 1011774854 1790349967 16 Nurse Practitioners GEBKE BRANDON M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 1847.9 0 0 0 0 0 0 1847.9 0 0 1011775485 1962945014 10 Physicians BATLEY NICHOLAS J 999999999 200 Cook 0 0 Emergency 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 0 285.62 0 0 0 0 0 0 285.62 0 0 1011776838 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23137.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23137.48 0 0 1011777028 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33998.4 0 0 0 0 0 0 0 0 0 0 0 0 0 33998.4 0 0 1011778526 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2664.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2664.7 0 0 1011779746 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.09 0 0 0 0 0 0 0 0 0 0 0 0 0 163.09 0 0 1011782849 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18587.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18587.8 0 0 1011783270 1629519061 10 Physicians PEIGH GRAHAM SPENCER 999999999 53 Kane 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 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 0 664.11 0 0 0 0 0 0 664.11 0 0 1011797150 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4657.75 0 0 0 0 0 0 0 0 0 0 0 0 0 4657.75 0 0 1011798730 1356904320 21 Licensed Practical Nurses PATEL FALGUNI 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 0 154 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 7545.22 0 0 0 0 0 0 7545.22 0 0 1011801308 1437385069 63 Other Providers of Medical Equipment/Supplies (Non-registered) COUNTRYWIDE MEDICAL 999999999 845 Texas 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 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6793.65 0 0 0 0 0 0 6793.65 0 0 1011801575 1750795696 10 Physicians THAKKAR JIGISHA 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 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 1117.73 0 0 0 0 0 0 1117.73 0 0 1011807276 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22167.23 0 0 0 0 0 0 0 0 0 0 0 0 0 22167.23 0 0 1011809060 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12840.85 0 0 0 0 0 0 0 0 0 0 0 0 0 12840.85 0 0 1011810453 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.22 0 0 0 0 0 0 0 0 0 0 0 0 0 92.22 0 0 1011812792 1144888173 91 Waiver service provider--Adults (DHS/DDD) MONTOYA MARTIN 999999999 91 Sangamon 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 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15084.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15084.18 0 0 1011814214 1902463557 91 Waiver service provider--Adults (DHS/DDD) GAODE ERIC BENJAMIN 999999999 200 Cook 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 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28184.66 0 0 0 0 0 0 0 0 0 0 0 0 0 28184.66 0 0 1011814650 1497258693 30 General Hospitals DIALYSIS CARE CENTER BEVERLY L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41076.04 0 0 0 0 0 41076.04 0 0 1011814981 1447713144 88 Other behavior health professional NESSLER LAURA 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 0 318.58 0 0 0 0 0 0 318.58 0 0 1011822155 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 1627.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1627.93 0 0 1011823162 1962968495 91 Waiver service provider--Adults (DHS/DDD) MARSH ERIN M 999999999 91 Sangamon 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70084.34 0 0 0 0 0 0 0 0 0 0 0 0 0 70084.34 0 0 1011823287 1487115374 33 Nursing Facilities SPRING CREEK 999999999 107 Will 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 0 277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 881560.84 0 0 0 0 0 0 0 881560.84 0 0 1011826618 16 Nurse Practitioners 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 0 0 0 0 0 0 0 0 0 0 1011829316 1326548678 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528.86 0 0 0 0 0 0 0 0 528.86 0 0 1011832874 1295951903 10 Physicians CRAWFORD JAMILA M 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 10 0 0 0 0 0 0 28 0 51 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 57 0 109 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 57 0 109 0 0 0 0 0 0 0 0 0 439.01 0 0 0 0 0 0 1822.82 0 5399.31 0 0 0 0 0 0 7661.14 0 0 1011849654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1825.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1825.56 0 0 1011850341 1235273574 89 Physician Assistant Only(Encounter Only) SVYMBERSKY ALESIA A 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 0 0 0 0 0 0 0 0 0 0 1011850608 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11869.13 0 0 0 0 0 0 0 0 0 0 0 0 0 11869.13 0 0 1011850617 1790248110 16 Nurse Practitioners STONE AMANDA R 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 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 8267.93 0 0 0 0 0 0 8267.93 0 0 1011850995 1689115032 10 Physicians SONI GAURISH A 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 657.22 0 0 0 0 0 0 657.22 0 0 1011854233 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22747.19 0 0 0 0 0 0 0 0 0 0 0 0 0 22747.19 0 0 1011854427 1578038022 60 Pharmacies PRESCRIPTIONS PLUS 999999999 852 Wisconsin 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 2343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33816.82 0 0 0 33816.82 0 0 1011855730 22 Physical Therapists 109 Winnebago 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 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 0 329.82 329.82 0 0 1011856245 1548445927 10 Physicians GANDEV GEORGE N 999999999 53 Kane 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 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 0 216.9 0 0 0 0 0 0 216.9 0 0 1011857072 1629414420 10 Physicians MOROZOV PAVEL 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 103 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.49 0 218.12 0 0 0 0 0 0 2301.61 0 0 1011857903 1760958813 48 Rural Health Clinics UNITYPOINT CLINIC FAMILY MEDIC 999999999 80 Peoria 0 0 0 87 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9496.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9496.95 0 0 1011858123 1417431248 16 Nurse Practitioners ODENWALD STEPHANIE 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 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 0 583.98 0 0 0 0 0 0 583.98 0 0 1011858853 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18665.02 0 0 0 0 0 0 0 0 0 0 0 0 0 18665.02 0 0 1011860752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24409.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24409.4 0 0 1011874398 1609348895 60 Pharmacies LINCOLN PHARMACY 999999999 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 3630 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.91 0 0 0 1203.91 0 0 1011876856 1215279898 10 Physicians JIVAN ARIF 999999999 200 Cook 0 0 Internal 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 0 271 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 4564.26 0 0 0 0 0 0 4564.26 0 0 1011879537 1659854198 16 Nurse Practitioners PHILIPS KEZIA 999999999 30 DuPage 0 0 0 0 0 10 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 854.16 0 0 0 0 0 0 0 0 2751.03 0 0 0 0 0 0 3605.19 0 0 1011881120 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 2990.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2990.19 0 0 1011888382 1811239312 10 Physicians SHORT RYAN G 999999999 200 Cook 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 0 179 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 1841.81 0 0 0 0 0 0 0 0 1841.81 0 0 1011889585 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 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 2824.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2824.58 0 0 1011890197 1588174007 11 Dentists BABBAR VIBHA 999999999 57 Lake 0 0 0 0 68 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 12071.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12071.37 0 0 1011895352 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1011896007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6611.28 0 0 0 0 0 0 0 0 0 0 0 0 0 6611.28 0 0 1011900438 1184129124 91 Waiver service provider--Adults (DHS/DDD) AUBRECHT WHITNEY 999999999 91 Sangamon 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 0 983 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 75126 0 0 0 0 0 0 0 0 0 0 0 0 0 75126 0 0 1011900922 1467949594 16 Nurse Practitioners ALMORES HAZEL H 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 0 310.85 0 0 0 0 0 0 310.85 0 0 1011901066 1780180851 16 Nurse Practitioners WHEELER SOFIA 999999999 109 Winnebago 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 793.39 0 0 0 0 0 0 793.39 0 0 1011903774 1124380332 10 Physicians BAUMANN ALEXANDRA 999999999 200 Cook 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 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 3101.23 0 0 0 0 0 0 3101.23 0 0 1011906705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 131.93 0 0 0 0 0 0 0 0 0 0 0 0 0 131.93 0 0 1011907009 1174080758 22 Physical Therapists BUSCH JENNIFER 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 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 3696.16 3696.16 0 0 1011907475 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 24046.17 0 0 0 0 0 0 0 0 0 0 0 0 0 24046.17 0 0 1011909329 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24615.36 0 0 0 0 0 0 0 0 0 0 0 0 0 24615.36 0 0 1011911158 1548587900 10 Physicians BACKUS JONATHON DAVID 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 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 1213.3 0 0 0 0 0 0 1213.3 0 0 1011918441 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16943.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16943.18 0 0 1011920697 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2753.71 0 0 0 0 0 0 0 0 0 0 0 0 0 2753.71 0 0 1011921313 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1011925159 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1258.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1258.05 0 0 1011932561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 267.64 0 0 0 0 0 0 0 0 0 0 0 0 0 267.64 0 0 1011932864 1003201880 10 Physicians LAIDIG JOHANNA 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 0 927.57 0 0 0 0 0 0 927.57 0 0 1011936858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.68 0 0 0 0 0 0 0 0 0 0 0 0 0 97.68 0 0 1011937880 1083178198 22 Physical Therapists LIDAYWA VICTOR E 999999999 70 McDonough 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 0 234 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 2607.71 2607.71 0 0 1011939744 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7920.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7920.5 0 0 1011953621 1457604704 86 Clinical Social Worker(Encounter Only) KNOX STACI M 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 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 1211.52 0 0 0 0 0 0 1211.52 0 0 1011962553 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24885.99 0 0 0 0 0 0 0 0 0 0 0 0 0 24885.99 0 0 1011967187 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37199.38 0 0 0 0 0 0 0 0 0 0 0 0 0 37199.38 0 0 1011969925 1659861912 16 Nurse Practitioners KANALEY KERRY 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 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 0 295.51 0 0 0 0 0 0 295.51 0 0 1011972546 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19184.6 0 0 0 0 0 0 0 0 0 0 0 0 0 19184.6 0 0 1011974009 100 Family Support Program 200 Cook 0 0 0 4 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 1410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526999.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526999.16 0 0 1011978477 1477852028 10 Physicians DE GUZMAN MARGRET D 999999999 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 2 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.63 0 4824.63 0 0 0 0 0 0 4836.26 0 0 1011978618 1528000114 89 Physician Assistant Only(Encounter Only) MESSMER TANIA M. 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 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 0 133.7 0 0 0 0 0 0 133.7 0 0 1011979378 1396159091 10 Physicians HERMELIN DANIELA M 999999999 80 Peoria 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 0 638 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 2530.39 0 0 0 0 0 0 0 0 2530.39 0 0 1011981124 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1197 0 0 0 0 0 0 0 0 0 0 0 0 0 1197 0 0 1011982861 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20402.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20402.95 0 0 1011983962 1952759755 10 Physicians BAIDOO KEVIN 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 13 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.3 0 493.69 0 0 0 0 0 0 684.99 0 0 1011984340 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20510.59 0 0 0 0 0 0 0 0 0 0 0 0 0 20510.59 0 0 1011986416 1881073013 10 Physicians TERAMOTO KYLA 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 14 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.12 0 1904.36 0 0 0 0 0 0 1911.48 0 0 1011989647 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5131.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5131.91 0 0 1011993774 1336395888 10 Physicians PULVER TANYA 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 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 1309.72 0 0 0 0 0 0 1309.72 0 0 1011999347 1366861130 10 Physicians WEI PENG-PENG F 999999999 91 Sangamon 0 0 Emergency 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 0 317.2 0 0 0 0 0 0 317.2 0 0 1012003915 1154795011 89 Physician Assistant Only(Encounter Only) FIEDLER AUSTIN R 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 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 0 255.92 0 0 0 0 0 0 255.92 0 0 1012005164 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13186.58 0 0 0 0 0 0 0 0 0 0 0 0 0 13186.58 0 0 1012007101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.8 0 0 0 0 0 0 0 0 0 0 0 0 0 104.8 0 0 1012013068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23712.34 0 0 0 0 0 0 0 0 0 0 0 0 0 23712.34 0 0 1012013788 1619107554 10 Physicians PATEL TEJAS 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 0 286 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 2471.53 0 0 0 0 0 0 2471.53 0 0 1012016417 1407358559 16 Nurse Practitioners PAUL LAUREN 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 0 216 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 7639.17 0 0 0 0 0 0 7639.17 0 0 1012017310 60 Pharmacies 805 California 0 0 0 0 0 0 0 0 0 0 0 0 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 1012019552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21573.81 0 0 0 0 0 0 0 0 0 0 0 0 0 21573.81 0 0 1012022855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3874.39 0 0 0 0 0 0 0 0 0 0 0 0 0 3874.39 0 0 1012029547 63 Other Providers of Medical Equipment/Supplies (Non-registered) 60 Lee 0 0 0 0 0 0 0 0 0 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 16.31 0 0 0 0 0 0 16.31 0 0 1012033477 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 0 0 0 0 0 0 0 0 0 0 1012035753 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14791.79 0 0 0 0 0 0 0 0 0 0 0 0 0 14791.79 0 0 1012035921 1427400852 10 Physicians MWANSA HUNTER 999999999 80 Peoria 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 0 280 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 2912.93 0 0 0 0 0 0 2912.93 0 0 1012036598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2602.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2602.28 0 0 1012039203 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 0 113.25 0 0 0 0 0 0 113.25 0 0 1012039462 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 0 127.31 0 0 0 0 0 0 127.31 0 0 1012046640 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 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 1012058351 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20181 0 0 0 0 0 0 0 0 0 0 0 0 0 20181 0 0 1012063902 88 Other behavior health professional 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 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 85.05 0 0 0 0 0 0 85.05 0 0 1012065558 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13324.13 0 0 0 0 0 0 0 0 0 0 0 0 0 13324.13 0 0 1012076594 1396087912 10 Physicians DONNAN ERICA N 999999999 200 Cook 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 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 1712.23 0 0 0 0 0 0 1712.23 0 0 1012077506 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.7 0 0 0 0 0 0 107.7 0 0 1012079945 89 Physician Assistant Only(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145.73 0 0 0 0 0 0 145.73 0 0 1012081792 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3044.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3044.85 0 0 1012082123 1417374604 10 Physicians DAVIS ANDREW 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 0 242 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 74696.13 0 0 0 0 0 0 74696.13 0 0 1012088389 1689023897 10 Physicians SIDDIQUI HISHAM M 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 0 211 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 1911.06 0 0 0 0 0 0 1911.06 0 0 1012089408 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16947.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16947.7 0 0 1012093174 21 Licensed Practical Nurses 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 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 1012098593 1821438607 10 Physicians NEPUTE JORDAN C 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 44 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395.78 0 2.54 0 0 0 0 0 0 398.32 0 0 1012101262 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 0 100 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 0 600.21 600.21 0 0 1012104285 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26120.91 0 0 0 0 0 0 0 0 0 0 0 0 0 26120.91 0 0 1012105512 10 Physicians 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 4.4 0 0 0 0 0 0 4.4 0 0 1012107995 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21074.31 0 0 0 0 0 0 0 0 0 0 0 0 0 21074.31 0 0 1012108772 1104212265 10 Physicians GHOPRIAL MAGED A 999999999 80 Peoria 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 8 0 67 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 156 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.13 0 3371.2 0 0 0 0 0 0 3382.33 0 0 1012113022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8242.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8242.55 0 0 1012116090 1598232910 89 Physician Assistant Only(Encounter Only) IVAN BRADLEY 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 0 108 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 0 239.23 0 0 0 0 0 0 239.23 0 0 1012116098 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 0 213.24 0 0 0 0 0 0 0 0 0 0 0 0 0 213.24 0 0 1012118211 89 Physician Assistant Only(Encounter Only) 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 0.64 0 0 0 0 0 0 0.64 0 0 1012118770 1891073102 89 Physician Assistant Only(Encounter Only) GARDNER-WOOD MICHELLE A 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 0 191 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 1337.37 0 0 0 0 0 0 1337.37 0 0 1012125629 1275824930 89 Physician Assistant Only(Encounter Only) PROKOP THOMAS 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1012126156 1699238220 16 Nurse Practitioners O''REILLY LISA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 118 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 32.15 0 0 0 0 0 0 0 0 3380.85 0 0 0 0 0 0 3413 0 0 1012127788 1033520804 10 Physicians ZARLING RACHEL P 999999999 200 Cook 0 0 Emergency Medicine 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 4033.05 0 0 0 0 0 0 4062.53 0 0 1012134660 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 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 1483.4 1483.4 0 0 1012135880 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20103.49 0 0 0 0 0 0 0 0 0 0 0 0 0 20103.49 0 0 1012138597 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 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8443.98 0 0 8443.98 0 0 1012143236 1508217662 10 Physicians LORENZ MITCHELL D 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 0 168 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 5955.14 0 0 0 0 0 0 5955.14 0 0 1012144640 1073178513 91 Waiver service provider--Adults (DHS/DDD) PENRY HANNAH R 999999999 200 Cook 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 1649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146348.14 0 0 0 0 0 0 0 0 0 0 0 0 0 146348.14 0 0 1012146470 1174086516 16 Nurse Practitioners STRAPPELLI JENNY A 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 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 0 598.55 0 0 0 0 0 0 598.55 0 0 1012148031 1750854212 75 Department of Alcohol and Substance Abuse Provider "FAMILY GUIDANCE CENTERS, INC." 999999999 200 Cook 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 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60711.83 0 0 60711.83 0 0 1012149908 1659834018 16 Nurse Practitioners HERMEZ DALAL 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 0 331.39 0 0 0 0 0 0 331.39 0 0 1012152917 1912463324 10 Physicians SHEOLAL RAVITHA 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1746.36 0 0 0 0 0 0 1746.36 0 0 1012153415 1902229784 10 Physicians NAMANA VINOD 999999999 200 Cook 0 0 Internal Medicine 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 2 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5802.84 0 0 0 0 0 0 5802.84 0 0 1012170917 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 31406.1 0 0 0 0 0 0 0 0 0 0 0 0 0 31406.1 0 0 1012170957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.51 0 0 0 0 0 0 0 0 0 0 0 0 0 248.51 0 0 1012175770 1396250346 16 Nurse Practitioners GAVRILOS TERRAH K 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 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 0 578.12 0 0 0 0 0 0 578.12 0 0 1012178710 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1732.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1732.91 0 0 1012188990 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 256.18 0 0 0 0 0 0 0 0 0 0 0 0 0 256.18 0 0 1012190137 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 12535.49 0 0 0 0 0 0 0 0 0 0 0 0 0 12535.49 0 0 1012193779 1871717231 22 Physical Therapists BORAWSKI ALICIA R 999999999 96 St Clair 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 0 317 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 2877.1 2877.1 0 0 1012194265 1770147738 16 Nurse Practitioners DECHOW EMILY L 999999999 80 Peoria 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 0 141 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 0 470.99 0 0 0 0 0 0 470.99 0 0 1012195377 4012195377 90 Waiver service provider--Elderly (DOA) "DESTINY HEALTHCARE SERVICE, IN" 999999999 200 Cook 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 4385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4385 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473464.68 0 0 0 0 0 0 0 0 0 0 0 0 0 473464.68 0 0 1012201015 1376020479 31 Psychiatric Hospitals SILVER OAKS BEHAVIORAL HOSPITA 999999999 107 Will 0 0 0 59 0 0 0 0 0 0 0 126 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 1674 0 0 0 0 0 0 0 0 0 0 88204.45 0 0 0 0 0 0 0 118840.81 0 0 0 0 0 0 0 0 0 207045.26 0 0 1012201679 1679969091 10 Physicians MUSGRAVES KRISTOPHER M 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 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 2430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2684.53 0 0 0 0 0 0 2684.53 0 0 1012204213 10 Physicians 35 Ford 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 78.09 0 0 0 0 0 0 78.09 0 0 1012205478 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23785.08 0 0 0 0 0 0 0 0 0 0 0 0 0 23785.08 0 0 1012207114 1962840868 10 Physicians RICHARD JAMIE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 244 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2855.39 0 3106.12 0 0 0 0 0 0 5961.51 0 0 1012211601 1235792045 16 Nurse Practitioners BARRETT MICHELLE A 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A 999999999 80 Peoria 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 0 151 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 2973.36 0 0 0 0 0 0 2973.36 0 0 1012222766 1376024026 11 Dentists RAHMAN MOMINA 999999999 200 Cook 0 0 General Dentistry 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503 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 12332.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12332.16 0 0 1012222914 1962961375 89 Physician Assistant Only(Encounter Only) WILLIS HANNAN 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 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 1042.28 0 0 0 0 0 0 1042.28 0 0 1012226445 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 31.01 0 0 0 0 0 0 31.01 0 0 1012229445 100 Family Support Program 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0 0 0 0 0 0 0 0 0 0 9 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 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48349.9 0 0 0 0 0 48349.9 0 0 1012272551 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 27695.85 0 0 0 0 0 0 0 0 0 0 0 0 0 27695.85 0 0 1012279388 1164949350 89 Physician Assistant Only(Encounter Only) LISBOA LIVIA 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 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 0 332.02 0 0 0 0 0 0 332.02 0 0 1012281123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27892.78 0 0 0 0 0 0 0 0 0 0 0 0 0 27892.78 0 0 1012281785 1851631592 10 Physicians KASIK CONNOR 999999999 58 La Salle 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 43 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451.52 0 5631.54 0 0 0 0 0 0 6083.06 0 0 1012282315 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18986.88 0 0 0 0 0 0 0 0 0 0 0 0 0 18986.88 0 0 1012282499 1477914158 16 Nurse Practitioners TURNER LISA A 999999999 57 Lake 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 0 541 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 1008.38 0 0 0 0 0 0 1008.38 0 0 1012282892 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18210.52 0 0 0 0 0 0 0 0 0 0 0 0 0 18210.52 0 0 1012282897 1083144562 10 Physicians POTKONJAK MARY 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 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 0 395.72 0 0 0 0 0 0 395.72 0 0 1012283639 1144885542 16 Nurse Practitioners WINTERS JENNA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 1469.64 0 0 0 0 0 0 1469.64 0 0 1012285425 1578040275 48 Rural Health Clinics OSF MEDICAL GROUP - GALVA 999999999 45 Henry 0 0 0 132 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14070.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14070.12 0 0 1012286263 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 24.32 0 0 0 0 0 0 24.32 0 0 1012287512 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.8 0 0 0 0 0 0 88.8 0 0 1012287552 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 19.99 0 0 0 0 0 0 19.99 0 0 1012287885 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 31.21 0 0 0 0 0 0 31.21 0 0 1012288237 1730747999 16 Nurse Practitioners MENDOZA ANA MARIA 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 3916.45 0 0 0 0 0 0 3916.45 0 0 1012288456 1528487972 10 Physicians LARSON DANIELLE N 999999999 200 Cook 0 0 Neurology 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 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 1323.25 0 0 0 0 0 0 1323.25 0 0 1012289146 1306105051 86 Clinical Social Worker(Encounter Only) HENRICHS JACQUELINE 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 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 0 701.06 0 0 0 0 0 0 701.06 0 0 1012289495 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 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43504.17 0 0 0 0 0 0 0 0 0 0 0 0 0 43504.17 0 0 1012291231 1427391515 10 Physicians RAMGOPAL SRIRAM 999999999 200 Cook 0 0 Pediatrics 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 3541.88 0 0 0 0 0 0 3541.88 0 0 1012291861 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 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 0 750.71 0 0 0 0 0 0 750.71 0 0 1012293804 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 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 0 350.25 350.25 0 0 1012294004 1982117768 30 General Hospitals FRESENIUS KIDNEY CARE WOODRIDG 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 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 0 595.73 0 0 0 0 0 595.73 0 0 1012295426 1679801856 10 Physicians GAIT PRIYANKA 999999999 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 25 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 2956.98 0 0 0 0 0 0 2956.98 0 0 1012296460 1093022873 10 Physicians POKORNEY RYAN T 999999999 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 12 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.87 0 1136.62 0 0 0 0 0 0 1318.49 0 0 1012296957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3577.61 0 0 0 0 0 0 0 0 0 0 0 0 0 3577.61 0 0 1012297400 1801359039 16 Nurse Practitioners PATEL RACHANA 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 0 143 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 3448.45 0 0 0 0 0 0 3448.45 0 0 1012298675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2572.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2572.2 0 0 1012298953 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 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580.45 0 0 0 0 0 0 580.45 0 0 1012358687 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.27 0 0 0 0 0 0 20.27 0 0 1012358878 1467855973 10 Physicians SALEM DHAFER 999999999 102 Warren 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 1056.17 0 0 0 0 0 0 1056.17 0 0 1012364427 1740795194 16 Nurse Practitioners ZIMMERMAN MEGAN 999999999 47 Jackson 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 0 109 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 0 895.51 0 0 0 0 0 0 895.51 0 0 1012365714 1265594485 70 Ambulance Service Providers NORTH SCOTT COUNTY AMBULANCE D 999999999 826 Missouri 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 0 110 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 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0 6493.68 0 0 0 0 0 0 871.23 0 5711.73 0 0 0 0 0 0 13076.64 0 0 1012366945 4012366945 90 Waiver service provider--Elderly (DOA) "SERENITY HOME HEALTH CARE, INC" 999999999 200 Cook 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 14079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1334496.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1334496.15 0 0 1012368292 1043796428 11 Dentists JORGENSEN ERIN 999999999 200 Cook 0 0 General Dentistry 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 0 910.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 910.46 0 0 1012368962 1780022897 10 Physicians PATEL RONAK V 999999999 200 Cook 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 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 1250.2 0 0 0 0 0 0 1250.2 0 0 1012369250 1912413915 55 Early Intervention Services WORSTELL ANDREA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 10549.75 0 0 0 0 0 0 10549.75 0 0 1012370967 1578923561 16 Nurse Practitioners CHYBOWSKA KINGA 999999999 200 Cook 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 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 0 959.09 0 0 0 0 0 0 959.09 0 0 1012371341 1881185650 22 Physical Therapists WAEHNER KAITLYN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 706 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 706 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55967.48 55967.48 0 0 1012372452 1629497870 10 Physicians WYMER DAVID T 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 355 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6847.56 0 76.65 0 0 0 0 0 0 6924.21 0 0 1012373386 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20313.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20313.16 0 0 1012373435 1134787559 12 Optometrists GREGG GRETA 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 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 1334.73 0 0 0 0 0 0 1334.73 0 0 1012374002 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 13698.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13698.9 0 0 1012374523 1568818128 10 Physicians BUKHARI USAMA 999999999 24 Coles 0 0 Internal Medicine 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 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.98 0 0 0 0 0 0 2901.98 0 0 1012375384 1063856342 10 Physicians KOPEC GRETCHEN L 999999999 200 Cook 0 0 Pediatrics 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 0 176 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 53964.25 0 0 0 0 0 0 53964.25 0 0 1012375735 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 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 23.93 0 0 0 0 0 0 23.93 0 0 1012375831 1497220743 16 Nurse Practitioners DANIELS KENISHA L 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 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 0 781.33 0 0 0 0 0 0 781.33 0 0 1012377155 1962974527 65 Independent Diagnostic Testing Facility (IDTF) "PRIME MEDICAL IMAGING, LLC" 999999999 107 Will 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 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 2272.96 0 0 0 0 0 0 0 0 2272.96 0 0 1012380256 1841751831 16 Nurse Practitioners WHITNEY BETHANY A 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 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 0 601.18 0 0 0 0 0 0 601.18 0 0 1012381082 1710437470 10 Physicians SHAKUNTULLA FNU 999999999 80 Peoria 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 0 735.6 0 0 0 0 0 0 735.6 0 0 1012382941 1518299940 16 Nurse Practitioners HEAD DAVID G 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.74 0 0 0 0 0 0 186.74 0 0 1012383371 1437438249 10 Physicians AEDMA KAPIL K 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 0 119 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 6517.71 0 0 0 0 0 0 6517.71 0 0 1012383440 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6044.89 0 0 0 0 0 0 0 0 0 0 0 0 0 6044.89 0 0 1012386490 1225599889 16 Nurse Practitioners PHEASANT JEREME C 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 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 2033.68 0 0 0 0 0 0 2033.68 0 0 1012386831 1548282916 10 Physicians COLAVITO STEFANIE A 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 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 1509.91 0 0 0 0 0 0 1509.91 0 0 1012387170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30641.93 0 0 0 0 0 0 0 0 0 0 0 0 0 30641.93 0 0 1012389320 1972894046 89 Physician Assistant Only(Encounter Only) OSBORNE LAUREN R 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 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 0 729.68 0 0 0 0 0 0 729.68 0 0 1012389609 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 0 0 0 0 0 0 0 0 0 0 1012389756 1649664129 10 Physicians SIECK ERIN G 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.83 0 578.9 0 0 0 0 0 0 632.73 0 0 1012390282 1639564446 10 Physicians DAJANI OMAR 999999999 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.4 0 2320.54 0 0 0 0 0 0 2330.94 0 0 1012390669 1770002099 16 Nurse Practitioners NATANAUAN KATRINA L 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 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 0 533.04 0 0 0 0 0 0 533.04 0 0 1012391755 1578941753 10 Physicians HORNIK JONATAN 999999999 47 Jackson 0 0 Neurology 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 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 0 861.31 0 0 0 0 0 0 861.31 0 0 1012392408 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23448.91 0 0 0 0 0 0 0 0 0 0 0 0 0 23448.91 0 0 1012392796 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1784.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1784.55 0 0 1012393098 1962969881 10 Physicians MUNRO MONIQUE P 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 50 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 96.37 0 11528.66 0 0 0 0 0 0 11625.03 0 0 1012393245 30 General Hospitals 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7185.68 0 0 0 0 0 0 0 0 0 7185.68 0 0 1012394604 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 0 0 0 0 0 0 0 0 0 0 1012395765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17203.61 0 0 0 0 0 0 0 0 0 0 0 0 0 17203.61 0 0 1012399369 1982269379 16 Nurse Practitioners KUNKEL JESSICA M 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 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 1345.05 0 0 0 0 0 0 1345.05 0 0 1012401237 1639630965 16 Nurse Practitioners BEDENKO ANNABELLE SUE 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 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 1201.3 0 0 0 0 0 0 1201.3 0 0 1012401494 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 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 6768.85 0 0 0 0 0 0 0 0 0 0 0 0 0 6768.85 0 0 1012401618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14505.48 0 0 0 0 0 0 0 0 0 0 0 0 0 14505.48 0 0 1012401626 1619531340 16 Nurse Practitioners ANDREWS TORY 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 934.61 0 0 0 0 0 0 934.61 0 0 1012402665 1689238644 33 Nursing Facilities "ALLURE OF PROPHETSTOWN, LLC" 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301459.28 0 0 0 0 0 0 0 301459.28 0 0 1012403051 1336240696 10 Physicians MAGEE MICHAEL D 999999999 50 Jersey 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 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 0 631.17 0 0 0 0 0 0 631.17 0 0 1012403919 1679969737 10 Physicians BING VICKI ZHU JUN 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1903.22 0 0 0 0 0 0 1903.22 0 0 1012403973 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15341.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15341.9 0 0 1012405266 1902255656 10 Physicians SHAH NISHITH 999999999 53 Kane 0 0 0 0 0 7 0 0 0 0 0 0 2 0 93 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 3 0 207 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 3 0 207 0 0 0 0 0 0 0 0 0 505.9 0 0 0 0 0 0 22.4 0 3326.06 0 0 0 0 0 0 3854.36 0 0 1012406597 1770008567 16 Nurse Practitioners THIELAN COURTNEY 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 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 43.54 0 0 0 0 0 0 43.54 0 0 1012407111 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 2560.04 0 139.56 0 0 0 0 0 0 2699.6 0 0 1012436441 1255758363 10 Physicians BISSING DAVID J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 0 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 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2006.33 0 0 0 0 0 0 2006.33 0 0 1012436969 1689179228 11 Dentists SLEZAK NICOLE 999999999 200 Cook 0 0 General Dentistry 0 0 124 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 12257.03 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 14891.48 0 0 1012437818 10 Physicians 10 Adams 0 0 0 0 0 0 0 0 0 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 0 389.82 0 0 0 0 0 0 389.82 0 0 1012440095 1306149554 16 Nurse Practitioners SPRAYBERRY MATTHEW D 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 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 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MOHAMMED SYED 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 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 0 574.11 0 0 0 0 0 0 574.11 0 0 1012445221 1356737076 10 Physicians BOBLICK KEVIN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 5 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 588.42 0 0 0 0 0 0 0 0 2862.59 0 0 0 0 0 0 3451.01 0 0 1012447316 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 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 7395.12 0 0 0 0 0 0 0 0 0 0 0 0 0 7395.12 0 0 1012447731 1548728256 16 Nurse Practitioners REXROAD TESSA 999999999 19 Champaign 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 0 134 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 3361.58 0 0 0 0 0 0 3361.58 0 0 1012448845 1285082743 10 Physicians ALI HAROON M 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 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 4856.84 0 0 0 0 0 0 4856.84 0 0 1012450792 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 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 5893.35 0 0 0 0 0 0 0 0 0 0 0 0 0 5893.35 0 0 1012451275 1255726048 10 Physicians KADELA KATARZYNA 999999999 30 DuPage 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 0 176 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 1633.64 0 0 0 0 0 0 1633.64 0 0 1012451513 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 0 0 0 0 1012451916 1538510656 13 Podiatrists STATKUS RIMVYDAS P 999999999 71 McHenry 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 0 273 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 1503.57 0 0 0 0 0 0 1503.57 0 0 1012452075 1548616857 10 Physicians KIMES MICHAEL 999999999 200 Cook 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 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 1023.92 0 0 0 0 0 0 1023.92 0 0 1012452554 1982947727 10 Physicians SHAH ARPAN S 999999999 91 Sangamon 0 0 Internal Medicine 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 0 221 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 10221.64 0 0 0 0 0 0 10221.64 0 0 1012453234 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2888.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2888.99 0 0 1012453246 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24973.52 0 0 0 0 0 0 0 0 0 0 0 0 0 24973.52 0 0 1012453511 1144740820 10 Physicians ZHAO DIANA 999999999 24 Coles 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 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 0 584.13 0 0 0 0 0 0 584.13 0 0 1012454721 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 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 2850.45 0 0 0 0 0 0 2850.45 0 0 1012455898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2973.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2973.67 0 0 1012456136 1770936692 10 Physicians DEVASENATHIPATHY BAVITHIRA 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 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 0 144.07 0 0 0 0 0 0 144.07 0 0 1012456470 1063869113 10 Physicians KON NJEWEL IRIS C 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 0 128 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 3571.67 0 0 0 0 0 0 3571.67 0 0 1012459295 1972983377 10 Physicians YOUNG DANIEL J 999999999 80 Peoria 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586.98 0 0 0 0 0 0 586.98 0 0 1012459315 1164878781 10 Physicians LUKOSE JAIRUS J 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 0 174 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 2358.57 0 0 0 0 0 0 2358.57 0 0 1012460045 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 5 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 7846.12 7846.12 0 0 1012460225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22049.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22049.25 0 0 1012460460 1023499050 10 Physicians KLUK MARK 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 0 249 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 3114.29 0 0 0 0 0 0 3114.29 0 0 1012461244 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15875.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15875.7 0 0 1012461413 1043654734 10 Physicians MONTOYA CASSANDRA 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 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 12107.32 0 0 0 0 0 0 12107.32 0 0 1012461677 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2255.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2255.18 0 0 1012461692 1396294336 16 Nurse Practitioners MCGEE JESSICA M 999999999 19 Champaign 0 0 0 0 0 70 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 2636.3 0 0 0 0 0 0 0 0 1877.5 0 0 0 0 0 0 4513.8 0 0 1012462189 1932763992 33 Nursing Facilities "ALLURE OF GENESEO, LLC" 999999999 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 2073 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 4026.3 0 552.29 0 0 0 0 0 0 4578.59 0 0 1012469106 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 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 1012472562 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1543.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1543.61 0 0 1012474612 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 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 0 597.76 597.76 0 0 1012475215 10 Physicians 90 Saline 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012475476 1043792641 16 Nurse Practitioners KLOCKE MALLORY M 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 0 308 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 49549.62 0 0 0 0 0 0 49549.62 0 0 1012475734 1417308867 10 Physicians TAHA AHMED AA 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 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 0 594.65 0 0 0 0 0 0 594.65 0 0 1012476632 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 0 111.58 0 0 0 0 0 0 111.58 0 0 1012476756 1467865295 10 Physicians SHAH USHMA 999999999 200 Cook 0 0 Internal Medicine 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 0 396 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 9503.23 0 0 0 0 0 0 9503.23 0 0 1012477200 1689163503 60 Pharmacies "MILLENIUM PHARMACY, LTD." 999999999 200 Cook 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 0 482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240678.53 0 0 0 240678.53 0 0 1012477970 1891112355 10 Physicians PHILLIPS MITCHELL 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 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 6847.51 0 0 0 0 0 0 6847.51 0 0 1012478025 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 0 162 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 12895.21 0 0 0 0 0 0 0 0 0 0 0 0 0 12895.21 0 0 1012478434 1376106674 89 Physician Assistant Only(Encounter Only) PATEL JASMINE 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 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 0 216.52 0 0 0 0 0 0 216.52 0 0 1012478761 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 23.46 0 0 0 0 0 0 23.46 0 0 1012479107 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12566.33 0 0 0 0 0 0 0 0 0 0 0 0 0 12566.33 0 0 1012480756 1215457429 10 Physicians KUNZ KYLE T 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 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 1582.14 0 0 0 0 0 0 1582.14 0 0 1012481647 1588848709 10 Physicians GAINES TYEESE 999999999 19 Champaign 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 79.72 0 0 0 0 0 0 79.72 0 0 1012483560 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 520.8 0 0 0 0 0 0 0 0 0 0 0 0 0 520.8 0 0 1012484540 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16563.28 0 0 0 0 0 0 0 0 0 0 0 0 0 16563.28 0 0 1012485967 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 70.87 0 0 0 0 0 0 70.87 0 0 1012487865 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 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 0 109.26 0 0 0 0 0 0 109.26 0 0 1012487980 16 Nurse Practitioners 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 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 0 440.82 0 0 0 0 0 0 440.82 0 0 1012488020 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23744.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23744.6 0 0 1012488182 1285085902 10 Physicians STERNBERG EVAN 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 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 0 272.6 0 0 0 0 0 0 272.6 0 0 1012488201 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012490710 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 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 35714.93 0 0 0 0 0 0 0 0 0 0 0 0 0 35714.93 0 0 1012491698 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3476.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3476.64 0 0 1012492118 1194073015 10 Physicians VARMA ANKUR 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 0 107 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 0 380.92 0 0 0 0 0 0 380.92 0 0 1012492818 1033761234 86 Clinical Social Worker(Encounter Only) SMITH ASHLEY M 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 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 1463.27 0 0 0 0 0 0 1463.27 0 0 1012492898 1821544776 10 Physicians SALEEM SALIHA 999999999 91 Sangamon 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 0 335 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 4841.24 0 0 0 0 0 0 4841.24 0 0 1012493823 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 14874.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14874.68 0 0 1012494028 1669971115 89 Physician Assistant Only(Encounter Only) BERGER MOLLY A 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 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 1162.39 0 0 0 0 0 0 1162.39 0 0 1012495227 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5958.48 0 0 0 0 0 0 0 0 0 0 0 0 0 5958.48 0 0 1012495736 1093367104 89 Physician Assistant Only(Encounter Only) HERBOTH SHARLINA D 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 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 1130.5 0 0 0 0 0 0 1130.5 0 0 1012497934 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15101.64 0 0 0 0 0 0 0 0 0 0 0 0 0 15101.64 0 0 1012498793 1801139670 10 Physicians PATEL VIVEK 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 402 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6622.86 0 707.74 0 0 0 0 0 0 7330.6 0 0 1012499409 1033694922 16 Nurse Practitioners OKORIE HELEN E 999999999 200 Cook 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 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5647.76 0 0 0 0 0 0 5647.76 0 0 1012500213 1750843199 16 Nurse Practitioners BERRYMAN ELIZABETH M 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 0 149 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 3165.32 0 0 0 0 0 0 3165.32 0 0 1012501957 1508325457 16 Nurse Practitioners BARNEWOLT EMILY L 999999999 80 Peoria 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 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 3113.95 0 0 0 0 0 0 3113.95 0 0 1012502903 1154982254 10 Physicians CHAMBERLAIN LUCAS 999999999 97 Stephenson 0 0 Family 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 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 1012504053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15523.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15523.6 0 0 1012504376 1891938619 89 Physician Assistant Only(Encounter Only) KHATOON FAHMIDA 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 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 81.59 0 0 0 0 0 0 81.59 0 0 1012504945 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 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 23.46 0 0 0 0 0 0 23.46 0 0 1012506892 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5359.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5359.68 0 0 1012508918 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 662.49 0 0 0 0 0 0 0 0 0 0 0 0 0 662.49 0 0 1012510698 1386612000 10 Physicians CHANG BARRY 999999999 19 Champaign 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016.02 0 0 0 0 0 0 1016.02 0 0 1012511608 1558834572 60 Pharmacies WALGREEN CO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 2724 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2416.13 0 0 0 2416.13 0 0 1012511818 1407206188 10 Physicians FAUCHER JOSHUA J 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 0 187 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 3561.36 0 0 0 0 0 0 3561.36 0 0 1012515188 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23801.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23801.36 0 0 1012515337 10 Physicians 30 DuPage 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 1077.94 0 0 0 0 0 0 1077.94 0 0 1012516149 10 Physicians 47 Jackson 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 69.17 0 0 0 0 0 0 69.17 0 0 1012516215 1124554209 10 Physicians LEWIS HAL 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 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 0 693.08 0 0 0 0 0 0 693.08 0 0 1012516734 1699122986 10 Physicians PATEL ANISH 999999999 30 DuPage 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 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 1106.69 0 0 0 0 0 0 1106.69 0 0 1012518250 1497313852 12 Optometrists PEREIRA CHRISTOPHER T 999999999 200 Cook 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 8 0 1 0 0 0 0 0 0 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 17.96 0 29.28 0 0 0 0 47.24 0 0 1012519787 70 Ambulance Service Providers 852 Wisconsin 0 0 0 0 0 0 0 0 0 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 0 278.31 0 0 0 0 0 0 278.31 0 0 1012521718 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2420.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2420.01 0 0 1012521968 1194105080 10 Physicians MARTINEZ-COSTA HELEN KRISTINA 999999999 200 Cook 0 0 Obstetric-Gynecology 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 3182.6 0 0 0 0 0 0 3185.2 0 0 1012522277 1366898983 10 Physicians BURNS BRITTANY E 999999999 200 Cook 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 0 239 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 6913.16 0 0 0 0 0 0 6913.16 0 0 1012522438 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 0 175.38 0 0 0 0 0 0 175.38 0 0 1012523191 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 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 0 358.76 358.76 0 0 1012524039 10 Physicians 200 Cook 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 1 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 1012525359 1417339375 10 Physicians HANNON CHARLES 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 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 0 168.08 0 0 0 0 0 0 168.08 0 0 1012526604 1699257105 16 Nurse Practitioners PATEL POOJA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295 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 4507.19 0 0 0 0 0 0 4507.19 0 0 1012526807 1376905034 10 Physicians JUMIC STEPHEN J 999999999 30 DuPage 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 0 269 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 2899.01 0 0 0 0 0 0 2899.01 0 0 1012528013 1508986308 10 Physicians GOLDSTEIN COREY 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 414 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.67 0 5211.95 0 0 0 0 0 0 5264.62 0 0 1012529367 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 1012531223 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1599.32 1599.32 0 0 1012531745 24 Speech Therapists 89 Rock Island 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 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 1532.82 1532.82 0 0 1012532476 1073950390 10 Physicians BERGER DANIEL 999999999 200 Cook 0 0 Internal Medicine 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 0 272 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 14159.92 0 0 0 0 0 0 14159.92 0 0 1012533291 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19709.73 0 0 0 0 0 0 0 0 0 0 0 0 0 19709.73 0 0 1012534523 1821448663 10 Physicians CHANG KEVIN M 999999999 80 Peoria 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 0 266 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 9193.97 0 0 0 0 0 0 9193.97 0 0 1012535216 10 Physicians 200 Cook 0 0 Pediatrics 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 23 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.14 0 1807.93 0 0 0 0 0 0 1858.07 0 0 1012535874 1467695361 10 Physicians PATIL KAUSTUBHA D 999999999 200 Cook 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 0 263 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 4018.84 0 0 0 0 0 0 4018.84 0 0 1012538357 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4911.1 0 0 0 0 0 0 0 0 0 0 0 0 0 4911.1 0 0 1012540972 1881018927 16 Nurse Practitioners FEDERER LINDA 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 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 2456.12 0 0 0 0 0 0 2456.12 0 0 1012541356 1427358530 89 Physician Assistant Only(Encounter Only) FREDERICK LINDA 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 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 0 279.21 0 0 0 0 0 0 279.21 0 0 1012542988 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20953.52 0 0 0 0 0 0 0 0 0 0 0 0 0 20953.52 0 0 1012543958 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 4684.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4684.52 0 0 1012544026 60 Pharmacies 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.59 0 0 0 226.59 0 0 1012544275 1023580099 16 Nurse Practitioners NGO AMY 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 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 0 216.03 0 0 0 0 0 0 216.03 0 0 1012546750 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11214.76 0 0 0 0 0 0 0 0 0 0 0 0 0 11214.76 0 0 1012548100 1215384391 55 Early Intervention Services HAFT KATIE L 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 7842.18 0 0 0 0 0 0 7842.18 0 0 1012548783 1548799133 10 Physicians HUH ALEXANDER 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 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 0 399.93 0 0 0 0 0 0 399.93 0 0 1012548787 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1970.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1970.36 0 0 1012549355 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 467.96 0 0 0 0 0 0 0 0 0 0 0 0 0 467.96 0 0 1012552025 39 Hospice 109 Winnebago 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2960.27 0 0 0 0 0 0 0 0 0 0 0 2960.27 0 0 1012552338 1477904936 10 Physicians WING ELISA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 3 0 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.44 0 7744.37 0 0 0 0 0 0 7832.81 0 0 1012552767 1740755115 89 Physician Assistant Only(Encounter Only) SEROWKA KAREN E 999999999 60 Lee 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 0 134 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 7132.33 0 0 0 0 0 0 7132.33 0 0 1012554646 1932768983 16 Nurse Practitioners SANCHEZ BRIANNA 999999999 57 Lake 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 1400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4913.4 0 0 0 0 0 0 4913.4 0 0 1012555215 1447686415 10 Physicians MUBAYED LAMYA 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 0 118 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 6930.18 0 0 0 0 0 0 6930.18 0 0 1012555728 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 82.25 0 0 0 0 0 0 82.25 0 0 1012556295 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 3391.46 0 0 0 0 0 0 0 0 0 0 0 0 0 3391.46 0 0 1012557336 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 8051.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8051.55 0 0 1012558577 1114589561 23 Occupational Therapists ASSOULINE CATHERINE 999999999 91 Sangamon 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 0 177 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 12980.19 12980.19 0 0 1012559156 1225697956 86 Clinical Social Worker(Encounter Only) SANDERS JOSEPH 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 0 108 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 1025.82 0 0 0 0 0 0 1025.82 0 0 1012560985 1063071819 16 Nurse Practitioners ATOMORI ABIODUN J 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 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 0 447.31 0 0 0 0 0 0 447.31 0 0 1012561879 1841635869 10 Physicians KIME AARON 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 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 18809.67 0 0 0 0 0 0 18809.67 0 0 1012563154 1922479617 16 Nurse Practitioners LYNN CHRISTOPHER 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 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 0 427.78 0 0 0 0 0 0 427.78 0 0 1012563583 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 49.15 0 0 0 0 0 0 49.15 0 0 1012565834 1255794657 10 Physicians WALKER JACOB 999999999 30 DuPage 0 0 Internal Medicine 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 0 304 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 2082.83 0 0 0 0 0 0 2082.83 0 0 1012567158 1124557152 10 Physicians LEE-KIM JOSEPHINE 999999999 53 Kane 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 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 1627.22 0 0 0 0 0 0 1627.22 0 0 1012567517 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146.8 0 0 0 0 0 0 146.8 0 0 1012567655 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4986.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4986.66 0 0 1012568141 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24334.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24334.53 0 0 1012568843 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 0 0 0 0 0 0 0 0 0 0 1012569443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17641.59 0 0 0 0 0 0 0 0 0 0 0 0 0 17641.59 0 0 1012569687 1437504107 10 Physicians KHALAF HABEEB A 999999999 200 Cook 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 0 162 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 4166.19 0 0 0 0 0 0 4166.19 0 0 1012570207 1154756955 10 Physicians GUTOVICH JORDAN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355.96 0 0 0 0 0 0 0 0 355.96 0 0 1012571578 1639527138 10 Physicians KIM DAEWON 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8706.21 0 0 0 0 0 0 8706.21 0 0 1012573281 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 1012573772 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 0 178 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 17493.27 0 0 0 0 0 0 0 0 0 0 0 0 0 17493.27 0 0 1012575042 55 Early Intervention Services 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 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 1680.36 0 0 0 0 0 0 1680.36 0 0 1012575462 1205298213 13 Podiatrists WINDSOR NATHAN S 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 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 40.48 0 0 0 0 0 0 40.48 0 0 1012577366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 8974.05 0 0 0 0 0 0 0 0 0 0 0 0 0 8974.05 0 0 1012578471 1093975500 10 Physicians WALCOTT BRIAN PATRICK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 35 0 0 0 0 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 0.43 0 953.89 0 0 0 0 0 0 954.32 0 0 1012578698 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 340.72 0 0 0 0 0 0 0 0 0 0 0 0 0 340.72 0 0 1012578836 1770145690 91 Waiver service provider--Adults (DHS/DDD) WILLIS TAYLOR D 999999999 91 Sangamon 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121623.49 0 0 0 0 0 0 0 0 0 0 0 0 0 121623.49 0 0 1012580320 1093211823 74 Hospital-Based Transportation Providers LAKESIDE EMS LLC 999999999 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352762.25 0 0 0 0 0 0 352762.25 0 0 1012580338 1700127982 10 Physicians AREKAT MOHAMED A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 725 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4609.69 0 0 0 0 0 0 4609.69 0 0 1012580931 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6157.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6157.91 0 0 1012581236 1841557899 10 Physicians AGGARWAL MANISH 999999999 200 Cook 0 0 Pediatrics 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 2635.94 0 0 0 0 0 0 2635.94 0 0 1012583514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 208.34 0 0 0 0 0 0 0 0 0 0 0 0 0 208.34 0 0 1012584308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12728.77 0 0 0 0 0 0 0 0 0 0 0 0 0 12728.77 0 0 1012584819 4012584819 90 Waiver service provider--Elderly (DOA) "SERENITY HOME HEALTH CARE, INC" 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 1407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130450.32 0 0 0 0 0 0 0 0 0 0 0 0 0 130450.32 0 0 1012584843 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11334.95 0 0 0 0 0 0 0 0 0 0 0 0 0 11334.95 0 0 1012585654 1639699127 10 Physicians HILL EUGENE D 999999999 200 Cook 0 0 Emergency Medicine 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 0 263 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 11314.35 0 0 0 0 0 0 11314.35 0 0 1012585986 1336532993 10 Physicians GARG GAURANG 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 0 273.77 0 0 0 0 0 0 273.77 0 0 1012590469 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1145.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1145.76 0 0 1012591503 1962852327 10 Physicians THOMAS MELVIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8513.13 0 0 0 0 0 0 8513.13 0 0 1012592029 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48222.72 0 0 0 0 0 0 0 0 0 0 0 0 0 48222.72 0 0 1012594317 1598739617 10 Physicians ALI AMJAD 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 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 0 797.21 0 0 0 0 0 0 797.21 0 0 1012594797 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21632.81 0 0 0 0 0 0 0 0 0 0 0 0 0 21632.81 0 0 1012597394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3560.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3560.68 0 0 1012598667 1619468428 10 Physicians ZAKKO JENNIFER 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19947.69 0 0 1012607068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20956.73 0 0 0 0 0 0 0 0 0 0 0 0 0 20956.73 0 0 1012607084 1871960195 61 Independent Laboratories COORDINATED CARE HEALTH SOLUTI 999999999 837 Oklahoma 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2807.23 0 0 0 0 0 0 0 0 2807.23 0 0 1012609192 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.43 1156.43 0 0 1012609297 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 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 3268.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3268.21 0 0 1012611442 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 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 87.14 0 0 0 0 0 0 87.14 0 0 1012613737 1215252978 10 Physicians SEAGER CATHERINE 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 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 3592.51 0 0 0 0 0 0 3592.51 0 0 1012614681 1700280971 61 Independent Laboratories "PREMIER BIOTECH LABS, LLC" 999999999 824 Minnesota 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 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23302.17 0 0 0 0 0 0 0 0 23302.17 0 0 1012615199 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 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 0 206.33 0 0 0 0 0 0 206.33 0 0 1012619947 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.96 0 0 0 0 0 0 73.96 0 0 1012620976 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 22902.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22902.76 0 0 1012621337 10 Physicians 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 0 120.95 0 0 0 0 0 0 120.95 0 0 1012621562 1841751732 33 Nursing Facilities PARC JOLIET 999999999 107 Will 0 0 1 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 298 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 6826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637302.75 0 0 0 0 0 0 0 637302.75 0 0 1012622704 1871045716 16 Nurse Practitioners BURFORD JENNIFER M 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 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 1003.84 0 0 0 0 0 0 1003.84 0 0 1012623129 1184771172 10 Physicians KIM SAMUEL S 999999999 53 Kane 0 0 Thoracic 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 0 107 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 3735.94 0 0 0 0 0 0 3735.94 0 0 1012624230 86 Clinical Social Worker(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 0 158 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 0 424.47 0 0 0 0 0 0 424.47 0 0 1012624735 1003478942 16 Nurse Practitioners KIM MINWOO 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 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0 0 0 0 0 0 146.8 0 0 0 0 0 0 146.8 0 0 1012649443 1710148739 10 Physicians STAMS VICTOR E 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 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 9812.82 0 0 0 0 0 0 9812.82 0 0 1012650450 1730526500 10 Physicians WILSON PARKER C 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.24 0 0 0 0 0 0 0 0 255.24 0 0 1012653149 1942760962 16 Nurse Practitioners PROVAX DESIREE P 999999999 200 Cook 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 0 479 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 4270.3 0 0 0 0 0 0 4270.3 0 0 1012653668 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 3 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 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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 0 319 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 23402.82 0 0 0 0 0 0 0 0 0 0 0 0 0 23402.82 0 0 1012663523 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 17229.41 0 0 0 0 0 0 0 0 0 0 0 0 0 17229.41 0 0 1012664140 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 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 0 340.08 340.08 0 0 1012664436 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 61.76 0 0 0 0 0 0 61.76 0 0 1012664567 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1210.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1210.26 0 0 1012664662 1639597529 10 Physicians JAIN SUPRIYA 999999999 200 Cook 0 0 Radiation Oncology 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 0 211 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 5525.43 0 0 0 0 0 0 5525.43 0 0 1012669185 1679925531 10 Physicians SAKYI DENISE A 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 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7666.87 0 0 0 0 0 0 7666.87 0 0 1012670526 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.28 0 0 0 0 0 0 106.28 0 0 1012671301 1750321667 16 Nurse Practitioners PETERSEN GENEVA A 999999999 72 McLean 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 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 85.65 0 0 0 0 0 0 0 0 584.38 0 0 0 0 0 0 670.03 0 0 1012672887 1720406812 10 Physicians LEE RYAN S 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 0 175 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 0 741.02 0 0 0 0 0 0 741.02 0 0 1012673360 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 1059 0 0 0 0 0 0 0 0 0 0 0 0 0 1059 0 0 1012673924 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4491.27 0 0 0 0 0 0 0 0 0 0 0 0 0 4491.27 0 0 1012674172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16227.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16227.18 0 0 1012676072 1881048767 10 Physicians PALASH MICHAEL 999999999 200 Cook 0 0 0 0 0 14 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 1434.48 0 0 0 0 0 0 0 0 1410.2 0 0 0 0 0 0 2844.68 0 0 1012676621 1134579402 10 Physicians AHMED UMAIR 999999999 30 DuPage 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 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 0 108.68 0 0 0 0 0 0 108.68 0 0 1012678674 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377.58 0 0 0 0 0 0 0 0 0 0 0 0 0 377.58 0 0 1012678923 1912470568 60 Pharmacies HOMETOWN PHARMACY 999999999 87 Randolph 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 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5011.45 0 0 0 5011.45 0 0 1012679432 1881001089 10 Physicians VARNEY BRITTANY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 232 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2594.28 0 3137.37 0 0 0 0 0 0 5731.65 0 0 1012680119 1427242767 10 Physicians HUSSAIN MOHAMMAD 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 0 101 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 5831 0 0 0 0 0 0 5831 0 0 1012682228 1760725352 10 Physicians RAJPUT MOHAMED Z 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 142 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3612.89 0 34.25 0 0 0 0 0 0 3647.14 0 0 1012684579 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11809.44 0 0 0 0 0 0 0 0 0 0 0 0 0 11809.44 0 0 1012689079 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10425.83 0 0 0 0 0 0 0 0 0 0 0 0 0 10425.83 0 0 1012689761 1225551732 55 Early Intervention Services HERNANDEZ KRISTIEN A 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 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 4119.05 0 0 0 0 0 0 4119.05 0 0 1012690182 1275996118 10 Physicians ASHLEY NICOLE 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 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 0 917.98 0 0 0 0 0 0 917.98 0 0 1012690204 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 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 1359.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1359.26 0 0 1012690222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33301.46 0 0 0 0 0 0 0 0 0 0 0 0 0 33301.46 0 0 1012690674 1902469182 16 Nurse Practitioners SHERIDAN JANICE R 999999999 54 Kankakee 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 2784.27 0 0 0 0 0 0 2784.27 0 0 1012691756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1913.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1913.18 0 0 1012692083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22303.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22303.6 0 0 1012693454 89 Physician Assistant Only(Encounter Only) 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012694095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14462.18 0 0 0 0 0 0 0 0 0 0 0 0 0 14462.18 0 0 1012695509 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 44196.64 0 0 0 0 0 0 0 0 0 0 0 0 0 44196.64 0 0 1012696936 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 0 569 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 33084.64 0 0 0 0 0 0 0 0 0 0 0 0 0 33084.64 0 0 1012696965 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 1012697167 1588224927 22 Physical Therapists BOYLE ASHLEY M 999999999 91 Sangamon 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 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 1260.51 1260.51 0 0 1012698068 1679911549 10 Physicians BOZANICH NADIA 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 0 119 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 4804.64 0 0 0 0 0 0 4804.64 0 0 1012698147 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5672.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5672.9 0 0 1012698573 1316266976 10 Physicians TAKYI VALERIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.52 0 396.14 0 0 0 0 0 0 415.66 0 0 1012700651 1770830853 22 Physical Therapists KING KATHLEEN A 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 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 0 834.37 834.37 0 0 1012701963 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 31544.72 0 0 0 0 0 0 0 0 0 0 0 0 0 31544.72 0 0 1012702082 16 Nurse Practitioners 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012703075 10 Physicians 65 Madison 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 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 0 109.64 0 0 0 0 0 0 109.64 0 0 1012703619 1205364098 10 Physicians PRIFTI ERIDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.62 0 0 467.03 0 0 0 0 0 0 597.65 0 0 1012704558 1285016923 13 Podiatrists GETZ BENJAMIN 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 0 223 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 5585.34 0 0 0 0 0 0 5585.34 0 0 1012704920 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11886.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11886.25 0 0 1012705019 1154841286 10 Physicians AHMED ALI 999999999 200 Cook 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 0 128 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 1532.55 0 0 0 0 0 0 1532.55 0 0 1012707691 1952505638 10 Physicians JANSSEN ARON 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726.12 0 0 0 0 0 0 726.12 0 0 1012709011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10105.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10105.06 0 0 1012709128 1427132307 10 Physicians MANGARELLI CAREN 999999999 200 Cook 0 0 Pediatrics 0 0 0 34 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 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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 7122.15 0 0 0 0 0 0 7122.15 0 0 1012713785 22 Physical Therapists 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457.1 457.1 0 0 1012714820 1770894669 10 Physicians WOODSON IDELLE 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 2 0 0 0 0 0 0 1 0 94 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 216 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 216 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 5.22 0 3249.16 0 0 0 0 0 0 3340.03 0 0 1012715582 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28693.86 0 0 0 0 0 0 0 0 0 0 0 0 0 28693.86 0 0 1012718909 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 5774.31 0 0 0 0 0 0 0 0 0 0 0 0 0 5774.31 0 0 1012719077 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284.49 0 0 0 0 0 0 284.49 0 0 1012719354 10 Physicians 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 87.1 0 0 0 0 0 0 87.1 0 0 1012720904 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 1.6 0 0 0 0 0 0 1.6 0 0 1012722372 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 8339.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8339.76 0 0 1012723341 1689967234 10 Physicians SCHARLE ELIZABETH A 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.68 0 3418.93 0 0 0 0 0 0 3459.61 0 0 1012725381 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23207.22 0 0 0 0 0 0 0 0 0 0 0 0 0 23207.22 0 0 1012728678 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22306.5 0 0 0 0 0 0 0 0 0 0 0 0 0 22306.5 0 0 1012728739 1760910897 10 Physicians PARIKH TAPAN K 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3531.21 0 0 0 0 0 0 3531.21 0 0 1012729125 1831571926 10 Physicians NIXON KAYLA E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.13 0 355.64 0 0 0 0 0 0 419.77 0 0 1012729459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5400.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5400.62 0 0 1012729825 1326314246 10 Physicians PONTIKIS GEORGE 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.99 0 0 0 0 0 0 139.99 0 0 1012730244 1730743519 12 Optometrists BERRY ALYSSA 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 0 107 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 1378.55 0 0 0 0 0 0 1378.55 0 0 1012731657 1326076548 10 Physicians KIMBALL JASON P 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 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 0 542.39 0 0 0 0 0 0 542.39 0 0 1012732162 1952873127 16 Nurse Practitioners XU JANICE Q 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 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 1622.04 0 0 0 0 0 0 1622.04 0 0 1012733540 1811254691 10 Physicians SHAH ARPEET S 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 3 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4807.96 0 0 0 0 0 0 4807.96 0 0 1012734896 1326429937 10 Physicians POWERS SHANNON MARIE 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 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 0 641.98 0 0 0 0 0 0 641.98 0 0 1012735448 10 Physicians 200 Cook 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 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 0 285.32 0 0 0 0 0 0 285.32 0 0 1012736005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19953.56 0 0 0 0 0 0 0 0 0 0 0 0 0 19953.56 0 0 1012741304 1851730907 10 Physicians ALEX GILLIAN 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 3496.2 0 0 0 0 0 0 3496.2 0 0 1012742827 1801318050 23 Occupational Therapists BALDOCK MACKENZIE 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 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 2660.37 2660.37 0 0 1012743245 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 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 53.81 0 0 0 0 0 0 53.81 0 0 1012744545 1588072292 10 Physicians KHATRI VIDITA V 999999999 54 Kankakee 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 0 196 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 3284.81 0 0 0 0 0 0 3284.81 0 0 1012745324 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 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 3896.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3896.22 0 0 1012745821 1326521121 16 Nurse Practitioners CORSIGA GISELLE M 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 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 0 289.08 0 0 0 0 0 0 289.08 0 0 1012746942 16 Nurse Practitioners 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 31.01 0 0 0 0 0 0 31.01 0 0 1012747921 10 Physicians 826 Missouri 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 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 38.76 0 0 0 0 0 0 38.76 0 0 1012747988 1508338351 16 Nurse Practitioners HUSTED COLIN 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 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 2342.87 0 0 0 0 0 0 2342.87 0 0 1012749114 1861952160 16 Nurse Practitioners SPLEHA MICHELLE 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 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 69.17 0 0 0 0 0 0 69.17 0 0 1012749121 1629530043 16 Nurse Practitioners PRANTNER ALISA 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 0 272 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 2025.49 0 0 0 0 0 0 2025.49 0 0 1012749731 1093026064 10 Physicians MIAN ALI Y 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 109 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4481.42 0 94.61 0 0 0 0 0 0 4576.03 0 0 1012749884 1366936627 11 Dentists FRAUSTO LAUREL V 999999999 200 Cook 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21474.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21474.55 0 0 1012750937 1710450051 70 Ambulance Service Providers "AIR EVAC EMS, INC" 420019117 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 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 6330.13 0 0 0 0 0 0 6330.13 0 0 1012751275 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16058 0 0 0 0 0 0 0 0 0 0 0 0 0 16058 0 0 1012751597 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 64.08 0 0 0 0 0 0 64.08 0 0 1012751729 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 20593.3 0 0 0 0 0 0 0 0 0 0 0 0 0 20593.3 0 0 1012752188 4012752188 92 Waiver service provider--Disability (DHS/DRS) "SERENITY HOME HEALTH CARE, INC" 999999999 200 Cook 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 0 249 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 584958.88 0 0 0 0 0 0 0 0 0 0 0 0 0 584958.88 0 0 1012752658 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24837.41 0 0 0 0 0 0 0 0 0 0 0 0 0 24837.41 0 0 1012754281 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23830.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23830.94 0 0 1012755006 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 92.9 0 0 0 0 0 0 92.9 0 0 1012755612 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 55.98 0 0 0 0 0 0 55.98 0 0 1012756400 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 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 0 357.09 0 0 0 0 0 0 357.09 0 0 1012757665 1659938728 11 Dentists KURI JEHAN 999999999 200 Cook 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 12820.76 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 13573.46 0 0 1012758403 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18359.77 0 0 0 0 0 0 0 0 0 0 0 0 0 18359.77 0 0 1012758769 1366732554 10 Physicians TORRES ANNIE 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 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 0 522.35 0 0 0 0 0 0 522.35 0 0 1012760378 1699188557 10 Physicians CHOW ALEXANDER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.75 0 7878.17 0 0 0 0 0 0 7923.92 0 0 1012761359 1417512328 16 Nurse Practitioners BRYANT NATHAN L 999999999 80 Peoria 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 0 124 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 1161.01 0 0 0 0 0 0 1161.01 0 0 1012761405 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30723.03 0 0 0 0 0 0 0 0 0 0 0 0 0 30723.03 0 0 1012761700 1982066494 10 Physicians KELLER JACLYN A 999999999 80 Peoria 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 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 1298.03 0 0 0 0 0 0 1298.03 0 0 1012762283 1801258322 10 Physicians CHAND MUMTAJ Y 999999999 200 Cook 0 0 Pediatrics 0 0 0 42 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 2551.81 0 0 0 0 0 0 0 0 1755.64 0 0 0 0 0 0 4307.45 0 0 1012764143 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 0 163 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 7454.62 0 0 0 0 0 0 0 0 0 0 0 0 0 7454.62 0 0 1012764477 1982039350 55 Early Intervention Services TRIMBLE JENNIFER 999999999 72 McLean 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 0 372 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 19497.54 0 0 0 0 0 0 19497.54 0 0 1012764683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3027.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3027.62 0 0 1012764983 10 Physicians 30 DuPage 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 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 95.24 0 0 0 0 0 0 95.24 0 0 1012765256 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5125.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5125.96 0 0 1012766069 55 Early Intervention Services 62 Logan 0 0 0 0 0 0 0 0 0 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 0 496.85 0 0 0 0 0 0 496.85 0 0 1012766483 1215301866 55 Early Intervention Services KARNCHANAPHATI RACHELLE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 17763.68 0 0 0 0 0 0 17763.68 0 0 1012766707 12 Optometrists 200 Cook 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 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.41 0 29.28 0 0 0 0 91.69 0 0 1012767421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27354.61 0 0 0 0 0 0 0 0 0 0 0 0 0 27354.61 0 0 1012768011 1164868527 10 Physicians HOESLI REBECCA C 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 422.73 0 0 0 0 0 0 422.73 0 0 1012768089 1811241953 16 Nurse Practitioners PATEL ROSHANI 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 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 0 807.68 0 0 0 0 0 0 807.68 0 0 1012769084 1891089777 10 Physicians LAURENCE DENNIS 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28671.51 0 0 0 0 0 0 0 0 0 0 0 0 0 28671.51 0 0 1012771545 1487135208 16 Nurse Practitioners HILSON DIANNA 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 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 0 146.49 0 0 0 0 0 0 146.49 0 0 1012771906 1891227344 55 Early Intervention Services TAYLOR TANIA D 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 0 173 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 10104.51 0 0 0 0 0 0 10104.51 0 0 1012772987 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10803.55 0 0 0 0 0 0 0 0 0 0 0 0 0 10803.55 0 0 1012774278 1407310204 16 Nurse Practitioners SEDAI GOMA 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 0 809 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 4630.26 0 0 0 0 0 0 4630.26 0 0 1012776358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2517.68 0 0 0 0 0 0 0 0 0 0 0 0 0 2517.68 0 0 1012779972 86 Clinical Social Worker(Encounter Only) 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 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 1012780052 1417417650 16 Nurse Practitioners SCHOLD NICHOLE R 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 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 3085.29 0 0 0 0 0 0 3085.29 0 0 1012780643 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0 0 0 0 0 0 8051.7 0 0 1012786220 1710324983 10 Physicians KRAUSS JILLIAN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 421 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9105.36 0 920.45 0 0 0 0 0 0 10025.81 0 0 1012787543 1730255977 10 Physicians GELOO ZEBA S 999999999 200 Cook 0 0 General Practice 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 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 0 149.72 0 0 0 0 0 0 149.72 0 0 1012788589 1265827778 10 Physicians GOODMAN CHELAIN R 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 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 0 671.52 0 0 0 0 0 0 671.52 0 0 1012790214 1154532315 50 Home Health Agencies - In Home DMJ HOME HEALTH SERVICES 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 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 8920.5 0 0 0 0 0 0 8920.5 0 0 1012792093 1902205107 10 Physicians NA INYOUNG 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 6 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 0 0 0 0 0 0 0 0 0 62.11 0 0 0 0 0 0 62.11 0 0 1012793927 1295154367 10 Physicians POWNELL BRANDY R 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1797.4 0 0 0 0 0 0 0 0 1797.4 0 0 1012794342 1144795873 16 Nurse Practitioners LORINCZ ANAMARIA I 999999999 71 McHenry 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 0 264 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 1367.18 0 0 0 0 0 0 1367.18 0 0 1012799436 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 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 24252.77 0 0 0 0 0 0 0 0 0 0 0 0 0 24252.77 0 0 1012800666 1205357902 55 Early Intervention Services MEDRANO GWEN E 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 0 180 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 10358.14 0 0 0 0 0 0 10358.14 0 0 1012801652 1497105704 10 Physicians UZOOKEREKE ADAKU M 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015.73 0 0 0 0 0 0 1015.73 0 0 1012802189 1114293024 10 Physicians RODENBARGER ANDREW L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.26 0 220.78 0 0 0 0 0 0 275.04 0 0 1012802287 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 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 0 377.06 377.06 0 0 1012802928 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21860.35 0 0 0 0 0 0 0 0 0 0 0 0 0 21860.35 0 0 1012803799 1992103477 89 Physician Assistant Only(Encounter Only) WYSONG JENNIFER 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 0 132 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 4649.2 0 0 0 0 0 0 4649.2 0 0 1012805961 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18558.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18558.28 0 0 1012807561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1617.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1617.33 0 0 1012807593 10 Physicians 89 Rock Island 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 0 0 0 0 0 0 0 0 0 0 1012811079 1013378652 10 Physicians COOPERSTEIN NOAH M 999999999 96 St Clair 0 0 Family Practice 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 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 1124.84 0 0 0 0 0 0 1124.84 0 0 1012812824 1477013407 89 Physician Assistant Only(Encounter Only) SUPAN EDWARD J 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 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 0 283.6 0 0 0 0 0 0 283.6 0 0 1012812896 1659396505 87 Psychologist(Encounter Only) VERDA MICHELE R 631101002 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 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 1447.61 0 0 0 0 0 0 1447.61 0 0 1012813065 1841570140 10 Physicians SATTAYAPRASERT PRASONGCHAI 999999999 91 Sangamon 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 0 135 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 0 725.64 0 0 0 0 0 0 725.64 0 0 1012814226 1124461322 10 Physicians ECK IVAN 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 22 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243.95 0 4075.2 0 0 0 0 0 0 4319.15 0 0 1012814647 1073078325 60 Pharmacies STAYWELL PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12597.68 0 0 0 12597.68 0 0 1012815120 1891358222 16 Nurse Practitioners ERKE KELLY J 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 0 291 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 0 755.64 0 0 0 0 0 0 755.64 0 0 1012815307 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26388.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26388.27 0 0 1012816046 1427477926 10 Physicians GEORGES ALAN 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 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 1516.04 0 0 0 0 0 0 1516.04 0 0 1012817661 55 Early Intervention Services 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 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 0 384.04 0 0 0 0 0 0 384.04 0 0 1012818338 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 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 2326.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2326.38 0 0 1012819655 1467866723 10 Physicians MILLER KRISTIN 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.47 0 5705.21 0 0 0 0 0 0 5712.68 0 0 1012819862 1730609595 10 Physicians HEMINGWAY KATHERINE 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 0 287.48 0 0 0 0 0 0 287.48 0 0 1012820331 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19584.54 0 0 0 0 0 0 0 0 0 0 0 0 0 19584.54 0 0 1012821155 1720647076 91 Waiver service provider--Adults (DHS/DDD) CHAPPELL JADE 999999999 91 Sangamon 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102654.8 0 0 0 0 0 0 0 0 0 0 0 0 0 102654.8 0 0 1012821430 1598238917 16 Nurse Practitioners CELLA KATHARINE 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 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 0 320.35 0 0 0 0 0 0 320.35 0 0 1012822828 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 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 5042.73 0 0 0 0 0 0 0 0 0 0 0 0 0 5042.73 0 0 1012822829 4012822829 72 Taxicabs and Livery Companies AGNES MEDITRANS INC. 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 0 973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9089.68 0 0 0 0 0 0 9089.68 0 0 1012824087 1942620026 10 Physicians BARR LUKE K 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 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 3086.41 0 0 0 0 0 0 3086.41 0 0 1012825503 30 General Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456.81 0 0 0 0 0 456.81 0 0 1012825898 1003291873 12 Optometrists HAZLEHURST RYAN E 999999999 72 McLean 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 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 1037.72 0 0 0 0 0 0 1037.72 0 0 1012828099 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19478.63 0 0 0 0 0 0 0 0 0 0 0 0 0 19478.63 0 0 1012829586 1679007868 10 Physicians SHEHATA KEROLUS 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 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 0 548.04 0 0 0 0 0 0 548.04 0 0 1012829736 1215478979 55 Early Intervention Services ALCANTAR KATHRYN 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 0 919 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52105.66 0 0 0 0 0 0 52105.66 0 0 1012830967 1972829240 10 Physicians PAUL DEVON 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 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10252.39 0 0 0 0 0 0 10252.39 0 0 1012831040 1043778905 24 Speech Therapists INGRAFFIA ANTONIA 999999999 200 Cook 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 0 183 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 13188.07 13188.07 0 0 1012831150 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27156.8 0 0 0 0 0 0 0 0 0 0 0 0 0 27156.8 0 0 1012831383 1477119006 16 Nurse Practitioners SIMONAITIS KATHLEEN A 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 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 0 679.73 0 0 0 0 0 0 679.73 0 0 1012834040 1194219212 10 Physicians WILLIAMS BIANCA 999999999 200 Cook 0 0 Pediatrics 0 0 0 3 0 0 0 0 0 0 5 0 8 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 110.16 0 0 0 0 0 0 440.93 0 333.2 0 0 0 0 0 0 884.29 0 0 1012834255 1326600966 11 Dentists DOMMARAJU NEELIMA 999999999 200 Cook 0 0 General Dentistry 0 0 75 0 0 0 0 0 0 0 0 0 0 0 11 0 0 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1215217286 89 Physician Assistant Only(Encounter Only) POTAKIS ISMENE 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 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 3492.43 0 0 0 0 0 0 3492.43 0 0 1012898827 10 Physicians 45 Henry 0 0 0 0 0 0 0 0 0 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 0 333.9 0 0 0 0 0 0 333.9 0 0 1012898878 1922457217 10 Physicians HECHT CLIFFORD 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1012899380 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1012899986 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 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0 0 0 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 1126.04 0 0 0 0 0 0 1126.04 0 0 1012908663 1508343203 48 Rural Health Clinics OSF MEDICAL GROUP - SHEFFIELD 999999999 15 Bureau 0 0 0 162 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16613.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16613.66 0 0 1012908872 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 1012913782 1568853422 10 Physicians RODRIGUEZ GISELLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.57 0 3086.62 0 0 0 0 0 0 3140.19 0 0 1012913934 1982835922 22 Physical Therapists CARTER SEAN A 999999999 40 Grundy 0 0 0 0 0 0 0 0 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200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 5 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.23 0 2035.76 0 0 0 0 0 0 2066.99 0 0 1012941420 1922340066 10 Physicians HUSSAIN REHAN M 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 7 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.86 0 52517.83 0 0 0 0 0 0 52585.69 0 0 1012941712 89 Physician Assistant Only(Encounter Only) 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012942363 1346650249 10 Physicians OLEAR OSEZUA JOHN 999999999 107 Will 0 0 Internal Medicine 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 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5862.03 0 0 0 0 0 0 5862.03 0 0 1012943162 1376100735 24 Speech Therapists GERSHUN NICOLE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49774.03 49774.03 0 0 1012945472 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15217.07 0 0 0 0 0 0 0 0 0 0 0 0 0 15217.07 0 0 1012945508 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012945813 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1576.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1576.54 0 0 1012946406 1760673099 10 Physicians SHACKOUR SALIM 999999999 91 Sangamon 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 0 292 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 4476.72 0 0 0 0 0 0 4476.72 0 0 1012946893 23 Occupational Therapists 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 0 333.21 333.21 0 0 1012947968 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 1147.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.32 0 0 1012948443 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19780.2 0 0 0 0 0 0 0 0 0 0 0 0 0 19780.2 0 0 1012948502 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1169.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1169.08 0 0 1012950338 1932101060 10 Physicians CHAE KYUNG AI 999999999 200 Cook 0 0 0 0 0 0 0 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 7.59 0 0 0 0 0 0 0 0 7.59 0 0 1012952057 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17533.56 0 0 0 0 0 0 0 0 0 0 0 0 0 17533.56 0 0 1012953962 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 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 0 382.58 0 0 0 0 0 0 0 0 0 0 0 0 0 382.58 0 0 1012954166 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 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 2577.1 0 0 0 0 0 0 2577.1 0 0 1012954417 1689137671 89 Physician Assistant Only(Encounter Only) MIESSAU JEFFREY B 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792.69 0 0 0 0 0 0 792.69 0 0 1012954587 1376923748 10 Physicians BROWN JUDITH N 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 61 0 113 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 127 0 206 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 127 0 206 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 2823.01 0 10497.63 0 0 0 0 0 0 13406.29 0 0 1012955447 1518304054 10 Physicians KOSINSKI MARK K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 25 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.8 0 5836.44 0 0 0 0 0 0 5909.24 0 0 1012955587 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20207.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20207.5 0 0 1012956052 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 0 0 0 0 0 0 0 0 0 0 1012957890 1801159264 10 Physicians DAVIS JENNIFER A 999999999 91 Sangamon 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 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 0 624.58 0 0 0 0 0 0 624.58 0 0 1012958530 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 459.91 0 0 0 0 0 0 0 0 0 0 0 0 0 459.91 0 0 1012959110 1538627252 16 Nurse Practitioners SCOTT MONICA N 999999999 24 Coles 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 0 180 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 2008.12 0 0 0 0 0 0 2008.12 0 0 1012964977 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10585.22 0 0 0 0 0 0 0 0 0 0 0 0 0 10585.22 0 0 1012966983 1194107607 13 Podiatrists WAVRUNEK MARK R 999999999 10 Adams 0 0 Orthopedic Surgery 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 0 369 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 4482.02 0 0 0 0 0 0 4482.02 0 0 1012967446 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3882.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3882.92 0 0 1012968365 1740676055 13 Podiatrists CHESSER ANTHONY M 999999999 89 Rock Island 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 0 378 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 5668.24 0 0 0 0 0 0 5668.24 0 0 1012969799 1508397274 55 Early Intervention Services FERGUSON MEGAN B 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 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 8316.91 0 0 0 0 0 0 8316.91 0 0 1012970191 1790345726 16 Nurse Practitioners LONG GILLIAN 999999999 65 Madison 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 0 177 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 3696.15 0 0 0 0 0 0 3696.15 0 0 1012971840 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1570.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1570.99 0 0 1012974972 1477029213 30 General Hospitals "FRESENIUS MEDICAL CARE ELGIN," 999999999 53 Kane DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 1533 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43789.91 0 0 0 0 0 43789.91 0 0 1012975578 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 16866.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16866.66 0 0 1012976017 1417938077 89 Physician Assistant Only(Encounter Only) GRASCH ANTHONY 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 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 4103.27 0 0 0 0 0 0 4103.27 0 0 1012976591 10 Physicians 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 73.03 0 0 0 0 0 0 0 0 73.03 0 0 1012978577 1861044547 10 Physicians MEWA FATEMA 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 0 213 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 1598.29 0 0 0 0 0 0 1598.29 0 0 1012978864 1487996526 10 Physicians MUMTAZ SHAHAM S 999999999 53 Kane 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 0 149 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 4293.34 0 0 0 0 0 0 4293.34 0 0 1012979042 1982085049 10 Physicians WOLFSON MAXIM 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 579.22 0 0 0 0 0 0 579.22 0 0 1012979501 1275978223 10 Physicians STARNES TAYLOR WILLIAMSON 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 5 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.22 0 3418.35 0 0 0 0 0 0 3440.57 0 0 1012979571 1295296838 16 Nurse Practitioners STACH ERICA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 791.5 0 0 0 0 0 0 791.5 0 0 1012979618 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1012980138 1356879555 24 Speech Therapists JOHN KAYLEY J 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 0 123 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 8604.97 8604.97 0 0 1012981266 1205480258 91 Waiver service provider--Adults (DHS/DDD) JARDAN SVETLANA 999999999 200 Cook 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127194.03 0 0 0 0 0 0 0 0 0 0 0 0 0 127194.03 0 0 1012981519 1629635180 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 68693.3 0 0 68693.3 0 0 1012982512 1831545987 10 Physicians FOGLE JEFFREY D 999999999 60 Lee 0 0 Emergency Medicine 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 0 241 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 5129.54 0 0 0 0 0 0 5129.54 0 0 1012982984 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 83.23 0 0 0 0 0 0 83.23 0 0 1012984276 1912561960 16 Nurse Practitioners HAYES TESSA C 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 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 0 212.56 0 0 0 0 0 0 212.56 0 0 1012984301 10 Physicians 49 Jefferson 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 1142.16 0 0 0 0 0 0 1142.16 0 0 1012986633 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 0 366.78 0 0 0 0 0 0 366.78 0 0 1012988396 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 4.74 0 0 0 0 0 0 4.74 0 0 1012988445 1326466384 10 Physicians KHAWJA SHUMAILA N 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 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 1667.83 0 0 0 0 0 0 1667.83 0 0 1012989601 1952751760 10 Physicians SKARPATHIOTIS STRATOS 999999999 200 Cook 0 0 0 0 0 28 0 0 0 0 0 0 13 0 46 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 15 0 85 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 15 0 85 0 0 0 0 0 0 0 0 0 2513.06 0 0 0 0 0 0 672.23 0 3849.26 0 0 0 0 0 0 7034.55 0 0 1012991981 1184189359 16 Nurse Practitioners HERRIN MELISSA K 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 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 0 393.07 0 0 0 0 0 0 393.07 0 0 1012993597 10 Physicians 91 Sangamon 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 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 0 218.61 0 0 0 0 0 0 218.61 0 0 1012993934 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 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 0 598.6 0 0 0 0 0 0 598.6 0 0 1012994702 1922413111 10 Physicians SOZZER ABDUL R 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 480 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5381.28 0 157.81 0 0 0 0 0 0 5539.09 0 0 1012994949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24064.26 0 0 0 0 0 0 0 0 0 0 0 0 0 24064.26 0 0 1012995024 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 241.4 0 0 0 0 0 0 0 0 0 0 0 0 0 241.4 0 0 1012995250 12 Optometrists 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 1012996387 1013339498 16 Nurse Practitioners MCCONNELL CAYCE AN 999999999 200 Cook 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 0 263 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 4850.37 0 0 0 0 0 0 4850.37 0 0 1012996636 10 Physicians 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 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 0 107.62 0 0 0 0 0 0 107.62 0 0 1012997192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17742.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17742.9 0 0 1012999502 1639308737 10 Physicians KROW-RODNEY ABENA A 999999999 102 Warren 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 0 161 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 3499.46 0 0 0 0 0 0 3499.46 0 0 1012999878 1053974790 16 Nurse Practitioners O''BRIEN PATRICK K 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200 Cook 0 0 Emergency Medicine 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 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12741.67 0 0 0 0 0 0 12741.67 0 0 1013008652 1508108226 10 Physicians MAGNETTA MICHAEL J 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 347 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5728.16 0 52.47 0 0 0 0 0 0 5780.63 0 0 1013011050 1962796631 13 Podiatrists PARISE DANIEL 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 0 406 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 0 650.76 0 0 0 0 0 0 650.76 0 0 1013011514 1134642796 55 Early Intervention Services WINTERS EMILY 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 0 125 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 7352.2 0 0 0 0 0 0 7352.2 0 0 1013012484 1164871984 10 Physicians CHERNY DMITRIY 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 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 0 744.03 0 0 0 0 0 0 744.03 0 0 1013012910 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 156.91 0 0 0 0 0 0 0 0 0 0 0 0 0 156.91 0 0 1013013552 1003468851 11 Dentists PATEL SOHA D 999999999 71 McHenry 0 0 General Dentistry 0 0 130 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 18896.8 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 20025.85 0 0 1013014341 1629193180 10 Physicians AGARWAL PIYUSH K 999999999 30 DuPage 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 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 4344.36 0 0 0 0 0 0 4349.53 0 0 1013014878 1700146826 10 Physicians BRETSCHNEIDER CAROL E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.23 0 589.15 0 0 0 0 0 0 594.38 0 0 1013015361 1801325972 10 Physicians BULLOCK CYDNEY 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 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 0 357.3 0 0 0 0 0 0 357.3 0 0 1013015368 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8582.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8582.49 0 0 1013016894 1285287888 16 Nurse Practitioners FOWLER-COELLO MELISSA 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 2144.88 0 0 0 0 0 0 2144.88 0 0 1013016898 1285865204 10 Physicians LERNER ANDRES 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 19 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286.51 0 4100.26 0 0 0 0 0 0 4386.77 0 0 1013017695 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 67.22 0 0 0 0 0 0 67.22 0 0 1013017752 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 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 21369.35 0 0 0 0 0 0 0 0 0 0 0 0 0 21369.35 0 0 1013018468 1154709731 10 Physicians NANDAM JANAKI 999999999 200 Cook 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 2 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 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0 1013022525 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20794.04 0 0 0 0 0 0 0 0 0 0 0 0 0 20794.04 0 0 1013025489 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 0 0 0 0 0 0 0 0 0 0 1013025880 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 25.77 0 0 0 0 0 0 25.77 0 0 1013026207 1952699159 10 Physicians KANIKE NEELAKANTA 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 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 4225.09 0 0 0 0 0 0 4225.09 0 0 1013028647 1780857979 10 Physicians CHATTERJEE ARINDAM R 999999999 105 White 0 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.99 0 1652.37 0 0 0 0 0 0 1772.36 0 0 1013032016 1972039469 16 Nurse Practitioners PATEL DIPEEKA 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 0 226 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 2926.68 0 0 0 0 0 0 2926.68 0 0 1013032378 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 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 0 840.5 0 0 0 0 0 0 0 0 0 0 0 0 0 840.5 0 0 1013033865 1720544554 55 Early Intervention Services JECKS SARAH M 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 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 3063.88 0 0 0 0 0 0 3063.88 0 0 1013034444 10 Physicians 109 Winnebago 0 0 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0 0 0 0 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 10281.44 0 0 0 0 0 0 10281.44 0 0 1013036587 1558929232 11 Dentists ALNUAIMI OMAR 999999999 200 Cook 0 0 General Dentistry 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18890.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18890.32 0 0 1013036858 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 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 1404.56 0 0 0 0 0 0 1404.56 0 0 1013037092 1801358627 89 Physician Assistant Only(Encounter Only) GURGANIOUS NICHOLAS L 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 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 2119.14 0 0 0 0 0 0 2119.14 0 0 1013039444 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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KALI G 999999999 80 Peoria 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1290.46 0 0 0 0 0 0 1290.46 0 0 1013043519 1407408149 16 Nurse Practitioners MOSLEY JEANETTE T 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 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 0 229.13 0 0 0 0 0 0 229.13 0 0 1013043598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28093.89 0 0 0 0 0 0 0 0 0 0 0 0 0 28093.89 0 0 1013045293 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 73.4 0 0 0 0 0 0 73.4 0 0 1013045337 1174937106 10 Physicians SIVAGNANAM MILANI 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 0 173 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 0 880.56 0 0 0 0 0 0 880.56 0 0 1013045866 1821327289 86 Clinical Social Worker(Encounter Only) JOHNSTON ELIZABETH S 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 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 1420.43 0 0 0 0 0 0 1420.43 0 0 1013046752 1720343908 10 Physicians BASIT ARSHI 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 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 0 329.16 0 0 0 0 0 0 329.16 0 0 1013048086 1134649296 10 Physicians ZHONG JING 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 0 485.61 0 0 0 0 0 0 485.61 0 0 1013048119 1346806783 55 Early Intervention Services BIELAT JANET MARIE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 15757.53 0 0 0 0 0 0 15757.53 0 0 1013048493 1417396185 10 Physicians RAZA YASMIN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.42 0 3728.13 0 0 0 0 0 0 3735.55 0 0 1013050889 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 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 3915.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3915.34 0 0 1013051956 1538519046 10 Physicians JILANI BASMAH N 999999999 47 Jackson 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 0 245 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 2728.65 0 0 0 0 0 0 2728.65 0 0 1013055458 1609258458 10 Physicians AL-SABEK KARIM 999999999 24 Coles 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 0 235 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 2853.15 0 0 0 0 0 0 2853.15 0 0 1013055878 1811309214 10 Physicians IYALLA KILALI I 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 276.18 0 0 0 0 0 0 276.18 0 0 1013056813 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 0 585.9 0 0 0 0 0 0 0 0 0 0 0 0 0 585.9 0 0 1013057525 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11351.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11351.23 0 0 1013058250 1043748098 55 Early Intervention Services CROOKS AMANDA F 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 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 4144.48 0 0 0 0 0 0 4144.48 0 0 1013058325 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 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 8188.15 0 0 0 0 0 0 0 0 0 0 0 0 0 8188.15 0 0 1013059638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 199.72 0 0 0 0 0 0 0 0 0 0 0 0 0 199.72 0 0 1013059650 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15934.05 0 0 0 0 0 0 0 0 0 0 0 0 0 15934.05 0 0 1013062118 1609430438 16 Nurse Practitioners KOEPPEN OKSANA 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 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 1590.88 0 0 0 0 0 0 1590.88 0 0 1013064265 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1458.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1458.84 0 0 1013064367 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 3 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 1688.7 1688.7 0 0 1013067912 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23104.11 0 0 0 0 0 0 0 0 0 0 0 0 0 23104.11 0 0 1013069003 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25262.49 0 0 0 0 0 0 0 0 0 0 0 0 0 25262.49 0 0 1013069788 1073597498 12 Optometrists GUNTHER PETER 999999999 109 Winnebago 0 0 Diagnostic Pharmaceutical Agents 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 0 227 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 1057.86 0 0 0 0 0 0 1057.86 0 0 1013070675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12418.98 0 0 0 0 0 0 0 0 0 0 0 0 0 12418.98 0 0 1013070827 1790138451 10 Physicians WAJE MELESSE B 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 87.08 0 0 0 0 0 0 87.08 0 0 1013071374 1588603435 10 Physicians RASQUE HOPE 999999999 30 DuPage 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 1292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9631.51 0 0 0 0 0 0 9631.51 0 0 1013071893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8280.29 0 0 0 0 0 0 0 0 0 0 0 0 0 8280.29 0 0 1013072026 1013576990 16 Nurse Practitioners WALLACE KELSEY A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 517.5 0 0 0 0 0 0 517.5 0 0 1013072262 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30944.73 0 0 0 0 0 0 0 0 0 0 0 0 0 30944.73 0 0 1013072669 16 Nurse Practitioners 42 Hancock 0 0 0 0 0 0 0 0 0 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 1013075869 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32094.3 0 0 0 0 0 0 0 0 0 0 0 0 0 32094.3 0 0 1013075918 1306290044 10 Physicians CROOKS JAMES N 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 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 8886.37 0 0 0 0 0 0 8886.37 0 0 1013076200 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 1298.42 0 0 0 0 0 0 0 0 0 0 0 0 0 1298.42 0 0 1013078086 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 10131.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10131.93 0 0 1013078252 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12184.89 0 0 0 0 0 0 0 0 0 0 0 0 0 12184.89 0 0 1013080352 1316213234 10 Physicians CLARK BRIAN C 999999999 200 Cook 0 0 Internal Medicine 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 0 372 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 2802.71 0 0 0 0 0 0 2802.71 0 0 1013081712 1669031530 16 Nurse Practitioners WATSON NIKKI 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 533.57 0 0 0 0 0 0 533.57 0 0 1013083058 10 Physicians 24 Coles 0 0 0 0 0 0 0 0 0 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 1013084750 1285163329 10 Physicians BIRK NAVINA K 999999999 200 Cook 0 0 Internal Medicine 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 0 111.58 0 0 0 0 0 0 111.58 0 0 1013084857 1902249154 10 Physicians RAU NICOLE M 999999999 80 Peoria 0 0 Pediatrics 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 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54556.81 0 0 0 0 0 0 54556.81 0 0 1013086879 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10097.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10097.88 0 0 1013087605 1225328271 10 Physicians HUYNH ALEXIS M 999999999 19 Champaign 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 0 160 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 1925.49 0 0 0 0 0 0 1925.49 0 0 1013088315 10 Physicians 200 Cook 0 0 General 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 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 0 210.7 0 0 0 0 0 0 210.7 0 0 1013088643 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 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 0 898.35 0 0 0 0 0 0 898.35 0 0 1013089544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16730.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16730.7 0 0 1013089753 1619396231 10 Physicians GILMORE BRENDAN 999999999 200 Cook 0 0 Internal 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 0 626 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 5502.25 0 0 0 0 0 0 5502.25 0 0 1013089937 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11326.59 0 0 0 0 0 0 0 0 0 0 0 0 0 11326.59 0 0 1013089978 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 1013090059 1649682089 10 Physicians CALHOUN BRENDAN R 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 319 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3594.34 0 383.5 0 0 0 0 0 0 3977.84 0 0 1013093192 1225485394 10 Physicians FOSTER ERIC 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Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 681.98 681.98 0 0 1013099006 1245494871 10 Physicians MASOOD SHUMAILA A 999999999 63 Macon 0 0 0 0 0 1 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 29.12 0 1088.99 0 0 0 0 0 0 1203.76 0 0 1013099947 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 0 186 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 28920.58 0 0 0 0 0 0 0 0 0 0 0 0 0 28920.58 0 0 1013100603 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 43209.84 0 0 0 0 0 0 0 0 0 0 0 0 0 43209.84 0 0 1013101609 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 1.08 0 0 0 0 0 0 1.08 0 0 1013102484 1134357023 10 Physicians SHAH BINISA 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 9 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.82 0 600.07 0 0 0 0 0 0 693.89 0 0 1013103334 1538508726 10 Physicians BREWER ERIKA M 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 12 0 142 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12 0 332 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12 0 332 0 0 0 0 0 0 0 0 0 28.3 0 0 0 0 0 0 28.88 0 25529.36 0 0 0 0 0 0 25586.54 0 0 1013103871 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2142.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2142.45 0 0 1013105191 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22675.91 0 0 0 0 0 0 0 0 0 0 0 0 0 22675.91 0 0 1013105261 1891180154 10 Physicians WILCZYNSKI DARA 999999999 89 Rock Island 0 0 Psychiatry 0 0 0 0 0 0 0 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 4480.7 0 0 0 0 0 0 4480.7 0 0 1013106184 1255519120 10 Physicians ACOSTA MONICA 999999999 200 Cook 0 0 Neurology 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 0 159 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 1491.48 0 0 0 0 0 0 1491.48 0 0 1013109623 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 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 63.17 0 0 0 0 0 0 63.17 0 0 1013109826 1356780944 10 Physicians NAVASARTIAN DOUGLAS J 999999999 42 Hancock 0 0 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0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 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 17794.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17794.04 0 0 1013112754 1396266474 11 Dentists ZAMIR ZOYA 999999999 200 Cook 0 0 General Dentistry 0 0 79 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 489 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 24177.33 0 0 0 0 0 0 0 0 0 0 0 2258.1 0 0 0 0 26435.43 0 0 1013113351 1861810350 10 Physicians ALIPERTI LOUIS A 999999999 88 Richland 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 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.92 0 0 0 0 0 0 197.92 0 0 1013116027 1669995189 55 Early Intervention Services ALVARADO DAISY 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 0 149 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 8676.77 0 0 0 0 0 0 8676.77 0 0 1013117185 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 0 166 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 16985.91 0 0 0 0 0 0 0 0 0 0 0 0 0 16985.91 0 0 1013117675 1487136131 16 Nurse Practitioners DONAHOE MEGHAN 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 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 0 198.96 0 0 0 0 0 0 198.96 0 0 1013118017 1841743812 10 Physicians MAJEED SAROSH 999999999 58 La Salle 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 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 0 748.94 0 0 0 0 0 0 748.94 0 0 1013118174 1174180178 16 Nurse Practitioners SABOL KILEY K 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 0 102 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 2013.26 0 0 0 0 0 0 2013.26 0 0 1013121044 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18707.34 0 0 0 0 0 0 0 0 0 0 0 0 0 18707.34 0 0 1013121319 1912418484 16 Nurse Practitioners MISKOVIC JOVANA 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 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 36.51 0 0 0 0 0 0 36.51 0 0 1013122284 1730425893 10 Physicians PATEL NILESHKUMAR 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9137.46 0 0 0 0 0 0 9137.46 0 0 1013122676 1871941385 10 Physicians PATEL ANKIT P 999999999 30 DuPage 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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CARE, INC" 999999999 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 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 202664.87 0 0 0 0 0 0 0 0 0 0 0 0 0 202664.87 0 0 1013129672 10 Physicians 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 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 1013130027 1730422742 10 Physicians SUNG JULIANA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 12 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334.6 0 987.57 0 0 0 0 0 0 1322.17 0 0 1013130666 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22866.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22866.22 0 0 1013132753 1447682703 89 Physician Assistant Only(Encounter Only) HOFFMANN PATRICK 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 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 0 534.73 0 0 0 0 0 0 534.73 0 0 1013133308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15465.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15465.99 0 0 1013133737 1891137501 10 Physicians GUPTA BHAVNA 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 0 104 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 8301.86 0 0 0 0 0 0 8301.86 0 0 1013134311 1497312672 16 Nurse Practitioners WADSWORTH HALEIGH D 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 1103.29 0 0 0 0 0 0 1199.74 0 0 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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 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 6566.78 0 0 0 0 0 0 6566.78 0 0 1013139515 1881122042 10 Physicians STAGL DANIEL 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 0 204 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 0 672.18 0 0 0 0 0 0 672.18 0 0 1013139669 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 313.7 0 0 0 0 0 0 313.7 0 0 1013144026 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 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 0 878.83 0 0 0 0 0 0 0 0 0 0 0 0 0 878.83 0 0 1013145018 1205375078 24 Speech Therapists SHANK KATIE 999999999 107 Will 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 0 116 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 9025.98 9025.98 0 0 1013145521 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273.32 0 0 0 0 0 0 273.32 0 0 1013146635 1700438538 24 Speech Therapists KUIPERS STEPHANIE 999999999 91 Sangamon 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 0 280 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 18813.1 18813.1 0 0 1013146652 1467794248 10 Physicians KIRSHENBAUM ERIC J 999999999 200 Cook 0 0 Urology 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 14 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.44 0 353.7 0 0 0 0 0 0 365.14 0 0 1013147779 1194233106 16 Nurse Practitioners THOMPSON TALIA S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 402 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 1488.86 0 0 0 0 0 0 1488.86 0 0 1013148227 1225318181 10 Physicians MISRA SARTHAK B 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 0 132 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 3941.22 0 0 0 0 0 0 3941.22 0 0 1013150513 1508429630 16 Nurse Practitioners THORMAN JESSICA L 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 0 173 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 0 732.41 0 0 0 0 0 0 732.41 0 0 1013152404 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 0 185.67 0 0 0 0 0 0 185.67 0 0 1013152535 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23776.94 0 0 0 0 0 0 0 0 0 0 0 0 0 23776.94 0 0 1013153098 1326538729 11 Dentists MALHOTRA ANKIT 999999999 91 Sangamon 0 0 General Dentistry 0 0 29 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 2901.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.91 0 0 1013153213 1023423118 10 Physicians SILVER ADAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186 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 1588.73 0 0 0 0 0 0 1588.73 0 0 1013153986 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1501.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1501.83 0 0 1013154476 1609131614 10 Physicians FAISAL MIR 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 11 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.73 0 5796.27 0 0 0 0 0 0 5925 0 0 1013155268 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15645.08 0 0 0 0 0 0 0 0 0 0 0 0 0 15645.08 0 0 1013156406 1417057290 10 Physicians ROSEN CHARLES L 999999999 72 McLean 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 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 7227.25 0 0 0 0 0 0 7227.25 0 0 1013156470 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2691.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2691.57 0 0 1013157219 1770068421 16 Nurse Practitioners BONADOR GIAN 999999999 30 DuPage 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 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6812.08 0 0 0 0 0 0 6812.08 0 0 1013158016 1891268355 89 Physician Assistant Only(Encounter Only) WATSON ERIC 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 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 24.78 0 0 0 0 0 0 24.78 0 0 1013158106 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 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 0 328 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9926.71 0 0 0 9926.71 0 0 1013159491 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 390.6 0 0 0 0 0 0 0 0 0 0 0 0 0 390.6 0 0 1013160444 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 0 0 0 0 0 0 0 0 0 0 1013163227 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2949.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2949.98 0 0 1013164655 1285015701 24 Speech Therapists LAKE LISA 999999999 107 Will 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 0 169 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 2529.34 2529.34 0 0 1013166614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2739.59 0 0 0 0 0 0 0 0 0 0 0 0 0 2739.59 0 0 1013167276 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 514.75 0 0 0 0 0 0 0 0 0 0 0 0 0 514.75 0 0 1013167611 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 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 0 262.48 0 0 0 0 0 0 262.48 0 0 1013167636 1649708926 86 Clinical Social Worker(Encounter Only) SELOCK SUSAN K 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 715.71 0 0 0 0 0 0 715.71 0 0 1013168010 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2783.65 0 0 0 0 0 0 0 0 0 0 0 0 0 2783.65 0 0 1013168371 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 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 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1013182520 1225534704 55 Early Intervention Services CLARK REBECCA 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 0 369 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 18271.42 0 0 0 0 0 0 18271.42 0 0 1013183453 1407316730 16 Nurse Practitioners MYERS LYNDI 999999999 24 Coles 0 0 0 0 0 0 0 0 0 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 0 708.43 0 0 0 0 0 0 708.43 0 0 1013184020 1881171296 16 Nurse Practitioners ORAHAM TINA F 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 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 0 444.22 0 0 0 0 0 0 444.22 0 0 1013184723 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 0 307.45 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 23400.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23400.92 0 0 1013188940 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 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 5.5 0 0 0 5.5 0 0 1013188987 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 0 146.8 0 0 0 0 0 0 146.8 0 0 1013189024 1407417397 55 Early Intervention Services CRIEL CHRISTINE 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 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25528.63 0 0 0 0 0 0 25528.63 0 0 1013191267 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 62.02 0 0 0 0 0 0 62.02 0 0 1013191413 1518308493 10 Physicians 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0 0 8115.21 0 0 1013198718 1558910265 16 Nurse Practitioners CARVAJAL JENNIFER 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 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 0 229.3 0 0 0 0 0 0 229.3 0 0 1013198732 1730554924 63 Other Providers of Medical Equipment/Supplies (Non-registered) "BREG, INC." 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 179 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8723.18 0 10297.8 0 0 0 0 19020.98 0 0 1013198908 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.82 0 0 0 0 0 0 0 0 0 0 0 0 0 99.82 0 0 1013199105 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21788.97 0 0 0 0 0 0 0 0 0 0 0 0 0 21788.97 0 0 1013199747 1629462288 10 Physicians AMPORT JEFFREY V 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 1 0 78 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 4733.36 0 0 0 0 0 0 4733.36 0 0 1013199757 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22705.67 0 0 0 0 0 0 0 0 0 0 0 0 0 22705.67 0 0 1013199859 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16621.88 0 0 0 0 0 0 0 0 0 0 0 0 0 16621.88 0 0 1013200332 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1360.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1360.51 0 0 1013214276 1508110198 10 Physicians ANEWENAH LESLIE 999999999 91 Sangamon 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 0 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12971.76 0 0 0 0 0 0 12971.76 0 0 1013214572 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 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 0 324.75 324.75 0 0 1013214776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10283.09 0 0 0 0 0 0 0 0 0 0 0 0 0 10283.09 0 0 1013214972 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 533.95 0 0 0 0 0 0 0 0 0 0 0 0 0 533.95 0 0 1013214999 1457794406 10 Physicians MARKS DANIEL 999999999 200 Cook 0 0 Internal Medicine 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.46 0 913.22 0 0 0 0 0 0 915.68 0 0 1013215407 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2816.66 0 0 0 0 0 0 0 0 0 0 0 0 0 2816.66 0 0 1013215596 4013215596 91 Waiver service provider--Adults (DHS/DDD) HARRIS CADE 999999999 91 Sangamon 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20908.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20908.95 0 0 1013215605 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 0 165 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 38788.73 0 0 0 0 0 0 0 0 0 0 0 0 0 38788.73 0 0 1013216018 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 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 2615.2 2615.2 0 0 1013216170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29457.44 0 0 0 0 0 0 0 0 0 0 0 0 0 29457.44 0 0 1013216255 1699193334 10 Physicians GARDEN BENJAMIN C 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 6 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.39 0 355.82 0 0 0 0 0 0 358.21 0 0 1013216273 1437414133 10 Physicians VANDENBRANDEN SARA K 999999999 200 Cook 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 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 7683.28 0 0 0 0 0 0 7683.28 0 0 1013216403 1992110548 10 Physicians VERMA ANKUR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4282.48 0 0 0 0 0 0 4282.48 0 0 1013216405 1801088992 10 Physicians HAMDAN SHADI EID MOHAMMAD 999999999 200 Cook 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 0 149 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 2362.87 0 0 0 0 0 0 2362.87 0 0 1013216541 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4478.88 0 0 0 0 0 0 0 0 0 0 0 0 0 4478.88 0 0 1013217146 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5975.56 0 0 0 0 0 0 0 0 0 0 0 0 0 5975.56 0 0 1013217430 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 24633.73 0 0 0 0 0 0 0 0 0 0 0 0 0 24633.73 0 0 1013217673 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 375.05 0 0 0 0 0 0 0 0 0 0 0 0 0 375.05 0 0 1013217833 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 0 190.25 0 0 0 0 0 0 190.25 0 0 1013217862 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 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 0 309.89 0 0 0 0 0 0 0 0 0 0 0 0 0 309.89 0 0 1013218222 1124688189 12 Optometrists ADAMS JOANN 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 203.1 0 0 0 0 0 0 203.1 0 0 1013218612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11070.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11070.4 0 0 1013218670 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6778.22 0 0 0 0 0 0 0 0 0 0 0 0 0 6778.22 0 0 1013218826 1275186173 11 Dentists THAKUR PRANEETA 999999999 200 Cook 0 0 General Dentistry 0 0 167 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 809 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 809 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 30019.91 0 0 0 0 0 0 0 0 0 0 0 16105.91 0 0 0 0 46125.82 0 0 1013219331 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1115.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1115.18 0 0 1013219422 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 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 1013219492 1336502533 10 Physicians SINGH NATASHA 999999999 30 DuPage 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 0 265 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 1744.06 0 0 0 0 0 0 1744.06 0 0 1013220067 1750775086 10 Physicians ZHENG LIDA Z 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 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1998 0 0 0 0 0 0 1998 0 0 1013220510 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3090.4 3090.4 0 0 1013220547 1821450420 10 Physicians SNOWDON MATTHEW JOHN 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 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 0 170.3 0 0 0 0 0 0 170.3 0 0 1013220767 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15482.95 0 0 0 0 0 0 0 0 0 0 0 0 0 15482.95 0 0 1013221009 1780239434 16 Nurse Practitioners MATTHEWS MAGGIE K 999999999 63 Macon 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 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 1501.05 0 0 0 0 0 0 1501.05 0 0 1013221540 1174899066 10 Physicians LEE VICTORIA 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 4831.55 0 0 0 0 0 0 4831.55 0 0 1013221607 1841517679 13 Podiatrists HOBBS LISA R 999999999 19 Champaign 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 0 184 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 2165.58 0 0 0 0 0 0 2165.58 0 0 1013221714 1164445268 10 Physicians BARTLETT STEPHEN T 999999999 200 Cook 0 0 Vascular Surgery 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 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 0 647.96 0 0 0 0 0 0 647.96 0 0 1013221887 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3055.32 0 0 0 0 0 0 0 0 0 0 0 0 0 3055.32 0 0 1013221988 1275189565 16 Nurse Practitioners STARKWEATHER KEVIN M 999999999 91 Sangamon 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 0 108 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 1943.84 0 0 0 0 0 0 1943.84 0 0 1013222189 1578112363 16 Nurse Practitioners GRAHAM AMANDA S 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 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 0 342.51 0 0 0 0 0 0 342.51 0 0 1013222321 10 Physicians 10 Adams 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1013222569 1669899316 10 Physicians CHANDRAN MEGAN 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 607 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9491.97 0 429.45 0 0 0 0 0 0 9921.42 0 0 1013222883 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19593.35 0 0 0 0 0 0 0 0 0 0 0 0 0 19593.35 0 0 1013223632 1740749779 89 Physician Assistant Only(Encounter Only) COLSON ALEC SAADI 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 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 1422.38 0 0 0 0 0 0 1422.38 0 0 1013224303 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23804.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23804.9 0 0 1013224474 1285054031 10 Physicians BIERMAN TODD V 999999999 24 Coles 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 0 273 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 5887.29 0 0 0 0 0 0 5887.29 0 0 1013224591 1609425701 55 Early Intervention Services NOWICKI - POWROZEK BRITTNEY M 999999999 91 Sangamon 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34221.64 0 0 0 0 0 0 34221.64 0 0 1013224619 1063948131 10 Physicians NIPPOLDT ERIC H 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 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 1093.14 0 0 0 0 0 0 1093.14 0 0 1013224898 1982042297 10 Physicians HAYAKAWA EMIKO J 999999999 53 Kane 0 0 Colon - Rectal 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 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 0 241.4 0 0 0 0 0 0 241.4 0 0 1013225089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1810.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1810.46 0 0 1013225178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4116.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4116.6 0 0 1013226157 4013226157 90 Waiver service provider--Elderly (DOA) "DESTINY HEALTHCARE SERVICE, IN" 999999999 200 Cook 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 6612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 594696.18 0 0 0 0 0 0 0 0 0 0 0 0 0 594696.18 0 0 1013226254 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14316.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14316.53 0 0 1013226267 1700227295 16 Nurse Practitioners STEFKO DEANA L 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 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 0 903.04 0 0 0 0 0 0 903.04 0 0 1013226578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23841.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23841.41 0 0 1013226605 1801443213 22 Physical Therapists REYNOLDS EMMA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 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 5288.08 5288.08 0 0 1013226705 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24254.13 0 0 0 0 0 0 0 0 0 0 0 0 0 24254.13 0 0 1013227470 16 Nurse Practitioners 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.64 0 0 0 0 0 0 26.64 0 0 1013227914 1649823089 11 Dentists UPWARDS ALEXANDER 999999999 200 Cook 0 0 0 0 17 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 2185.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2185.65 0 0 1013228093 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 651.2 0 0 0 0 0 0 0 0 0 0 0 0 0 651.2 0 0 1013228174 1164865200 10 Physicians KIRBY ALANA 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 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 0 464.85 0 0 0 0 0 0 464.85 0 0 1013228196 10 Physicians 200 Cook 0 0 0 0 0 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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 0 480.37 0 0 0 0 0 0 480.37 0 0 1013230489 1114584992 63 Other Providers of Medical Equipment/Supplies (Non-registered) M&L MEDICAL SUPPLIES INC 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16618.58 0 0 0 0 0 0 16618.58 0 0 1013230671 12 Optometrists 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 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 0 157.17 0 0 0 0 0 0 157.17 0 0 1013231291 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6432.42 0 0 0 0 0 0 0 0 0 0 0 0 0 6432.42 0 0 1013231879 10 Physicians 91 Sangamon 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 0 0 0 0 0 0 0 0 0 0 1013231931 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 0 168 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 44654.4 0 0 0 0 0 0 0 0 0 0 0 0 0 44654.4 0 0 1013232126 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37967.3 0 0 0 0 0 0 0 0 0 0 0 0 0 37967.3 0 0 1013232144 1396304788 89 Physician Assistant Only(Encounter Only) CALDERON KARINA 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 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 0 634.58 0 0 0 0 0 0 634.58 0 0 1013232440 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23372 0 0 0 0 0 0 0 0 0 0 0 0 0 23372 0 0 1013232649 1811496821 16 Nurse Practitioners KROPP LYNN M 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 0 389 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 6353.01 0 0 0 0 0 0 6353.01 0 0 1013232848 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7974.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7974.71 0 0 1013232972 1366095333 16 Nurse Practitioners FLORES GODWIN 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 0 186 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 5338.2 0 0 0 0 0 0 5338.2 0 0 1013233605 1861931529 16 Nurse Practitioners SCHROEDER ELIZABETH J 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 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 0 521.19 0 0 0 0 0 0 521.19 0 0 1013233628 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24964.91 0 0 0 0 0 0 0 0 0 0 0 0 0 24964.91 0 0 1013233635 1457908295 89 Physician Assistant Only(Encounter Only) OSTERMANN HANNAH C 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 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 0 732.59 0 0 0 0 0 0 732.59 0 0 1013233690 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 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 0.57 0 0 0 0 0 0 0.57 0 0 1013233811 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 52.48 0 0 0 0 0 0 52.48 0 0 1013233980 1467096958 89 Physician Assistant Only(Encounter Only) CRAIN ERIN 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 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 0 328.71 0 0 0 0 0 0 328.71 0 0 1013234345 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.15 0 0 0 0 0 0 0 0 8.15 0 0 1013234700 1528537388 16 Nurse Practitioners MANDRELL MICHAEL R 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 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 0 284.88 0 0 0 0 0 0 284.88 0 0 1013234759 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20792.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20792.86 0 0 1013234769 10 Physicians 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.52 0 0 0 0 0 0 105.52 0 0 1013234903 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3522.97 0 0 0 0 0 0 0 0 0 0 0 0 0 3522.97 0 0 1013235705 1619325149 10 Physicians LIVERPOOL SIMONE 999999999 200 Cook 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 0 169 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 3402.15 0 0 0 0 0 0 3402.15 0 0 1013235802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18241.74 0 0 0 0 0 0 0 0 0 0 0 0 0 18241.74 0 0 1013235842 1487996799 10 Physicians CORNICELLI MATTHEW 999999999 200 Cook 0 0 Pediatrics 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 0 211 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 5531.11 0 0 0 0 0 0 5531.11 0 0 1013236134 1366823544 10 Physicians ADERIBIGBE OYINADE 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 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 1022.39 0 0 0 0 0 0 1022.39 0 0 1013236529 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21234.86 0 0 0 0 0 0 0 0 0 0 0 0 0 21234.86 0 0 1013237712 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12871.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12871.39 0 0 1013237729 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36585.19 0 0 0 0 0 0 0 0 0 0 0 0 0 36585.19 0 0 1013237816 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15189.09 0 0 0 0 0 0 0 0 0 0 0 0 0 15189.09 0 0 1013237885 1477845337 10 Physicians LARSEN TIMOTHY R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 1320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.95 0 14573.84 0 0 0 0 0 0 14583.79 0 0 1013238062 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 99.31 99.31 0 0 1013238158 1760821474 10 Physicians FIALA JUSTIN A 999999999 200 Cook 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 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 1233.34 0 0 0 0 0 0 1233.34 0 0 1013238515 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 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 5935.1 0 0 0 0 0 0 0 0 0 0 0 0 0 5935.1 0 0 1013238737 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 0 0 0 0 0 0 0 0 0 0 1013238748 1124470745 13 Podiatrists MCGUIRE AMANDA M 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 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 0 489.51 0 0 0 0 0 0 489.51 0 0 1013238811 1891143566 10 Physicians NIKOLIC MARIJA 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 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 1410.93 0 0 0 0 0 0 1410.93 0 0 1013238965 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23960.09 0 0 0 0 0 0 0 0 0 0 0 0 0 23960.09 0 0 1013239010 1013112283 10 Physicians HUYNH LONG H 999999999 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.58 0 0 0 0 0 0 1203.58 0 0 1013239221 1710535950 16 Nurse Practitioners NORMOYLE MELISSA 999999999 53 Kane 0 0 0 0 0 2 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 228.76 0 0 0 0 0 0 0 0 1493.13 0 0 0 0 0 0 1721.89 0 0 1013239262 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11945.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11945.45 0 0 1013239283 1053791848 10 Physicians LEWANDOWSKI ALYSSA S 999999999 88 Richland 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 0 106 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 3284.85 0 0 0 0 0 0 3284.85 0 0 1013239443 1881045219 10 Physicians MYONG ALEXANDER S 999999999 200 Cook 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 0 113 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 3040.33 0 0 0 0 0 0 3040.33 0 0 1013239463 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 1132.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.1 0 0 1013239832 1942846217 16 Nurse Practitioners LANDOWSKI MAGDALENA 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 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 0 357.63 0 0 0 0 0 0 357.63 0 0 1013240022 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 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 4696.78 0 0 0 0 0 0 0 0 0 0 0 0 0 4696.78 0 0 1013240247 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8916.17 0 0 0 0 0 0 0 0 0 0 0 0 0 8916.17 0 0 1013240348 1609437268 20 Registered nurse MANEK KSHITI 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 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 0 266.29 0 0 0 0 0 0 266.29 0 0 1013240597 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013240732 1285869099 10 Physicians DUVVURI PADMARAJ D 999999999 80 Peoria 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 0 141 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 2147.76 0 0 0 0 0 0 2147.76 0 0 1013240903 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 23473.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23473.92 0 0 1013240995 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15992.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15992.85 0 0 1013241104 1952751877 10 Physicians ABOUSAAD ELIAS 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 195 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.77 0 3035.84 0 0 0 0 0 0 3054.61 0 0 1013241123 1376961680 10 Physicians MAMIC MARKO 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 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 1027.3 0 0 0 0 0 0 1027.3 0 0 1013241497 1063054278 89 Physician Assistant Only(Encounter Only) VON HOLTEN NICHOLAS R 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 748.3 0 0 0 0 0 0 748.3 0 0 1013241650 1841729985 16 Nurse Practitioners ANDERSON KIM 999999999 91 Sangamon 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 0 0 0 0 0 0 0 0 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0 35 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1503.35 0 5281.93 0 0 0 0 0 0 6785.28 0 0 1013242613 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 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 0 583.5 0 0 0 0 0 0 583.5 0 0 1013242615 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 0 647.9 0 0 0 0 0 0 647.9 0 0 1013242937 1336569557 10 Physicians ANDERSEN JENNIFER T 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1396.43 0 0 0 0 0 0 1396.43 0 0 1013243377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14716.75 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 1946.82 0 0 0 0 0 0 1946.82 0 0 1013244339 1982254090 16 Nurse Practitioners ANDERSON SARAH A 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 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 0 299.18 0 0 0 0 0 0 299.18 0 0 1013244471 10 Physicians 107 Will 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1013244519 1184967770 10 Physicians ANGULO EVELYN L 999999999 200 Cook 0 0 Allergy-Immunization 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 1834.42 0 0 0 0 0 0 1834.42 0 0 1013244611 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351.54 0 0 0 0 0 0 0 0 0 0 0 0 0 351.54 0 0 1013244948 10 Physicians 91 Sangamon 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 43.88 0 0 0 0 0 0 43.88 0 0 1013245005 1386007359 10 Physicians MENDOZA JAMES P 999999999 53 Kane 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 0 344.47 0 0 0 0 0 0 344.47 0 0 1013245055 1366785206 10 Physicians LIU SHU-HAO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15240.65 0 0 0 0 0 0 15240.65 0 0 1013245373 1326483280 16 Nurse Practitioners ROTERT MARK A 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 653.67 0 0 0 0 0 0 653.67 0 0 1013245626 1164084133 16 Nurse Practitioners RUFFIN REGINA 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 0 652.38 0 0 0 0 0 0 652.38 0 0 1013245714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15745.44 0 0 0 0 0 0 0 0 0 0 0 0 0 15745.44 0 0 1013246142 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 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 0 366.68 366.68 0 0 1013246252 1457992521 16 Nurse Practitioners BAJWA TRIPT 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.85 0 0 0 0 0 0 181.85 0 0 1013246349 1407199755 10 Physicians STROTMAN PATRICK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.99 0 1785.45 0 0 0 0 0 0 1821.44 0 0 1013246535 1548554975 24 Speech Therapists HILL ANN 999999999 53 Kane 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 0 128 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 9620.33 9620.33 0 0 1013246569 1053767046 10 Physicians BUGENHAGEN SCOTT M 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 489.83 0 0 0 0 0 0 0 0 489.83 0 0 1013246701 1982999462 10 Physicians MAR PHILIP 999999999 200 Cook 0 0 Internal Medicine 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 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145 0 0 0 0 0 0 5145 0 0 1013246862 1154984987 55 Early Intervention Services LEONARD SHALANDA V 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 0 761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 761 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43381.8 0 0 0 0 0 0 43381.8 0 0 1013246910 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29255 0 0 0 0 0 0 0 0 0 0 0 0 0 29255 0 0 1013247337 1922061332 88 Other behavior health professional POWELL KELLY G 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 0 114.51 0 0 0 0 0 0 114.51 0 0 1013247502 1043659907 10 Physicians BAJA CATARINICCHIA ANGELA 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 6 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662.63 0 1055.76 0 0 0 0 0 0 1718.39 0 0 1013247507 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.53 0 0 0 0 0 0 64.53 0 0 1013247570 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 18959.81 0 0 0 0 0 0 0 0 0 0 0 0 0 18959.81 0 0 1013247751 1659927382 12 Optometrists PATEL POOJA K 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 54 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 865.5 0 1259.04 0 0 0 0 2124.54 0 0 1013247772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6142.68 0 0 0 0 0 0 0 0 0 0 0 0 0 6142.68 0 0 1013248004 1487069183 10 Physicians KING CHRISTOPHER R 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1159.52 0 0 0 0 0 0 1159.52 0 0 1013248063 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30337.86 0 0 0 0 0 0 0 0 0 0 0 0 0 30337.86 0 0 1013248086 89 Physician Assistant Only(Encounter Only) 11 Alexander 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013248756 1851763700 89 Physician Assistant Only(Encounter Only) BUJA MEGAN E 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 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 1239.42 1239.42 0 0 1013249628 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 0 106.99 0 0 0 0 0 0 106.99 0 0 1013249794 1952643405 10 Physicians CAHILL JENNIFER 999999999 57 Lake 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 0 134 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 4877.44 0 0 0 0 0 0 4877.44 0 0 1013249807 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3226.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3226.87 0 0 1013249832 1598311946 16 Nurse Practitioners NALLY MARISA L 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 0 657.11 0 0 0 0 0 0 657.11 0 0 1013250016 1851896286 11 Dentists BEDMUTHA KETAN 999999999 200 Cook 0 0 General Dentistry 0 0 10 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1435.07 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 2187.77 0 0 1013250365 1427608082 89 Physician Assistant Only(Encounter Only) QUAID EMILY M 999999999 35 Ford 0 0 0 0 0 9 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 237.85 0 0 0 0 0 0 0 0 639.46 0 0 0 0 0 0 877.31 0 0 1013250563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5541.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5541.74 0 0 1013250578 1649783143 16 Nurse Practitioners LAGATAO MARY JOYCE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 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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 7369.32 0 0 0 0 0 0 0 0 0 0 0 0 0 7369.32 0 0 1013253007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1149.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1149.21 0 0 1013253554 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 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 1211.74 0 0 0 0 0 0 1211.74 0 0 1013253576 1386079481 10 Physicians SCHWARTZ MELISSA 999999999 80 Peoria 0 0 Obstetric-Gynecology 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 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 0 616.26 0 0 0 0 0 0 616.26 0 0 1013253746 1255712535 10 Physicians KRATER RACHEL ELANA 999999999 200 Cook 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 0 132 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 1568.56 0 0 0 0 0 0 1568.56 0 0 1013253877 1700309234 16 Nurse Practitioners OLEK ELLEN 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 0 416 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 2241.47 0 0 0 0 0 0 2241.47 0 0 1013254136 4013254136 91 Waiver service provider--Adults (DHS/DDD) LOVSEY BRYCE 999999999 91 Sangamon 0 0 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 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 18548.39 0 0 0 0 0 0 0 0 0 0 0 0 0 18548.39 0 0 1013254293 1477083236 10 Physicians ENRIGHT JENNIFER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.73 0 1299.76 0 0 0 0 0 0 1415.49 0 0 1013254330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 599.88 0 0 0 0 0 0 0 0 0 0 0 0 0 599.88 0 0 1013254702 1538267281 16 Nurse Practitioners SINTSOV DMITRIY 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 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 0 640.04 0 0 0 0 0 0 640.04 0 0 1013254748 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1015.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1015.56 0 0 1013255644 1811316201 10 Physicians STEPAN JEFFREY G 999999999 30 DuPage 0 0 Orthopedic Surgery 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 0 107 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 8583.38 0 0 0 0 0 0 8583.38 0 0 1013255741 10 Physicians 89 Rock Island 0 0 Internal Medicine 0 0 0 0 0 0 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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 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 7872 0 0 0 0 0 0 0 0 0 0 0 0 0 7872 0 0 1013257005 1366007007 36 Community mental health provider "CENTERSTONE OF ILLINOIS, INC." 999999999 108 Williamson 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 125.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 964.39 0 0 1090.11 0 0 1013257262 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27941.03 0 0 0 0 0 0 0 0 0 0 0 0 0 27941.03 0 0 1013257735 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 0 546.27 0 0 0 0 0 0 0 0 0 0 0 0 0 546.27 0 0 1013257768 1255696605 10 Physicians JAFRI AFTAB 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 0 197 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 3852.92 0 0 0 0 0 0 3852.92 0 0 1013257830 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8030.85 0 0 0 0 0 0 0 0 0 0 0 0 0 8030.85 0 0 1013257869 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22359.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22359.63 0 0 1013257943 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33413.07 0 0 0 0 0 0 0 0 0 0 0 0 0 33413.07 0 0 1013257958 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9092.38 0 0 0 0 0 0 0 0 0 0 0 0 0 9092.38 0 0 1013257963 1548812258 16 Nurse Practitioners RACHAN JENNIFER L 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 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 1013258134 1538635198 100 Family Support Program "NEURORESTORATIVE, ILLINOIS" 999999999 200 Cook 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 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 642000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 642000 0 0 1013258475 1174985634 10 Physicians JAHANGIR NUMAN 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 0 196 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 3221.48 0 0 0 0 0 0 3221.48 0 0 1013258797 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6510.66 0 0 0 0 0 0 0 0 0 0 0 0 0 6510.66 0 0 1013258906 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3683.93 3683.93 0 0 1013259237 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189.55 0 0 0 0 0 0 0 0 0 0 0 0 0 189.55 0 0 1013259781 10 Physicians 200 Cook 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 39.86 0 0 0 0 0 0 39.86 0 0 1013259925 1669829776 10 Physicians SMITH BONNIE J 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 1259.88 0 0 0 0 0 0 1259.88 0 0 1013260402 1174504674 10 Physicians ALEXANDER MICHAEL B 999999999 47 Jackson 0 0 Emergency Medicine 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 0 111 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 2826.52 0 0 0 0 0 0 2826.52 0 0 1013260629 1386288660 89 Physician Assistant Only(Encounter Only) TONE ERIKA 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 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 1.62 0 0 0 0 0 0 1.62 0 0 1013260750 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3277.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3277.47 0 0 1013260897 1992217178 10 Physicians MUSTAFA YASER R 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 18 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 855.16 0 1492.65 0 0 0 0 0 0 2347.81 0 0 1013260907 1972161347 89 Physician Assistant Only(Encounter Only) SCHEMMEL ROBIN 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 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 0 239.06 0 0 0 0 0 0 239.06 0 0 1013260962 1932442076 10 Physicians ALFIERI DAVID 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 19 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.08 0 2353.99 0 0 0 0 0 0 2443.07 0 0 1013261218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22907.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22907.25 0 0 1013261230 1649566480 10 Physicians ALLAM EMAD 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1166 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1971 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10031.52 0 236.21 0 0 0 0 0 0 10267.73 0 0 1013261653 1770927337 10 Physicians GOODWIN MATTHEW L 999999999 106 Whiteside 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 10 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 1148.24 0 0 0 0 0 0 1148.24 0 0 1013261836 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 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 2701.21 0 0 0 0 0 0 2701.21 0 0 1013262241 1558682096 10 Physicians SIEBENALER JOSEPH 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 5 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7185.2 0 0 0 0 0 0 7185.2 0 0 1013262392 1316367972 24 Speech Therapists RAO CARRIE 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 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 3019.13 3019.13 0 0 1013262542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5199.54 0 0 0 0 0 0 0 0 0 0 0 0 0 5199.54 0 0 1013262608 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.59 0 0 0 0 0 0 0 0 0 0 0 0 0 58.59 0 0 1013262875 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6455.74 0 0 0 0 0 0 0 0 0 0 0 0 0 6455.74 0 0 1013263029 1760959209 16 Nurse Practitioners VAUGHN LATONYA S 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 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 2518.21 0 0 0 0 0 0 2518.21 0 0 1013263123 1003389503 16 Nurse Practitioners DANAIATA EDITA 999999999 106 Whiteside 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 0 764.88 0 0 0 0 0 0 764.88 0 0 1013263508 1669817128 10 Physicians NGUYEN CUONG V 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 54 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1303.87 0 2039.06 0 0 0 0 0 0 3342.93 0 0 1013264094 1578124103 25 Audiologists CORRIGAN MEGAN L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 244.66 244.66 0 0 1013264248 1932457785 61 Independent Laboratories CONSOLIDATED PATHOLOGY INC 999999999 844 Tennessee 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 0 322 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 5461.12 0 0 0 0 0 0 0 0 5461.12 0 0 1013264590 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11644.01 0 0 0 0 0 0 0 0 0 0 0 0 0 11644.01 0 0 1013264640 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12206.13 0 0 0 0 0 0 0 0 0 0 0 0 0 12206.13 0 0 1013264841 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 43.54 0 0 0 0 0 0 43.54 0 0 1013265448 1508258393 89 Physician Assistant Only(Encounter Only) BUCKLES LINDSEY E 999999999 50 Jersey 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 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 0 516.72 0 0 0 0 0 0 516.72 0 0 1013265866 1871835249 10 Physicians CASEY KEVIN 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 0 153 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 3116.71 0 0 0 0 0 0 3116.71 0 0 1013265869 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25550.37 0 0 0 0 0 0 0 0 0 0 0 0 0 25550.37 0 0 1013265888 1992124994 10 Physicians LYNCH NICHOLAS 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 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 0 374.64 0 0 0 0 0 0 374.64 0 0 1013266040 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5512.98 0 0 0 0 0 0 0 0 0 0 0 0 0 5512.98 0 0 1013266319 1568815660 10 Physicians CHATTERJEE TULIKA 999999999 80 Peoria 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 0 117 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 1086.06 0 0 0 0 0 0 1086.06 0 0 1013266382 1154762870 10 Physicians MORAD MOHAMMAD 999999999 200 Cook 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 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4349.27 0 0 0 0 0 0 4349.27 0 0 1013266459 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10755.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10755.92 0 0 1013266980 1366825119 10 Physicians CHO JANIS 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 0 254 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 2238.66 0 0 0 0 0 0 2238.66 0 0 1013267001 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20834.42 0 0 0 0 0 0 0 0 0 0 0 0 0 20834.42 0 0 1013267093 1821442237 13 Podiatrists AHMED MANSOOR 999999999 57 Lake 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 0 270.39 0 0 0 0 0 0 270.39 0 0 1013267124 1447605126 10 Physicians EL-DIN MAGDY A 999999999 30 DuPage 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 4513.87 0 0 0 0 0 0 4513.87 0 0 1013267199 1710340252 10 Physicians LAPINSKI JESSICA 999999999 53 Kane 0 0 Family Practice 0 0 0 3 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 93 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 103.08 0 0 0 0 0 0 0 0 1710.15 0 0 0 0 0 0 1813.23 0 0 1013267401 1326522459 16 Nurse Practitioners JAMES SHARAINE 999999999 200 Cook 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 0 307 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 2875.91 0 0 0 0 0 0 2875.91 0 0 1013267855 1316591761 16 Nurse Practitioners KERN SHELBY 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 134.16 0 0 0 0 0 0 0 0 1894.11 0 0 0 0 0 0 2028.27 0 0 1013268290 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13398.51 0 0 0 0 0 0 0 0 0 0 0 0 0 13398.51 0 0 1013268293 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22667.83 0 0 0 0 0 0 0 0 0 0 0 0 0 22667.83 0 0 1013268566 1497317119 89 Physician Assistant Only(Encounter Only) KENNEY MOLLY 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 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 0 152.73 0 0 0 0 0 0 152.73 0 0 1013269046 1518527365 91 Waiver service provider--Adults (DHS/DDD) JAKOVLJEVIC STEPHANIE 999999999 19 Champaign 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 2431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93418.07 0 0 0 0 0 0 0 0 0 0 0 0 0 93418.07 0 0 1013269252 1609422864 16 Nurse Practitioners COWAN KAITLYN 999999999 200 Cook 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 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 29.2 0 0 0 0 0 0 0 0 2275.53 0 0 0 0 0 0 2304.73 0 0 1013269506 1023577442 16 Nurse Practitioners KEEN CHRISTIE M 999999999 24 Coles 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 2109.2 0 0 0 0 0 0 2109.2 0 0 1013269630 1255778015 10 Physicians TRAN FRANK K 999999999 91 Sangamon 0 0 General Practice 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 39 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 906.78 0 0 0 0 0 0 991.4 0 0 1013269733 1043668239 10 Physicians GRAHAM EDITH 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 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 1611.19 0 0 0 0 0 0 1611.19 0 0 1013269790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7567.87 0 0 0 0 0 0 0 0 0 0 0 0 0 7567.87 0 0 1013269792 4013269792 71 Medicar Provider HIS GRACE MEDICAR 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 1161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9346.52 0 0 0 0 0 0 9346.52 0 0 1013269836 1528422631 10 Physicians RAJABBIK MHD HASHEM 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1270.5 0 0 0 0 0 0 1270.5 0 0 1013269905 1356995401 16 Nurse Practitioners CHAMBERS CASSANDRA E 999999999 47 Jackson 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 0 188 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 1467.34 0 0 0 0 0 0 1467.34 0 0 1013270064 10 Physicians 24 Coles 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.8 0 0 0 0 0 0 178.8 0 0 1013270114 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23679.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23679.04 0 0 1013270219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3926.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3926.06 0 0 1013270446 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 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 23275.76 0 0 0 0 0 0 0 0 0 0 0 0 0 23275.76 0 0 1013270586 1861830655 10 Physicians PATEL SHAWN 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 326.6 0 0 0 0 0 0 326.6 0 0 1013270934 1831559509 48 Rural Health Clinics FAMILY MEDICAL CENTER - OAKLAN 999999999 24 Coles 0 0 0 59 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6839.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6839.16 0 0 1013271239 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23110.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23110.5 0 0 1013271673 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21270.29 0 0 0 0 0 0 0 0 0 0 0 0 0 21270.29 0 0 1013271716 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 0 242.46 0 0 0 0 0 0 242.46 0 0 1013271738 1649436510 10 Physicians WILLIAMS CAMILLE F 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 0 406 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 2715.47 0 0 0 0 0 0 2715.47 0 0 1013271772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24233.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24233.57 0 0 1013271953 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 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 0 331.08 0 0 0 0 0 0 331.08 0 0 1013272213 10 Physicians 815 Indiana 0 0 Radiation Oncology 0 0 0 0 0 0 0 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 0 154.68 0 0 0 0 0 0 154.68 0 0 1013272444 1952874562 16 Nurse Practitioners CONLIN SAMANTHA R 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 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 0 234.27 0 0 0 0 0 0 234.27 0 0 1013272607 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 25381.81 0 0 0 0 0 0 0 0 0 0 0 0 0 25381.81 0 0 1013272847 1982947149 10 Physicians KNOBELOCH DEIRDRE H 999999999 23 Clinton 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 7 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575.2 0 2773.77 0 0 0 0 0 0 3348.97 0 0 1013273326 1962857185 10 Physicians KADIA YANNICK A 999999999 80 Peoria 0 0 Internal 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 0 142 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 1460.6 0 0 0 0 0 0 1460.6 0 0 1013273423 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16249.83 0 0 0 0 0 0 0 0 0 0 0 0 0 16249.83 0 0 1013273439 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 47.62 0 0 0 0 0 0 47.62 0 0 1013273799 1750380820 10 Physicians GLASS JAMES D 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.63 0 1381.66 0 0 0 0 0 0 1400.29 0 0 1013274133 1245643618 10 Physicians LIN JEAN Y 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 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 66.4 0 0 0 0 0 0 66.4 0 0 1013274350 1154347359 89 Physician Assistant Only(Encounter Only) CROFT DELLA D 999999999 60 Lee 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 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 39.07 0 0 0 0 0 0 39.07 0 0 1013274526 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24054.33 0 0 0 0 0 0 0 0 0 0 0 0 0 24054.33 0 0 1013274730 1346380367 10 Physicians CLARE MICHELLE 999999999 10 Adams 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 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 1980.83 0 0 0 0 0 0 1980.83 0 0 1013274732 1427519974 89 Physician Assistant Only(Encounter Only) JAKUBONIS LUKAS 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 276.23 0 0 0 0 0 0 276.23 0 0 1013274921 4013274921 72 Taxicabs and Livery Companies HEALTHY JOURNEY TRANSPORTATION 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 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6173.06 0 0 0 0 0 0 6173.06 0 0 1013274940 1306481890 10 Physicians JOCUM JONATHAN 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1173.34 0 0 0 0 0 0 1173.34 0 0 1013274967 1083068639 87 Psychologist(Encounter Only) HARDIN ABIGAIL S 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 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 0 695.79 0 0 0 0 0 0 695.79 0 0 1013275177 1194194100 12 Optometrists DHARIA NEHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 82 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 161 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 161 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 93.69 0 0 4841.51 0 1727.52 0 0 0 0 6662.72 0 0 1013275270 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 0 180.12 0 0 0 0 0 0 180.12 0 0 1013275319 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 20640.53 0 0 0 0 0 0 0 0 0 0 0 0 0 20640.53 0 0 1013275368 1477196533 89 Physician Assistant Only(Encounter Only) COREY SAMANTHA 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3095.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3095.37 0 0 1013276049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13139.57 0 0 0 0 0 0 0 0 0 0 0 0 0 13139.57 0 0 1013276106 1831683820 10 Physicians MARINSHAW JEFFREY 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 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 0 362.57 0 0 0 0 0 0 362.57 0 0 1013276189 1639642333 16 Nurse Practitioners LIPINSKI MATTHEW T 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 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 1281.28 0 0 0 0 0 0 1281.28 0 0 1013276239 1407386667 12 Optometrists HANSEN RYAN J 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 25 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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 0 185 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 11151.93 0 0 0 0 0 0 0 0 0 0 0 0 0 11151.93 0 0 1013293113 1811335748 10 Physicians LEUNG PATRICK 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 21 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.12 0 1989.18 0 0 0 0 0 0 2070.3 0 0 1013293283 1437794559 24 Speech Therapists BRUNNER MICHELLE T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 5439.98 5439.98 0 0 1013293686 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1045.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1045.99 0 0 1013293917 91 Waiver service 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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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.05 0 0 0 0 0 0 1.05 0 0 1013295958 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37781.73 0 0 0 0 0 0 0 0 0 0 0 0 0 37781.73 0 0 1013296005 1932669835 87 Psychologist(Encounter Only) RYNAR LAUREN Z 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 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 0 407.43 0 0 0 0 0 0 407.43 0 0 1013296046 1003374182 16 Nurse Practitioners RUIZ BRENDA 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 0 354.42 0 0 0 0 0 0 354.42 0 0 1013296300 94 Waiver service 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1013297278 1003463225 16 Nurse Practitioners JASON GRAUER 999999999 91 Sangamon 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 0 135 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 3541.32 0 0 0 0 0 0 3541.32 0 0 1013297380 1891105920 10 Physicians HOU JUE 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 2609.5 0 0 0 0 0 0 2609.5 0 0 1013297448 1194369223 86 Clinical Social Worker(Encounter Only) MERIWETHER RACHEL 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 0 645.27 0 0 0 0 0 0 645.27 0 0 1013297561 10 Physicians 200 Cook 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 39.86 0 0 0 0 0 0 39.86 0 0 1013297601 1083256572 16 Nurse Practitioners LEE AMY 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 56 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 51.52 0 0 0 0 0 0 0 0 2440.45 0 0 0 0 0 0 2491.97 0 0 1013297864 1467973396 12 Optometrists PRESTWICH CLINTON R 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 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 0 958.41 0 0 0 0 0 0 958.41 0 0 1013298073 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1486.45 0 0 0 0 0 0 0 0 0 0 0 0 0 1486.45 0 0 1013298159 10 Physicians 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 81.88 0 0 0 0 0 0 81.88 0 0 1013298224 91 Waiver service 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891.14 0 0 1013298965 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 89.48 0 0 0 0 0 0 89.48 0 0 1013299368 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 0 132 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 12467.52 0 0 0 0 0 0 0 0 0 0 0 0 0 12467.52 0 0 1013299568 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 8515.04 0 0 0 0 0 0 0 0 0 0 0 0 0 8515.04 0 0 1013299993 1295381556 16 Nurse Practitioners SKINNER KRISTINA C 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 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 46.27 0 0 0 0 0 0 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0 0 0 1071.53 0 0 1013301186 1972917292 10 Physicians QIU MARY 999999999 30 DuPage 0 0 Ophthalmology 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 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 8194.72 0 0 0 0 0 0 8194.72 0 0 1013301273 1184268286 23 Occupational Therapists SCHLINK KAITLYN 999999999 80 Peoria 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 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 2327.71 2327.71 0 0 1013301427 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 0 184.67 0 0 0 0 0 0 184.67 0 0 1013301742 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2628.9 0 0 0 0 0 0 2628.9 0 0 1013301851 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 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 5989.07 0 0 0 0 0 0 0 0 0 0 0 0 0 5989.07 0 0 1013302064 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013302273 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312.47 0 0 0 0 0 0 0 0 0 0 0 0 0 312.47 0 0 1013302348 1255853859 10 Physicians DE OLIVEIRA SOARES RICARDO M 999999999 53 Kane 0 0 Urology 0 0 0 0 0 0 0 0 0 0 7 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.46 0 4122.41 0 0 0 0 0 0 4135.87 0 0 1013302830 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013302995 1861802621 10 Physicians DOLAN PATRICK 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 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 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6205.3 0 0 0 0 0 0 6205.3 0 0 1013303054 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29610.04 0 0 0 0 0 0 0 0 0 0 0 0 0 29610.04 0 0 1013303277 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19665.13 0 0 0 0 0 0 0 0 0 0 0 0 0 19665.13 0 0 1013303331 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14022.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14022.77 0 0 1013303724 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 93.03 0 0 0 0 0 0 93.03 0 0 1013303848 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 0 0 0 0 0 0 0 0 0 0 1013303857 1194373662 16 Nurse Practitioners MONSIVAIS ALYSSA 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 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 2200.89 0 0 0 0 0 0 2200.89 0 0 1013304544 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380.72 0 0 0 0 0 0 380.72 0 0 1013304909 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 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 3046.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3046.64 0 0 1013305083 1679981096 11 Dentists TANIELIAN ALEX 999999999 200 Cook 0 0 0 0 37 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 11536.39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11536.39 0 0 1013305305 1245636695 10 Physicians LANTIGUA HECTOR 999999999 19 Champaign 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 6836.92 0 0 0 0 0 0 6836.92 0 0 1013305376 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 2 0 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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 0 211 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 16508.51 0 0 0 0 0 0 0 0 0 0 0 0 0 16508.51 0 0 1013305615 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 69.17 0 0 0 0 0 0 69.17 0 0 1013305966 1194377325 16 Nurse Practitioners MAGILLIGAN COLLIN PATRICK 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 410.9 0 0 0 0 0 0 410.9 0 0 1013306314 1831745041 16 Nurse Practitioners MATTHEWS MEGHAN 999999999 63 Macon 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 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 1472.23 0 0 0 0 0 0 1472.23 0 0 1013306452 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 0 0 0 10 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 0 553.68 553.68 0 0 1013307287 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4891.14 0 0 0 0 0 0 0 0 0 0 0 0 0 4891.14 0 0 1013307656 1629368519 10 Physicians ROZELL JOSEPH 999999999 88 Richland 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 521.84 0 0 0 0 0 0 0 0 521.84 0 0 1013307968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16853.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16853.7 0 0 1013308042 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8766.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8766.8 0 0 1013308556 1043484561 10 Physicians PAPAGIANNIS IOANNIS 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 0 116 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 2008.92 0 0 0 0 0 0 2008.92 0 0 1013309096 1740789064 55 Early Intervention Services TEACHOUT APRIL MICHELLE 999999999 91 Sangamon 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 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40868.05 0 0 0 0 0 0 40868.05 0 0 1013309497 1922418375 10 Physicians FIELD MATTHEW S 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 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 0 347.84 0 0 0 0 0 0 347.84 0 0 1013310053 1306494877 16 Nurse Practitioners BECK JERRY M 999999999 19 Champaign 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1628.06 0 0 0 0 0 0 1628.06 0 0 1013310399 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 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 10383.45 0 0 0 0 0 0 0 0 0 0 0 0 0 10383.45 0 0 1013310468 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3300.93 0 0 0 0 0 0 0 0 0 0 0 0 0 3300.93 0 0 1013310539 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 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 0 695.28 0 0 0 0 0 0 695.28 0 0 1013310581 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 0 151.76 0 0 0 0 0 0 151.76 0 0 1013310667 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 1013310734 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5183.44 0 0 0 0 0 0 0 0 0 0 0 0 0 5183.44 0 0 1013311206 1669866836 10 Physicians REISH NICHOLAS J 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 962.87 0 0 0 0 0 0 962.87 0 0 1013311380 1902034499 10 Physicians VUONG GIAO 999999999 30 DuPage 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 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 0 472.18 0 0 0 0 0 0 472.18 0 0 1013311473 1871937060 10 Physicians RICHARDSON AIDA I 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 25 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 0 866.62 0 0 0 0 0 0 0 0 866.62 0 0 1013311731 1770134371 16 Nurse Practitioners ROTHWELL MARY 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 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 0 880.07 0 0 0 0 0 0 880.07 0 0 1013311812 1821656273 12 Optometrists JANKIEWICZ JESSICA 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 0 188.04 0 0 0 0 0 0 188.04 0 0 1013311936 1417503988 16 Nurse Practitioners KELSON HOLLY E 999999999 200 Cook 0 0 0 0 0 12 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 1058.54 0 0 0 0 0 0 0 0 1170.59 0 0 0 0 0 0 2229.13 0 0 1013312072 1386164739 10 Physicians YANG DONALD L 999999999 80 Peoria 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 0 128 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 0 646.51 0 0 0 0 0 0 646.51 0 0 1013312144 1326507195 16 Nurse Practitioners MITCHELL MELISSA R 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 0 184.09 0 0 0 0 0 0 184.09 0 0 1013312626 89 Physician Assistant Only(Encounter Only) 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.56 0 0 0 0 0 0 168.56 0 0 1013314239 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 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 2675.34 2675.34 0 0 1013314795 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 0 224 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 15820.09 0 0 0 0 0 0 0 0 0 0 0 0 0 15820.09 0 0 1013315020 1558382366 10 Physicians BESSETTE PETER 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 346 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11991.04 0 232.37 0 0 0 0 0 0 12223.41 0 0 1013315066 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24878.03 0 0 0 0 0 0 0 0 0 0 0 0 0 24878.03 0 0 1013315248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22985.62 0 0 0 0 0 0 0 0 0 0 0 0 0 22985.62 0 0 1013315756 1952530032 10 Physicians ROSEMAN DANIEL 999999999 200 Cook 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 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9767.75 0 0 0 0 0 0 9767.75 0 0 1013315890 1649753435 16 Nurse Practitioners WAKSMUNDZKI-PAVLIK MICHELLE N 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 1679.85 0 0 0 0 0 0 1679.85 0 0 1013316017 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3406.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3406.64 0 0 1013316021 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21405.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21405.48 0 0 1013316362 1033353792 10 Physicians ACHUFUSI TED GEORGE ODY 999999999 200 Cook 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 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 0 186.58 0 0 0 0 0 0 186.58 0 0 1013316763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15516.61 0 0 0 0 0 0 0 0 0 0 0 0 0 15516.61 0 0 1013316992 1255987749 24 Speech Therapists PUGSLEY MOLLY 999999999 91 Sangamon 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 0 454 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 31539.65 31539.65 0 0 1013317132 1568728939 10 Physicians FOELLER MEGAN E 999999999 49 Jefferson 0 0 Obstetric-Gynecology 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 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.48 0 132.96 0 0 0 0 0 0 259.44 0 0 1013317408 1386184893 55 Early Intervention Services GANG JENNIFER 999999999 53 Kane 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 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36756.35 0 0 0 0 0 0 36756.35 0 0 1013317555 1710336631 10 Physicians TAN ISAAC C 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.26 0 2369.66 0 0 0 0 0 0 2424.92 0 0 1013317920 1366001299 16 Nurse Practitioners RODRIGUEZ BRITTNEE J 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 945.85 0 0 0 0 0 0 945.85 0 0 1013318087 1831692821 22 Physical Therapists ALOBA RENE GREGORY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 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 0 965.22 965.22 0 0 1013318112 1255825220 10 Physicians AL-KHALIL BILAL 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 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 0 307.49 0 0 0 0 0 0 307.49 0 0 1013318216 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 1392.79 0 0 0 0 0 0 1392.79 0 0 1013318616 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18506.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18506.28 0 0 1013318630 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 0 0 0 0 0 0 0 0 0 0 1013318858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2228.21 0 0 0 0 0 0 0 0 0 0 0 0 0 2228.21 0 0 1013319132 10 Physicians 107 Will 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 0 161.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.42 0 0 1013319235 1447543475 10 Physicians TRIPATHI SHIVANI V 999999999 47 Jackson 0 0 Dermatology 0 0 0 0 0 0 0 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 93.66 0 0 0 0 0 0 93.66 0 0 1013319607 1881259943 16 Nurse Practitioners ELLINGSON KATHERINE E 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 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 74.5 0 0 0 0 0 0 74.5 0 0 1013319992 1770137937 33 Nursing Facilities HILLTOP SKILLED NURSING AND RE 999999999 24 Coles 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400880.08 0 0 0 0 0 0 0 400880.08 0 0 1013320064 1508352113 25 Audiologists ANDERSON KAITLIN M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1107.59 1107.59 0 0 1013320717 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7099.55 0 0 0 0 0 0 0 0 0 0 0 0 0 7099.55 0 0 1013320781 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28514.32 0 0 0 0 0 0 0 0 0 0 0 0 0 28514.32 0 0 1013321545 1700377603 10 Physicians ZOBRIST KACEY C 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 242.48 0 0 0 0 0 0 339.08 0 0 1013321687 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20819.12 0 0 0 0 0 0 0 0 0 0 0 0 0 20819.12 0 0 1013321814 1952849390 55 Early Intervention Services LOITERMAN NITZA 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 0 127 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 7612.44 0 0 0 0 0 0 7612.44 0 0 1013321831 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356.9 0 0 0 0 0 0 0 0 0 0 0 0 0 356.9 0 0 1013322556 1962936047 10 Physicians KNIGHT ROBERT J 999999999 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 0 163 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 1943.65 0 0 0 0 0 0 1943.65 0 0 1013322639 1437719291 16 Nurse Practitioners FELCKOWSKI DAKOTA L 999999999 109 Winnebago 0 0 0 0 0 42 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 3799.4 0 0 0 0 0 0 0 0 3143.37 0 0 0 0 0 0 6942.77 0 0 1013322841 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17713.19 0 0 0 0 0 0 0 0 0 0 0 0 0 17713.19 0 0 1013322878 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1982.77 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.77 0 0 1013322934 1235471905 10 Physicians LINDLE LAUREN F 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 6 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 199.08 0 0 0 0 0 0 0 0 2757.18 0 0 0 0 0 0 2956.26 0 0 1013323302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3239.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3239.37 0 0 1013323325 1851551428 10 Physicians PORAYETTE PRASHOB 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 0 157.46 0 0 0 0 0 0 157.46 0 0 1013323692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18333.92 0 0 0 0 0 0 0 0 0 0 0 0 0 18333.92 0 0 1013323796 1245626951 10 Physicians PHILIP MICHELLE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 16 0 19 0 0 0 0 0 0 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 21 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.62 0 456.96 0 0 0 0 0 0 520.58 0 0 1013324132 1497306302 22 Physical Therapists JACOBS MORGAN 999999999 106 Whiteside 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 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 0 614.71 614.71 0 0 1013324422 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5058.38 0 0 0 0 0 0 0 0 0 0 0 0 0 5058.38 0 0 1013324722 1972914869 10 Physicians GUPTA SAHIL 999999999 47 Jackson 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 2 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 516 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.52 0 6482.93 0 0 0 0 0 0 6505.45 0 0 1013324737 1194279000 16 Nurse Practitioners BIVENS SHAUNA L 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 329.24 0 0 0 0 0 0 329.24 0 0 1013324931 1194139923 10 Physicians NGO THOI 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 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 3886.02 0 0 0 0 0 0 3886.02 0 0 1013325063 1992122410 10 Physicians MITHAL DIVAKAR S 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 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 2468.88 0 0 0 0 0 0 2468.88 0 0 1013325068 16 Nurse Practitioners 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 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 0 109.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.72 0 0 1013325195 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 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 3392.38 0 0 0 0 0 0 0 0 0 0 0 0 0 3392.38 0 0 1013325205 1609213958 10 Physicians CHAUDHRY HUNAN 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 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 2176.82 0 0 0 0 0 0 2176.82 0 0 1013325337 1003269846 10 Physicians BAN SUYEUN 999999999 10 Adams 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 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 0 393 0 0 0 0 0 0 393 0 0 1013325364 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9068.21 0 0 0 0 0 0 0 0 0 0 0 0 0 9068.21 0 0 1013325468 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21352.7 0 0 0 0 0 0 0 0 0 0 0 0 0 21352.7 0 0 1013325678 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550.8 0 0 0 0 0 0 0 0 0 0 0 0 0 550.8 0 0 1013325798 1457919557 11 Dentists BAKIR YASMIN 999999999 200 Cook 0 0 General Dentistry 0 0 139 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 601 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 18337.25 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 18713.6 0 0 1013325847 1124461645 10 Physicians GROENWALD MATTHEW T 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 175 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2436.84 0 3843.96 0 0 0 0 0 0 6280.8 0 0 1013326551 94 Waiver service provider--Children's support (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 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 4564.38 0 0 0 0 0 0 0 0 0 0 0 0 0 4564.38 0 0 1013326783 1366947368 11 Dentists MAZON ABIGAIL A 999999999 200 Cook 0 0 General Dentistry 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2103.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2103.47 0 0 1013326952 1518306489 10 Physicians LYGRISSE DANIEL R 999999999 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 39 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695.58 0 6600.61 0 0 0 0 0 0 7296.19 0 0 1013327089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37836.9 0 0 0 0 0 0 0 0 0 0 0 0 0 37836.9 0 0 1013327801 1225591480 11 Dentists GARRIGAN CARLY 999999999 200 Cook 0 0 0 0 209 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1139 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 1139 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 47192.3 0 0 0 0 0 0 0 0 0 0 0 6021.6 0 0 0 0 53213.9 0 0 1013328665 1467927103 91 Waiver service provider--Adults (DHS/DDD) BAKHSHI KHIZRAN M 606033353 200 Cook 0 0 0 0 0 0 0 19 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 1405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133233.6 0 0 0 0 0 0 0 0 0 0 0 0 0 133233.6 0 0 1013328682 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31580.26 0 0 0 0 0 0 0 0 0 0 0 0 0 31580.26 0 0 1013328742 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 30.47 0 0 0 0 0 0 30.47 0 0 1013329031 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25240.08 0 0 0 0 0 0 0 0 0 0 0 0 0 25240.08 0 0 1013329032 1881951259 10 Physicians JOHN SARAH E 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 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 4592.56 0 0 0 0 0 0 4592.56 0 0 1013329042 1427462282 10 Physicians PATEL GOPI R 999999999 200 Cook 0 0 Anesthesiology 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6191.88 0 0 0 0 0 0 6191.88 0 0 1013329543 1891115077 10 Physicians KIM ANDREW D 999999999 200 Cook 0 0 Anesthesiology 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 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 3880.78 0 0 0 0 0 0 3880.78 0 0 1013329605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22643.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22643.47 0 0 1013329657 1669029013 16 Nurse Practitioners ENZWEILER KELLEY L 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 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 0 470.25 0 0 0 0 0 0 470.25 0 0 1013330200 1194377846 33 Nursing Facilities SOUTHVIEW MANOR 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 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349181.57 0 0 0 0 0 0 0 349181.57 0 0 1013330489 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23739.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23739.8 0 0 1013330518 10 Physicians 19 Champaign 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430.98 0 0 0 0 0 0 430.98 0 0 1013330527 1164788741 10 Physicians DESAI LAJJA 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 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 1741.13 0 0 0 0 0 0 1741.13 0 0 1013330711 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20156.31 0 0 0 0 0 0 0 0 0 0 0 0 0 20156.31 0 0 1013331083 1205841707 10 Physicians EROGLU YASEMEN 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 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 0 659.08 0 0 0 0 0 0 659.08 0 0 1013331388 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21846.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21846.47 0 0 1013331757 1770010233 10 Physicians SALAMA MOHAMAD 999999999 200 Cook 0 0 Family Practice 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 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 0 815.81 0 0 0 0 0 0 815.81 0 0 1013332330 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 1013332649 1033764998 16 Nurse Practitioners KOLACKI TERRA L 999999999 53 Kane 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 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 1809.3 0 0 0 0 0 0 1809.3 0 0 1013332651 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 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 96.97 0 0 0 0 0 0 96.97 0 0 1013333172 1861430373 10 Physicians FATEMI NASTARAN 999999999 105 White 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 585.84 0 0 0 0 0 0 0 0 585.84 0 0 1013333198 1356985063 16 Nurse Practitioners KYULULE SUZANNA 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 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 0 506.24 0 0 0 0 0 0 506.24 0 0 1013333577 10 Physicians 25 Crawford 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 0 242.39 0 0 0 0 0 0 242.39 0 0 1013333598 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11233.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11233.2 0 0 1013333677 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 0 145 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 5741.67 0 0 0 0 0 0 0 0 0 0 0 0 0 5741.67 0 0 1013333814 1346808912 24 Speech Therapists SUNVOLD MARY 999999999 200 Cook 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 0 291 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 20490.46 20490.46 0 0 1013333852 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23671.12 0 0 0 0 0 0 0 0 0 0 0 0 0 23671.12 0 0 1013334102 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 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 0 443.2 443.2 0 0 1013334264 1164866216 10 Physicians BARREDA CHRISTINA 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 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 0 695.07 0 0 0 0 0 0 695.07 0 0 1013334602 1467927392 12 Optometrists HANISH NICOLE 999999999 108 Williamson 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Practitioners GAREY ANN H 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 0 191 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 2073.08 0 0 0 0 0 0 2073.08 0 0 1013336053 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 761.62 0 0 0 0 0 0 0 0 0 0 0 0 0 761.62 0 0 1013336145 1568859775 10 Physicians BOLY FRANCES JEAN 999999999 200 Cook 0 0 Internal Medicine 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 0 406 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 5983.61 0 0 0 0 0 0 5983.61 0 0 1013336174 1124464789 10 Physicians MA KAREN H 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 0 117 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 2661.05 0 0 0 0 0 0 2661.05 0 0 1013336196 1992153308 16 Nurse Practitioners MILEWSKI AMY 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.2 0 0 0 0 0 0 233.2 0 0 1013336241 1043861883 23 Occupational Therapists HARPER KELSIE A 999999999 88 Richland 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 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 5649.69 5649.69 0 0 1013336258 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18260.46 0 0 0 0 0 0 0 0 0 0 0 0 0 18260.46 0 0 1013336386 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 1013336423 1043330749 16 Nurse 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provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24420 0 0 0 0 0 0 0 0 0 0 0 0 0 24420 0 0 1013337220 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 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 1013337422 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 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 0 507.06 0 0 0 0 0 0 507.06 0 0 1013337851 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31498.31 0 0 0 0 0 0 0 0 0 0 0 0 0 31498.31 0 0 1013337952 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462.95 0 0 0 0 0 0 0 0 0 0 0 0 0 462.95 0 0 1013338008 1669811220 10 Physicians MIKESELL TIMOTHY 999999999 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 480 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 695 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5890.33 0 957.11 0 0 0 0 0 0 6847.44 0 0 1013338425 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6086.41 0 0 0 0 0 0 0 0 0 0 0 0 0 6086.41 0 0 1013338574 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16207.65 0 0 0 0 0 0 0 0 0 0 0 0 0 16207.65 0 0 1013338812 1871143792 16 Nurse Practitioners HAWS NATHAN 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 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 0 872.57 0 0 0 0 0 0 872.57 0 0 1013338926 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8632.47 0 0 0 0 0 0 0 0 0 0 0 0 0 8632.47 0 0 1013338958 1144514423 10 Physicians MAJUMDER ARNAB 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 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 1325.58 0 0 0 0 0 0 1325.58 0 0 1013339079 1063862985 10 Physicians MERZ JEFFREY 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 0 183 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 1934.41 0 0 0 0 0 0 1934.41 0 0 1013339293 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 0 253.3 0 0 0 0 0 0 253.3 0 0 1013339657 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 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 0 397.27 0 0 0 0 0 0 397.27 0 0 1013340499 1154980001 89 Physician Assistant Only(Encounter Only) WARNER NATHAN D 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 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 2260.99 0 0 0 0 0 0 2260.99 0 0 1013340543 1245797364 16 Nurse Practitioners MALONEY MEGAN K 999999999 30 DuPage 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 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 0 315.23 0 0 0 0 0 0 315.23 0 0 1013340555 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1013340606 1619330115 10 Physicians SINGH KARAMJIT 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2845.26 0 0 0 0 0 0 2845.26 0 0 1013340659 1518411081 16 Nurse Practitioners HOLTZ GERALDINE M 999999999 53 Kane 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 0 122 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 1577.24 0 0 0 0 0 0 1577.24 0 0 1013340773 1760031462 89 Physician Assistant Only(Encounter Only) MORAN CHRISTINE 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 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 0 414.22 0 0 0 0 0 0 414.22 0 0 1013341248 1699200048 16 Nurse Practitioners CLIFT SARAH J 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 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 0 794.86 0 0 0 0 0 0 794.86 0 0 1013341280 1144888686 89 Physician Assistant Only(Encounter Only) EGGERT ALEXA R 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 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 0 388.4 0 0 0 0 0 0 388.4 0 0 1013341298 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23162.18 0 0 0 0 0 0 0 0 0 0 0 0 0 23162.18 0 0 1013341415 1003466806 33 Nursing Facilities HEARTLAND SENIOR LIVING 999999999 26 Cumberland 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101538.75 0 0 0 0 0 0 0 101538.75 0 0 1013341754 1245616473 89 Physician Assistant Only(Encounter Only) BALDEO RYAN 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 0 166 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 0 449.15 0 0 0 0 0 0 449.15 0 0 1013341848 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16343.86 0 0 0 0 0 0 0 0 0 0 0 0 0 16343.86 0 0 1013341981 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 920.17 0 0 0 0 0 0 0 0 0 0 0 0 0 920.17 0 0 1013342265 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24171.73 0 0 0 0 0 0 0 0 0 0 0 0 0 24171.73 0 0 1013342371 1174165294 16 Nurse Practitioners HAGEN KERRY 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 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 0 336.38 0 0 0 0 0 0 336.38 0 0 1013342609 1609435072 91 Waiver service provider--Adults (DHS/DDD) "BLISS HAVEN, INC." 999999999 108 Williamson 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939727.95 0 0 0 0 0 0 0 0 0 0 0 0 0 939727.95 0 0 1013342903 1457701120 10 Physicians GADDI KIRAN LAIQUE 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 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 3566.33 0 0 0 0 0 0 3566.33 0 0 1013343051 1376984377 10 Physicians IRIME IOANA 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 0 212 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 3495.56 0 0 0 0 0 0 3495.56 0 0 1013343586 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11066.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11066.78 0 0 1013343720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25206.69 0 0 0 0 0 0 0 0 0 0 0 0 0 25206.69 0 0 1013343724 1841586450 10 Physicians PURNELL CHAD A 999999999 200 Cook 0 0 Plastic Surgery 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 2 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.58 0 27984.26 0 0 0 0 0 0 28016.84 0 0 1013343874 1588058796 10 Physicians ROCHE MICHAEL R 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 12 0 41 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 13 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 13 0 56 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 260.27 0 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0 0 0 0 0 0 0 0 0 0 81.88 0 0 0 0 0 0 81.88 0 0 1013345312 1033766159 89 Physician Assistant Only(Encounter Only) TELLIER BENJAMIN R 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 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 1723.47 0 0 0 0 0 0 1723.47 0 0 1013345483 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 15278.78 0 0 0 0 0 0 0 0 0 0 0 0 0 15278.78 0 0 1013345671 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20991.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20991.16 0 0 1013345838 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 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 0 821.92 821.92 0 0 1013345932 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8668.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8668.68 0 0 1013346098 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1013346599 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.68 0 0 0 0 0 0 0 0 0 0 0 0 0 97.68 0 0 1013346847 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 1013347007 1841840352 16 Nurse Practitioners SILVA JULIO R 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 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 0 450.56 0 0 0 0 0 0 450.56 0 0 1013347185 1629366406 10 Physicians KASSAS IBRAHIM 999999999 200 Cook 0 0 Internal 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 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5464.52 0 0 0 0 0 0 5464.52 0 0 1013347253 1346656493 10 Physicians CARSON JENNIFER 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 0 185 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 3219.56 0 0 0 0 0 0 3219.56 0 0 1013347420 1427439298 10 Physicians O'BRYHIM BLISS 999999999 90 Saline 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 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 42.49 0 909.26 0 0 0 0 0 0 951.75 0 0 1013347484 1639656994 22 Physical Therapists TEIJIDO MATTHEW 999999999 89 Rock Island 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 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 0 759.03 759.03 0 0 1013347519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1820.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1820.85 0 0 1013347522 1841854205 16 Nurse Practitioners RAMIREZ VANESSA 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 0 180.03 0 0 0 0 0 0 180.03 0 0 1013347724 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2792.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2792.79 0 0 1013347751 89 Physician Assistant Only(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 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 1013347863 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 32.53 0 0 0 0 0 0 32.53 0 0 1013348012 1811548035 16 Nurse Practitioners FAULSTICH AUDREY L 999999999 34 Fayette 0 0 General Psychiatry Residency 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 16 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 1143.47 0 0 0 0 0 0 1158.07 0 0 1013348578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34408.37 0 0 0 0 0 0 0 0 0 0 0 0 0 34408.37 0 0 1013348912 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7724.1 0 0 0 0 0 0 0 0 0 0 0 0 0 7724.1 0 0 1013349077 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28079.44 0 0 0 0 0 0 0 0 0 0 0 0 0 28079.44 0 0 1013349739 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1432.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1432.2 0 0 1013350054 1922323047 10 Physicians DISCHERT KEVIN 999999999 89 Rock Island 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 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1244.78 0 0 0 0 0 0 1244.78 0 0 1013350693 1831539808 10 Physicians AFZAL AMBER 999999999 200 Cook 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 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 0 728.28 0 0 0 0 0 0 728.28 0 0 1013351023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1269.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1269.36 0 0 1013351132 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 16.76 0 0 0 0 0 0 16.76 0 0 1013351511 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 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 2854.59 2854.59 0 0 1013351857 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25204.52 0 0 0 0 0 0 0 0 0 0 0 0 0 25204.52 0 0 1013351893 75 Department of Alcohol and Substance Abuse Provider 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.08 0 0 211.08 0 0 1013352075 1962067371 24 Speech Therapists FLOOD COURTNEY 999999999 30 DuPage 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 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 5500.51 5500.51 0 0 1013352370 10 Physicians 10 Adams 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 0 228.85 0 0 0 0 0 0 228.85 0 0 1013352534 1578112553 16 Nurse Practitioners KOPMANN MARIANNE 999999999 19 Champaign 0 0 0 0 0 3 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 116 0 0 0 0 0 0 0 0 0 208.56 0 0 0 0 0 0 0 0 3017.11 0 0 0 0 0 0 3225.67 0 0 1013352580 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3646.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3646.72 0 0 1013352950 1619514031 23 Occupational Therapists BROWN ALLISON E 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 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 3437.9 3437.9 0 0 1013353025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8654.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8654.44 0 0 1013353159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6642.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6642.24 0 0 1013353323 1689115909 10 Physicians KURIHARA CHITARU 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 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 4580.84 0 0 0 0 0 0 4580.84 0 0 1013353700 1306487178 89 Physician Assistant Only(Encounter Only) SWINGLER MORGAN K 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 0 507.49 0 0 0 0 0 0 507.49 0 0 1013353706 1639522998 10 Physicians ANOKA IFEANYICHUKWU ALEX 999999999 87 Randolph 0 0 Emergency 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 0 173 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 5563.31 0 0 0 0 0 0 5563.31 0 0 1013353732 1659758068 10 Physicians SPAIN ADAM R 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 0 194 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 5305.18 0 0 0 0 0 0 5305.18 0 0 1013353846 10 Physicians 200 Cook 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 39.86 0 0 0 0 0 0 39.86 0 0 1013353897 1003270398 10 Physicians BURSTEIN DAVID S 999999999 200 Cook 0 0 Internal Medicine 0 0 0 1 0 0 0 0 0 0 4 0 140 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 253 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 253 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 33.88 0 3787.45 0 0 0 0 0 0 3926.29 0 0 1013353933 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21946.92 0 0 0 0 0 0 0 0 0 0 0 0 0 21946.92 0 0 1013353936 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 0 220.2 0 0 0 0 0 0 220.2 0 0 1013354206 1174707004 89 Physician Assistant Only(Encounter Only) CHANEY SCOTT 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 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 0 457.26 0 0 0 0 0 0 457.26 0 0 1013354579 1508336231 23 Occupational Therapists BURGE SARA B 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 0 140 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 8623.64 8623.64 0 0 1013354736 1972065423 16 Nurse Practitioners YAU MATTHEW H 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 0 276.26 0 0 0 0 0 0 276.26 0 0 1013354813 1184990673 10 Physicians HUSSAIN SHOEB M 999999999 200 Cook 0 0 Internal Medicine 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 0 284 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 2863.32 0 0 0 0 0 0 2863.32 0 0 1013355503 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 47.62 0 0 0 0 0 0 47.62 0 0 1013355565 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 0 0 0 0 0 0 0 0 0 0 1013355737 1467715235 10 Physicians CHEN DENNIS D 999999999 30 DuPage 0 0 Internal Medicine 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1345.56 0 0 0 0 0 0 1345.56 0 0 1013356050 1154847572 24 Speech Therapists SHELL AMY LEE 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 363 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 28792.52 28792.52 0 0 1013356408 10 Physicians 50 Jersey 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 97.18 0 0 0 0 0 0 97.18 0 0 1013356501 1649513151 10 Physicians SINGLA RUCHI 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 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 0 985.25 0 0 0 0 0 0 985.25 0 0 1013356720 1386080802 10 Physicians RAMOS NICHOLAS 999999999 200 Cook 0 0 Orthopedic Surgery 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 0 318 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 9253.56 0 0 0 0 0 0 9253.56 0 0 1013357089 1083261291 16 Nurse Practitioners RAFTERY KATHLEEN 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 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 0 334.8 0 0 0 0 0 0 334.8 0 0 1013357094 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8190.19 0 0 0 0 0 0 0 0 0 0 0 0 0 8190.19 0 0 1013357312 1306256284 10 Physicians SEIPP REGAN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.22 0 2737.15 0 0 0 0 0 0 2759.37 0 0 1013357342 1467832691 10 Physicians AHMAD MUHAMMAD 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 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3261.04 0 0 0 0 0 0 3261.04 0 0 1013357691 1730611898 10 Physicians BRUTMAN DANIELLA D 999999999 200 Cook 0 0 Family Practice 0 0 0 17 0 0 0 0 0 0 6 0 52 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 7 0 81 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 7 0 81 0 0 0 0 0 0 0 0 0 671.32 0 0 0 0 0 0 17.51 0 1856.84 0 0 0 0 0 0 2545.67 0 0 1013358028 1114475597 16 Nurse Practitioners JOHNSTON LINDSEY A 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 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 0 245.47 0 0 0 0 0 0 245.47 0 0 1013358347 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1029.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1029.76 0 0 1013358520 1083609986 89 Physician Assistant Only(Encounter Only) VOEGEL VICTORIA C 999999999 72 McLean 0 0 0 0 0 1 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 0 0 908.6 0 0 0 0 0 0 923.2 0 0 1013358724 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 0 496.21 0 0 0 0 0 0 0 0 0 0 0 0 0 496.21 0 0 1013358853 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 14.97 14.97 0 0 1013359015 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18922.07 0 0 0 0 0 0 0 0 0 0 0 0 0 18922.07 0 0 1013359124 1982018271 10 Physicians LOGEMAN ANDREW W 999999999 19 Champaign 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 0 145 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 9150.39 0 0 0 0 0 0 0 0 0 0 0 0 0 9150.39 0 0 1013376762 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 0 115 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 14977.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14977.6 0 0 1013376889 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1013377285 1053831214 10 Physicians VANNITAMBY HOLLY E 999999999 80 Peoria 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 17 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 0 181.22 0 0 0 0 0 0 0 0 881.27 0 0 0 0 0 0 1062.49 0 0 1013378152 1679968812 10 Physicians OYER MARK A 999999999 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 27 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 352.91 0 4384.77 0 0 0 0 0 0 4737.68 0 0 1013378620 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24557.87 0 0 0 0 0 0 0 0 0 0 0 0 0 24557.87 0 0 1013378825 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 1013379198 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 56.43 0 0 0 0 0 0 0 0 56.43 0 0 1013379640 1922661958 89 Physician Assistant Only(Encounter Only) POSEY SARAH J 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 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 0 294.95 0 0 0 0 0 0 294.95 0 0 1013379842 1639427933 10 Physicians HOSEIN SALIM 999999999 47 Jackson 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3193.24 0 0 0 0 0 0 3193.24 0 0 1013380750 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 13.91 0 0 0 0 0 0 13.91 0 0 1013381200 1497259527 16 Nurse Practitioners RAHMAN JOSEPH 999999999 57 Lake 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 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 0 313.71 0 0 0 0 0 0 313.71 0 0 1013381518 1609242239 11 Dentists SANCHEZ ANGELICA 999999999 200 Cook 0 0 0 0 20 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 2631.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2631.3 0 0 1013381674 1598310849 89 Physician Assistant Only(Encounter Only) BOPP CATHERINE M 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 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 67.49 0 0 0 0 0 0 67.49 0 0 1013381688 1932761137 11 Dentists QURAISHI MASEERA 999999999 30 DuPage 0 0 General Dentistry 0 0 127 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 636 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 636 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 19278.87 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 21160.62 0 0 1013381964 1821522301 10 Physicians WRIGHT ERIK H 999999999 80 Peoria 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 0 118 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 4522.74 0 0 0 0 0 0 4522.74 0 0 1013382050 1346898210 16 Nurse Practitioners PIHL CASANDRA 999999999 53 Kane 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 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 0 109.1 0 0 0 0 0 0 109.1 0 0 1013382443 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4817.93 0 0 0 0 0 0 0 0 0 0 0 0 0 4817.93 0 0 1013382534 1942658380 10 Physicians DELOS SANTOS GERALDINE M 999999999 200 Cook 0 0 General Practice 0 0 0 3 0 0 0 0 0 0 6 0 16 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 10 0 32 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 10 0 32 0 0 0 0 0 0 0 0 0 256.69 0 0 0 0 0 0 160.23 0 629.26 0 0 0 0 0 0 1046.18 0 0 1013382586 1891259362 16 Nurse Practitioners BLADE ALLISON J 999999999 96 St Clair 0 0 0 0 0 4 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 152.07 0 0 0 0 0 0 0 0 1869.33 0 0 0 0 0 0 2021.4 0 0 1013382801 1053880781 16 Nurse Practitioners DAVIS HEATHER D 999999999 47 Jackson 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 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 0 169.9 0 0 0 0 0 0 169.9 0 0 1013382933 1528454642 10 Physicians DALAL VIDHI 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 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 0 809.11 0 0 0 0 0 0 809.11 0 0 1013382937 1790798304 10 Physicians DAGHMAN BASSAM 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 114 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1402.37 0 0 0 0 0 0 0 0 1402.37 0 0 1013383340 1154684728 10 Physicians GONZALEZ MARITZA G 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 13 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 675.74 0 4918.56 0 0 0 0 0 0 5594.3 0 0 1013383350 1568017333 16 Nurse Practitioners BROOKS DUSTIN 999999999 57 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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 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 40.51 0 0 0 0 0 0 40.51 0 0 1013384251 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013384562 1336533827 10 Physicians SAFVI ADNAN 999999999 200 Cook 0 0 Psychiatry 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 0 258 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 6074.54 0 0 0 0 0 0 6074.54 0 0 1013384754 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20251.35 0 0 0 0 0 0 0 0 0 0 0 0 0 20251.35 0 0 1013384778 1578913521 10 Physicians AWATI NEHA V 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 0 157.26 0 0 0 0 0 0 157.26 0 0 1013385005 1871941427 10 Physicians MOY DAVID 999999999 71 McHenry 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 0 302 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 13277.3 0 0 0 0 0 0 13277.3 0 0 1013385069 1639531106 10 Physicians TESSNER JOSHUA 999999999 53 Kane 0 0 Emergency 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 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 1152.27 0 0 0 0 0 0 1152.27 0 0 1013385252 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 0 0 0 0 73.4 0 0 1013385294 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23213.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23213.52 0 0 1013385336 1376999847 10 Physicians KALARI SARAH E 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 6 0 51 0 0 0 0 0 0 0 0 0 57.75 0 0 0 0 0 0 25.4 0 662.89 0 0 0 0 0 0 746.04 0 0 1013385636 94 Waiver service provider--Children's support (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 0 187 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 16307.49 0 0 0 0 0 0 0 0 0 0 0 0 0 16307.49 0 0 1013385946 10 Physicians 200 Cook 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 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.34 0 511.15 0 0 0 0 0 0 521.49 0 0 1013385985 1861904955 86 Clinical Social Worker(Encounter Only) HERNANDEZ PATRICA 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 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 1220.37 0 0 0 0 0 0 1220.37 0 0 1013386828 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24647.84 0 0 0 0 0 0 0 0 0 0 0 0 0 24647.84 0 0 1013387095 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 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46715.46 0 0 0 0 0 0 0 0 0 0 0 0 0 46715.46 0 0 1013387270 1356879456 16 Nurse Practitioners TRAN GRACE 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 0 381 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 1273.5 0 0 0 0 0 0 1273.5 0 0 1013387272 11 Dentists 107 Will 0 0 General Dentistry 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 0 310.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.6 0 0 1013387275 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 0 127 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 12806.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12806.01 0 0 1013387410 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10141.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10141.6 0 0 1013387471 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 47.62 0 0 0 0 0 0 47.62 0 0 1013387516 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14351.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14351.14 0 0 1013388050 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10211.63 0 0 0 0 0 0 0 0 0 0 0 0 0 10211.63 0 0 1013388093 1447613252 10 Physicians DOLAN CLAIRE 999999999 200 Cook 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 0 335 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 3949.68 0 0 0 0 0 0 3949.68 0 0 1013388117 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 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 12238.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12238.8 0 0 1013388148 1003159153 10 Physicians KOMINSKY MATTHEW S 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 9896.13 0 0 0 0 0 0 9908.15 0 0 1013388451 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 0 194 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 16862.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16862.93 0 0 1013388485 1609029917 10 Physicians VAZQUEZ GUILLAMET RODRIGO 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 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 0 561.78 0 0 0 0 0 0 561.78 0 0 1013388503 1659633980 10 Physicians COLOMBO JAMIE N 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3201.38 0 0 0 0 0 0 3201.38 0 0 1013388506 10 Physicians 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 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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 0 794.87 0 0 0 0 0 0 794.87 0 0 1013407737 1295390490 75 Department of Alcohol and Substance Abuse Provider CROSSING RECOVERY CENTER WOMEN 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 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 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21776.58 0 0 21776.58 0 0 1013407775 91 Waiver service provider--Adults (DHS/DDD) 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 0 273 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 23036.15 0 0 0 0 0 0 0 0 0 0 0 0 0 23036.15 0 0 1013407868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1059.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1059.88 0 0 1013408099 1598110868 13 Podiatrists KIRCHNER KYLE J 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 0 222.57 0 0 0 0 0 0 222.57 0 0 1013408623 1396197604 13 Podiatrists BUFFINGTON ADAM 999999999 19 Champaign 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 0 199 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 1260.89 0 0 0 0 0 0 1260.89 0 0 1013408826 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10816.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10816.18 0 0 1013408950 1144648023 10 Physicians JAIN SUMEET K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 551 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 4335.73 0 0 0 0 0 0 4335.73 0 0 1013408978 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 16669.64 0 0 0 0 0 0 0 0 0 0 0 0 0 16669.64 0 0 1013408988 1588026348 10 Physicians EMUCHAY NGOZI 999999999 200 Cook 0 0 Internal 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 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 0 982.1 0 0 0 0 0 0 982.1 0 0 1013409085 1700134087 10 Physicians EL HANGOUCHE NADIA 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 571 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6014.22 0 0 0 0 0 0 6014.22 0 0 1013409578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 694.98 0 0 0 0 0 0 0 0 0 0 0 0 0 694.98 0 0 1013410238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3472.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3472.75 0 0 1013410290 1710538004 47 Local Education Agencies BRONZEVILLE ACADEMY CHARTER SC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12842.1 0 12842.1 0 0 1013410405 1336602267 16 Nurse Practitioners MITCHELL CHRISTOPHER D 999999999 75 Monroe 0 0 0 0 0 0 0 0 0 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 0 564.58 0 0 0 0 0 0 564.58 0 0 1013410496 1720646367 16 Nurse Practitioners LIBERATO NAYELI 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.86 0 0 0 0 0 0 601.86 0 0 1013410647 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 751.6 0 0 0 0 0 0 0 0 0 0 0 0 0 751.6 0 0 1013411047 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 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 0 234.58 234.58 0 0 1013411351 1942842018 16 Nurse Practitioners SUBYANTORO TAMARRA L 999999999 80 Peoria 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 83 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 232.01 0 0 0 0 0 0 0 0 1228.85 0 0 0 0 0 0 1460.86 0 0 1013411482 1760860829 10 Physicians KLEIN ERICA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 308 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2915.64 0 81.31 0 0 0 0 0 0 2996.95 0 0 1013411854 1124135744 60 Pharmacies ST. LOUIS CHILDREN''S HOSPITAL 999999999 826 Missouri 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 0 711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15812 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40793.33 0 0 0 40793.33 0 0 1013412472 1821635566 16 Nurse Practitioners SCHLESINGER KATHERINE A 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 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 1683.57 0 0 0 0 0 0 1683.57 0 0 1013412645 1346689502 10 Physicians MCHENRY SCOTT A 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 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 0 679.05 0 0 0 0 0 0 679.05 0 0 1013413096 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 16803.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16803.67 0 0 1013413353 1073962650 10 Physicians MAAS MEAGAN E 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 1484.67 0 0 0 0 0 0 1484.67 0 0 1013413842 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10485.23 0 0 0 0 0 0 0 0 0 0 0 0 0 10485.23 0 0 1013413893 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 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 0 217.7 0 0 0 0 0 0 217.7 0 0 1013414539 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6662 0 0 0 0 0 0 0 0 0 0 0 0 0 6662 0 0 1013414744 1912397639 10 Physicians KANESHIRO KELSEY 999999999 200 Cook 0 0 Pediatrics 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 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 3736.52 0 0 0 0 0 0 3736.52 0 0 1013414862 1962817338 10 Physicians HANSON KATHRYN M 999999999 200 Cook 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 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 5409.85 0 0 0 0 0 0 5409.85 0 0 1013415098 1669598421 10 Physicians SHANKAR CHANDRIKA N 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 0 253 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 6789.33 0 0 0 0 0 0 6789.33 0 0 1013415629 1881031144 10 Physicians MARTINS DANILO 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 0 164 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 3338.27 0 0 0 0 0 0 3338.27 0 0 1013415864 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13442.71 0 0 0 0 0 0 0 0 0 0 0 0 0 13442.71 0 0 1013416456 1518340231 10 Physicians GUNTUPALLI NAGA P 999999999 54 Kankakee 0 0 Psychiatry 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 0 416 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 13486.35 0 0 0 0 0 0 13486.35 0 0 1013417407 1588079107 10 Physicians STUNKEL LEANNE D 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 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 0 322.09 0 0 0 0 0 0 322.09 0 0 1013417567 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 15537.2 0 0 0 0 0 0 0 0 0 0 0 0 0 15537.2 0 0 1013417938 1477781177 10 Physicians MUSIELAK MATTHEW 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8424.64 0 0 0 0 0 0 8424.64 0 0 1013417954 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17360 0 0 0 0 0 0 0 0 0 0 0 0 0 17360 0 0 1013418153 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 0 0 0 0 0 0 0 0 0 0 1013418251 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21177.73 0 0 0 0 0 0 0 0 0 0 0 0 0 21177.73 0 0 1013418389 1386296606 11 Dentists NALLAPARAJU HARITHA 999999999 96 St Clair 0 0 General Dentistry 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2576.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2576.43 0 0 1013418751 1841844917 89 Physician Assistant Only(Encounter Only) MACK BLAIR 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 1035.68 0 0 0 0 0 0 1035.68 0 0 1013418799 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 30.47 0 0 0 0 0 0 30.47 0 0 1013418859 1720340490 10 Physicians ATHANASATOS GEORGE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 31 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.64 0 2346.52 0 0 0 0 0 0 2412.16 0 0 1013418898 60 Pharmacies 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6399.61 0 0 0 6399.61 0 0 1013419169 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 0 838.29 0 0 0 0 0 0 0 0 0 0 0 0 0 838.29 0 0 1013419208 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 0 977.13 0 0 0 0 0 0 0 0 0 0 0 0 0 977.13 0 0 1013419305 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 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 0 156.93 156.93 0 0 1013419538 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 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 4041.51 0 0 0 0 0 0 0 0 0 0 0 0 0 4041.51 0 0 1013419776 1235392218 16 Nurse Practitioners KONTSEVYY BOHDAN 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 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 0 506.25 0 0 0 0 0 0 506.25 0 0 1013420350 1609411743 16 Nurse Practitioners DELINSKI HOLLY JO 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 0 105 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 1194.93 0 0 0 0 0 0 1194.93 0 0 1013420527 1801432711 33 Nursing Facilities SHERIDAN VILLAGE NRSG & RHB 999999999 200 Cook 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 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 944818.67 0 0 0 0 0 0 0 944818.67 0 0 1013420574 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 0 630.24 0 0 0 0 0 0 0 0 0 0 0 0 0 630.24 0 0 1013421090 1184277964 75 Department of Alcohol and Substance Abuse Provider EVA MAE RECOVERY HOPE INC. 999999999 200 Cook 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 1681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104869.7 0 0 104869.7 0 0 1013421291 1114283041 10 Physicians RAY AMRIK 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.01 0 6087.38 0 0 0 0 0 0 6127.39 0 0 1013421346 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8593.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8593.2 0 0 1013421365 1285021964 10 Physicians ROBLES RAQUEL T 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 4 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.48 0 427.54 0 0 0 0 0 0 536.02 0 0 1013421542 1881168151 16 Nurse Practitioners ANGER LISA 999999999 71 McHenry 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 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 0 0 0 0 0 0 0 0 0 0 1013421619 1417590506 55 Early Intervention Services ROSE KRISTIN A 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 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 2251.15 0 0 0 0 0 0 2251.15 0 0 1013421831 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 1013422725 1578112603 16 Nurse Practitioners SPINKER KATHRYN A 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 911.41 0 0 0 0 0 0 911.41 0 0 1013422906 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7123.02 0 0 0 0 0 0 0 0 0 0 0 0 0 7123.02 0 0 1013423475 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1022.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1022.16 0 0 1013423741 1316034861 89 Physician Assistant Only(Encounter Only) OESER EILEEN J 999999999 53 Kane 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 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708.2 0 0 0 0 0 0 708.2 0 0 1013424298 86 Clinical Social Worker(Encounter Only) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301.98 0 0 0 0 0 0 301.98 0 0 1013424399 1376184036 11 Dentists HEROTH BRANDON 999999999 200 Cook 0 0 0 0 19 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 2826.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2826.09 0 0 1013424693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11903.43 0 0 0 0 0 0 0 0 0 0 0 0 0 11903.43 0 0 1013425053 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 0 128.16 0 0 0 0 0 0 128.16 0 0 1013425066 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5045.23 0 0 0 0 0 0 0 0 0 0 0 0 0 5045.23 0 0 1013425246 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22820.29 0 0 0 0 0 0 0 0 0 0 0 0 0 22820.29 0 0 1013425672 1760938138 10 Physicians DEMORY JONATHAN 999999999 200 Cook 0 0 Emergency 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 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 1034.88 0 0 0 0 0 0 1034.88 0 0 1013425683 1629638788 16 Nurse Practitioners HARRIS ETHAN S 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1997.27 0 0 0 0 0 0 1997.27 0 0 1013425685 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 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 0 571.56 571.56 0 0 1013426545 1376074161 10 Physicians AKAOLISA NKOLI 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 1393.07 0 0 0 0 0 0 1393.07 0 0 1013426619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9569.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9569.2 0 0 1013426755 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19336.06 0 0 0 0 0 0 0 0 0 0 0 0 0 19336.06 0 0 1013426853 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 0 0 0 0 0 0 0 0 0 0 1013427065 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10370.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10370.36 0 0 1013427351 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.91 0 0 0 0 0 0 0 0 0 0 0 0 0 64.91 0 0 1013427463 1851951552 16 Nurse Practitioners CHAPMAN HOLLY 999999999 20 Christian 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 0 413.74 0 0 0 0 0 0 413.74 0 0 1013427684 24 Speech Therapists 40 Grundy 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 59.88 59.88 0 0 1013428051 1417119488 10 Physicians MORRIS MICHAEL A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 7 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7190.16 0 0 0 0 0 0 7190.16 0 0 1013428054 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23121.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23121.35 0 0 1013428125 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 0 168.56 0 0 0 0 0 0 168.56 0 0 1013428900 1649280793 10 Physicians REMYNSE LOUIS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.7 0 5983.83 0 0 0 0 0 0 6126.53 0 0 1013429404 1508408345 16 Nurse Practitioners JUMP JENNIFER M 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 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 0 143.6 0 0 0 0 0 0 143.6 0 0 1013429426 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 0 153 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 22848.69 0 0 0 0 0 0 0 0 0 0 0 0 0 22848.69 0 0 1013430021 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 1013430294 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 0 560.68 0 0 0 0 0 0 560.68 0 0 1013431571 1699065151 10 Physicians DUNHAM STEVEN 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 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 0 599.28 0 0 0 0 0 0 599.28 0 0 1013431960 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 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 7529.9 0 0 0 0 0 0 0 0 0 0 0 0 0 7529.9 0 0 1013431971 1063060275 11 Dentists KHAN MALIK ZEESHAN S 999999999 30 DuPage 0 0 General Dentistry 0 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26329.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26329.69 0 0 1013432062 1336528835 10 Physicians PYLE TIA 999999999 107 Will 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 16 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 54.03 0 0 0 0 0 0 54.03 0 0 1013432399 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 296 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21868.17 0 0 0 0 0 0 0 0 0 0 0 0 0 21868.17 0 0 1013432579 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 22040.69 0 0 0 0 0 0 0 0 0 0 0 0 0 22040.69 0 0 1013433058 1568704690 10 Physicians LEE ROSE 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 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 0 902.73 0 0 0 0 0 0 902.73 0 0 1013433139 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1013433470 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 35.8 0 0 0 0 0 0 35.8 0 0 1013433577 1306265327 10 Physicians MASTERS ADRIANNA H 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2274.09 0 0 0 0 0 0 2274.09 0 0 1013433884 10 Physicians 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 78.09 0 0 0 0 0 0 78.09 0 0 1013434500 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 81.59 0 0 0 0 0 0 81.59 0 0 1013434509 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 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 0 149 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 5597.49 0 0 0 0 0 0 0 0 0 0 0 0 0 5597.49 0 0 1013435249 1972944247 10 Physicians MURAD HARIS F 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 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.95 0 0 0 0 0 0 203.95 0 0 1013435318 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1013435387 1285167262 10 Physicians PFEIFFER PENELOPE 999999999 19 Champaign 0 0 Emergency Medicine 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 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.15 0 10447.02 0 0 0 0 0 0 10509.17 0 0 1013435395 1639729239 91 Waiver service provider--Adults (DHS/DDD) SCHNEIDER ANNA 999999999 91 Sangamon 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 1813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206412 0 0 0 0 0 0 0 0 0 0 0 0 0 206412 0 0 1013435590 1326467069 10 Physicians ULBRICH KENDALL ANNE 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 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 9409.08 0 0 0 0 0 0 9409.08 0 0 1013435626 10 Physicians 63 Macon 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 0 122.6 0 0 0 0 0 0 122.6 0 0 1013435710 1295056026 10 Physicians HENRY MATTHEW D 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 33 0 0 0 0 0 0 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 0 0 1959.74 0 0 0 0 0 0 1959.74 0 0 1013436305 1477784841 13 Podiatrists LAPLANT JIMMIE G 999999999 200 Cook 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 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 479.43 0 0 0 0 0 0 479.43 0 0 1013436361 1386080943 10 Physicians WOLLNER KATHERINE 999999999 200 Cook 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 7 0 62 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 7 0 118 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 7 0 118 0 0 0 0 0 0 0 0 0 404.17 0 0 0 0 0 0 32.15 0 7397.43 0 0 0 0 0 0 7833.75 0 0 1013436367 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8642 0 0 0 0 0 0 0 0 0 0 0 0 0 8642 0 0 1013436368 10 Physicians 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 369.85 0 0 0 0 0 0 369.85 0 0 1013436411 55 Early Intervention Services 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 0 117.92 0 0 0 0 0 0 117.92 0 0 1013436447 1376938977 10 Physicians ADAMS FOSTER C 999999999 200 Cook 0 0 Internal Medicine 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 0 311.41 0 0 0 0 0 0 311.41 0 0 1013436685 10 Physicians 89 Rock Island 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 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 0 361.16 0 0 0 0 0 0 361.16 0 0 1013437192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 426.37 0 0 0 0 0 0 0 0 0 0 0 0 0 426.37 0 0 1013437334 1811551492 11 Dentists MAROUF TARIQ 999999999 200 Cook 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 10701.05 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 11453.75 0 0 1013437346 1528627833 16 Nurse Practitioners CLARK GREGORY S 999999999 47 Jackson 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 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 1490.74 0 0 0 0 0 0 1490.74 0 0 1013437510 1184945164 10 Physicians URBIZTONDO NED 999999999 200 Cook 0 0 Anesthesiology 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 0 184 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 2065.69 0 0 0 0 0 0 2065.69 0 0 1013437613 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 2.14 0 0 0 0 0 0 2.14 0 0 1013437759 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 741.02 0 0 0 0 0 0 0 0 0 0 0 0 0 741.02 0 0 1013437879 1902455140 16 Nurse Practitioners BUCHER BAILEY J 999999999 70 McDonough 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 1 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 148.21 0 0 0 0 0 0 217.73 0 0 1013438180 1174971899 10 Physicians MOGUL ASHLEY 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 6 0 253 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 353 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.47 0 9830.01 0 0 0 0 0 0 9907.48 0 0 1013438217 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3050.82 0 0 0 0 0 0 0 0 0 0 0 0 0 3050.82 0 0 1013438284 1316251176 16 Nurse Practitioners DERYLO MARIA 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 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 0 766.88 0 0 0 0 0 0 766.88 0 0 1013438470 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25811.88 0 0 0 0 0 0 0 0 0 0 0 0 0 25811.88 0 0 1013438516 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14194.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14194.88 0 0 1013438902 1225487259 10 Physicians NANDHAN VIKRAM 999999999 200 Cook 0 0 0 0 0 63 0 0 0 0 0 0 14 0 94 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 16 0 114 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 16 0 114 0 0 0 0 0 0 0 0 0 2297.8 0 0 0 0 0 0 70.06 0 3919.2 0 0 0 0 0 0 6287.06 0 0 1013438944 1124513635 16 Nurse Practitioners ESCHEL MARY 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 0 384.3 0 0 0 0 0 0 384.3 0 0 1013439097 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8195.1 0 0 0 0 0 0 0 0 0 0 0 0 0 8195.1 0 0 1013439100 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20052.32 0 0 0 0 0 0 0 0 0 0 0 0 0 20052.32 0 0 1013439253 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 0 167 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 17820.93 0 0 0 0 0 0 0 0 0 0 0 0 0 17820.93 0 0 1013439498 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7504.26 0 0 0 0 0 0 0 0 0 0 0 0 0 7504.26 0 0 1013440002 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11093.87 0 0 0 0 0 0 0 0 0 0 0 0 0 11093.87 0 0 1013440028 1871054601 10 Physicians DRULLINSKY DAVID 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 0 591.61 0 0 0 0 0 0 591.61 0 0 1013440029 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14888.25 0 0 0 0 0 0 0 0 0 0 0 0 0 14888.25 0 0 1013440177 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20347.72 0 0 0 0 0 0 0 0 0 0 0 0 0 20347.72 0 0 1013440711 1336605757 25 Audiologists HART ROSE 999999999 200 Cook 0 0 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 1627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271174.05 271174.05 0 0 1013440764 1124599592 89 Physician Assistant Only(Encounter Only) PESAVENTO JESSICA A 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 916.22 0 0 0 0 0 0 916.22 0 0 1013440914 1851946602 16 Nurse Practitioners ROBERG JENNIFER L 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 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 1603.69 0 0 0 0 0 0 1603.69 0 0 1013441464 1649836156 16 Nurse Practitioners QUINN MEGAN C 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 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 2955.8 0 0 0 0 0 0 2955.8 0 0 1013441562 1164066940 23 Occupational Therapists KAPPAS JULIE M 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 0 184 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 11747.7 11747.7 0 0 1013441576 1821643834 55 Early Intervention Services BIBBS MORGAN J 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 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20291.89 0 0 0 0 0 0 20291.89 0 0 1013441669 1881242725 16 Nurse Practitioners HENDRICKSON NICOLE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 77.33 0 0 0 0 0 0 77.33 0 0 1013441767 1861036519 89 Physician Assistant Only(Encounter Only) DINKLENBURG CATHERINE 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 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 41.52 0 0 0 0 0 0 41.52 0 0 1013441974 1073623104 10 Physicians SWANSON JONATHAN 999999999 109 Winnebago 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 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 0 303.05 0 8.81 0 0 0 0 0 0 311.86 0 0 1013442010 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47752.38 0 0 0 0 0 0 0 0 0 0 0 0 0 47752.38 0 0 1013442017 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 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 39257.04 0 0 0 0 0 0 0 0 0 0 0 0 0 39257.04 0 0 1013442088 1093799157 10 Physicians MONTGOMERY PAUL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 69 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1227.5 0 43.8 0 0 0 0 0 0 1271.3 0 0 1013442705 1497160725 10 Physicians PATEL GOPI 999999999 30 DuPage 0 0 Neurology 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 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 2109.1 0 0 0 0 0 0 2109.1 0 0 1013442753 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 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 0 308.14 0 0 0 0 0 0 0 0 0 0 0 0 0 308.14 0 0 1013442843 1780952184 86 Clinical Social Worker(Encounter Only) BARTLETT ANDREA 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 0 136 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 5263.08 0 0 0 0 0 0 5263.08 0 0 1013442882 1760030530 25 Audiologists STABRAWA PAIGE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1472.83 1472.83 0 0 1013442949 1639711963 89 Physician Assistant Only(Encounter Only) LADOWITZ STACI J 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 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 0 310.9 0 0 0 0 0 0 310.9 0 0 1013442991 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16551.64 0 0 0 0 0 0 0 0 0 0 0 0 0 16551.64 0 0 1013443729 1811340672 86 Clinical Social Worker(Encounter Only) COLLINS JENNIFER 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 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 1210.58 0 0 0 0 0 0 1210.58 0 0 1013444045 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2187.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2187.01 0 0 1013444120 1114576584 16 Nurse Practitioners CARMAN CATHERINE E 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 0 258.97 0 0 0 0 0 0 258.97 0 0 1013444312 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 19865.12 0 0 0 0 0 0 0 0 0 0 0 0 0 19865.12 0 0 1013444526 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 58.27 0 0 0 0 0 0 58.27 0 0 1013444687 1881154649 16 Nurse Practitioners DOCKEMEYER LINDSEY M 999999999 54 Kankakee 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 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 0 307.85 0 0 0 0 0 0 307.85 0 0 1013444698 1487944849 10 Physicians HUGHES CHARLES T 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 6 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.9 0 1152.74 0 0 0 0 0 0 1168.64 0 0 1013444870 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13813.58 0 0 0 0 0 0 0 0 0 0 0 0 0 13813.58 0 0 1013445238 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 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 1013445302 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.31 0 0 0 0 0 0 98.31 0 0 1013445659 1457795858 10 Physicians DOLL EMILY D 999999999 30 DuPage 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 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 3802.88 0 0 0 0 0 0 3802.88 0 0 1013445828 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 0 152 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 24461.66 0 0 0 0 0 0 0 0 0 0 0 0 0 24461.66 0 0 1013446734 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 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 6487.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.58 0 0 1013446902 1972151512 16 Nurse Practitioners WISHNE LAUREN J 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 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 3140.75 0 0 0 0 0 0 3140.75 0 0 1013447059 1871156547 60 Pharmacies PROHEALTH PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2464.15 0 0 0 2464.15 0 0 1013447114 1780231886 16 Nurse Practitioners GUILD MICHELLE 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 0 116 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 2100.63 0 0 0 0 0 0 2100.63 0 0 1013447136 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.25 0 0 0 0 0 0 230.25 0 0 1013447264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315.86 0 0 0 0 0 0 0 0 0 0 0 0 0 315.86 0 0 1013447475 1265765812 10 Physicians SUIDAN RUDY 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 14 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 0 821.76 0 0 0 0 0 0 821.76 0 0 1013447840 1821408725 10 Physicians COPPES OSCAR JM 999999999 30 DuPage 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 0 205 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 6616.58 0 0 0 0 0 0 6616.58 0 0 1013448027 98 Waiver service provider--TBI (DHS/DRS) 33 Effingham 0 0 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 4336.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4336.8 0 0 1013448259 1942786934 87 Psychologist(Encounter Only) BERNARD ALEXANDRA 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 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 3424.61 0 0 0 0 0 0 3424.61 0 0 1013448325 1699110379 10 Physicians MENDELSOHN MARC 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 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 0 365.22 0 0 0 0 0 0 365.22 0 0 1013448448 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 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 66.8 0 267.21 0 0 0 0 0 0 334.01 0 0 1013448604 1982771408 11 Dentists MITTLER WILLIAM 999999999 80 Peoria 0 0 0 0 21 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 8649.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8649.54 0 0 1013448671 1730740663 23 Occupational Therapists LAZICKI KRISTEN 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 0 167 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 12311.68 12311.68 0 0 1013448892 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 0 138.34 0 0 0 0 0 0 138.34 0 0 1013448972 1558359174 10 Physicians CARPENTER MARTIN W 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 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 0 384.21 0 0 0 0 0 0 384.21 0 0 1013449181 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 1586.31 0 0 0 0 0 0 1586.31 0 0 1013449198 1225502057 75 Department of Alcohol and Substance Abuse Provider CROSSING RECOVERY CENTER DETOX 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12484.8 0 0 12484.8 0 0 1013449275 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1820.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1820.67 0 0 1013449688 1578117578 16 Nurse Practitioners CHAKOUR SARA 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 0 518.32 0 0 0 0 0 0 518.32 0 0 1013449780 1366097511 12 Optometrists HANLON JOHN P 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3161.08 0 823.29 0 0 0 0 3984.37 0 0 1013449906 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 78.09 0 0 0 0 0 0 78.09 0 0 1013449928 1649409202 10 Physicians FRAZINE DANA A 999999999 33 Effingham 0 0 0 0 0 3 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 27.94 0 186.06 0 0 0 0 0 0 278.3 0 0 1013449961 1659865319 10 Physicians AHMED NATASHA 999999999 97 Stephenson 0 0 Family 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 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 57.67 0 0 0 0 0 0 57.67 0 0 1013450726 1962842658 10 Physicians OH JIN SOL 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 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 4906.32 0 0 0 0 0 0 4906.32 0 0 1013451072 16 Nurse Practitioners 99 Union 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2227.93 0 0 0 0 0 0 2227.93 0 0 1013451163 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 76.36 0 0 0 0 0 0 76.36 0 0 1013451177 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 0 0 0 0 0 0 0 0 0 0 1013451349 1801457510 30 General Hospitals ADVENTHEALTH HEART OF FLORIDA 999999999 810 Florida ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 5 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 447.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447.86 0 0 1013451585 11 Dentists 200 Cook 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1013452153 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22117.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22117.84 0 0 1013452287 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6788.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6788.86 0 0 1013452901 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15363.59 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.59 0 0 1013453103 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3396.14 0 0 0 0 0 0 0 0 0 0 0 0 0 3396.14 0 0 1013453498 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 99.78 0 0 0 0 0 0 99.78 0 0 1013453868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19642.53 0 0 0 0 0 0 0 0 0 0 0 0 0 19642.53 0 0 1013453971 1386938157 10 Physicians KADOW BRIAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.43 0 545.35 0 0 0 0 0 0 558.78 0 0 1013455091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17216.45 0 0 0 0 0 0 0 0 0 0 0 0 0 17216.45 0 0 1013455315 1871576256 89 Physician Assistant Only(Encounter Only) SKORACZEWSKI KRISTIN 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 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 0 137.04 0 0 0 0 0 0 137.04 0 0 1013455610 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2256.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2256.8 0 0 1013455722 1093971004 10 Physicians KATHOLI BENJAMIN 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 225 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 10209.03 0 0 0 0 0 0 10209.03 0 0 1013456165 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14363.3 0 0 0 0 0 0 0 0 0 0 0 0 0 14363.3 0 0 1013456270 1518511096 91 Waiver service provider--Adults (DHS/DDD) KILLAM MELISSA K 999999999 30 DuPage 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49567.64 0 0 0 0 0 0 0 0 0 0 0 0 0 49567.64 0 0 1013456362 89 Physician Assistant Only(Encounter Only) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1752.6 0 0 0 0 0 0 1752.6 0 0 1013456600 1154856060 89 Physician Assistant Only(Encounter Only) DALY ELLEN M 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 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 0 381.36 0 0 0 0 0 0 381.36 0 0 1013456650 10 Physicians 80 Peoria 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 1013456849 1396065249 10 Physicians GRINSTEIN JONATHAN S 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 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 5680.9 0 0 0 0 0 0 5680.9 0 0 1013456899 1346496528 10 Physicians KOTECHA MANISH K 999999999 200 Cook 0 0 Interventional Radiology 0 0 0 0 0 0 0 0 0 0 29 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 627.59 0 17.62 0 0 0 0 0 0 645.21 0 0 1013457052 1154963379 86 Clinical Social Worker(Encounter Only) ALLEN CARA 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 26.77 0 0 0 0 0 0 26.77 0 0 1013457267 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 1013457309 1841846607 28 Waiver service provider--Supportive living facility (HFS) "POINTE AT JACKSONVILLE, THE" 999999999 77 Morgan 0 0 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 1496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121373.38 0 0 0 0 0 0 0 0 0 0 0 0 0 121373.38 0 0 1013457369 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20653.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20653.16 0 0 1013457769 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10578.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10578.79 0 0 1013458050 55 Early Intervention Services 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 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 2522.06 0 0 0 0 0 0 2522.06 0 0 1013458314 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11211.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11211.1 0 0 1013458456 1649825514 16 Nurse Practitioners GRYS LINDSEY L 999999999 80 Peoria 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 0 175 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 2017.09 0 0 0 0 0 0 2017.09 0 0 1013458563 1386174381 10 Physicians BEGGS BENJAMIN C 999999999 96 St Clair 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 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 0 914.24 0 0 0 0 0 0 914.24 0 0 1013459053 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 0 129 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 10822.13 0 0 0 0 0 0 0 0 0 0 0 0 0 10822.13 0 0 1013459115 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20551.97 0 0 0 0 0 0 0 0 0 0 0 0 0 20551.97 0 0 1013459287 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 141.1 0 0 0 0 0 0 0 0 0 0 0 0 0 141.1 0 0 1013459933 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5137.83 0 0 0 0 0 0 0 0 0 0 0 0 0 5137.83 0 0 1013460172 1982267696 16 Nurse Practitioners WALLACE SHELBY 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 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 1620.52 0 0 0 0 0 0 1620.52 0 0 1013460333 1780172064 10 Physicians KHAN SABA 999999999 200 Cook 0 0 Family Practice 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 63 0 0 0 0 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 5.17 0 1493.8 0 0 0 0 0 0 1498.97 0 0 1013460334 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 630.44 0 0 0 0 0 0 0 0 0 0 0 0 0 630.44 0 0 1013460478 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 1013460642 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.04 0 0 0 0 0 0 63.04 0 0 1013461329 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 1013461762 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 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 0 457.88 457.88 0 0 1013461827 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.99 18.99 0 0 1013462343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1157.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1157.4 0 0 1013462363 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5606.63 0 0 0 0 0 0 0 0 0 0 0 0 0 5606.63 0 0 1013462442 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11239.42 0 0 0 0 0 0 0 0 0 0 0 0 0 11239.42 0 0 1013462511 1093120545 10 Physicians HICKS CHRISTOPHER 999999999 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 1 0 0 0 0 0 0 2 0 75 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 338 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 338 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 66.02 0 5313.13 0 0 0 0 0 0 5385.55 0 0 1013462584 40 Federally Qualified Health Centers 816 Iowa 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.61 0 0 1013462632 10 Physicians 108 Williamson 0 0 Allergy-Immunization 0 0 0 0 0 0 0 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 86.6 0 0 0 0 0 0 86.6 0 0 1013463113 1427523125 40 Federally Qualified Health Centers HOWARD BROWN HEALTH CENTER 999999999 200 Cook 0 0 0 64 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 9875.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9875.89 0 0 1013463222 1053631465 10 Physicians RAJKOWSKI SAMUEL 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 429 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17370.35 0 251.72 0 0 0 0 0 0 17622.07 0 0 1013463503 1851659643 10 Physicians GHEE CHARLES 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 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 7626.53 0 0 0 0 0 0 7626.53 0 0 1013463738 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 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 0 358.05 0 0 0 0 0 0 0 0 0 0 0 0 0 358.05 0 0 1013463871 1972144715 16 Nurse Practitioners MIRELES REBECCA A 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 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 3096.06 0 0 0 0 0 0 3096.06 0 0 1013463888 1861849069 23 Occupational Therapists JENKS SIERRA T 999999999 91 Sangamon 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 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 0 829.97 829.97 0 0 1013463914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7759 0 0 0 0 0 0 0 0 0 0 0 0 0 7759 0 0 1013464013 1528488509 10 Physicians SULTANA FARHEEN 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 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 12713.51 0 0 0 0 0 0 12713.51 0 0 1013464015 1861044588 16 Nurse Practitioners ARACKAL JOCELYN 999999999 57 Lake 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 0 219 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 3798.96 0 0 0 0 0 0 3798.96 0 0 1013464243 1740830694 16 Nurse Practitioners TILLOTSON EMILY 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1088.64 0 0 0 0 0 0 1088.64 0 0 1013464317 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9960.3 0 0 0 0 0 0 0 0 0 0 0 0 0 9960.3 0 0 1013464665 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 23.46 0 0 0 0 0 0 23.46 0 0 1013464678 1881986503 10 Physicians MASHRUWALA NEIL 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 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 5035.19 0 0 0 0 0 0 5035.19 0 0 1013465473 1215234687 10 Physicians KRAMER JESSICA B 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 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 2294.27 0 0 0 0 0 0 2294.27 0 0 1013465704 1790214674 10 Physicians HARKEY JENNIFER 999999999 53 Kane 0 0 Psychiatry 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 0 200 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 5798.94 0 0 0 0 0 0 5798.94 0 0 1013465728 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35170.67 0 0 0 0 0 0 0 0 0 0 0 0 0 35170.67 0 0 1013465732 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9639.57 0 0 0 0 0 0 0 0 0 0 0 0 0 9639.57 0 0 1013465880 1043576101 10 Physicians RICE TERESA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.63 0 0 0 0 0 0 14.63 0 0 1013466240 1316367451 10 Physicians WENZEL AMANDA A 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 0 115 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 5823.84 0 0 0 0 0 0 5823.84 0 0 1013466514 1760047583 63 Other Providers of Medical Equipment/Supplies (Non-registered) CRANIAL TECHNOLOGIES INC. 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 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 10928.56 0 0 0 0 0 0 10928.56 0 0 1013466562 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 21591.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21591.5 0 0 1013466613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4141.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4141.9 0 0 1013466699 1659929644 89 Physician Assistant Only(Encounter Only) KERN MADELYN 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.22 0 0 0 0 0 0 71.22 0 0 1013466759 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 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 0 261.63 0 0 0 0 0 0 261.63 0 0 1013466880 1245402601 22 Physical Therapists GUTIERREZ VINCE 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 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 1296.3 1296.3 0 0 1013467111 16 Nurse Practitioners 51 Jo Daviess 0 0 0 0 0 0 0 0 0 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 1013467266 1477871705 10 Physicians MUSTAFA MD ASIF 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 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 2001.16 0 0 0 0 0 0 2001.16 0 0 1013467904 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20978.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20978.44 0 0 1013467965 1376109918 16 Nurse Practitioners CHANG SHUYING 999999999 200 Cook 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 0 994 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 994 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22845.16 0 0 0 0 0 0 22845.16 0 0 1013468683 1851740930 10 Physicians GHOUSE AMRIEN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 722.43 0 0 0 0 0 0 722.43 0 0 1013469192 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1597.84 1597.84 0 0 1013469238 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 62.74 0 0 0 0 0 0 62.74 0 0 1013469257 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2029.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2029.74 0 0 1013469295 1083261218 16 Nurse Practitioners PULLIAM DEBORAH 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 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 0 328.35 0 0 0 0 0 0 328.35 0 0 1013469389 1164832705 16 Nurse Practitioners JOHNS ELIZABETH J 999999999 10 Adams 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 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 0 666.53 0 0 0 0 0 0 666.53 0 0 1013469676 1871142703 24 Speech Therapists CULL MOLLY 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 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 4693.04 4693.04 0 0 1013469711 1124382825 10 Physicians ALRADAWI SULIMAN 999999999 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 0 151 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 2590.33 0 0 0 0 0 0 2590.33 0 0 1013469967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12082.12 0 0 0 0 0 0 0 0 0 0 0 0 0 12082.12 0 0 1013470221 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 11376 0 0 0 0 0 0 0 0 0 0 0 0 0 11376 0 0 1013470338 10 Physicians 81 Perry 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 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 0 174.16 0 0 0 0 0 0 174.16 0 0 1013470631 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 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 7284.69 0 0 0 0 0 0 0 0 0 0 0 0 0 7284.69 0 0 1013471757 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 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 0 316.39 0 0 0 0 0 0 316.39 0 0 1013471892 1942599832 10 Physicians ZHANG RONG MEI 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 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.81 0 0 0 0 0 0 245.81 0 0 1013471920 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11973.94 0 0 0 0 0 0 0 0 0 0 0 0 0 11973.94 0 0 1013472074 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 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 10950.24 0 0 0 0 0 0 0 0 0 0 0 0 0 10950.24 0 0 1013472485 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17939.14 0 0 0 0 0 0 0 0 0 0 0 0 0 17939.14 0 0 1013473069 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 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 6804.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6804.34 0 0 1013473631 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 0 0 0 0 0 0 0 0 0 0 1013473759 1285841916 10 Physicians ARMSTRONG LINDA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 53 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1114.27 0 0 0 0 0 0 0 0 1114.27 0 0 1013474559 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6227.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6227.1 0 0 1013475348 1396197869 10 Physicians JAFFER DANISH 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 335.26 0 0 0 0 0 0 335.26 0 0 1013475967 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10349.97 0 0 0 0 0 0 0 0 0 0 0 0 0 10349.97 0 0 1013476002 1841292240 89 Physician Assistant Only(Encounter Only) ORVINO CHRISTOPHER M 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 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 0 570.81 0 0 0 0 0 0 570.81 0 0 1013476047 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1822.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1822.8 0 0 1013476256 1467984435 10 Physicians JIANG DAVID 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 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 3206.76 0 0 0 0 0 0 3206.76 0 0 1013476436 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 12.12 0 0 0 0 0 0 12.12 0 0 1013476543 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26136 0 0 0 0 0 0 0 0 0 0 0 0 0 26136 0 0 1013477580 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 0 184.76 0 0 0 0 0 0 184.76 0 0 1013477588 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.89 142.89 0 0 1013478103 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6217.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6217.27 0 0 1013478282 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10258.74 0 0 0 0 0 0 0 0 0 0 0 0 0 10258.74 0 0 1013478360 1356982979 16 Nurse Practitioners DICOSOLA ASHLEY 999999999 200 Cook 0 0 0 0 0 2 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 38 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 13.46 0 0 0 0 0 0 0 0 1360.04 0 0 0 0 0 0 1373.5 0 0 1013478444 1558727636 16 Nurse Practitioners LUCIA ROBERT J 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 1785.65 0 0 0 0 0 0 1849.95 0 0 1013478481 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24490.62 0 0 0 0 0 0 0 0 0 0 0 0 0 24490.62 0 0 1013478503 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 0 113 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 19456.84 0 0 0 0 0 0 0 0 0 0 0 0 0 19456.84 0 0 1013478872 1689131740 25 Audiologists MORGAN SARAH K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 416.14 416.14 0 0 1013478999 1902269145 10 Physicians GONZALEZ JAIME S 999999999 19 Champaign 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 4 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 437 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13665.8 0 0 0 0 0 0 13665.8 0 0 1013479018 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3675.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3675.68 0 0 1013479083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22372.55 0 0 0 0 0 0 0 0 0 0 0 0 0 22372.55 0 0 1013479198 1912384306 10 Physicians REGISTER WILLIAM G 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 0 448.75 0 0 0 0 0 0 448.75 0 0 1013479403 1831509090 10 Physicians DARRELL CAITLIN M 999999999 30 DuPage 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 0 234 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 1065.37 0 0 0 0 0 0 0 0 1065.37 0 0 1013479644 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 0 0 0 0 0 0 0 0 0 0 1013479689 1699973131 10 Physicians WENDEL AMANDA 999999999 53 Kane 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 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 0 610.78 0 0 0 0 0 0 610.78 0 0 1013479784 1013046994 10 Physicians BARNWELL-GRAYSON ANNE-BATTISTE 999999999 59 Lawrence 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 1540.77 0 0 0 0 0 0 1540.77 0 0 1013480174 1760034920 16 Nurse Practitioners JONES ALEXANDRIA 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 0 182.45 0 0 0 0 0 0 182.45 0 0 1013480267 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 0 307 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 23623.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23623.49 0 0 1013480546 1295077196 10 Physicians PIERCE DAVID 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 513 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7316.53 0 5533.66 0 0 0 0 0 0 12850.19 0 0 1013480863 1417444373 16 Nurse Practitioners AREVALO DARRELL C 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 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 0 455 0 0 0 0 0 0 455 0 0 1013481037 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 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 0 513.15 513.15 0 0 1013481038 1457912834 89 Physician Assistant Only(Encounter Only) MCNAMARA SHANNON L 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 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 0 307.28 0 0 0 0 0 0 307.28 0 0 1013481157 1508328410 16 Nurse Practitioners PAPAZIAN HOURI 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 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 0 140.65 0 0 0 0 0 0 140.65 0 0 1013481287 1659882736 16 Nurse Practitioners LEWIS SHANNON 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 38.55 0 0 0 0 0 0 0 0 1736.29 0 0 0 0 0 0 1774.84 0 0 1013481336 10 Physicians 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.25 0 0 0 0 0 0 230.25 0 0 1013481370 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0 0 6721.71 0 1756.71 0 0 0 0 8478.42 0 0 1013485522 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16711.42 0 0 0 0 0 0 0 0 0 0 0 0 0 16711.42 0 0 1013485881 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10484.32 0 0 0 0 0 0 0 0 0 0 0 0 0 10484.32 0 0 1013485936 1669724001 60 Pharmacies OAKWOOD APOTHECARY 619511452 78 Moultrie 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 0 553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28370 0 0 0 28370 0 0 1013485976 1942291604 10 Physicians POYLIN VITALIY Y 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 508.78 0 0 0 0 0 0 508.78 0 0 1013486774 1578114161 23 Occupational Therapists SOPPE ANGELICA K 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1626.59 1626.59 0 0 1013486923 1649619453 10 Physicians STOTTER BRIAN ROSS 999999999 53 Kane 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 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 1365.82 0 0 0 0 0 0 1365.82 0 0 1013487029 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 74.95 0 0 0 0 0 0 74.95 0 0 1013487201 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 1013487376 1174012454 16 Nurse Practitioners FITZGERALD NICOLE 999999999 200 Cook 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 0 174 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 70.7 0 0 0 0 0 0 0 0 5392.51 0 0 0 0 0 0 5463.21 0 0 1013487636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14923.07 0 0 0 0 0 0 0 0 0 0 0 0 0 14923.07 0 0 1013487670 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 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 0 106.41 0 0 0 0 0 0 106.41 0 0 1013487693 1801184767 10 Physicians CHATURVEDULA SURYA TEJA 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.56 0 3335.36 0 0 0 0 0 0 3344.92 0 0 1013487743 1952752057 10 Physicians HAWKINS MADDELYNN 999999999 200 Cook 0 0 Emergency 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 0 183 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 4905.86 0 0 0 0 0 0 4905.86 0 0 1013488440 1285279612 16 Nurse Practitioners RENFRO TIFFANY N 999999999 91 Sangamon 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 0 135 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 2166.57 0 0 0 0 0 0 2166.57 0 0 1013488535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 854.32 0 0 0 0 0 0 0 0 0 0 0 0 0 854.32 0 0 1013488977 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.94 0 0 0 0 0 0 212.94 0 0 1013492113 1336706845 16 Nurse Practitioners MENDALUK JENNIFER M 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 0 215 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 85677.76 0 0 0 0 0 0 85677.76 0 0 1013492347 1518513605 16 Nurse Practitioners HARDESTY MELISSA A 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 787.8 0 0 0 0 0 0 800.6 0 0 1013492536 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14834.01 0 0 0 0 0 0 0 0 0 0 0 0 0 14834.01 0 0 1013493168 1831751999 23 Occupational Therapists CHAHEINE LUZ M 999999999 53 Kane 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 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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 11901.42 0 0 0 0 0 0 11901.42 0 0 1013493729 72 Taxicabs and Livery Companies 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 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 0 214.57 0 0 0 0 0 0 214.57 0 0 1013494203 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13469.04 0 0 0 0 0 0 0 0 0 0 0 0 0 13469.04 0 0 1013494391 1487200986 33 Nursing Facilities APERION CARE BRADLEY 999999999 54 Kankakee 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 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4513 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434529.19 0 0 0 0 0 0 0 434529.19 0 0 1013494396 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 20182.72 0 0 0 0 0 0 0 0 0 0 0 0 0 20182.72 0 0 1013494443 1881178366 16 Nurse Practitioners ISHIDA KANAKO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 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 7408.88 0 0 0 0 0 0 7408.88 0 0 1013494522 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 22547.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22547.8 0 0 1013494675 1285287540 11 Dentists PATEL KRUPA 999999999 200 Cook 0 0 General Dentistry 0 0 55 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 10950.54 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 12832.29 0 0 1013494730 1306488127 86 Clinical Social Worker(Encounter Only) MILLER PATRICIA 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 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 0 250.15 0 0 0 0 0 0 250.15 0 0 1013494810 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 23696.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23696.4 0 0 1013494862 4013494862 71 Medicar Provider "LEAP OF FAITH TRANSPORTATION,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 3645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20765.86 0 0 0 0 0 0 20765.86 0 0 1013495032 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.69 0 0 0 0 0 0 0 0 0 0 0 0 0 71.69 0 0 1013495073 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1254.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1254.18 0 0 1013495115 1902367642 10 Physicians KO SEBASTIAN 999999999 200 Cook 0 0 Orthopedic Surgery 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 0 131 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 3288.28 0 0 0 0 0 0 3288.28 0 0 1013495285 1205096609 10 Physicians ABAZEED MOHAMED 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 0 858.05 0 0 0 0 0 0 858.05 0 0 1013495756 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 0 178.2 0 0 0 0 0 0 178.2 0 0 1013496440 1023092319 89 Physician Assistant Only(Encounter Only) LYKOWSKI TARA 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 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 0 227 0 0 0 0 0 0 227 0 0 1013496518 1962791343 10 Physicians WONG JEREMY 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 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 0 532.93 0 0 0 0 0 0 532.93 0 0 1013496728 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 543.09 0 0 0 0 0 0 0 0 0 0 0 0 0 543.09 0 0 1013497562 1982269601 75 Department of Alcohol and Substance Abuse Provider "CENTERSTONE OF ILLINOIS, INC" 999999999 108 Williamson 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 0 168 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 11804.59 0 0 11804.59 0 0 1013497810 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 244.11 0 0 0 0 0 0 0 0 0 0 0 0 0 244.11 0 0 1013497905 1205488954 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) KANKAKEE TERRACE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 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 1431 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149404.02 0 0 0 0 0 0 0 149404.02 0 0 1013498969 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3011.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3011.99 0 0 1013499263 1811451594 60 Pharmacies SAV-MOR PHARMACY 999999999 20 Christian 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 0 309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20592.41 0 0 0 20592.41 0 0 1013499452 1871144832 16 Nurse Practitioners KELLAHAN SARA R 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 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 0 775.02 0 0 0 0 0 0 775.02 0 0 1013499764 1952943953 16 Nurse Practitioners KIM JENNY Y 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 9 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 19 0 0 0 0 0 0 0 0 0 505.14 0 0 0 0 0 0 0 0 808.03 0 0 0 0 0 0 1313.17 0 0 1013499811 1396062253 10 Physicians CHAWLA AKHIL 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 629.58 0 0 0 0 0 0 629.58 0 0 1013499969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24957.24 0 0 0 0 0 0 0 0 0 0 0 0 0 24957.24 0 0 1013500041 1417901620 86 Clinical Social Worker(Encounter Only) CHACKO ALEXANDER 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 0 199 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 3564.05 0 0 0 0 0 0 3564.05 0 0 1013500515 1770041949 89 Physician Assistant Only(Encounter Only) RYAN LAURA 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 0 129.68 0 0 0 0 0 0 129.68 0 0 1013500790 1326241605 10 Physicians STANSFIELD WILLIAM 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 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 5525.04 0 0 0 0 0 0 5525.04 0 0 1013500855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25112.27 0 0 0 0 0 0 0 0 0 0 0 0 0 25112.27 0 0 1013500861 1003083270 10 Physicians KABADI MITESH M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3214.28 0 0 0 0 0 0 3214.28 0 0 1013501217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37801.9 0 0 0 0 0 0 0 0 0 0 0 0 0 37801.9 0 0 1013502024 1508329525 16 Nurse Practitioners BRENNAN MEGAN J 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 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 1306.27 0 0 0 0 0 0 1306.27 0 0 1013502066 1083033278 10 Physicians BIENIA BENJAMIN 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 388 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 571 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9178.34 0 568.42 0 0 0 0 0 0 9746.76 0 0 1013502096 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 8791.91 0 0 0 0 0 0 0 0 0 0 0 0 0 8791.91 0 0 1013502132 1316251796 10 Physicians MERT ISMAIL 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 645.31 0 0 0 0 0 0 645.31 0 0 1013502535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1567.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1567.46 0 0 1013502564 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1619.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1619.86 0 0 1013502794 1386100444 16 Nurse Practitioners NOKIELSKI JOANNE 999999999 57 Lake 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 0 252 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 6618.3 0 0 0 0 0 0 6618.3 0 0 1013502967 1033762802 16 Nurse Practitioners MOY PIAN P 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1013503098 1083160329 13 Podiatrists JONES RASHONDA 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 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 0 579.69 0 0 0 0 0 0 579.69 0 0 1013503195 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2205.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2205.12 0 0 1013503701 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 0 0 0 0 0 0 0 0 0 0 1013504919 1336678739 16 Nurse Practitioners FUGELSETH SARAH B 999999999 200 Cook 0 0 0 0 0 8 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 477.31 0 0 0 0 0 0 0 0 2903.52 0 0 0 0 0 0 3380.83 0 0 1013505200 1578112322 11 Dentists SEO YOU SEEN 999999999 200 Cook 0 0 General Dentistry 0 0 94 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 13905.78 0 0 0 0 0 0 0 0 0 0 0 3387.15 0 0 0 0 17292.93 0 0 1013505991 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 4 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 0 591.54 591.54 0 0 1013506583 1356878425 10 Physicians DONATO FRANCISCO 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 13 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.1 0 21.33 0 0 0 0 0 0 258.43 0 0 1013506611 1952666976 10 Physicians AMORNSAWADWATTANA SURACHAI 999999999 109 Winnebago 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 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 0 948.71 0 0 0 0 0 0 948.71 0 0 1013506899 1417248212 10 Physicians SULO DENISE M 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 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 1779.44 0 0 0 0 0 0 1779.44 0 0 1013506981 1679996037 16 Nurse Practitioners STARK DANTRI 999999999 30 DuPage 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 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 2209.32 0 0 0 0 0 0 2209.32 0 0 1013507208 1700148483 10 Physicians CHAKOUR KENNETH S 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8398.95 0 0 0 0 0 0 8398.95 0 0 1013507462 1144683863 10 Physicians CLARK BRADLEY 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 10 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.33 0 42.18 0 0 0 0 0 0 79.51 0 0 1013507699 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20208.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20208.16 0 0 1013508025 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3119.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3119.9 0 0 1013508467 1124673256 16 Nurse Practitioners GINDER GRETCHEN L 999999999 88 Richland 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 0 131 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 131 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 2957 0 0 0 0 0 0 3034.87 0 0 1013508547 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9472.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9472.04 0 0 1013508966 1629425996 10 Physicians WEBERMAN-STONE RACHEL B 999999999 80 Peoria 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 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 0 466.65 0 0 0 0 0 0 466.65 0 0 1013509009 1841379484 89 Physician Assistant Only(Encounter Only) TONG CINDY 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 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17129.03 0 0 0 0 0 0 17129.03 0 0 1013509045 75 Department of Alcohol and Substance Abuse Provider 22 Clay 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 663.26 0 0 663.26 0 0 1013509293 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21315.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21315.47 0 0 1013509673 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 0 108.07 0 0 0 0 0 0 108.07 0 0 1013510378 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7163.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7163.2 0 0 1013510595 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36360.46 0 0 0 0 0 0 0 0 0 0 0 0 0 36360.46 0 0 1013510776 1285270082 12 Optometrists RICCARDI MALGORZATA 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 27 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209.08 0 439.2 0 0 0 0 1648.28 0 0 1013511022 1134562150 10 Physicians HUSSAIN NIDA 999999999 53 Kane 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 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 2242.35 0 0 0 0 0 0 2242.35 0 0 1013511141 1457911810 16 Nurse Practitioners DAVIS SARAH J 999999999 96 St Clair 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 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 0 299.22 0 0 0 0 0 0 299.22 0 0 1013511224 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5859.28 0 0 0 0 0 0 0 0 0 0 0 0 0 5859.28 0 0 1013511262 1013479575 23 Occupational Therapists DAVIDSON JENNIFER 999999999 53 Kane 0 0 0 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 0 225.99 0 0 0 0 0 0 0 0 0 0 0 0 225.99 0 0 1013511278 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23381.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23381.7 0 0 1013511372 1366885766 10 Physicians PITRODA PRIYANKA 999999999 53 Kane 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 0 193 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 1809.38 0 0 0 0 0 0 1809.38 0 0 1013511671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16560.95 0 0 0 0 0 0 0 0 0 0 0 0 0 16560.95 0 0 1013511678 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 830.28 0 0 0 0 0 0 0 0 0 0 0 0 0 830.28 0 0 1013511939 4013511939 91 Waiver service provider--Adults (DHS/DDD) KING CONSTANCE 999999999 91 Sangamon 0 0 0 0 0 0 0 20 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 20061.11 0 0 0 0 0 0 0 0 0 0 0 0 0 20061.11 0 0 1013512210 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 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 10586.07 0 0 0 0 0 0 0 0 0 0 0 0 0 10586.07 0 0 1013512455 1750736880 10 Physicians KIM VICTOR D 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 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 0 183.73 0 0 0 0 0 0 183.73 0 0 1013512993 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4320.48 0 0 0 0 0 0 0 0 0 0 0 0 0 4320.48 0 0 1013513280 1023665031 22 Physical Therapists KNOTT KATHRYN 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 909.12 909.12 0 0 1013513283 1366898058 10 Physicians DUKIC NIKOLA 999999999 200 Cook 0 0 Pediatrics 0 0 0 32 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 3379.41 0 0 0 0 0 0 4.5 0 1216.57 0 0 0 0 0 0 4600.48 0 0 1013513338 1093272999 70 Ambulance Service Providers ARCH AIR MEDICAL SERVICE 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 12690 0 0 0 0 0 0 12690 0 0 1013513956 1609255546 10 Physicians BRYSON WESLEY N 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 31 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.3 0 97.11 0 0 0 0 0 0 280.41 0 0 1013514119 1386114858 16 Nurse Practitioners PATEL KRINA 999999999 57 Lake 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 1232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5868.35 0 0 0 0 0 0 5868.35 0 0 1013514203 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14725.69 0 0 0 0 0 0 0 0 0 0 0 0 0 14725.69 0 0 1013514207 1881013647 10 Physicians FOLZ JOSEPH 999999999 91 Sangamon 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 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2270.51 0 0 0 0 0 0 2270.51 0 0 1013514236 1275979825 10 Physicians FLESSNER TYLER 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 789 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1366 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1366 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10668.32 0 785.29 0 0 0 0 0 0 11453.61 0 0 1013514651 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 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 0 523.44 0 0 0 0 0 0 523.44 0 0 1013514849 1447690961 10 Physicians WOLFE ALEXIS 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 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 1548.97 0 0 0 0 0 0 1548.97 0 0 1013514878 1972155588 11 Dentists ALSAKINI MANAR 999999999 200 Cook 0 0 0 0 222 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 39934.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39934.13 0 0 1013514918 1881246502 89 Physician Assistant Only(Encounter Only) SCHNELL ARIEL 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 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 0 153.48 0 0 0 0 0 0 153.48 0 0 1013515023 11 Dentists 107 Will 0 0 General Dentistry 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 0 104.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.4 0 0 1013515152 1487035432 10 Physicians MADDEN ABBI A 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 43.14 0 2232.55 0 0 0 0 0 0 2275.69 0 0 1013515353 1992352645 47 Local Education Agencies AMANDLA CHARTER SCHOOL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1854.33 0 1854.33 0 0 1013515602 1609414119 16 Nurse Practitioners RECOB LAURA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.41 0 0 0 0 0 0 93.41 0 0 1013515868 1467803098 10 Physicians HULYALKAR MANASI 999999999 91 Sangamon 0 0 Pediatrics 0 0 0 12 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 1217.87 0 0 0 0 0 0 0 0 1364.04 0 0 0 0 0 0 2581.91 0 0 1013515874 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 0 190 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 18553.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18553.5 0 0 1013516567 1508419540 12 Optometrists NOUHAKIS ELENI 999999999 56 Knox 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 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 46.45 0 0 0 0 0 0 46.45 0 0 1013516605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4401.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4401.96 0 0 1013516666 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 0 106 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 14548.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14548.39 0 0 1013516704 1063778462 10 Physicians PRATIVADI RAMANUJAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 317 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7369.59 0 186.64 0 0 0 0 0 0 7556.23 0 0 1013516711 1508229949 10 Physicians ABDEL-LATIEF EMAN A 999999999 200 Cook 0 0 Pediatrics 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 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 2235.2 0 0 0 0 0 0 2235.2 0 0 1013516867 1619521705 16 Nurse Practitioners AHMED SAKIF 999999999 30 DuPage 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 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 0 295.79 0 0 0 0 0 0 295.79 0 0 1013517108 1942680640 10 Physicians AKHRAS ANWAR 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1066.52 0 0 0 0 0 0 1066.52 0 0 1013517846 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 7390.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7390.8 0 0 1013518525 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25040.28 0 0 0 0 0 0 0 0 0 0 0 0 0 25040.28 0 0 1013518612 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1770.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1770.25 0 0 1013518698 1205190576 10 Physicians BANACH BRIDGET 999999999 200 Cook 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 0 105 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 1409.06 0 0 0 0 0 0 0 0 1409.06 0 0 1013518722 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23549.02 0 0 0 0 0 0 0 0 0 0 0 0 0 23549.02 0 0 1013518868 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 0 0 0 0 0 0 0 0 0 0 1013519076 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22671 0 0 0 0 0 0 0 0 0 0 0 0 0 22671 0 0 1013519598 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23858.34 0 0 0 0 0 0 0 0 0 0 0 0 0 23858.34 0 0 1013519912 1033224654 89 Physician Assistant Only(Encounter Only) NUGENT JOHN W 999999999 108 Williamson 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 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15332.84 0 0 0 0 0 0 15332.84 0 0 1013520080 1861887291 10 Physicians SUVAR TOLGA 999999999 109 Winnebago 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2482.27 0 0 0 0 0 0 2482.27 0 0 1013520460 1972948313 10 Physicians PAVKOVICH DAVID S 999999999 30 DuPage 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 0 271 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 3438.29 0 0 0 0 0 0 3438.29 0 0 1013520751 1457902884 23 Occupational Therapists SIMMONS ALISON J 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 28.68 0 0 0 0 0 418.68 447.36 0 0 1013520937 1497013767 10 Physicians CICCIA EILEEN ANNA 999999999 10 Adams 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 0 123 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 0 507.36 0 0 0 0 0 0 507.36 0 0 1013521458 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 13177.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13177.79 0 0 1013521556 1639528136 10 Physicians SZATKO GABRIELA MARIA 999999999 80 Peoria 0 0 Emergency Medicine 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 0 255 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 7932.15 0 0 0 0 0 0 7932.15 0 0 1013521827 1538507538 10 Physicians MAKIEWICZ KRISTINE U 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 60.02 0 0 0 0 0 0 60.02 0 0 1013521842 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 512.76 0 0 0 0 0 0 0 0 0 0 0 0 0 512.76 0 0 1013521903 1407327638 89 Physician Assistant Only(Encounter Only) WALTHER DAKOTA L 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 0 503.21 0 0 0 0 0 0 503.21 0 0 1013521921 1073163838 16 Nurse Practitioners VERNER TAMISHA L 999999999 97 Stephenson 0 0 0 0 0 27 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 2774.11 0 0 0 0 0 0 0 0 3056 0 0 0 0 0 0 5830.11 0 0 1013522175 1912369570 10 Physicians SONNABEND HAJERAH H 999999999 200 Cook 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 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 0 869.23 0 0 0 0 0 0 869.23 0 0 1013522351 1386937167 10 Physicians MAEZA ALAEDDIN A 999999999 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.19 0 3472.09 0 0 0 0 0 0 3481.28 0 0 1013522463 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 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 1380.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1380.12 0 0 1013522595 1407353949 16 Nurse Practitioners PATEL NILAM A 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 137.02 0 0 0 0 0 0 137.02 0 0 1013522738 1316490246 11 Dentists SHANG MELANIE 999999999 91 Sangamon 0 0 Orthodontist 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 2580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2580 0 0 1013522850 63 Other Providers of Medical Equipment/Supplies (Non-registered) 805 California 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663.29 0 0 0 0 0 0 663.29 0 0 1013523089 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 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 1640.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1640.52 0 0 1013523242 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 47.77 0 0 0 0 0 0 47.77 0 0 1013523550 1043536832 10 Physicians FEI LI KUANG 999999999 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 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 0 331.51 0 0 0 0 0 0 331.51 0 0 1013523597 1114571262 11 Dentists AHMED SAIRA 999999999 30 DuPage 0 0 General Dentistry 0 0 78 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 13704 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 14080.35 0 0 1013523717 1043776958 16 Nurse Practitioners LIVINGSTON JULIE M 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 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 3191.03 0 0 0 0 0 0 3191.03 0 0 1013523948 1679075022 16 Nurse Practitioners MAY KYLE 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 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 1005.85 0 0 0 0 0 0 1005.85 0 0 1013524101 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 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 1013524393 1225596364 22 Physical Therapists LINTAKAS RIMA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 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 22974.12 22974.12 0 0 1013524406 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.96 51.96 0 0 1013524533 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 0 161 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 12565.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12565.97 0 0 1013524652 1962863894 10 Physicians SAMSAMI DORSA 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 0 293 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 4649.33 0 0 0 0 0 0 4649.33 0 0 1013524927 1164817334 10 Physicians PANDYA SHACHI D 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 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 0 149.44 0 0 0 0 0 0 149.44 0 0 1013524932 1558579755 10 Physicians NORMAN ROBERT M 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 0 203 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 5123.55 0 0 0 0 0 0 5123.55 0 0 1013525376 1023559218 10 Physicians COZZA EUGENE M 999999999 53 Kane 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 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 1111.92 0 0 0 0 0 0 1111.92 0 0 1013525411 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 6181.99 0 0 0 0 0 0 0 0 0 0 0 0 0 6181.99 0 0 1013525756 1952953176 25 Audiologists ELSTON CODY 999999999 91 Sangamon 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 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 1003.17 1003.17 0 0 1013526152 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23809.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.5 0 0 1013526153 10 Physicians 30 DuPage 0 0 0 0 0 0 0 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 0 297.08 0 0 0 0 0 0 0 0 297.08 0 0 1013526178 1528523057 89 Physician Assistant Only(Encounter Only) LEE JUSTIN W 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 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 1325.52 0 0 0 0 0 0 1325.52 0 0 1013526374 1467938464 16 Nurse Practitioners CLAPHAM STEPHANIE 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 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 1260.33 0 0 0 0 0 0 1260.33 0 0 1013526712 1770067563 16 Nurse Practitioners SIMON RACHEL A. 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 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 2773.94 0 0 0 0 0 0 2773.94 0 0 1013527478 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1676.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1676.27 0 0 1013527559 1912549965 16 Nurse Practitioners HUDSON BROOKE A 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 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 0 203.15 0 0 0 0 0 0 203.15 0 0 1013527605 1386294817 16 Nurse Practitioners BOLLIGER JOSHUA T 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 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 2340.65 0 0 0 0 0 0 2340.65 0 0 1013527678 1356994545 55 Early Intervention Services PARTON LINDSAY 999999999 72 McLean 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 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 17608.67 0 0 0 0 0 0 17608.67 0 0 1013527804 1245294586 10 Physicians RAMSEY KEITH P 999999999 80 Peoria 0 0 Pediatrics 0 0 0 33 0 0 0 0 0 0 19 0 45 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 21 0 92 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 21 0 92 0 0 0 0 0 0 0 0 0 2746.84 0 0 0 0 0 0 237.37 0 5538.69 0 0 0 0 0 0 8522.9 0 0 1013527812 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 0 0 0 0 0 0 0 0 0 0 1013528058 1972949154 10 Physicians FLANAGAN MARGARET E 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 372.59 0 0 0 0 0 0 0 0 372.59 0 0 1013528090 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 0 113.26 0 0 0 0 0 0 113.26 0 0 1013528376 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16781.89 0 0 0 0 0 0 0 0 0 0 0 0 0 16781.89 0 0 1013528679 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2340.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2340.24 0 0 1013528824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2833 0 0 0 0 0 0 0 0 0 0 0 0 0 2833 0 0 1013529074 10 Physicians 91 Sangamon 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013529139 1306498142 87 Psychologist(Encounter Only) MACKIE MELISSA-ANN 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 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 0 362.12 0 0 0 0 0 0 362.12 0 0 1013529444 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17849.58 0 0 0 0 0 0 0 0 0 0 0 0 0 17849.58 0 0 1013529531 1457903056 55 Early Intervention Services MCCRADY JENNA 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7530.1 0 0 0 0 0 0 7530.1 0 0 1013529586 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8983.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8983.8 0 0 1013529600 1801000476 10 Physicians HUSSEIN AHMED 999999999 107 Will 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 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 1972.02 0 0 0 0 0 0 1972.02 0 0 1013529655 1073043352 10 Physicians RAJANI JACKIE 999999999 200 Cook 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 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 438 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7723.56 0 0 0 0 0 0 7723.56 0 0 1013529867 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 0 154.28 0 0 0 0 0 0 154.28 0 0 1013530632 1285284646 91 Waiver service provider--Adults (DHS/DDD) JOYNER ZALIKA A 999999999 91 Sangamon 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5239.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5239.8 0 0 1013530638 4013530638 92 Waiver service provider--Disability (DHS/DRS) SERENDIPITY HOME HEALTH INC 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 0 116 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 272769.88 0 0 0 0 0 0 0 0 0 0 0 0 0 272769.88 0 0 1013530698 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013531161 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 0 0 0 0 0 0 0 0 0 0 1013531256 1649210766 89 Physician Assistant Only(Encounter Only) MASON DAVID E 999999999 47 Jackson 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 0 133 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 3774.79 0 0 0 0 0 0 3774.79 0 0 1013531263 10 Physicians 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.35 0 0 1013531624 1992354385 55 Early Intervention Services HEFNER PAURAVI 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2827.02 0 0 0 0 0 0 2827.02 0 0 1013532106 1689689093 10 Physicians RAJA DURRE S 999999999 200 Cook 0 0 Anesthesiology 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 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.63 0 2964.02 0 0 0 0 0 0 2970.65 0 0 1013532109 1366857286 10 Physicians TAZUDEEN NOOR 999999999 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 6 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.17 0 699.55 0 0 0 0 0 0 706.72 0 0 1013532807 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11132.76 0 0 0 0 0 0 0 0 0 0 0 0 0 11132.76 0 0 1013533005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12766.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12766.82 0 0 1013533233 1225596950 22 Physical Therapists PETERSON LAURA M 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 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 3011.89 3011.89 0 0 1013533361 1861052441 10 Physicians FARHAT WALID A 999999999 109 Winnebago 0 0 Urology 0 0 0 0 0 0 0 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 0 451.96 0 0 0 0 0 0 451.96 0 0 1013533922 1548618549 10 Physicians LIGGETT ANNA B 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 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 0 175.64 0 0 0 0 0 0 175.64 0 0 1013534023 1154810778 10 Physicians PATEL LISA 999999999 54 Kankakee 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 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 0 430.61 0 0 0 0 0 0 430.61 0 0 1013534264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17050.75 0 0 0 0 0 0 0 0 0 0 0 0 0 17050.75 0 0 1013534397 1669826822 10 Physicians MALONE ISABEL 999999999 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 2 0 200 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 41.27 0 4354.66 0 0 0 0 0 0 4395.93 0 0 1013534471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16308.46 0 0 0 0 0 0 0 0 0 0 0 0 0 16308.46 0 0 1013534632 1770044711 16 Nurse Practitioners DANIEL JESSICA 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 0 146 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 1371.09 0 0 0 0 0 0 1371.09 0 0 1013534934 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7700.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7700.5 0 0 1013534954 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 2.54 0 0 0 0 0 0 2.54 0 0 1013535088 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17737.47 0 0 0 0 0 0 0 0 0 0 0 0 0 17737.47 0 0 1013535528 1174918957 10 Physicians LEIDNER ALEXANDER S 999999999 200 Cook 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1013535833 1114351921 12 Optometrists HOMANN ALEXANDRA S 999999999 96 St Clair 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 0 172.26 0 0 0 0 0 0 172.26 0 0 1013535927 1023561859 10 Physicians ZHANG WANNA 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 0 293 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 2713.35 0 0 0 0 0 0 2713.35 0 0 1013536354 1225672611 16 Nurse Practitioners SAWYER SARA 999999999 200 Cook 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 0 860 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 119241.74 0 0 0 0 0 0 119241.74 0 0 1013536384 1114418803 16 Nurse Practitioners VARKEY CHINNU 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 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 0 0 0 0 0 0 0 0 0 0 1013536551 1912465758 16 Nurse Practitioners SIBANDA SINOKUTHABA L 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 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 0 790.41 0 0 0 0 0 0 790.41 0 0 1013536652 1346489945 10 Physicians PUTHUMANA NEAL 999999999 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 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 2700.14 0 0 0 0 0 0 2700.14 0 0 1013537189 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 0 138.58 0 0 0 0 0 0 138.58 0 0 1013537234 1386114874 16 Nurse Practitioners SOEST EDWARD H 999999999 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 0 0 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 0 301.33 0 0 0 0 0 0 301.33 0 0 1013537351 1750729018 10 Physicians PAPAGIANNOPOULOS PETER 999999999 200 Cook 0 0 Otolaryngology 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 0 292 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 6541.2 0 0 0 0 0 0 6541.2 0 0 1013537665 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23015.02 0 0 0 0 0 0 0 0 0 0 0 0 0 23015.02 0 0 1013537670 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 294.35 0 0 0 0 0 0 0 0 0 0 0 0 0 294.35 0 0 1013537754 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 1013537872 10 Physicians 64 Macoupin 0 0 0 0 0 0 0 0 0 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 1013537982 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1387.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1387.9 0 0 1013537994 1902893860 10 Physicians BRITTON ELISABETH 999999999 81 Perry 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 853.79 0 0 0 0 0 0 853.79 0 0 1013538315 1891100889 10 Physicians MOHAMMED SAFI 999999999 54 Kankakee 0 0 Urology 0 0 0 0 0 0 0 0 0 0 11 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.22 0 2994.01 0 0 0 0 0 0 3022.23 0 0 1013538591 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9164.5 0 0 0 0 0 0 0 0 0 0 0 0 0 9164.5 0 0 1013538762 1164803953 10 Physicians ZEI MARKUS G 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 348 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2889.94 0 132.23 0 0 0 0 0 0 3022.17 0 0 1013539159 1215322110 10 Physicians SHAH VEER A 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 29 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 0 0 743 0 0 1013539160 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 0 322.35 0 0 0 0 0 0 322.35 0 0 1013539180 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 42.14 0 0 0 0 0 0 42.14 0 0 1013539327 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17989.94 0 0 0 0 0 0 0 0 0 0 0 0 0 17989.94 0 0 1013539578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24859.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24859.68 0 0 1013539726 1689154320 10 Physicians DILLMAN DARYL B 999999999 30 DuPage 0 0 Orthopedic Surgery 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 0 153 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 39735.3 0 0 0 0 0 0 39735.3 0 0 1013540461 1750732210 10 Physicians TUCKER ALEXANDER J 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 361.14 0 0 0 0 0 0 361.14 0 0 1013540667 1275917957 10 Physicians SIDDIQUI MOHAMMED 999999999 63 Macon 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 0 268 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 4807.13 0 0 0 0 0 0 4807.13 0 0 1013540774 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 47.62 0 0 0 0 0 0 47.62 0 0 1013540916 1336671569 10 Physicians SCHOENHOFEN THOMAS 999999999 200 Cook 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 89.9 0 0 0 0 0 0 0 0 487.77 0 0 0 0 0 0 577.67 0 0 1013540978 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 0 300 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 30651.14 0 0 0 0 0 0 0 0 0 0 0 0 0 30651.14 0 0 1013541275 1689025108 10 Physicians BASITH EMAAD 999999999 79 Ogle 0 0 Family Practice 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 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 0 835.17 0 0 0 0 0 0 835.17 0 0 1013541530 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12965.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12965.9 0 0 1013541539 1497284921 55 Early Intervention Services CALANGI MICHAELA 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 0 447 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 27039.33 0 0 0 0 0 0 27039.33 0 0 1013542177 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9767.06 0 0 0 0 0 0 0 0 0 0 0 0 0 9767.06 0 0 1013542192 1649830159 87 Psychologist(Encounter Only) BERGER NATALIE I 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 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 2366.1 0 0 0 0 0 0 2366.1 0 0 1013542247 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30763.48 0 0 0 0 0 0 0 0 0 0 0 0 0 30763.48 0 0 1013542443 1730149550 10 Physicians SHAW WILLIAM E 999999999 30 DuPage 0 0 Ophthalmology 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 0 206 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 3543.36 0 0 0 0 0 0 3543.36 0 0 1013542720 1578728218 10 Physicians SHARMA POOJA 999999999 80 Peoria 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 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 1232.28 0 0 0 0 0 0 1232.28 0 0 1013542899 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12737.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12737.4 0 0 1013543758 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 5662.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5662.86 0 0 1013543777 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 0 0 0 0 0 0 0 0 0 0 1013543839 1013203660 10 Physicians KREZALEK MONIKA A 999999999 200 Cook 0 0 Colon - Rectal 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 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 1002.36 0 0 0 0 0 0 1002.36 0 0 1013543945 1356768253 10 Physicians ALEXANDER MICHAEL JASON 999999999 200 Cook 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 0 130 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 3939.99 0 0 0 0 0 0 3939.99 0 0 1013544783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14817.29 0 0 0 0 0 0 0 0 0 0 0 0 0 14817.29 0 0 1013544786 1598306565 24 Speech Therapists WEINGARZ CLARE M 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 0 165 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 11518.92 11518.92 0 0 1013544945 1366623126 89 Physician Assistant Only(Encounter Only) NWABUDIKE SINCHIEZE 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 0 299.48 0 0 0 0 0 0 299.48 0 0 1013545204 1528602034 16 Nurse Practitioners BURTIS EDWARD 999999999 47 Jackson 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 0 167 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 0 922.14 0 0 0 0 0 0 922.14 0 0 1013545327 1346883808 16 Nurse Practitioners STACHURA SHEREE L 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 956.65 0 0 0 0 0 0 956.65 0 0 1013545705 1437707247 16 Nurse Practitioners SCHICHT ARYELLE L 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 0 132 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 0 886.2 0 0 0 0 0 0 886.2 0 0 1013545846 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 0 280 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 19354.9 0 0 0 0 0 0 0 0 0 0 0 0 0 19354.9 0 0 1013545996 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21308.89 0 0 0 0 0 0 0 0 0 0 0 0 0 21308.89 0 0 1013546058 1962994483 16 Nurse Practitioners RUEBHAUSEN MARISSA N 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 0 109.64 0 0 0 0 0 0 109.64 0 0 1013546066 10 Physicians 30 DuPage 0 0 Neurology 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.47 0 0 0 0 0 0 10.47 0 0 1013546783 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 1354.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1354.23 0 0 1013546817 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 0 192.02 0 0 0 0 0 0 192.02 0 0 1013546848 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4546.68 0 0 0 0 0 0 0 0 0 0 0 0 0 4546.68 0 0 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91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464.07 464.07 0 0 1013564780 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 3003.66 0 0 0 0 0 0 0 0 0 0 0 0 0 3003.66 0 0 1013564814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1117.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1117.2 0 0 1013565100 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 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 9.6 0 0 0 0 0 0 9.6 0 0 1013565140 1184276297 89 Physician Assistant Only(Encounter Only) NIEMASZYK KELLY 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 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 0 326.67 0 0 0 0 0 0 326.67 0 0 1013565369 1538565551 89 Physician Assistant Only(Encounter Only) PARIKH OJAS S 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 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 0 369.6 0 0 0 0 0 0 369.6 0 0 1013565796 1467943308 10 Physicians ZAYA RAYMON 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 0 225.05 0 0 0 0 0 0 225.05 0 0 1013565882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5266.57 0 0 0 0 0 0 0 0 0 0 0 0 0 5266.57 0 0 1013565901 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23549.18 0 0 0 0 0 0 0 0 0 0 0 0 0 23549.18 0 0 1013565907 1689092389 10 Physicians RAO NISHA K 999999999 30 DuPage 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 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 0 582.02 0 0 0 0 0 0 582.02 0 0 1013566081 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8064.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8064.84 0 0 1013566143 1518384916 10 Physicians MODH ANKIT 999999999 19 Champaign 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1856.44 0 0 0 0 0 0 1856.44 0 0 1013566402 1154828390 10 Physicians SACA DANIEL R 999999999 80 Peoria 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 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 0 315.04 0 0 0 0 0 0 315.04 0 0 1013566667 1871856690 10 Physicians LANIER STEVEN TYLER 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 0 116 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 4973.09 0 0 0 0 0 0 4973.09 0 0 1013567068 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 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 0 248.32 248.32 0 0 1013567069 1275091548 16 Nurse Practitioners SZAJNA ROBIN 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 0 131 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 0 934.98 0 0 0 0 0 0 934.98 0 0 1013567222 1063751824 89 Physician Assistant Only(Encounter Only) STEELE MARGARET M 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 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 1018.27 0 0 0 0 0 0 1018.27 0 0 1013567232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1100.94 0 0 0 0 0 0 0 0 0 0 0 0 0 1100.94 0 0 1013567366 1790335008 16 Nurse Practitioners EVANS JENNIFER V 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 299.56 0 0 0 0 0 0 299.56 0 0 1013567576 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1435.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1435.68 0 0 1013568084 1255988069 24 Speech Therapists HADDEN REX R 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 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 5847.75 5847.75 0 0 1013568524 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 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 0 299.65 299.65 0 0 1013569266 1144635855 10 Physicians OGILVIE ROSS A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 311 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3664.84 0 2051.05 0 0 0 0 0 0 5715.89 0 0 1013569326 1356730576 86 Clinical Social Worker(Encounter Only) CORSO JOHN 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 0 135 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 7688.01 0 0 0 0 0 0 7688.01 0 0 1013569485 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 6567.25 0 0 0 0 0 0 0 0 0 0 0 0 0 6567.25 0 0 1013569739 1023670247 16 Nurse Practitioners MITCHELL KIRSTI 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 1 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 168 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 0 0 7184.07 0 0 0 0 0 0 7290.79 0 0 1013570226 1386192888 55 Early Intervention Services GORMAN CHRISTIANNA 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 0 149 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 10947.05 0 0 0 0 0 0 10947.05 0 0 1013570616 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 1013570686 1467942409 10 Physicians GHANAYEM KUBILIUS KATHRYN M 999999999 30 DuPage 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 8 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 0 111.36 0 0 0 0 0 0 0 0 392.97 0 0 0 0 0 0 504.33 0 0 1013570693 1932493731 10 Physicians PURDY JUSTIN 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 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 0 337 0 0 0 0 0 0 337 0 0 1013570703 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2082.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2082.46 0 0 1013570813 1164839361 10 Physicians HAMDAN MAHMOUD 999999999 19 Champaign 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 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 2402.87 0 0 0 0 0 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1083270938 89 Physician Assistant Only(Encounter Only) SHAW CHRISTINE A 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 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 0 223.16 0 0 0 0 0 0 223.16 0 0 1013571438 1669026852 11 Dentists POULOS NICHOLAS 999999999 200 Cook 0 0 General Dentistry 0 0 71 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 11405.09 0 0 0 0 0 0 0 0 0 0 0 4892.55 0 0 0 0 16297.64 0 0 1013571480 23 Occupational 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 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 0 141.47 141.47 0 0 1013571712 1629635826 11 Dentists ROSALEZ JOSE A 999999999 200 Cook 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 416 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 14339.1 0 0 0 0 0 0 0 0 0 0 0 2258.1 0 0 0 0 16597.2 0 0 1013571738 1417330127 10 Physicians RAUSEO ACEVEDO ADRIANA MILAGRO 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 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 0 133.7 0 0 0 0 0 0 133.7 0 0 1013571769 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 373.26 0 0 0 0 0 0 0 0 0 0 0 0 0 373.26 0 0 1013571902 1487042057 89 Physician Assistant Only(Encounter Only) KRIESBERG KEITH 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 299.8 0 0 0 0 0 0 299.8 0 0 1013572134 1194091074 10 Physicians WOLFF BIRTE J 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.97 0 2080.66 0 0 0 0 0 0 2106.63 0 0 1013572321 1912568395 16 Nurse Practitioners MORRIS SAVANNAH 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 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 2408.87 0 0 0 0 0 0 2408.87 0 0 1013572463 1265819478 10 Physicians ASSADI RAMI-JAMES K 999999999 30 DuPage 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 653.1 0 0 0 0 0 0 653.1 0 0 1013572546 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 47998.46 0 0 0 0 0 0 0 0 0 0 0 0 0 47998.46 0 0 1013572627 1629632401 16 Nurse Practitioners CARROLL HILLARY W 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 367 0 0 0 0 0 0 0 0 0 225.01 0 0 0 0 0 0 0 0 10393.15 0 0 0 0 0 0 10618.16 0 0 1013573077 1316396468 10 Physicians EMMANUEL PAMELA 999999999 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 6235.58 0 0 0 0 0 0 6265.06 0 0 1013573133 1114289550 10 Physicians LIN JOSHUA 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1013573156 1265639173 10 Physicians ELLIS CARLA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 728.55 0 0 0 0 0 0 0 0 728.55 0 0 1013573194 1508234667 10 Physicians ALKAPHOURY MUHAMMAD G 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 652 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 929 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 929 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7693.64 0 1471.39 0 0 0 0 0 0 9165.03 0 0 1013573383 1609428978 16 Nurse Practitioners GILLEN PETER 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 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 1139.25 0 0 0 0 0 0 1139.25 0 0 1013574103 10 Physicians 200 Cook 0 0 Vascular 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971.77 0 0 0 0 0 0 971.77 0 0 1013574357 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 1008.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1008.6 0 0 1013574856 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 31.01 0 0 0 0 0 0 31.01 0 0 1013574987 1033613351 10 Physicians JACKSON KAMARI 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 0 259.02 0 0 0 0 0 0 259.02 0 0 1013575448 1629332127 10 Physicians FRAZIER WENDY 999999999 65 Madison 0 0 Family Practice 0 0 0 0 0 0 0 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 0 525.61 0 0 0 0 0 0 525.61 0 0 1013575548 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8983.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8983.8 0 0 1013575752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33070.13 0 0 0 0 0 0 0 0 0 0 0 0 0 33070.13 0 0 1013575843 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013576715 1326197336 10 Physicians JHAVERI RAVI R 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1881.3 0 0 0 0 0 0 1881.3 0 0 1013576808 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013576936 1912343732 10 Physicians BALL CAROLINE 999999999 200 Cook 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 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3063.13 0 0 0 0 0 0 3063.13 0 0 1013576960 1285047977 10 Physicians REDDY DEEPAK N 999999999 80 Peoria 0 0 Neurology 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 0 123 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 6353.24 0 0 0 0 0 0 6353.24 0 0 1013577035 1215341912 10 Physicians ALNAJAR HUSSEIN 999999999 200 Cook 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 0 173 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 2145.9 0 0 0 0 0 0 0 0 2145.9 0 0 1013577082 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5374.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5374.69 0 0 1013577120 1598059354 13 Podiatrists WISBY DANA 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 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 14.34 0 0 0 0 0 0 14.34 0 0 1013577224 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5805.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5805.62 0 0 1013577297 1467009464 16 Nurse Practitioners SLEDGE ALICIA J 999999999 31 Edgar 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 0 959.6 0 0 0 0 0 0 959.6 0 0 1013577513 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 0 166 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 19313 0 0 0 0 0 0 0 0 0 0 0 0 0 19313 0 0 1013578483 1285996389 10 Physicians WATANABE KAE 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 0 200 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 9246.77 0 0 0 0 0 0 9246.77 0 0 1013578899 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013578943 1972024701 89 Physician Assistant Only(Encounter Only) DAVE SHIVALI 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 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 0 601.41 0 0 0 0 0 0 601.41 0 0 1013578955 1699093401 10 Physicians ARMSTRONG QIANNA 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 0 312 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 1887.6 0 0 0 0 0 0 1887.6 0 0 1013579099 1417514134 12 Optometrists GERSON AMANDA 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 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 46.45 0 0 0 0 0 0 46.45 0 0 1013579390 1942859681 16 Nurse Practitioners FALLINGS AMY U 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 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 0 551.59 0 0 0 0 0 0 551.59 0 0 1013579673 10 Physicians 96 St Clair 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1140 0 0 0 0 0 0 1140 0 0 1013579955 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 78.09 0 0 0 0 0 0 78.09 0 0 1013580718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18983.69 0 0 0 0 0 0 0 0 0 0 0 0 0 18983.69 0 0 1013580853 60 Pharmacies 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2079 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3644.63 0 0 0 3644.63 0 0 1013581010 4013581010 91 Waiver service provider--Adults (DHS/DDD) CERVANTES ESTELA 627621000 91 Sangamon 0 0 0 0 0 0 0 11 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 5699.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5699.4 0 0 1013581093 1770945222 10 Physicians SHERIFF RAMEEZA 999999999 200 Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 3 0 71 0 0 0 0 0 0 0 0 0 1011.5 0 0 0 0 0 0 15.66 0 1814.68 0 0 0 0 0 0 2841.84 0 0 1013581144 1609332188 16 Nurse Practitioners TARALA MARIA V 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 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 0 629.83 0 0 0 0 0 0 629.83 0 0 1013581193 1295153047 10 Physicians PRIGGE ANDREW 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 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 13760.75 0 0 0 0 0 0 13760.75 0 0 1013581466 1437711140 60 Pharmacies KIRBY RX 999999999 82 Piatt 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 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5852.81 0 0 0 5852.81 0 0 1013582801 1306015227 10 Physicians HOANG MARY THERESA 999999999 200 Cook 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 0 132 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 0 304.25 0 0 0 0 0 0 304.25 0 0 1013582832 1033567110 10 Physicians MANN SHAINA S 999999999 200 Cook 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 0 324 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 2832.81 0 0 0 0 0 0 2832.81 0 0 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0 0 0 0 0 14532.29 0 0 0 0 0 0 0 0 0 0 0 0 0 14532.29 0 0 1013585418 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 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 77.49 0 0 0 0 0 0 77.49 0 0 1013585471 1285078030 10 Physicians DAVIS WILLIAM A 999999999 200 Cook 0 0 Orthopedic Surgery 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 11 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.64 0 789.46 0 0 0 0 0 0 907.1 0 0 1013585545 1548829450 16 Nurse Practitioners GAVONI CHRISTINA 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 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 0 138.34 0 0 0 0 0 0 138.34 0 0 1013585711 1023472321 10 Physicians KLEIST KYLE J 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 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 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221.73 0 0 0 0 0 0 235.77 0 0 1013590918 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24590.94 0 0 0 0 0 0 0 0 0 0 0 0 0 24590.94 0 0 1013591081 1790047736 10 Physicians AWUOR STEPHEN O 999999999 47 Jackson 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 748 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.64 0 10258.61 0 0 0 0 0 0 10322.25 0 0 1013591638 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23367.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23367.52 0 0 1013591794 1952714636 10 Physicians JULOORI ADITYA 999999999 30 DuPage 0 0 Radiation Oncology 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 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6608.31 0 0 0 0 0 0 6608.31 0 0 1013592315 1861037632 91 Waiver service provider--Adults (DHS/DDD) LABRANCHE DIANNA 999999999 91 Sangamon 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128121.71 0 0 0 0 0 0 0 0 0 0 0 0 0 128121.71 0 0 1013592482 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4049.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4049.61 0 0 1013593093 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 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 0 654.99 0 0 0 0 0 0 654.99 0 0 1013593160 10 Physicians 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 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0 896 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11277.05 0 820.12 0 0 0 0 0 0 12097.17 0 0 1013594400 1518515162 11 Dentists SURESH MANJU 999999999 107 Will 0 0 General Dentistry 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11762.21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11762.21 0 0 1013595124 1194173658 10 Physicians VOGELER KENDALL E 999999999 60 Lee 0 0 Family Practice 0 0 0 18 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 1931.8 0 0 0 0 0 0 0 0 1540.96 0 0 0 0 0 0 3472.76 0 0 1013595857 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.24 0 0 0 0 0 0 42.24 0 0 1013596103 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11607.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11607.3 0 0 1013596109 1841268521 10 Physicians SZYCH GREGORY A 999999999 47 Jackson 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 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 1995.69 0 0 0 0 0 0 1995.69 0 0 1013596419 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 118.84 0 0 0 0 0 0 0 0 0 0 0 0 0 118.84 0 0 1013596638 1295179497 10 Physicians LIPPNER ELIZABETH 999999999 200 Cook 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 68 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 71.99 0 3589.41 0 0 0 0 0 0 3674.2 0 0 1013596899 1508055401 16 Nurse Practitioners SARCHET AIMEE R 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 0 122 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 5097.87 0 0 0 0 0 0 5097.87 0 0 1013596966 1033772876 55 Early Intervention Services SPANGLER CASSANDRA L 999999999 94 Shelby 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 0 454 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 19684.39 0 0 0 0 0 0 19684.39 0 0 1013597122 1568007102 16 Nurse Practitioners MORGAN KARYN 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 1727.01 0 0 0 0 0 0 1727.01 0 0 1013597332 1174968846 10 Physicians SHAH KRUPA 999999999 54 Kankakee 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 0 147 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 3971.68 0 0 0 0 0 0 3971.68 0 0 1013597564 1518349067 10 Physicians CHUN YEONA 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 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 8040.45 0 0 0 0 0 0 8040.45 0 0 1013597779 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 0 220.05 0 0 0 0 0 0 220.05 0 0 1013598068 1699194480 10 Physicians KAPLAN JONATHAN 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 0 227 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 3483.37 0 0 0 0 0 0 3483.37 0 0 1013598143 1972947703 10 Physicians MEISS JORDAN M 999999999 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 32 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 227.07 0 4144.61 0 0 0 0 0 0 4371.68 0 0 1013598416 1386910370 10 Physicians SHROYER ROBERT 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.9 0 10.08 0 0 0 0 0 0 132.98 0 0 1013598724 1770977845 10 Physicians STEIN JONATHAN H 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 22 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.48 0 118.89 0 0 0 0 0 0 330.37 0 0 1013598756 1477584340 10 Physicians MULHOLLAND SHANNON 999999999 200 Cook 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 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 0 383.05 0 0 0 0 0 0 0 0 383.05 0 0 1013598794 1881044493 10 Physicians CORNELIUS SEAN A 999999999 19 Champaign 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 0 237 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 2727.36 0 0 0 0 0 0 2759.51 0 0 1013599092 1699316588 16 Nurse Practitioners GOLDEN-BARNETT MELISSA 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 6917.18 0 0 0 0 0 0 6917.18 0 0 1013599213 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24573.99 0 0 0 0 0 0 0 0 0 0 0 0 0 24573.99 0 0 1013599294 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9192.13 0 0 0 0 0 0 0 0 0 0 0 0 0 9192.13 0 0 1013599700 1740842129 11 Dentists KIM SUNG-KYUNG 999999999 80 Peoria 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3476.3 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 4229 0 0 1013599707 1942756705 10 Physicians EL SAWDA JACK Y 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 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 0 761.8 0 0 0 0 0 0 761.8 0 0 1013599723 89 Physician Assistant Only(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 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 1013599741 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.03 108.03 0 0 1013599807 1437608569 10 Physicians OGBODO VALENTINE 999999999 47 Jackson 0 0 Emergency Medicine 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6091.05 0 0 0 0 0 0 6091.05 0 0 1013600084 91 Waiver service provider--Adults (DHS/DDD) 91 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CATANESE JACLYN 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 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 0 240.61 0 0 0 0 0 0 240.61 0 0 1013601563 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 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 9881.12 0 0 0 0 0 0 0 0 0 0 0 0 0 9881.12 0 0 1013601987 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 400.29 0 0 0 0 0 0 0 0 0 0 0 0 0 400.29 0 0 1013602212 10 Physicians 87 Randolph 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 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 0 824.97 0 0 0 0 0 0 824.97 0 0 1013602225 1619435252 16 Nurse Practitioners SMITH AMY 999999999 200 Cook 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 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 9581.93 0 0 0 0 0 0 0 0 0 0 0 0 0 9581.93 0 0 1013606008 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 0 0 0 0 0 0 0 0 0 0 1013606143 1871919134 10 Physicians LYGRISSE NADA A 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 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 1231.79 0 0 0 0 0 0 1231.79 0 0 1013606449 1518475615 16 Nurse Practitioners MUSSER KYLA 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 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 0 108.69 0 0 0 0 0 0 108.69 0 0 1013606484 16 Nurse Practitioners 107 Will 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 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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 0 134.31 0 0 0 0 0 0 134.31 0 0 1013608689 1578828612 10 Physicians NUKALA MELANIE RENEE 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 8 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.09 0 5704.89 0 0 0 0 0 0 5764.98 0 0 1013608736 1063063584 89 Physician Assistant Only(Encounter Only) GUDINO 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 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 0 496.56 0 0 0 0 0 0 496.56 0 0 1013608751 1497317093 89 Physician Assistant Only(Encounter Only) CURAN MEGAN E 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 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 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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 1656.47 0 0 0 0 0 0 1656.47 0 0 1013609260 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 23716.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23716.36 0 0 1013609401 1689626046 10 Physicians COULTER STEVEN 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 2109.36 0 0 0 0 0 0 2114.53 0 0 1013609555 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 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 29825.43 0 0 0 0 0 0 0 0 0 0 0 0 0 29825.43 0 0 1013609681 1952965253 30 General Hospitals DIALYSIS CARE CENTER ELGIN LLC 999999999 53 Kane DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 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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 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 20054.25 0 0 0 0 0 0 0 0 0 0 0 0 0 20054.25 0 0 1013612798 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4265.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4265.22 0 0 1013612993 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 351.54 0 0 0 0 0 0 0 0 0 0 0 0 0 351.54 0 0 1013613446 1376199190 30 General Hospitals DIALYSIS CARE CENTER HAZEL CRE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1742 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82233.95 0 0 0 0 0 82233.95 0 0 1013613490 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13880.16 0 0 0 0 0 0 0 0 0 0 0 0 0 13880.16 0 0 1013613529 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.7 0 0 0 0 0 0 0 0 0 0 0 0 0 78.7 0 0 1013613684 1306293311 10 Physicians SOTOMAYOR BRENDAN 999999999 54 Kankakee 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 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 0 392.07 0 0 0 0 0 0 392.07 0 0 1013613986 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17169.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17169.04 0 0 1013614014 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 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 1013614152 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 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 3992.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3992.8 0 0 1013614215 1962864199 10 Physicians GUIMONT NATHANIEL 999999999 200 Cook 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 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 0 330.46 0 0 0 0 0 0 330.46 0 0 1013614400 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.68 9.68 0 0 1013614796 1457910093 89 Physician Assistant Only(Encounter Only) GOFF MARLEE 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 0 106.83 0 0 0 0 0 0 106.83 0 0 1013614939 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 49.22 0 0 0 0 0 0 49.22 0 0 1013615031 10 Physicians 200 Cook 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 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.08 0 111.24 0 0 0 0 0 0 122.32 0 0 1013615244 1386036085 10 Physicians AMIR MOHAMMAD 999999999 97 Stephenson 0 0 Emergency Medicine 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 0 178 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 6087.56 0 0 0 0 0 0 6087.56 0 0 1013615491 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 0 292.6 0 0 0 0 0 0 292.6 0 0 1013615504 10 Physicians 80 Peoria 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1013615930 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15301.04 0 0 0 0 0 0 0 0 0 0 0 0 0 15301.04 0 0 1013616374 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 0 153.5 0 0 0 0 0 0 153.5 0 0 1013616532 1043770589 89 Physician Assistant Only(Encounter Only) BOGUE TAYLOR M 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 0 266.36 0 0 0 0 0 0 266.36 0 0 1013617299 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17735.4 0 0 0 0 0 0 0 0 0 0 0 0 0 17735.4 0 0 1013617377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17350.41 0 0 0 0 0 0 0 0 0 0 0 0 0 17350.41 0 0 1013617472 13 Podiatrists 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 40.13 0 0 0 0 0 0 40.13 0 0 1013618196 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2343.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2343.6 0 0 1013618364 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24712.63 0 0 0 0 0 0 0 0 0 0 0 0 0 24712.63 0 0 1013618516 1548624604 10 Physicians ANAND REENA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 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 7062.82 0 0 0 0 0 0 7062.82 0 0 1013618625 1801351648 16 Nurse Practitioners GARRELS JENNIFER A 999999999 200 Cook 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 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 2700.98 0 0 0 0 0 0 2700.98 0 0 1013618872 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 13512.97 0 0 0 0 0 0 0 0 0 0 0 0 0 13512.97 0 0 1013618930 1144410283 10 Physicians STEADMAN BRENT T 999999999 826 Missouri 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 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 0 154.53 0 0 0 0 0 0 0 0 154.53 0 0 1013619172 1043604556 10 Physicians LEE MELODY 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 0 214 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 3747.41 0 0 0 0 0 0 3747.41 0 0 1013619197 1508253410 89 Physician Assistant Only(Encounter Only) DOMINGO HAZEL DHATES 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 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 0 253.07 0 0 0 0 0 0 253.07 0 0 1013619417 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 1013619456 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 20883.17 0 0 0 0 0 0 0 0 0 0 0 0 0 20883.17 0 0 1013619539 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13415.14 0 0 0 0 0 0 0 0 0 0 0 0 0 13415.14 0 0 1013619676 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17419.66 0 0 0 0 0 0 0 0 0 0 0 0 0 17419.66 0 0 1013619910 1841721925 10 Physicians CURRY CHELSEA A 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 25 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 1129.57 0 0 0 0 0 0 1129.57 0 0 1013619915 1376998336 10 Physicians CHIMANJI NEERAJ 999999999 200 Cook 0 0 Emergency 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 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 1356.59 0 0 0 0 0 0 1356.59 0 0 1013619982 1205062825 10 Physicians LI LORETTA S 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 1118.85 0 0 0 0 0 0 1118.85 0 0 1013620238 1497221162 16 Nurse Practitioners LACY COMFORT O 999999999 200 Cook 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 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6060.81 0 0 0 0 0 0 6060.81 0 0 1013620617 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6581.61 0 0 0 0 0 0 0 0 0 0 0 0 0 6581.61 0 0 1013620664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.52 0 0 0 0 0 0 0 0 0 0 0 0 0 56.52 0 0 1013620831 1821363870 89 Physician Assistant Only(Encounter Only) HAYDUK WILLIAM T 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 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 1024.13 0 0 0 0 0 0 1024.13 0 0 1013621554 1851602684 10 Physicians LAWRANCE CHRISTOPHER 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 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 3618.38 0 0 0 0 0 0 3618.38 0 0 1013621557 10 Physicians 200 Cook 0 0 General Practice 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 1.59 0 49.22 0 0 0 0 0 0 50.81 0 0 1013621785 1902101603 10 Physicians MICHAEL SARA ELLEN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 12 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.24 0 235.83 0 0 0 0 0 0 319.07 0 0 1013621825 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 11249.9 0 0 0 0 0 0 0 0 0 0 0 0 0 11249.9 0 0 1013621917 1366903866 16 Nurse Practitioners SKURSKI KATHERINE J 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 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 1049.02 0 0 0 0 0 0 1049.02 0 0 1013622158 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.09 0 0 0 0 0 0 0.09 0 0 1013622260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24463.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24463.96 0 0 1013622561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15798.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15798.7 0 0 1013623001 1841645207 10 Physicians AFZAL AZKA 999999999 30 DuPage 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 0 303 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 0 930.64 0 0 0 0 0 0 930.64 0 0 1013623327 1942862479 16 Nurse Practitioners ZAHORICK MARIE 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 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 0 528.77 0 0 0 0 0 0 528.77 0 0 1013623901 10 Physicians 19 Champaign 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 0 0 0 0 0 0 0 0 0 0 1013623921 1083032577 10 Physicians HUSAINI MUSTAFA 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 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 0 552.16 0 0 0 0 0 0 552.16 0 0 1013625263 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10065.11 0 0 0 0 0 0 0 0 0 0 0 0 0 10065.11 0 0 1013625604 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.52 0 0 0 0 0 0 0 0 6.52 0 0 1013626105 1992114011 16 Nurse Practitioners MURTAGH KATHLEEN A 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 1316.72 0 0 0 0 0 0 1316.72 0 0 1013626147 1396265666 13 Podiatrists MCCARTHY LAUREN 999999999 60 Lee 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 0 323 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 4333.15 0 0 0 0 0 0 4333.15 0 0 1013627341 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1013627386 1508318148 16 Nurse Practitioners SEEHAM GLADYS 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 299.4 0 0 0 0 0 0 0 0 1393.13 0 0 0 0 0 0 1692.53 0 0 1013627420 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16999.28 0 0 0 0 0 0 0 0 0 0 0 0 0 16999.28 0 0 1013627578 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24895.27 0 0 0 0 0 0 0 0 0 0 0 0 0 24895.27 0 0 1013627824 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16728.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16728.66 0 0 1013627859 1548350168 10 Physicians SCHREIBER ERNST G 999999999 91 Sangamon 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 0 102 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 3743.06 0 0 0 0 0 0 3743.06 0 0 1013627888 1245720705 16 Nurse Practitioners STEVENS STEPHANIE 999999999 91 Sangamon 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 0 216 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 2330.59 0 0 0 0 0 0 2330.59 0 0 1013628330 1255893814 22 Physical Therapists GILKEY DANIEL 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 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 0 501.87 501.87 0 0 1013628353 1174165310 16 Nurse Practitioners FULKS BRETT A 999999999 19 Champaign 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 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 0 484.66 0 0 0 0 0 0 484.66 0 0 1013628829 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14365.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14365.4 0 0 1013628846 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013628925 1467815209 10 Physicians DESAI POOJA S 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4619.58 0 0 0 0 0 0 4619.58 0 0 1013629021 1750925210 24 Speech Therapists EIMERS CHRISTINA L 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 948 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 948 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73380.73 73380.73 0 0 1013629155 1750624045 10 Physicians MUKERJI AMAR 999999999 74 Mercer 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.38 0 3564.14 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18164.81 0 0 0 0 0 0 0 0 0 0 0 0 0 18164.81 0 0 1013633178 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 1013633285 1649665571 10 Physicians EBY JESSIKA 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 0 344 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 3637.84 0 0 0 0 0 0 3637.84 0 0 1013633770 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3872.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3872.62 0 0 1013633816 1316412034 30 General Hospitals RESILIENCE HEALTHCARE -WEISS M 606405759 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 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1619469244 46 Ambulatory Surgical Treatment Centers RUSH OAK BROOK SURGERY CENTER 999999999 30 DuPage 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 0 125 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 5012.22 0 0 0 0 0 5012.22 0 0 1013634735 1841671864 10 Physicians SUDHOLT STACEY M 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.28 0 2653.47 0 0 0 0 0 0 2755.75 0 0 1013635108 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2281.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2281.01 0 0 1013635178 1164078788 16 Nurse Practitioners BEALE LENA 999999999 58 La Salle 0 0 0 0 0 4 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 57.6 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 107.6 0 0 1013635438 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 30.47 0 0 0 0 0 0 30.47 0 0 1013635740 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6625.96 0 0 0 0 0 0 0 0 0 0 0 0 0 6625.96 0 0 1013635827 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18525.42 0 0 0 0 0 0 0 0 0 0 0 0 0 18525.42 0 0 1013636247 1063054203 16 Nurse Practitioners WEAVER NATALIE J 999999999 19 Champaign 0 0 General Psychiatry Residency 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 0 215 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 9700.96 0 0 0 0 0 0 9700.96 0 0 1013636273 1902269301 13 Podiatrists CABAI JILLIAN F 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 0 125 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 0 205.57 0 0 0 0 0 0 205.57 0 0 1013636390 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8287.19 0 0 0 0 0 0 0 0 0 0 0 0 0 8287.19 0 0 1013636456 1740832237 55 Early Intervention Services GIENKO MARY 999999999 24 Coles 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 0 473 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 27027.91 0 0 0 0 0 0 27027.91 0 0 1013636651 1144606583 10 Physicians BHANDARI AMIT 999999999 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 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1938.98 0 0 0 0 0 0 1938.98 0 0 1013640172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24501.98 0 0 0 0 0 0 0 0 0 0 0 0 0 24501.98 0 0 1013640320 1487139085 30 General Hospitals BRICKYARD DIALYSIS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 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 27127.82 0 0 0 0 0 27127.82 0 0 1013640482 1083028880 10 Physicians STOECKER WILLIAM C 999999999 200 Cook 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 1070 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1070 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9148.61 0 0 0 0 0 0 9148.61 0 0 1013640573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9876.87 0 0 0 0 0 0 0 0 0 0 0 0 0 9876.87 0 0 1013640675 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 0 178.2 0 0 0 0 0 0 178.2 0 0 1013640876 1063864155 10 Physicians MEJIA CHEW CARLOS R 999999999 106 Whiteside 0 0 Internal Medicine 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 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 0 197.11 0 0 0 0 0 0 197.11 0 0 1013640950 22 Physical Therapists 54 Kankakee 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 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 0 152 152 0 0 1013641017 1548780687 10 Physicians MURPHY IAN C 999999999 42 Hancock 0 0 0 0 0 0 0 0 0 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 0 458.3 0 0 0 0 0 0 458.3 0 0 1013641162 1649814625 16 Nurse Practitioners LARTEY LETICIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154423.01 0 0 0 0 0 0 154423.01 0 0 1013641760 1891278560 91 Waiver service provider--Adults (DHS/DDD) DZUGAN EMILY 999999999 91 Sangamon 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8729.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8729.4 0 0 1013642431 10 Physicians 200 Cook 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.08 0 0 0 0 0 0 141.08 0 0 1013642804 1336793918 16 Nurse Practitioners WILSON HEATHER 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 81 0 0 0 0 0 0 0 0 0 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 0 332 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 23808.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23808.36 0 0 1013644651 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22991.43 0 0 0 0 0 0 0 0 0 0 0 0 0 22991.43 0 0 1013644945 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25397.68 0 0 0 0 0 0 0 0 0 0 0 0 0 25397.68 0 0 1013645002 1649653916 10 Physicians WASEY WAIZ 999999999 91 Sangamon 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 0 299 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 4615.84 0 0 0 0 0 0 4615.84 0 0 1013645190 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22631.11 0 0 0 0 0 0 0 0 0 0 0 0 0 22631.11 0 0 1013645207 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18498.15 0 0 0 0 0 0 0 0 0 0 0 0 0 18498.15 0 0 1013645342 10 Physicians 37 Fulton 0 0 Surgery General 0 0 0 0 0 0 0 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 82.86 0 0 0 0 0 0 82.86 0 0 1013645692 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 2571.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2571.24 0 0 1013646010 1750775227 10 Physicians HENDRICKS REBECCA 606225646 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 22 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 6201.8 0 0 0 0 0 0 6201.8 0 0 1013646569 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28263.33 0 0 0 0 0 0 0 0 0 0 0 0 0 28263.33 0 0 1013646636 1992238000 55 Early Intervention Services CACIOPPO GINA MARIE 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 0 188 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 10547.21 0 0 0 0 0 0 10547.21 0 0 1013646706 1063831204 10 Physicians KHANDAI ABHISEK C 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 0 102 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 7313.02 0 0 0 0 0 0 7313.02 0 0 1013646787 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.99 0 0 0 0 0 0 54.99 0 0 1013647234 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 30.47 0 0 0 0 0 0 30.47 0 0 1013647413 1427514280 16 Nurse Practitioners HYNES MEGAN M 999999999 200 Cook 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 0 112 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 2187.67 0 0 0 0 0 0 2187.67 0 0 1013647589 1356987135 16 Nurse Practitioners PERRY TAYLOR L 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 159.16 0 0 0 0 0 0 0 0 1773.34 0 0 0 0 0 0 1932.5 0 0 1013648498 22 Physical Therapists 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.7 83.7 0 0 1013648662 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 0 114 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 7769.95 0 0 0 0 0 0 0 0 0 0 0 0 0 7769.95 0 0 1013648680 1073076832 16 Nurse Practitioners STACEY SEAN B 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 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 0 431.1 0 0 0 0 0 0 431.1 0 0 1013648702 1922565506 61 Independent Laboratories LIFESCAN LABS OF ILLINOIS LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 1152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 21525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 21525 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1692.66 699370.36 0 0 0 0 0 0 0 0 701063.02 0 0 1013648750 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 83.23 0 0 0 0 0 0 83.23 0 0 1013648944 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 1013649013 10 Physicians 30 DuPage 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 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 0 450.66 0 0 0 0 0 0 450.66 0 0 1013649271 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013649486 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 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 98.4 0 0 0 0 0 0 98.4 0 0 1013649814 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 0 107.62 0 0 0 0 0 0 107.62 0 0 1013649899 1417317249 10 Physicians MCDONNELL PETER 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 47.62 0 0 0 0 0 0 47.62 0 0 1013649924 1073179339 16 Nurse Practitioners GIZA JOANNA J 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 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 1173.09 0 0 0 0 0 0 1173.09 0 0 1013650127 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14350.82 0 0 0 0 0 0 0 0 0 0 0 0 0 14350.82 0 0 1013650260 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 584.81 0 0 0 0 0 0 0 0 0 0 0 0 0 584.81 0 0 1013650659 1982051165 10 Physicians MHLABA JULIA MARIE 999999999 200 Cook 0 0 Dermatology 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 0 988.12 0 0 0 0 0 0 988.12 0 0 1013650916 1245676949 10 Physicians FRANKLIN ANDREW DAVID 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 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 5828.51 0 0 0 0 0 0 5828.51 0 0 1013651774 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 69.76 0 0 0 0 0 0 0 0 0 0 0 0 0 69.76 0 0 1013651845 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1558.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1558.25 0 0 1013652122 86 Clinical Social Worker(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 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 1245.24 0 0 0 0 0 0 1245.24 0 0 1013652421 16 Nurse Practitioners 89 Rock Island 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 0 308.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 308.81 0 0 1013652626 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 1399.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1399.67 0 0 1013652700 1891052510 60 Pharmacies KELLOGG GB PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 1393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9476.75 0 0 0 9476.75 0 0 1013653049 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23565.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23565.3 0 0 1013653312 1104470426 16 Nurse Practitioners ADAMS JULIE L 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 0 481.07 0 0 0 0 0 0 481.07 0 0 1013653430 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 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 80.3 80.3 0 0 1013653732 1780141481 89 Physician Assistant Only(Encounter Only) GOODALL ELIZABETH 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 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 0 298.11 0 0 0 0 0 0 298.11 0 0 1013653863 1861810822 10 Physicians SCHWAEDE ABIGAIL N 999999999 200 Cook 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 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 2829.08 0 0 0 0 0 0 2835.48 0 0 1013653908 1891842365 10 Physicians RIVARD DOUGLAS C 999999999 10 Adams 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 47 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 675.98 0 9.81 0 0 0 0 0 0 685.79 0 0 1013653997 1366478455 10 Physicians STEPHENSON ANDREW J 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 7 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.27 0 3635.13 0 0 0 0 0 0 3714.4 0 0 1013654118 1609411719 16 Nurse Practitioners TEXTOR LINDSEY N 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 1204.7 0 0 0 0 0 0 1204.7 0 0 1013654358 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 26.06 0 0 0 0 0 0 26.06 0 0 1013654601 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23375.31 0 0 0 0 0 0 0 0 0 0 0 0 0 23375.31 0 0 1013654612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22678.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22678.04 0 0 1013654616 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.56 0 0 0 0 0 0 168.56 0 0 1013655209 1215586193 89 Physician Assistant Only(Encounter Only) WALSH PATRICIA D 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 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 64 0 0 0 0 0 0 64 0 0 1013655537 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22775 0 0 0 0 0 0 0 0 0 0 0 0 0 22775 0 0 1013655676 1023673365 33 Nursing Facilities ELEVATE CARE CHICAGO NORTH 999999999 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 12643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2512229.19 0 0 0 0 0 0 0 2512229.19 0 0 1013655782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10190.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10190.93 0 0 1013655814 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 83.23 0 0 0 0 0 0 83.23 0 0 1013656549 1902456155 89 Physician Assistant Only(Encounter Only) WHELAN MARY KATHERINE E 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 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 5.32 0 0 0 0 0 0 5.32 0 0 1013656768 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 0 105 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 19120.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19120.86 0 0 1013657031 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16361.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16361.8 0 0 1013657415 1760716161 10 Physicians PAWALE AMIT 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 4565.72 0 0 0 0 0 0 4565.72 0 0 1013657479 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47272.57 0 0 0 0 0 0 0 0 0 0 0 0 0 47272.57 0 0 1013657736 1255861597 10 Physicians CHEVENON MARIE A 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.6 0 671.92 0 0 0 0 0 0 689.52 0 0 1013657849 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 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 4012.95 0 0 0 0 0 0 0 0 0 0 0 0 0 4012.95 0 0 1013657881 1174180582 16 Nurse Practitioners LOEHR TRACIE R 999999999 69 Massac 0 0 0 0 0 0 0 0 0 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 0 205.2 0 0 0 0 0 0 205.2 0 0 1013658077 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 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 2673.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2673.44 0 0 1013658221 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 0 112 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 3743.96 0 0 0 0 0 0 0 0 0 0 0 0 0 3743.96 0 0 1013658250 10 Physicians 98 Tazewell 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 0 166.47 0 0 0 0 0 0 166.47 0 0 1013658594 11 Dentists 107 Will 0 0 General Dentistry/Anesthesiology 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 0 648.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648.5 0 0 1013659445 1790102804 10 Physicians MOHAMMED ABDUL S 999999999 200 Cook 0 0 Internal Medicine 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.31 0 25911.4 0 0 0 0 0 0 25921.71 0 0 1013659455 1477902484 10 Physicians PATEL JEREMY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.17 0 1275.94 0 0 0 0 0 0 1368.11 0 0 1013659493 1770977100 10 Physicians JAMES KRISTEN 999999999 65 Madison 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 16 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 772.01 0 7438.72 0 0 0 0 0 0 8210.73 0 0 1013659595 89 Physician Assistant Only(Encounter Only) 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.22 0 0 0 0 0 0 49.22 0 0 1013659773 1295208320 28 Waiver service provider--Supportive living facility (HFS) ACORN ESTATES 999999999 101 Wabash 0 0 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 0 606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64709.68 0 0 0 0 0 0 0 0 0 0 0 0 0 64709.68 0 0 1013659840 1205904190 10 Physicians WILLIAMS BRIAN H 999999999 30 DuPage 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 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 3035.37 0 0 0 0 0 0 3035.37 0 0 1013659915 1639588023 89 Physician Assistant Only(Encounter Only) BERGER ABIGAIL 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 74.95 0 0 0 0 0 0 74.95 0 0 1013660012 1598844532 10 Physicians WEXLER SUSAN S 999999999 53 Kane 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 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 2078.67 0 0 0 0 0 0 2078.67 0 0 1013660201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1486.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1486.22 0 0 1013660496 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 0 179.36 0 0 0 0 0 0 179.36 0 0 1013660675 55 Early Intervention Services 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 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 1958.8 0 0 0 0 0 0 1958.8 0 0 1013660747 1194915066 10 Physicians BABAIAN KARA M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 18 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.89 0 15056.51 0 0 0 0 0 0 15089.4 0 0 1013660981 1750932604 89 Physician Assistant Only(Encounter Only) THOMAS MEGAN C 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 198.83 0 0 0 0 0 0 0 0 2152.72 0 0 0 0 0 0 2351.55 0 0 1013661046 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7556.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7556.2 0 0 1013661214 1215200472 10 Physicians OWERCZUK MONICA E 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 92 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3639.11 0 2675.97 0 0 0 0 0 0 6315.08 0 0 1013661317 1013495878 10 Physicians WALLMAN JAMIE 999999999 91 Sangamon 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 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1401.05 0 0 0 0 0 0 1401.05 0 0 1013661680 1689159832 60 Pharmacies BENZER PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1333 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4608.29 0 0 0 4608.29 0 0 1013661846 1336533983 10 Physicians WHITEHEAD JENNIFER 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 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 25.6 0 0 0 0 0 0 0 0 1464.37 0 0 0 0 0 0 1489.97 0 0 1013661902 1659913200 16 Nurse Practitioners PATEL NIKETA 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 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3016.5 0 0 0 0 0 0 3016.5 0 0 1013662156 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19029.34 0 0 0 0 0 0 0 0 0 0 0 0 0 19029.34 0 0 1013662218 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21287.76 0 0 0 0 0 0 0 0 0 0 0 0 0 21287.76 0 0 1013662339 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 0 154 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 15014.69 0 0 0 0 0 0 0 0 0 0 0 0 0 15014.69 0 0 1013662541 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10204.4 0 0 0 0 0 0 0 0 0 0 0 0 0 10204.4 0 0 1013663440 1720375819 10 Physicians WATTI HUSSAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7072.19 0 0 0 0 0 0 7072.19 0 0 1013663489 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25171.44 0 0 0 0 0 0 0 0 0 0 0 0 0 25171.44 0 0 1013663551 1023653342 16 Nurse Practitioners DRAPER MADDISON P 999999999 80 Peoria 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 0 100 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 2233.54 0 0 0 0 0 0 2233.54 0 0 1013663555 1457798324 10 Physicians DIXON CHANAE D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 478 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13932.93 0 338.15 0 0 0 0 0 0 14271.08 0 0 1013663613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17420.38 0 0 0 0 0 0 0 0 0 0 0 0 0 17420.38 0 0 1013663700 86 Clinical Social Worker(Encounter Only) 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4485.05 0 0 0 0 0 0 4485.05 0 0 1013663724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3161.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3161.04 0 0 1013663982 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17956.66 0 0 0 0 0 0 0 0 0 0 0 0 0 17956.66 0 0 1013664371 1619530987 16 Nurse Practitioners SPARKS DENNA L 999999999 19 Champaign 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 0 864.04 0 0 0 0 0 0 864.04 0 0 1013664673 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24790.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24790.37 0 0 1013665026 1205488947 33 Nursing Facilities COMMUNITY CARE CENTER 999999999 200 Cook 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 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546910.64 0 0 0 0 0 0 0 546910.64 0 0 1013665367 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 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 1013666036 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 0 841.12 0 0 0 0 0 0 0 0 0 0 0 0 0 841.12 0 0 1013666054 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24156.18 0 0 0 0 0 0 0 0 0 0 0 0 0 24156.18 0 0 1013666099 1578823324 10 Physicians MITHAIWALA MARIAH 999999999 200 Cook 0 0 Emergency 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 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 1091.92 0 0 0 0 0 0 1091.92 0 0 1013666328 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3461.29 0 0 0 0 0 0 0 0 0 0 0 0 0 3461.29 0 0 1013666788 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 0 149.82 0 0 0 0 0 0 149.82 0 0 1013667233 1053500819 16 Nurse Practitioners CHAMBERS JAMAE 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 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 72.26 0 0 0 0 0 0 72.26 0 0 1013667478 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7101.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7101.74 0 0 1013667704 1780074476 10 Physicians SUMMA KEITH C 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1013667965 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2958.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2958.89 0 0 1013668020 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4403.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4403.74 0 0 1013668050 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 0 209 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 6751.97 0 0 0 0 0 0 0 0 0 0 0 0 0 6751.97 0 0 1013668319 1841847456 89 Physician Assistant Only(Encounter Only) CLARKE ELLEN C 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 0 161.75 0 0 0 0 0 0 161.75 0 0 1013668430 1558655167 10 Physicians VESTER DAVID M 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 37 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 750.22 0 1196.03 0 0 0 0 0 0 1946.25 0 0 1013668854 1831359512 10 Physicians CHABAK MICKEY 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 977 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1445 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16972.45 0 804.16 0 0 0 0 0 0 17776.61 0 0 1013668919 1871980516 89 Physician Assistant Only(Encounter Only) KRISCHEL MICHELLE 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 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 1575.99 0 0 0 0 0 0 1575.99 0 0 1013669013 1861768780 10 Physicians CAMACHO JENNY 999999999 30 DuPage 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 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 3543.4 0 0 0 0 0 0 3543.4 0 0 1013669211 1104266980 10 Physicians RICHARDSON KRISTIN J 999999999 107 Will 0 0 Internal Medicine 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 1586.48 0 0 0 0 0 0 1586.48 0 0 1013669597 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 5443.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5443.88 0 0 1013669624 89 Physician Assistant Only(Encounter Only) 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.85 0 0 0 0 0 0 66.85 0 0 1013670020 1396383030 91 Waiver service provider--Adults (DHS/DDD) KELLY JACK 999999999 91 Sangamon 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66617.07 0 0 0 0 0 0 0 0 0 0 0 0 0 66617.07 0 0 1013670671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32271.99 0 0 0 0 0 0 0 0 0 0 0 0 0 32271.99 0 0 1013670902 1659729002 10 Physicians ROSSI ASHLEY 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 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 0 403.43 0 0 0 0 0 0 403.43 0 0 1013671236 1689228819 33 Nursing Facilities TAYLORVILLE SKILLED NURSING & 999999999 20 Christian 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443573.83 0 0 0 0 0 0 0 443573.83 0 0 1013671295 1871150615 22 Physical Therapists ELFANBAUM MADELYN 999999999 200 Cook 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 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 0 705.21 705.21 0 0 1013671474 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 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 40797.87 0 0 0 0 0 0 0 0 0 0 0 0 0 40797.87 0 0 1013671693 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24174.87 0 0 0 0 0 0 0 0 0 0 0 0 0 24174.87 0 0 1013671891 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26257.88 0 0 0 0 0 0 0 0 0 0 0 0 0 26257.88 0 0 1013671949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9923.15 0 0 0 0 0 0 0 0 0 0 0 0 0 9923.15 0 0 1013672129 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 0 854.63 0 0 0 0 0 0 0 0 0 0 0 0 0 854.63 0 0 1013672390 1669025920 11 Dentists DUDAS-SZEWCZYK KATHERINE 999999999 200 Cook 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 411 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 16421.43 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 18303.18 0 0 1013672523 1336708270 16 Nurse Practitioners LIKENS JENNIFER A 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 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 0 204.47 0 0 0 0 0 0 204.47 0 0 1013673018 1437556024 10 Physicians ALMANSOORI KHALED 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 19 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412.62 0 16417.05 0 0 0 0 0 0 16829.67 0 0 1013673031 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 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 1013673318 1447297676 89 Physician Assistant Only(Encounter Only) ROBERG ISAAC A 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 0 276 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 1898.09 0 0 0 0 0 0 1898.09 0 0 1013673936 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 1013674417 1699074336 10 Physicians PLATZ JOSEPH 999999999 109 Winnebago 0 0 Thoracic Surgery 0 0 0 0 0 0 0 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 0 551.91 0 0 0 0 0 0 551.91 0 0 1013674676 1346448867 10 Physicians AHMED NEELUM 999999999 53 Kane 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 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 17.72 0 232.39 0 0 0 0 0 0 250.11 0 0 1013675473 1720645971 11 Dentists CANAVAN KELLY 999999999 200 Cook 0 0 General Dentistry 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 1247.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.72 0 0 1013675889 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3641.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3641.7 0 0 1013676316 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10259.48 0 0 0 0 0 0 0 0 0 0 0 0 0 10259.48 0 0 1013676791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7826.53 0 0 0 0 0 0 0 0 0 0 0 0 0 7826.53 0 0 1013676863 1235609819 16 Nurse Practitioners BATSON ANTOINETTE 999999999 47 Jackson 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3646.54 0 0 0 0 0 0 3646.54 0 0 1013677292 1578853743 10 Physicians SALAHUDEEN AMEEN 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 0 343.63 0 0 0 0 0 0 343.63 0 0 1013677322 1700270816 10 Physicians GRIFFIN KRISTEN 999999999 10 Adams 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 20 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2313.88 0 6788.61 0 0 0 0 0 0 9102.49 0 0 1013677768 1669892683 10 Physicians AGARWAL ANUBHA 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 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 0 0 0 0 0 0 0 0 0 0 1013678063 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24191.11 0 0 0 0 0 0 0 0 0 0 0 0 0 24191.11 0 0 1013678161 1881624906 10 Physicians TAMKUS DEIMANTE 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1013678338 1306406210 24 Speech Therapists CHAMBLISS JESSICA 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 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 2839.36 2839.36 0 0 1013678425 1073997037 10 Physicians QURAISHI HANZLA 999999999 30 DuPage 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 1532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1532 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3989.11 0 0 0 0 0 0 3989.11 0 0 1013679118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19714.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19714.46 0 0 1013679223 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24411.86 0 0 0 0 0 0 0 0 0 0 0 0 0 24411.86 0 0 1013679277 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 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49752.66 0 0 0 0 0 0 0 0 0 0 0 0 0 49752.66 0 0 1013679851 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7845.04 0 0 0 0 0 0 0 0 0 0 0 0 0 7845.04 0 0 1013679920 1407386477 10 Physicians RYAN KELLY 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 211 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 7356.44 0 0 0 0 0 0 7377.76 0 0 1013679933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38051.84 0 0 0 0 0 0 0 0 0 0 0 0 0 38051.84 0 0 1013680641 1770142705 11 Dentists JUNG YEON JIN 999999999 200 Cook 0 0 General Dentistry 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9549.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9549.14 0 0 1013680660 1780976977 10 Physicians BONAR KYLE 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 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 1329.12 0 0 0 0 0 0 1329.12 0 0 1013681104 1669822318 10 Physicians MOHAMED BILAL A 999999999 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 0 162 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 2024.85 0 0 0 0 0 0 2024.85 0 0 1013681235 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24053.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24053.7 0 0 1013681707 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10258.26 0 0 0 0 0 0 0 0 0 0 0 0 0 10258.26 0 0 1013682162 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 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 43.73 0 0 0 0 0 0 43.73 0 0 1013682215 1255716403 10 Physicians LANG ADAM J 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 157 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1639.34 0 34.89 0 0 0 0 0 0 1674.23 0 0 1013682288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26347.74 0 0 0 0 0 0 0 0 0 0 0 0 0 26347.74 0 0 1013682469 1730531849 10 Physicians CREARY JONATHAN T 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 0 294.98 0 0 0 0 0 0 294.98 0 0 1013682537 1285296459 22 Physical Therapists BUCK ARRON D 999999999 109 Winnebago 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 0 136 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 1410.71 1410.71 0 0 1013682727 1184271538 89 Physician Assistant Only(Encounter Only) BROWNE COURTNEY 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 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 1013683072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16642.1 0 0 0 0 0 0 0 0 0 0 0 0 0 16642.1 0 0 1013683560 1447717525 16 Nurse Practitioners ABRAMS KELLY J 999999999 19 Champaign 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 0 784.72 0 0 0 0 0 0 784.72 0 0 1013683618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3336.96 0 0 0 0 0 0 0 0 0 0 0 0 0 3336.96 0 0 1013683708 1326498551 10 Physicians SHELTON SARAH F 999999999 53 Kane 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 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 0 746.32 0 0 0 0 0 0 746.32 0 0 1013684033 1104480995 16 Nurse Practitioners TSE TSZ F 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 0 341.11 0 0 0 0 0 0 341.11 0 0 1013684173 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4985.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4985.61 0 0 1013684271 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 52.94 0 0 0 0 0 0 0 0 52.94 0 0 1013684521 1902455900 89 Physician Assistant Only(Encounter Only) CHAPMAN NATALIA 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 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 0 178.63 0 0 0 0 0 0 178.63 0 0 1013684865 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.84 0 0 0 0 0 0 27.84 0 0 1013684935 1578715488 10 Physicians VAZQUEZ GUILLAMET MARIA C 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 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 0 759.29 0 0 0 0 0 0 759.29 0 0 1013685024 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4176.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4176.98 0 0 1013685045 1629280839 10 Physicians MEENA HEMLATA 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 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 4706.83 0 0 0 0 0 0 4706.83 0 0 1013685073 1912562109 16 Nurse Practitioners HARTMAN KATIE 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 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 6331.1 0 0 0 0 0 0 6331.1 0 0 1013685259 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5144.9 0 0 0 0 0 0 0 0 0 0 0 0 0 5144.9 0 0 1013685644 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 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 1195.72 0 0 0 0 0 0 1195.72 0 0 1013685725 1285916403 10 Physicians VIGNESWARAN YALINI 999999999 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 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 0 988.4 0 0 0 0 0 0 988.4 0 0 1013685882 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1013686153 55 Early Intervention Services 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 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 1974.37 0 0 0 0 0 0 1974.37 0 0 1013686154 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25189.45 0 0 0 0 0 0 0 0 0 0 0 0 0 25189.45 0 0 1013686237 1568016335 16 Nurse Practitioners RIVERS ANDI 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 0 129 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 4181.47 0 0 0 0 0 0 4181.47 0 0 1013686511 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 0 296.31 0 0 0 0 0 0 0 0 0 0 0 0 0 296.31 0 0 1013686623 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013686649 1730259714 10 Physicians CHUNGA JOHN P 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 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 1933.32 0 0 0 0 0 0 1933.32 0 0 1013686949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21001.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21001.8 0 0 1013687245 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634.92 0 0 0 0 0 0 0 0 0 0 0 0 0 634.92 0 0 1013688077 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 66.02 0 0 0 0 0 0 66.02 0 0 1013688586 1992355812 16 Nurse Practitioners NKRUMAH GIDEON B 999999999 91 Sangamon 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 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 1621.86 0 0 0 0 0 0 1621.86 0 0 1013689499 1326526112 50 Home Health Agencies - In Home CHITOWN HOME CARE 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 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 7659 0 0 0 0 0 0 7659 0 0 1013689592 1538547872 11 Dentists XU LUSHA 999999999 200 Cook 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 14859.19 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 15611.89 0 0 1013689923 1780017749 10 Physicians KHAN AHMED A 999999999 24 Coles 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 0 292 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 1694.95 0 0 0 0 0 0 1694.95 0 0 1013689934 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.98 0 0 0 0 0 0 141.98 0 0 1013690042 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16090.55 0 0 0 0 0 0 0 0 0 0 0 0 0 16090.55 0 0 1013690589 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 0 227 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 16523.76 0 0 0 0 0 0 0 0 0 0 0 0 0 16523.76 0 0 1013690799 1336567536 10 Physicians GUPTA SHEENA 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 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 2434.78 0 0 0 0 0 0 2434.78 0 0 1013691147 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 0 149.9 0 0 0 0 0 0 149.9 0 0 1013691325 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 23.46 0 0 0 0 0 0 23.46 0 0 1013691705 1730379355 10 Physicians LUDWIG DREW 999999999 200 Cook 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 0 376 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 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Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17483.36 0 0 0 0 0 0 0 0 0 0 0 0 0 17483.36 0 0 1013692105 1699238022 23 Occupational Therapists KELLER MEGAN L 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 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 0 302.06 302.06 0 0 1013692255 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12040.78 0 0 0 0 0 0 0 0 0 0 0 0 0 12040.78 0 0 1013692376 1417390923 10 Physicians CHIPPA VENU M 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528.89 0 0 0 0 0 0 528.89 0 0 1013692473 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 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 7714.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7714.4 0 0 1013692545 1194106872 10 Physicians NITTI JAMES 999999999 200 Cook 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 18 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 650.68 0 4923.71 0 0 0 0 0 0 5574.39 0 0 1013692546 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 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 65.31 0 0 0 0 0 0 65.31 0 0 1013692653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25774.78 0 0 0 0 0 0 0 0 0 0 0 0 0 25774.78 0 0 1013693191 1205887312 10 Physicians FURUYA KATRYN N 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 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 0 575.79 0 0 0 0 0 0 575.79 0 0 1013693449 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19928.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19928.91 0 0 1013693668 1306498506 22 Physical Therapists DAPITON KRIS 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 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 0 420.35 420.35 0 0 1013693885 1629625967 16 Nurse Practitioners MIGUEL MAY F 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 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 0 846.73 0 0 0 0 0 0 846.73 0 0 1013693890 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40157.95 0 0 0 0 0 0 0 0 0 0 0 0 0 40157.95 0 0 1013694005 1104276591 10 Physicians ZAFAR ALEEM 999999999 53 Kane 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 0 115 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 1241.1 0 0 0 0 0 0 1241.1 0 0 1013694039 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.63 0 0 0 0 0 0 0.63 0 0 1013694197 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7210.6 0 0 0 0 0 0 0 0 0 0 0 0 0 7210.6 0 0 1013694460 89 Physician Assistant Only(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 83.23 0 0 0 0 0 0 83.23 0 0 1013694538 1538719596 22 Physical Therapists ZINZER NATHAN R 999999999 30 DuPage 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 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 0 529.64 529.64 0 0 1013694792 1033364849 10 Physicians PANJWANI SAMEER G 999999999 200 Cook 0 0 Family Practice 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 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 1226.15 0 0 0 0 0 0 1226.15 0 0 1013694828 1154633618 10 Physicians HEFTY MATTHEW 999999999 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 1 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4449.18 0 0 0 0 0 0 4449.18 0 0 1013695349 1013250695 10 Physicians HENDLER STEVEN 999999999 200 Cook 0 0 Internal Medicine 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.56 0 6934.62 0 0 0 0 0 0 6961.18 0 0 1013695474 1508415951 16 Nurse Practitioners WICINSKI BRIANNA M 999999999 57 Lake 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 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 92.2 0 0 0 0 0 0 92.2 0 0 1013696284 1629555925 24 Speech Therapists OLSEN SHEEREEN J 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 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 11373.58 11373.58 0 0 1013696387 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15210.14 0 0 0 0 0 0 0 0 0 0 0 0 0 15210.14 0 0 1013696513 1457792269 10 Physicians YASSAN LINDSAY 999999999 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 153 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2935.86 0 34.35 0 0 0 0 0 0 2970.21 0 0 1013697222 1215389861 10 Physicians MILLER GREGORY 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 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 0 492.59 0 0 0 0 0 0 492.59 0 0 1013697369 1962883165 10 Physicians SHMUYLOVICH LEONID 999999999 19 Champaign 0 0 Dermatology 0 0 0 0 0 0 0 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 0 553.87 0 0 0 0 0 0 553.87 0 0 1013697758 1013334499 10 Physicians HENINGER JACOB 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 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 10681.65 0 0 0 0 0 0 10681.65 0 0 1013698001 1902255110 10 Physicians HAWKINS CAMILLE F 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 0 121 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 0 778.74 0 0 0 0 0 0 778.74 0 0 1013698347 1629619085 16 Nurse Practitioners HUDSON RAQUEL 999999999 200 Cook 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 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79003.7 0 0 0 0 0 0 79003.7 0 0 1013698487 1578829321 10 Physicians ROSBURG KRISTOPHER C 999999999 80 Peoria 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 0 216 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 81192.46 0 0 0 0 0 0 81192.46 0 0 1013698592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6185.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6185.24 0 0 1013698733 40 Federally Qualified Health Centers 47 Jackson 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 0 161.65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.65 0 0 1013698828 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20761.07 0 0 0 0 0 0 0 0 0 0 0 0 0 20761.07 0 0 1013699228 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16936.85 0 0 0 0 0 0 0 0 0 0 0 0 0 16936.85 0 0 1013699278 1609134063 10 Physicians IMBERY TERENCE E 999999999 200 Cook 0 0 Otolaryngology 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 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 1960.71 0 0 0 0 0 0 1960.71 0 0 1013699415 1629495825 10 Physicians HENTZ COURTNEY 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 0 131 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 3322.38 0 0 0 0 0 0 3322.38 0 0 1013699519 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 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 1379.52 1379.52 0 0 1013699766 1316399140 10 Physicians SETTIPALLE NEESHA 999999999 91 Sangamon 0 0 Internal Medicine 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 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 0 688.88 0 0 0 0 0 0 688.88 0 0 1013700005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2326.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2326.52 0 0 1013700068 1669881702 10 Physicians KUMARI DIVYA 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.24 0 336.85 0 0 0 0 0 0 369.09 0 0 1013700313 1114176708 10 Physicians KHAN MUHAMMAD 999999999 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 514 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7939.93 0 0 0 0 0 0 7939.93 0 0 1013700684 1538225842 65 Independent Diagnostic Testing Facility (IDTF) MIDWEST XRAY INC 601853739 30 DuPage 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 0 266 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 0 915.79 0 0 0 0 0 0 0 0 915.79 0 0 1013701110 1437615044 16 Nurse Practitioners BERNEKING ASHLEY 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 0 155.05 0 0 0 0 0 0 155.05 0 0 1013702132 1952621971 10 Physicians VU ERIC 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 4226 0 0 0 0 0 0 4226 0 0 1013702260 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23463.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23463.55 0 0 1013702307 1326488156 10 Physicians FRIEDMAN SAUL N 999999999 80 Peoria 0 0 Radiology Diagnosis 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 0 965.2 0 0 0 0 0 0 965.2 0 0 1013702332 1164087276 16 Nurse Practitioners CLOUSER AMANDA M 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 0 140 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 13440.14 0 0 1013704187 1659837367 16 Nurse Practitioners WARDEN MARTEL 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 0 135 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 3743.73 0 0 0 0 0 0 3743.73 0 0 1013704552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22680.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22680.15 0 0 1013704590 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7344.57 0 0 0 0 0 0 0 0 0 0 0 0 0 7344.57 0 0 1013704802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12113.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12113.82 0 0 1013704936 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25928.65 0 0 0 0 0 0 0 0 0 0 0 0 0 25928.65 0 0 1013705083 1558922591 22 Physical Therapists KERR ALISHA K 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 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 4543.6 4543.6 0 0 1013705272 1245758416 16 Nurse Practitioners WIRTH ELIZABETH A 999999999 54 Kankakee 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 0 121 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 0 385.17 0 0 0 0 0 0 385.17 0 0 1013705521 1457911562 16 Nurse Practitioners SMITH MANDA 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 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 2554.74 0 0 0 0 0 0 2554.74 0 0 1013705562 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 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 19655.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19655.22 0 0 1013705788 1932611522 16 Nurse Practitioners HUMPHREY NICOLE M 999999999 65 Madison 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 0 101 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 2387.93 0 0 0 0 0 0 2387.93 0 0 1013706117 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10469.78 0 0 0 0 0 0 0 0 0 0 0 0 0 10469.78 0 0 1013706144 10 Physicians 63 Macon 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 0 0 0 0 0 0 0 0 0 0 1013706635 1982257374 91 Waiver service provider--Adults (DHS/DDD) WOLFE NATALIE V 999999999 200 Cook 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 2642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36210.28 0 0 0 0 0 0 0 0 0 0 0 0 0 36210.28 0 0 1013706704 1528408903 10 Physicians FINKLE JOSHUA HARRY 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 483 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 801 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 801 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11739.69 0 1257.38 0 0 0 0 0 0 12997.07 0 0 1013707199 1427619865 60 Pharmacies HOUCHENS EXPRESS PHARMACY LLC 999999999 101 Wabash 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 1441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43340.36 0 0 0 43340.36 0 0 1013707393 1689216491 16 Nurse Practitioners WASSELL KYLEE C 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 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 0 728.45 0 0 0 0 0 0 728.45 0 0 1013707499 1508422478 89 Physician Assistant Only(Encounter Only) MCCLAIN KAYLEE 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 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 0 770.46 0 0 0 0 0 0 770.46 0 0 1013707580 11 Dentists 200 Cook 0 0 General Dentistry 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 64.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.4 0 0 1013707940 1821581992 10 Physicians MULLAJ ELDA 999999999 200 Cook 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 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 0 821.31 0 0 0 0 0 0 821.31 0 0 1013708037 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 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 0 184.88 0 0 0 0 0 0 184.88 0 0 1013708114 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33040.25 0 0 0 0 0 0 0 0 0 0 0 0 0 33040.25 0 0 1013708239 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 0 209.48 0 0 0 0 0 0 209.48 0 0 1013708499 10 Physicians 31 Edgar 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 12.65 0 0 0 0 0 0 12.65 0 0 1013708811 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22789.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22789.2 0 0 1013709262 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 604.75 0 0 0 0 0 0 604.75 0 0 1013710295 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700.8 0 0 0 0 0 0 0 0 0 0 0 0 0 700.8 0 0 1013710695 1740838333 10 Physicians RODRIGUES EDUARDO 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 3 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.63 0 10965.08 0 0 0 0 0 0 11069.71 0 0 1013710884 1578926143 10 Physicians ALIA LENA 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 11 0 48 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 18 0 82 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 18 0 82 0 0 0 0 0 0 0 0 0 34.28 0 0 0 0 0 0 344.07 0 7486.18 0 0 0 0 0 0 7864.53 0 0 1013711150 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 2.02 0 0 0 0 0 0 0 0 2.02 0 0 1013711239 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21246.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21246.01 0 0 1013711825 1912060617 10 Physicians KAPITSINOU PINELOPI 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 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 0 192.29 0 0 0 0 0 0 192.29 0 0 1013712508 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23913.34 0 0 0 0 0 0 0 0 0 0 0 0 0 23913.34 0 0 1013712572 1184018277 10 Physicians SANCHEZ-COLLINS SHAKIRA L 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 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 0 445.43 0 0 0 0 0 0 445.43 0 0 1013712714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1495.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1495.9 0 0 1013712770 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23023.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23023.7 0 0 1013712957 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 0 288 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 14479.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14479.86 0 0 1013713248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21699.99 0 0 0 0 0 0 0 0 0 0 0 0 0 21699.99 0 0 1013713520 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24520 0 0 0 0 0 0 0 0 0 0 0 0 0 24520 0 0 1013713760 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8906.27 0 0 0 0 0 0 0 0 0 0 0 0 0 8906.27 0 0 1013714139 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22897.82 0 0 0 0 0 0 0 0 0 0 0 0 0 22897.82 0 0 1013714518 1245689793 10 Physicians JARRETT BENJAMIN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 559.72 0 0 0 0 0 0 559.72 0 0 1013715202 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8685.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8685.38 0 0 1013715542 1801342522 89 Physician Assistant Only(Encounter Only) OSMANSKI ANGIE 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 0 103 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 0 725.29 0 0 0 0 0 0 725.29 0 0 1013715548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6078.66 0 0 0 0 0 0 0 0 0 0 0 0 0 6078.66 0 0 1013715608 1275896482 10 Physicians PATEL RAVI BHARAT 999999999 200 Cook 0 0 Internal 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 0 149 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 0 969.73 0 0 0 0 0 0 969.73 0 0 1013715898 22 Physical Therapists 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.27 165.27 0 0 1013716002 1720460686 10 Physicians MORKOS EL HAYEK SAHAR 999999999 24 Coles 0 0 Emergency 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 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 1359.15 0 0 0 0 0 0 1359.15 0 0 1013716086 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24604.72 0 0 0 0 0 0 0 0 0 0 0 0 0 24604.72 0 0 1013716107 1366976300 89 Physician Assistant Only(Encounter Only) FRITTS ALLYSON K 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 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1013716386 1912047085 10 Physicians MECKLENBURG BRIAN W 999999999 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4433.6 0 0 0 0 0 0 4433.6 0 0 1013716644 1730463282 10 Physicians BALABANOVA TANIA 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 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 79.16 0 0 0 0 0 0 79.16 0 0 1013716765 93 Waiver service provider--HIV/AIDS (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 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0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 391.9 0 0 0 0 0 0 82.71 0 753.1 0 0 0 0 0 0 1227.71 0 0 1013758163 1609267533 10 Physicians SCHIEBER MICHAEL 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 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 1183.72 0 0 0 0 0 0 1183.72 0 0 1013758202 1912342452 10 Physicians NOLAN BRIAN E 999999999 200 Cook 0 0 Pediatrics 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 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 6.4 0 0 0 0 0 0 0 0 1728.98 0 0 0 0 0 0 1735.38 0 0 1013758308 1851895528 10 Physicians RIVAS ORLYN 999999999 200 Cook 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 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 0 249.69 0 0 0 0 0 0 249.69 0 0 1013758400 98 Waiver service provider--TBI (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 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0 0 0 0 0 0 0 0 304.5 0 0 0 0 0 0 304.5 0 0 1013762803 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14375.24 0 0 0 0 0 0 0 0 0 0 0 0 0 14375.24 0 0 1013762878 1528525789 22 Physical Therapists BARANYI BRIAN 999999999 200 Cook 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 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 0 801.83 801.83 0 0 1013762933 1780230227 12 Optometrists CARBONARO NICOLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 832 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 832 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16599.87 0 15.75 0 0 0 0 16615.62 0 0 1013763080 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 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 62.74 0 0 0 0 0 0 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0 0 0 149.88 0 0 1013763938 1245715127 16 Nurse Practitioners OPACIAN SUSAN J 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 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 0 823.23 0 0 0 0 0 0 823.23 0 0 1013764006 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24505.47 0 0 0 0 0 0 0 0 0 0 0 0 0 24505.47 0 0 1013764119 1386083194 10 Physicians FROLOVA ANTONINA I 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.36 0 719.43 0 0 0 0 0 0 1087.79 0 0 1013764763 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 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 1776.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1776.96 0 0 1013764779 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24579.88 0 0 0 0 0 0 0 0 0 0 0 0 0 24579.88 0 0 1013764819 1326467440 10 Physicians DEMARS ANDREW H 999999999 98 Tazewell 0 0 Emergency 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 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 1685.27 0 0 0 0 0 0 1685.27 0 0 1013765056 1992768147 10 Physicians IMAM NAIYER 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 666 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 973.15 0 198.01 0 0 0 0 0 0 1171.16 0 0 1013765138 1003291162 11 Dentists MAHASSEK HEATHER D 999999999 65 Madison 0 0 0 0 99 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 18481.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18481.08 0 0 1013765162 1104110832 10 Physicians SPIELBERG DAVID R 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 1557.84 0 0 0 0 0 0 1557.84 0 0 1013765257 1134675218 10 Physicians IBRAHIM JOHN F 999999999 15 Bureau 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 0 111 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 0 986.21 0 0 0 0 0 0 986.21 0 0 1013765453 1043673817 10 Physicians PARUCHURI ARPANA 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 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 0 197.94 0 0 0 0 0 0 197.94 0 0 1013765788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2221.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2221.24 0 0 1013765876 1326690066 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) BOURBONNAIS TERRACE 999999999 54 Kankakee 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331315.44 0 0 0 0 0 0 0 331315.44 0 0 1013765944 1417308925 13 Podiatrists WIRT TIMOTHY C 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 0 177 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 3976.6 0 0 0 0 0 0 3976.6 0 0 1013766583 1124465877 10 Physicians BARRETT BRETT C 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 13 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.8 0 9743.21 0 0 0 0 0 0 9907.01 0 0 1013767975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8557.52 0 0 0 0 0 0 0 0 0 0 0 0 0 8557.52 0 0 1013768095 1760708895 10 Physicians FINEBERG STEVEN J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.96 0 374.14 0 0 0 0 0 0 407.1 0 0 1013768116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4989.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4989.49 0 0 1013768225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22775.72 0 0 0 0 0 0 0 0 0 0 0 0 0 22775.72 0 0 1013768274 1659723385 10 Physicians ATASHIAN CHRISTOPHER 999999999 30 DuPage 0 0 Emergency Medicine 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 1464.5 0 0 0 0 0 0 1464.5 0 0 1013768286 1710305651 10 Physicians MATHEW ANITA 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1748.47 0 0 0 0 0 0 1748.47 0 0 1013768708 1245609676 89 Physician Assistant Only(Encounter Only) ROBINS CHRISTA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 0 0 0 0 0 21.32 0 0 1013768778 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 56.94 0 0 0 0 0 0 56.94 0 0 1013768847 1184166605 55 Early Intervention Services TOLENTINO JACQUELINE 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 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 5268.46 0 0 0 0 0 0 5268.46 0 0 1013769461 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.84 0 0 0 0 0 0 129.84 0 0 1013769988 1992068845 10 Physicians SONDGEROTH KRISTINA 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 162 0 73 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 314 0 100 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 314 0 100 0 0 0 0 0 0 0 0 0 30.36 0 0 0 0 0 0 34760.79 0 6714.61 0 0 0 0 0 0 41505.76 0 0 1013770041 1760950737 48 Rural Health Clinics EZ CARE MARSHALL 999999999 31 Edgar 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10300.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10300.32 0 0 1013770589 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 3400.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3400.19 0 0 1013770720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2963.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2963.1 0 0 1013770806 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 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 0 293.03 0 0 0 0 0 0 293.03 0 0 1013770864 1174904809 10 Physicians LEE DANIEL 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 0 308.17 0 0 0 0 0 0 308.17 0 0 1013770909 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4964.78 0 0 0 0 0 0 0 0 0 0 0 0 0 4964.78 0 0 1013771441 1063854404 10 Physicians DESAI KRUTI 999999999 91 Sangamon 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 0 260 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 1421.6 0 0 0 0 0 0 1421.6 0 0 1013771940 1225392368 10 Physicians PSIHOS PETER J 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 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 4526.99 0 0 0 0 0 0 4526.99 0 0 1013772302 1265731863 13 Podiatrists MAKER JARED M 999999999 19 Champaign 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 0 124 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 4537.84 0 0 0 0 0 0 4537.84 0 0 1013772605 1558773473 10 Physicians LILE DEACON 999999999 101 Wabash 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 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 2566.87 0 0 0 0 0 0 2566.87 0 0 1013772630 1316300593 10 Physicians WHERLEY ANDREW 999999999 80 Peoria 0 0 0 0 0 16 0 0 0 0 0 0 12 0 81 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 14 0 129 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 14 0 129 0 0 0 0 0 0 0 0 0 1043.36 0 0 0 0 0 0 239.18 0 1636.95 0 0 0 0 0 0 2919.49 0 0 1013773005 1245580604 10 Physicians PANDEY ANITA 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 0 299 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 30354.91 0 0 0 0 0 0 30354.91 0 0 1013773062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22132.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22132.1 0 0 1013773783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9417.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9417.2 0 0 1013774046 1700230539 10 Physicians LOOMIS JENNIFER 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.02 0 0 0 0 0 0 226.02 0 0 1013774059 1356904148 16 Nurse Practitioners JONES ANDREA M 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 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 1918.08 0 0 0 0 0 0 1918.08 0 0 1013774240 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15986.25 0 0 0 0 0 0 0 0 0 0 0 0 0 15986.25 0 0 1013774406 1841682374 10 Physicians BLACKWELL DUSTIN 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 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 0 486.77 0 463.53 0 0 0 0 0 0 950.3 0 0 1013775476 1063070373 24 Speech Therapists CAPPUCCILLI CAITLIN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 742 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 53789.58 53789.58 0 0 1013775748 1184911737 23 Occupational Therapists PEITZMANN REBECCA 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 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 0 635.16 635.16 0 0 1013775820 1548493588 10 Physicians PAYANT MCKENNA THERESA 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 0 187 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 5363.69 0 0 0 0 0 0 5363.69 0 0 1013776194 1003233552 10 Physicians MACQUARRIE KYLE 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 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 1327.71 0 0 0 0 0 0 1327.71 0 0 1013776253 1508368523 16 Nurse Practitioners CHOVANEC ABBY 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 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 0 378.91 0 0 0 0 0 0 378.91 0 0 1013776348 10 Physicians 56 Knox 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 0 0 0 0 0 0 0 0 0 0 1013776727 1255995205 23 Occupational Therapists STORTZUM STEPHANIE M 999999999 91 Sangamon 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 0 111 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 4154.94 4154.94 0 0 1013776750 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 0 215 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 15443.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15443.99 0 0 1013776785 1356463897 10 Physicians NAGPAL AGNIESZKA G 999999999 200 Cook 0 0 Ophthalmology 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 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.6 0 5960.84 0 0 0 0 0 0 6060.44 0 0 1013776915 1982145967 16 Nurse Practitioners RIOS EDNA M 999999999 200 Cook 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 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 10033.89 0 0 0 0 0 0 10033.89 0 0 1013777619 1891137980 10 Physicians PATEL VIREN R 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 439 0 108 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1891 0 115 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1891 0 115 0 0 0 0 0 0 0 0 0 5.93 0 0 0 0 0 0 12392.18 0 11278.45 0 0 0 0 0 0 23676.56 0 0 1013778069 1558724161 10 Physicians PETRAGLIA FRANK W 999999999 200 Cook 0 0 0 0 0 0 0 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 25.51 0 0 0 0 0 0 0 0 25.51 0 0 1013778085 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.76 68.76 0 0 1013778804 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 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 3915.79 0 0 0 0 0 0 0 0 0 0 0 0 0 3915.79 0 0 1013778907 1023153160 46 Ambulatory Surgical Treatment Centers "ADVANTAGE HEALTH CARE, LTD" 999999999 30 DuPage 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 0 267 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 152463.5 0 0 0 0 0 0 152463.5 0 0 1013779008 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11986.15 0 0 0 0 0 0 0 0 0 0 0 0 0 11986.15 0 0 1013779105 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3215.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3215.85 0 0 1013779219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17313.07 0 0 0 0 0 0 0 0 0 0 0 0 0 17313.07 0 0 1013779266 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 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7318.35 0 0 0 0 0 0 0 0 0 0 0 0 0 7318.35 0 0 1013788942 10 Physicians 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 104.82 0 0 0 0 0 0 104.82 0 0 1013788996 1184758286 16 Nurse Practitioners LASTRES ALAINA 999999999 200 Cook 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 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20592.59 0 0 0 0 0 0 20592.59 0 0 1013789208 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19697.87 0 0 0 0 0 0 0 0 0 0 0 0 0 19697.87 0 0 1013789280 1518420074 16 Nurse Practitioners BUSSE KARMEN 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 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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1013792134 1518508381 16 Nurse Practitioners BAUBIE STEPHANIE FRUEHAUF 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 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 0 386.6 0 0 0 0 0 0 386.6 0 0 1013792757 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12390.24 0 0 0 0 0 0 0 0 0 0 0 0 0 12390.24 0 0 1013792819 1851731590 10 Physicians JOHNSON BENJAMIN E 999999999 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.1 0 3136.85 0 0 0 0 0 0 3155.95 0 0 1013793110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30004.99 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3356.87 0 0 0 0 0 0 3356.87 0 0 1013795590 1891112579 10 Physicians HINTON ISAAC J 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 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 3906.14 0 0 0 0 0 0 3906.14 0 0 1013795603 1699064824 10 Physicians LANIOSZ VALERIE 999999999 30 DuPage 0 0 Dermatology 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.39 0 45.67 0 0 0 0 0 0 48.06 0 0 1013796318 22 Physical Therapists 19 Champaign 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199.17 199.17 0 0 1013796332 1760046288 89 Physician Assistant Only(Encounter Only) REED CLARISSA A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 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 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4136.96 0 0 0 0 0 0 4136.96 0 0 1013803662 1396298642 13 Podiatrists SMITH PAUL F 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 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 31.84 0 0 0 0 0 0 31.84 0 0 1013803871 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10912.95 0 0 0 0 0 0 0 0 0 0 0 0 0 10912.95 0 0 1013803991 1588126049 60 Pharmacies TOTAL CARE PHARMACY 999999999 30 DuPage 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 1664 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14356.22 0 0 0 14356.22 0 0 1013804003 1609214063 10 Physicians KU KIMBERLY 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 30 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 924 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202 0 924 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2190.48 0 209791.2 0 0 0 0 0 0 211981.68 0 0 1013804069 1053755710 10 Physicians BABAR ASIM K 999999999 200 Cook 0 0 Internal Medicine 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 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2652.85 0 0 0 0 0 0 2652.85 0 0 1013804348 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 23.76 0 0 0 0 0 0 23.76 0 0 1013804455 1881150860 16 Nurse Practitioners DEAN SARAH A 999999999 107 Will 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 0 179 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 0 606.33 0 0 0 0 0 0 606.33 0 0 1013804706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4011.05 0 0 0 0 0 0 0 0 0 0 0 0 0 4011.05 0 0 1013805316 1154801702 30 General Hospitals FORD CITY DIALYSIS 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5539.41 0 0 0 0 0 5539.41 0 0 1013805324 1982253670 16 Nurse Practitioners HARRIS CHRISTINE 999999999 109 Winnebago 0 0 0 0 0 2 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 1082.11 0 0 0 0 0 0 1094.91 0 0 1013805545 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21284.4 0 0 0 0 0 0 0 0 0 0 0 0 0 21284.4 0 0 1013805735 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4474.23 0 0 0 0 0 0 0 0 0 0 0 0 0 4474.23 0 0 1013805791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29266.9 0 0 0 0 0 0 0 0 0 0 0 0 0 29266.9 0 0 1013806175 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9853.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9853.08 0 0 1013806609 1053960609 16 Nurse Practitioners DONNELLY BRANDI 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 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 2876.81 0 0 0 0 0 0 2876.81 0 0 1013806668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15721.87 0 0 0 0 0 0 0 0 0 0 0 0 0 15721.87 0 0 1013806814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14113.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14113.68 0 0 1013807427 1497102297 10 Physicians PATTON ANDREW 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 270 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 5719.52 0 0 0 0 0 0 5719.52 0 0 1013807434 1619442266 30 General Hospitals PIPELINE-WEST SUBURBAN MEDICAL 603022519 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 1 0 0 0 1183 0 0 0 0 588 0 0 0 877 0 0 0 0 0 1 0 0 0 1481 0 0 0 0 632 0 0 0 1988 0 0 0 0 0 1 0 0 0 1481 0 0 0 0 3314 0 0 0 2264 0 0 0 0 0 186.8 0 0 0 236918.26 0 0 0 0 2117199.72 0 0 0 930031.31 0 0 0 0 0 3284336.09 0 0 1013807741 1619388576 10 Physicians FARAG MITCHELL A 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 427 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 814 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 814 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7092.57 0 1609.69 0 0 0 0 0 0 8702.26 0 0 1013807992 1841847464 16 Nurse Practitioners THACKER SARAH J 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 0 0 0 0 0 0 0 0 0 0 1013808038 1841752284 16 Nurse Practitioners ABDALLAH MAHUBAH 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 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 2902.89 0 0 0 0 0 0 2902.89 0 0 1013808175 1336634237 10 Physicians WEBER NICHOLAS 999999999 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 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 99.39 0 0 0 0 0 0 99.39 0 0 1013808216 1902388010 60 Pharmacies BURBANK PHARMACY LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 2262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1083.21 0 0 0 1083.21 0 0 1013808294 1437590866 10 Physicians JEGADEESAN RAMPRESAD 999999999 91 Sangamon 0 0 Internal Medicine 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21019.35 0 0 0 0 0 0 21019.35 0 0 1013808382 1215249669 10 Physicians CIAL PARUL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 43 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286.93 0 1295.92 0 0 0 0 0 0 1582.85 0 0 1013808611 1073097184 61 Independent Laboratories 4EVERY1 LABORATORY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 19 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 1817.4 0 0 0 0 0 0 0 0 1817.4 0 0 1013808717 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9698.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9698.34 0 0 1013808785 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2734.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2734.18 0 0 1013808836 1336403237 10 Physicians FOX DERRICK A 999999999 80 Peoria 0 0 Neurology 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 2322.63 0 0 0 0 0 0 2322.63 0 0 1013809015 1720063357 16 Nurse Practitioners OWENS SHERRLYN H 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 0 112 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 0 778.56 0 0 0 0 0 0 778.56 0 0 1013809096 10 Physicians 107 Will 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 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 0 0 43.01 0 0 0 0 0 0 43.01 0 0 1013809189 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29268.82 0 0 0 0 0 0 0 0 0 0 0 0 0 29268.82 0 0 1013809640 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 5318.18 0 0 0 0 0 0 0 0 0 0 0 0 0 5318.18 0 0 1013809693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11013.42 0 0 0 0 0 0 0 0 0 0 0 0 0 11013.42 0 0 1013809783 16 Nurse Practitioners 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 14 0 0 0 0 0 0 14 0 0 1013809874 1659573749 10 Physicians GATTON BARBARA J 999999999 47 Jackson 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 0 168 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 4569.91 0 0 0 0 0 0 4569.91 0 0 1013810415 1538560818 89 Physician Assistant Only(Encounter Only) MAHONEY KAITILIN 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 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 0 117.22 0 0 0 0 0 0 117.22 0 0 1013810446 1235784182 89 Physician Assistant Only(Encounter Only) MICHNA REBECCA 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 0 170.19 0 0 0 0 0 0 170.19 0 0 1013810463 1801326095 10 Physicians BODNAR YAROSLAV 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 0 0 0 0 0 363.18 0 0 0 0 0 0 363.18 0 0 1013810689 1730397175 63 Other Providers of Medical Equipment/Supplies (Non-registered) "WOUND CARE CONCEPTS, INC." 999999999 839 Pennsylvania 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 3518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123607.75 0 0 0 0 0 0 123607.75 0 0 1013810765 1215384318 10 Physicians ORHANI ELVISA 999999999 30 DuPage 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 0 317 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 1728.63 0 0 0 0 0 0 1728.63 0 0 1013810889 1720461494 10 Physicians GOLUB LIDIYA A 999999999 200 Cook 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 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 1419.95 0 0 0 0 0 0 1419.95 0 0 1013810946 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7073.66 0 0 0 0 0 0 0 0 0 0 0 0 0 7073.66 0 0 1013811338 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 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 3791.43 0 0 0 0 0 0 0 0 0 0 0 0 0 3791.43 0 0 1013811535 1902442650 10 Physicians IRAVANI TABRIZIPOUR AMIR 999999999 200 Cook 0 0 Nuclear 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 0 588.11 0 0 0 0 0 0 588.11 0 0 1013811668 1396039442 10 Physicians ARES WILLIAM JOSEPH 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.21 0 5018.69 0 0 0 0 0 0 5040.9 0 0 1013811993 1144660572 10 Physicians WRIGLEY PETER 999999999 19 Champaign 0 0 Neurology 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 0 282 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 6816.81 0 0 0 0 0 0 6816.81 0 0 1013812012 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6375.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6375.55 0 0 1013812047 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 1013812223 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.36 0 0 0 0 0 0 129.36 0 0 1013812505 1548803802 16 Nurse Practitioners STOPKA KATARZYNA 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 0 198 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 0 380.5 0 0 0 0 0 0 380.5 0 0 1013812733 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 11414.16 0 0 0 0 0 0 0 0 0 0 0 0 0 11414.16 0 0 1013812890 1619329380 10 Physicians PLATA DIANA M 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 5.22 0 488.95 0 0 0 0 0 0 494.17 0 0 1013812970 1306121678 91 Waiver service provider--Adults (DHS/DDD) MCGEE CYNTHIA A 999999999 91 Sangamon 0 0 0 0 0 0 0 15 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 5037.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5037.15 0 0 1013813143 1376031831 16 Nurse Practitioners MAU KRISTEN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 767.77 0 0 0 0 0 0 767.77 0 0 1013813183 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22295.85 0 0 0 0 0 0 0 0 0 0 0 0 0 22295.85 0 0 1013813232 1427609775 16 Nurse Practitioners ANDERSON BRANDI L 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 153.71 0 0 0 0 0 0 153.71 0 0 1013813388 1154709756 10 Physicians JOHN JESWIN B 999999999 19 Champaign 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3204.59 0 0 0 0 0 0 3204.59 0 0 1013813420 1912548587 89 Physician Assistant Only(Encounter Only) REDZIC ADELA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 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 0 798.09 0 0 0 0 0 0 798.09 0 0 1013813428 1528624640 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELEVATE CARE WAUKEGAN 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 0 225 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 37237.5 0 0 0 0 0 0 37237.5 0 0 1013813515 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1978.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1978.88 0 0 1013813821 1316275662 89 Physician Assistant Only(Encounter Only) SMALLEY SARAH 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 0 100.63 0 0 0 0 0 0 100.63 0 0 1013813944 89 Physician Assistant Only(Encounter Only) 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 43.54 0 0 0 0 0 0 43.54 0 0 1013813999 1104478312 22 Physical Therapists KAMINSKI JUSTINE 999999999 200 Cook 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 0 120 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 0 821.34 821.34 0 0 1013814257 1376906164 10 Physicians DAWSON WHITNEY M 999999999 19 Champaign 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 0 439 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 6283.66 0 0 0 0 0 0 6283.66 0 0 1013814287 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 0 198 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 15992.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15992.21 0 0 1013814723 1841854353 89 Physician Assistant Only(Encounter Only) SIMPSON JAMIE 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 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 0 109.64 0 0 0 0 0 0 109.64 0 0 1013815235 1245899715 89 Physician Assistant Only(Encounter Only) SHEN ISABEL 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 0 103 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 1053.85 0 0 0 0 0 0 1053.85 0 0 1013815554 1801023809 10 Physicians GONZALEZ MARIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 128 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7879.53 0 36.76 0 0 0 0 0 0 7916.29 0 0 1013815655 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.12 0 0 0 0 0 0 9.12 0 0 1013815781 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 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 6141.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6141.91 0 0 1013815830 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 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 2636.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2636.52 0 0 1013816070 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013816195 1528627007 16 Nurse Practitioners DONALDSON RANDI 999999999 10 Adams 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 0 121 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 1808.64 0 0 0 0 0 0 1808.64 0 0 1013816561 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 64.08 0 0 0 0 0 0 64.08 0 0 1013816994 1568027803 33 Nursing Facilities ELEVATE CARE NILES 999999999 200 Cook 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 0 569 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2504055.19 0 0 0 0 0 0 0 2504055.19 0 0 1013817162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31810.67 0 0 0 0 0 0 0 0 0 0 0 0 0 31810.67 0 0 1013817688 1942857081 16 Nurse Practitioners BRENNEMAN DANA C 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 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 1817.94 0 0 0 0 0 0 1817.94 0 0 1013817699 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 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 46.45 0 0 0 0 0 0 46.45 0 0 1013818064 1679925366 16 Nurse Practitioners HOUSTON KELLY M 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 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 0 443.8 0 0 0 0 0 0 443.8 0 0 1013818542 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12747.24 0 0 0 0 0 0 0 0 0 0 0 0 0 12747.24 0 0 1013818782 1508252156 10 Physicians SALMAN ALICJA 999999999 200 Cook 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 0 310 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 6975.46 0 0 0 0 0 0 6975.46 0 0 1013818870 1871052522 16 Nurse Practitioners KRONMILLER MICHELLE C 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 0 103 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 2623.33 0 0 0 0 0 0 2623.33 0 0 1013818985 11 Dentists 200 Cook 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 0 183.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.35 0 0 1013819282 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23002 0 0 0 0 0 0 0 0 0 0 0 0 0 23002 0 0 1013819789 1144631557 10 Physicians FADIA MITHILA 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 25 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 1847.01 0 0 0 0 0 0 1847.01 0 0 1013820035 1639681836 16 Nurse Practitioners ALEXANDER CHRISTINA E 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 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 47.42 0 0 0 0 0 0 47.42 0 0 1013820280 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166.93 0 0 0 0 0 0 166.93 0 0 1013820345 1871153189 16 Nurse Practitioners FRANKS MARY 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 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 0 429.82 0 0 0 0 0 0 429.82 0 0 1013820436 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11566.89 0 0 0 0 0 0 0 0 0 0 0 0 0 11566.89 0 0 1013820678 1518433077 60 Pharmacies PRISM PHARMACY ELGIN 999999999 53 Kane 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 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11816.54 0 0 0 11816.54 0 0 1013820820 1528327665 10 Physicians PATEL DIPIKA 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 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 0 458.02 0 0 0 0 0 0 458.02 0 0 1013820897 1790338853 11 Dentists PHAGAN CASSIDY 999999999 200 Cook 0 0 0 0 243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27302.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27302.72 0 0 1013821085 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6050.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6050.86 0 0 1013821346 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17504.38 0 0 0 0 0 0 0 0 0 0 0 0 0 17504.38 0 0 1013821529 10 Physicians 109 Winnebago 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 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 0 194.61 0 0 0 0 0 0 194.61 0 0 1013821902 1033591417 10 Physicians NOSAL CATHERINE A 999999999 200 Cook 0 0 Obstetric-Gynecology 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 5317.98 0 0 0 0 0 0 5353.93 0 0 1013822424 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 12378.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12378.05 0 0 1013823040 1831675743 16 Nurse Practitioners ORTIZ ELVIA 999999999 30 DuPage 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 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 1630.4 0 0 0 0 0 0 1630.4 0 0 1013823129 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 65.06 0 0 0 0 0 0 65.06 0 0 1013823140 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 5781.23 0 0 0 0 0 0 0 0 0 0 0 0 0 5781.23 0 0 1013823573 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 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 0 138.27 138.27 0 0 1013823866 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 0 0 0 0 0 0 0 0 0 0 1013824259 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4066.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4066.32 0 0 1013824607 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7072.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7072.15 0 0 1013824875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22192.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22192.9 0 0 1013825459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4538.99 0 0 0 0 0 0 0 0 0 0 0 0 0 4538.99 0 0 1013825494 1558562322 11 Dentists O'DONOVAN BRIAN J 999999999 107 Will 0 0 General Dentistry 0 0 31 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 2783.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2783.99 0 0 1013825649 25 Audiologists 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 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 2263.08 2263.08 0 0 1013826066 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9464.7 0 0 0 0 0 0 0 0 0 0 0 0 0 9464.7 0 0 1013826080 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 87.63 0 0 0 0 0 0 87.63 0 0 1013826338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23873.87 0 0 0 0 0 0 0 0 0 0 0 0 0 23873.87 0 0 1013826401 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20941.89 0 0 0 0 0 0 0 0 0 0 0 0 0 20941.89 0 0 1013826598 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 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 1013826628 1700103603 10 Physicians LAUX ANNE 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 5 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.36 0 1860.73 0 0 0 0 0 0 1902.09 0 0 1013826792 1194816389 10 Physicians HAKKI AHADI 999999999 200 Cook 0 0 Thoracic 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 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 1574.19 0 0 0 0 0 0 1574.19 0 0 1013827017 1811126469 10 Physicians THOMPSON KELLY 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 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 1655.15 0 0 0 0 0 0 1655.15 0 0 1013827038 1427573518 10 Physicians BATHINA BINDU 999999999 80 Peoria 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 0 162 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 1064.31 0 0 0 0 0 0 1064.31 0 0 1013827123 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 0 0 0 0 0 0 0 0 0 0 1013827306 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 0 0 0 0 0 0 0 0 0 0 1013827410 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19091.07 0 0 0 0 0 0 0 0 0 0 0 0 0 19091.07 0 0 1013827511 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16125.52 0 0 0 0 0 0 0 0 0 0 0 0 0 16125.52 0 0 1013827513 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 62708.78 0 0 0 0 0 0 0 0 0 0 0 0 0 62708.78 0 0 1013827595 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26346.85 0 0 0 0 0 0 0 0 0 0 0 0 0 26346.85 0 0 1013827784 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 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 1013827788 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 0 130 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 13842.07 0 0 0 0 0 0 0 0 0 0 0 0 0 13842.07 0 0 1013827986 1811326440 89 Physician Assistant Only(Encounter Only) HOUSERIGHT LAUREN D 999999999 47 Jackson 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 0 102 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 0 264.69 0 0 0 0 0 0 264.69 0 0 1013828654 1174165880 16 Nurse Practitioners MAZYA YANA 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 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3722.88 0 0 0 0 0 0 3722.88 0 0 1013829101 1538700497 16 Nurse Practitioners FLICK RYAN 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 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 2734.3 0 0 0 0 0 0 2734.3 0 0 1013829122 1477988087 16 Nurse Practitioners HONORABLE CARMEKA D 999999999 91 Sangamon 0 0 0 0 0 5 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 258.64 0 0 0 0 0 0 0 0 1898.91 0 0 0 0 0 0 2157.55 0 0 1013829567 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15201.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15201.52 0 0 1013829752 1316141658 10 Physicians OPYRCHAL MATEUSZ 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 0 658 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 90204.8 0 0 0 0 0 0 90204.8 0 0 1013829897 1689223729 89 Physician Assistant Only(Encounter Only) HAERTLING BRAEDON 999999999 49 Jefferson 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 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 492 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4338.69 0 0 0 0 0 0 4338.69 0 0 1013830085 1427463074 10 Physicians SAMANT MAANASI 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 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 0 973.71 0 0 0 0 0 0 973.71 0 0 1013830108 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30714.78 0 0 0 0 0 0 0 0 0 0 0 0 0 30714.78 0 0 1013830256 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10392.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10392.92 0 0 1013830260 10 Physicians 91 Sangamon 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 14.23 0 0 0 0 0 0 0 0 14.23 0 0 1013830655 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1251.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1251.43 0 0 1013831050 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2385.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2385.02 0 0 1013831080 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 1013831129 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23964.93 0 0 0 0 0 0 0 0 0 0 0 0 0 23964.93 0 0 1013831180 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1339.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1339.04 0 0 1013831375 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 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 1013831611 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 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 13158.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13158.05 0 0 1013831817 1255981528 16 Nurse Practitioners MARRIOTT STACY R 999999999 50 Jersey 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 0 224 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 1863.26 0 0 0 0 0 0 1863.26 0 0 1013831956 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 14664.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14664.21 0 0 1013832282 1235524091 10 Physicians GRUNER ADAM 999999999 30 DuPage 0 0 Emergency 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 0 217 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 5349.26 0 0 0 0 0 0 5349.26 0 0 1013832594 1801387089 16 Nurse Practitioners ELLIS TARRYN 999999999 57 Lake 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 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 1889.35 0 0 0 0 0 0 1889.35 0 0 1013832713 1851952717 16 Nurse Practitioners PERSE ADRIANA C 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 83.84 0 0 0 0 0 0 83.84 0 0 1013833848 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 8.19 0 0 0 0 0 0 8.19 0 0 1013834057 1548826209 11 Dentists SUNNY LOIS 999999999 53 Kane 0 0 General Dentistry 0 0 194 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 873 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 873 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 30459.81 0 0 0 0 0 0 0 0 0 0 0 3763.5 0 0 0 0 34223.31 0 0 1013834229 1518318070 10 Physicians WILSON REBECCA L 999999999 30 DuPage 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2403.8 0 0 0 0 0 0 2403.8 0 0 1013834432 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 83.2 0 0 0 0 0 0 83.2 0 0 1013834545 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6090.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6090.33 0 0 1013834891 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 0 172 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 13079.97 0 0 0 0 0 0 0 0 0 0 0 0 0 13079.97 0 0 1013835500 1265875330 10 Physicians MAGNETTA DEFNE 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 0 172 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 7781.77 0 0 0 0 0 0 7781.77 0 0 1013835578 1720632508 16 Nurse Practitioners BEHNKEN KAITLIN E 999999999 47 Jackson 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 0 203 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 1567.78 0 0 0 0 0 0 1567.78 0 0 1013835754 1073856118 10 Physicians RAHIM SHIRAZ 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 1056 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1895 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1895 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25725.18 0 1545.09 0 0 0 0 0 0 27270.27 0 0 1013835854 1720544943 16 Nurse Practitioners MONTGOMERY ELIZABETH N 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 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 0 212.76 0 0 0 0 0 0 212.76 0 0 1013836532 1255985164 16 Nurse Practitioners ZITO KIMBERLY D 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 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 0 579.42 0 0 0 0 0 0 579.42 0 0 1013836742 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 0 108 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 15835.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15835.8 0 0 1013836780 1447801998 16 Nurse Practitioners MARTINEZ-O''CONNOR GISELLE 999999999 200 Cook 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 0 108 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 4621.51 0 0 0 0 0 0 4621.51 0 0 1013836978 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24989.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24989.8 0 0 1013836991 1437790425 88 Other behavior health professional ZARIT BEN 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 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 0 921.31 0 0 0 0 0 0 921.31 0 0 1013837429 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 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 14718.11 0 0 0 0 0 0 0 0 0 0 0 0 0 14718.11 0 0 1013837522 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16862.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16862.56 0 0 1013837782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4517.75 0 0 0 0 0 0 0 0 0 0 0 0 0 4517.75 0 0 1013837827 1801358163 16 Nurse Practitioners THOMAS WILLIAM W 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 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 0 402.45 0 0 0 0 0 0 402.45 0 0 1013837950 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 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 1584.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1584.1 0 0 1013838048 1558918987 22 Physical Therapists GARTLAN KATHLEEN A 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 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 1749.8 1749.8 0 0 1013838188 1598790180 86 Clinical Social Worker(Encounter Only) CARTER BRENDA 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 2527.71 0 0 0 0 0 0 2527.71 0 0 1013838206 1356756985 10 Physicians TRAN LILY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 101 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1592.2 0 34.89 0 0 0 0 0 0 1627.09 0 0 1013838241 1326488594 10 Physicians SALIH MOHSIN 999999999 91 Sangamon 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 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 1102.63 0 0 0 0 0 0 1102.63 0 0 1013838322 22 Physical Therapists 56 Knox 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 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 0 325.15 325.15 0 0 1013838413 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18255.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18255.45 0 0 1013838523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 54523.82 0 0 0 0 0 0 0 0 0 0 0 0 0 54523.82 0 0 1013839066 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 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 8957.22 0 0 0 0 0 0 0 0 0 0 0 0 0 8957.22 0 0 1013839306 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 0 118 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 13475.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13475.7 0 0 1013839345 10 Physicians 96 St Clair 0 0 Psychiatry 0 0 0 0 0 0 0 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 1013839567 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013839612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1986.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1986.16 0 0 1013839619 1134786783 91 Waiver service provider--Adults (DHS/DDD) KERWIN STACEY 999999999 91 Sangamon 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 1667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105903 0 0 0 0 0 0 0 0 0 0 0 0 0 105903 0 0 1013839888 1295384733 91 Waiver service provider--Adults (DHS/DDD) ADENEKAN ADEDAYO M 999999999 66 Marion 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 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151349.55 0 0 0 0 0 0 0 0 0 0 0 0 0 151349.55 0 0 1013839911 1053976712 86 Clinical Social Worker(Encounter Only) SIEGEL JOSEPH D 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 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 1790.95 0 0 0 0 0 0 1790.95 0 0 1013840282 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2672.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2672.42 0 0 1013840530 1366706079 10 Physicians SINGH PIYUSH K 999999999 89 Rock Island 0 0 0 0 0 38 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 1786.4 0 0 0 0 0 0 0 0 4330.02 0 0 0 0 0 0 6116.42 0 0 1013840630 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2748.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2748.07 0 0 1013840837 1356710362 10 Physicians BALASURIYA RAJINDER D 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 1506.72 0 0 0 0 0 0 1506.72 0 0 1013841166 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10898.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10898.8 0 0 1013841550 1447593116 10 Physicians CORNELIUS TYLER 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 534 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8886.07 0 477.35 0 0 0 0 0 0 9363.42 0 0 1013841762 1275899155 10 Physicians BELL JASON 999999999 89 Rock Island 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 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 5170.43 0 0 0 0 0 0 5170.43 0 0 1013842050 89 Physician Assistant Only(Encounter Only) 68 Mason 0 0 0 0 0 0 0 0 0 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 0 370.27 0 0 0 0 0 0 370.27 0 0 1013842309 1336599240 10 Physicians FOSTER CATHERINE D 999999999 80 Peoria 0 0 Anesthesiology 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1666.74 0 0 0 0 0 0 1666.74 0 0 1013842428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25974.9 0 0 0 0 0 0 0 0 0 0 0 0 0 25974.9 0 0 1013842498 1881120863 10 Physicians BORDEN JOEL J 999999999 80 Peoria 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 0 171 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 2541.32 0 0 0 0 0 0 2541.32 0 0 1013842867 1114214111 10 Physicians VRASICH CHUCK 999999999 200 Cook 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 0 490.34 0 0 0 0 0 0 490.34 0 0 1013843345 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 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0 0 1013848566 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 1013848738 1225472392 10 Physicians FORYOUNG KENEDY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199.64 0 0 0 0 0 0 0 0 199.64 0 0 1013848835 1699017715 10 Physicians ROSENBERG ARI J 999999999 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 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 1556.23 0 0 0 0 0 0 1556.23 0 0 1013848954 1467004929 23 Occupational Therapists GOLDHIRSH ZOE A 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 0 543.33 543.33 0 0 1013849108 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 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 1020.35 1020.35 0 0 1013849541 1255898482 16 Nurse Practitioners KAPUSTKA BERNADETA AGNIESZKA 999999999 200 Cook 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 0 556 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 2284.42 0 0 0 0 0 0 2284.42 0 0 1013849578 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 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 0 375.16 375.16 0 0 1013850353 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 0 147 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 15038.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15038.1 0 0 1013850499 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 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 1013850519 1427409093 10 Physicians FRANCOIS MARLY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 16 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478.1 0 3446.36 0 0 0 0 0 0 3924.46 0 0 1013850675 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 418.62 0 0 0 0 0 0 418.62 0 0 1013850805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1424.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1424.66 0 0 1013851208 1093375743 24 Speech Therapists WILLIS KELLIE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013852291 86 Clinical Social Worker(Encounter Only) 87 Randolph 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1013852401 1114378213 13 Podiatrists ROESKE STEPHEN K 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 1266.41 0 0 0 0 0 0 1266.41 0 0 1013852532 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9930.06 0 0 0 0 0 0 0 0 0 0 0 0 0 9930.06 0 0 1013852534 1689232522 16 Nurse Practitioners SCHROCK SARAH 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 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provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17828.97 0 0 0 0 0 0 0 0 0 0 0 0 0 17828.97 0 0 1013854754 1508209313 10 Physicians MUSLEH AMJAD 999999999 200 Cook 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 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 0 481.8 0 0 0 0 0 0 481.8 0 0 1013854944 1336795871 16 Nurse Practitioners MASSEY SARAH E 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 0 149 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 3138.97 0 0 0 0 0 0 3138.97 0 0 1013855597 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14582.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14582.4 0 0 1013855607 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 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 0 859.28 859.28 0 0 1013855764 1942651898 10 Physicians HOLLAND DANIEL T 999999999 53 Kane 0 0 Family 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 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 0 762.62 0 0 0 0 0 0 762.62 0 0 1013855832 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1013855877 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 0 148 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 13405.15 0 0 0 0 0 0 0 0 0 0 0 0 0 13405.15 0 0 1013855973 10 Physicians 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1013856005 24 Speech Therapists 98 Tazewell 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 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 5354.13 5354.13 0 0 1013856025 1851945612 16 Nurse Practitioners DZUROVCIK MEGHAN 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 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 0 755.82 0 0 0 0 0 0 755.82 0 0 1013856408 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 24924.02 0 0 0 0 0 0 0 0 0 0 0 0 0 24924.02 0 0 1013856550 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 47.71 0 0 0 0 0 0 47.71 0 0 1013856802 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7452.39 0 0 0 0 0 0 0 0 0 0 0 0 0 7452.39 0 0 1013857855 1467012187 16 Nurse Practitioners LEADLEY ERIC J 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 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 1206.24 0 0 0 0 0 0 1206.24 0 0 1013857975 1255987418 22 Physical Therapists SESTAK CLINT T 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 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 0 614.08 614.08 0 0 1013858288 1275948192 10 Physicians NOLTING TARA 999999999 19 Champaign 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458.09 0 0 0 0 0 0 458.09 0 0 1013858488 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 0 376.84 0 0 0 0 0 0 376.84 0 0 1013859051 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 1006.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1006.16 0 0 1013859337 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31194.86 0 0 0 0 0 0 0 0 0 0 0 0 0 31194.86 0 0 1013859556 1508416272 11 Dentists HUSSEIN MOHAMMED A 999999999 200 Cook 0 0 General Dentistry 0 0 122 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 36614.22 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 37366.92 0 0 1013860070 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 0 149.83 0 0 0 0 0 0 149.83 0 0 1013860138 1134643364 10 Physicians MAFRAJI MUSTAFA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 492 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13579.39 0 158.07 0 0 0 0 0 0 13737.46 0 0 1013860326 1831465806 10 Physicians GEYNISMAN TAN JULIA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 2.18 0 2150.35 0 0 0 0 0 0 2152.53 0 0 1013860467 1356989917 16 Nurse Practitioners BOWSER LESLIE N 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 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 0 498.67 0 0 0 0 0 0 498.67 0 0 1013860673 1417513813 16 Nurse Practitioners CARTER NANCY 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 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 0 264.9 0 0 0 0 0 0 264.9 0 0 1013860801 1912496829 24 Speech Therapists TASKUNAITE DONATA 999999999 91 Sangamon 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 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23980.88 23980.88 0 0 1013860883 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 1013860912 1821632506 89 Physician Assistant Only(Encounter Only) HARTNETT ALLISON M 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 0 198.66 0 0 0 0 0 0 198.66 0 0 1013861006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17146.52 0 0 0 0 0 0 0 0 0 0 0 0 0 17146.52 0 0 1013861253 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 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 0 245.56 0 0 0 0 0 0 245.56 0 0 1013861648 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 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 1013861722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39705.56 0 0 0 0 0 0 0 0 0 0 0 0 0 39705.56 0 0 1013861782 10 Physicians 89 Rock Island 0 0 General 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 380.67 0 0 0 0 0 0 380.67 0 0 1013861802 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 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 1013862004 1013354760 10 Physicians HENGARTNER DIANA 999999999 53 Kane 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 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 0 273.82 0 0 0 0 0 0 273.82 0 0 1013862163 1023375433 10 Physicians MARTINS HAYLEY 999999999 80 Peoria 0 0 0 0 0 19 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 2062.23 0 0 0 0 0 0 0 0 2446.64 0 0 0 0 0 0 4508.87 0 0 1013862578 1477103752 57 Home Nursing Agency CARTERS CARE SERVICES 999999999 200 Cook 0 0 0 0 0 0 0 17 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1481 1449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1481 1449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 599532.3 180705.3 0 0 0 0 0 0 0 0 0 0 0 0 780237.6 0 0 1013862833 1437564804 10 Physicians TRAYLOR PHILLIP R 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 7 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8663.38 0 0 0 0 0 0 8663.38 0 0 1013862918 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22119.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22119.25 0 0 1013863190 1740847011 16 Nurse Practitioners FEILNER GREGORY S 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 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 0 538.73 0 0 0 0 0 0 538.73 0 0 1013863228 1699242131 75 Department of Alcohol and Substance Abuse Provider EGYPTIAN BEHAVIORAL HEALTH 999999999 104 Wayne 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 4589.73 0 0 4589.73 0 0 1013863479 1184190829 89 Physician Assistant Only(Encounter Only) BROWN MATTHEW D 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 662.58 0 0 0 0 0 0 662.58 0 0 1013863513 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20331.39 0 0 0 0 0 0 0 0 0 0 0 0 0 20331.39 0 0 1013863925 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23338.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23338.35 0 0 1013864407 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22409.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22409.42 0 0 1013864947 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 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 1536.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1536.36 0 0 1013865561 1700263506 10 Physicians SHEMWELL KATHRYN 999999999 106 Whiteside 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1345.53 0 0 0 0 0 0 1345.53 0 0 1013865602 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 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 1013865661 1881078392 10 Physicians CHIMATA RADHIKA LAKSHMI 999999999 200 Cook 0 0 Psychiatry 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 0 244 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 5717.53 0 0 0 0 0 0 5717.53 0 0 1013865849 1720304140 10 Physicians PORTNOY ELIZABETH 999999999 200 Cook 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.44 0 0 0 0 0 0 186.44 0 0 1013866662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27700.35 0 0 0 0 0 0 0 0 0 0 0 0 0 27700.35 0 0 1013866829 1558859025 24 Speech Therapists MILLER KELSEY DAWN 999999999 12 Bond 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40609.08 40609.08 0 0 1013867009 1053966606 16 Nurse Practitioners DELGADO JESSICA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.83 0 0 0 0 0 0 93.83 0 0 1013867158 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870.55 0 0 0 0 0 0 0 0 0 0 0 0 0 23870.55 0 0 1013867500 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 0 212.34 0 0 0 0 0 0 0 0 0 0 0 0 0 212.34 0 0 1013867626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14404.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14404.68 0 0 1013868022 1841607587 16 Nurse Practitioners RICHIE FULI 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 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 0 190.05 0 0 0 0 0 0 190.05 0 0 1013868314 1336793298 16 Nurse Practitioners VASQUEZ LISA M 999999999 200 Cook 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 0 303 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 7023.9 0 0 0 0 0 0 7023.9 0 0 1013868428 1124468129 10 Physicians JACOBS KALEB L 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 3947.67 0 0 0 0 0 0 3947.67 0 0 1013868664 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19614.32 0 0 0 0 0 0 0 0 0 0 0 0 0 19614.32 0 0 1013869392 1760801377 10 Physicians GUO CANTING 999999999 91 Sangamon 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 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 0 676.6 0 0 0 0 0 0 676.6 0 0 1013869520 1437564614 10 Physicians DECKER GREGORY M 999999999 19 Champaign 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 369.2 0 0 0 0 0 0 369.2 0 0 1013869822 1275184509 16 Nurse Practitioners BUSK LAUREN N 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 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 0 531.62 0 0 0 0 0 0 531.62 0 0 1013869913 1437718335 89 Physician Assistant Only(Encounter Only) VELLOOKUNNEL SHILPA 999999999 200 Cook 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 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 0 245.36 0 0 0 0 0 0 245.36 0 0 1013870059 1841649845 10 Physicians DEEN MUHAMMAD 999999999 200 Cook 0 0 Family Practice 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 0 125 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 1953.04 0 0 0 0 0 0 1953.04 0 0 1013870199 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4649.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4649.22 0 0 1013870406 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10531.52 0 0 0 0 0 0 0 0 0 0 0 0 0 10531.52 0 0 1013870523 1275096380 28 Waiver service provider--Supportive living facility (HFS) GRAND REGENCY OF PEORIA 999999999 80 Peoria 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2875 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 232290.8 0 0 0 0 0 0 0 0 0 0 0 0 0 232290.8 0 0 1013871050 1013250885 10 Physicians HAHN GRANT R 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 0 213 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 32288.5 0 0 0 0 0 0 32288.5 0 0 1013871100 1124402573 10 Physicians WANG WEI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 62 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1669.38 0 0 0 0 0 0 0 0 1669.38 0 0 1013871215 1003370743 16 Nurse Practitioners GAY JESSICA S 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 160.75 0 0 0 0 0 0 0 0 2732.69 0 0 0 0 0 0 2893.44 0 0 1013871494 1184966913 10 Physicians HOFFMAN JENNIFER A 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 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 3047.3 0 0 0 0 0 0 3047.3 0 0 1013871543 1366002354 16 Nurse Practitioners LEVI GEMMA 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 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 0 229.28 0 0 0 0 0 0 229.28 0 0 1013871764 1245229111 89 Physician Assistant Only(Encounter Only) MASON GRETCHEN 999999999 108 Williamson 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 0 363 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 5823.51 0 0 0 0 0 0 5823.51 0 0 1013871970 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25937.93 0 0 0 0 0 0 0 0 0 0 0 0 0 25937.93 0 0 1013872203 1831732999 55 Early Intervention Services MCTEAGUE JILL 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 0 226 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 11183.03 0 0 0 0 0 0 11183.03 0 0 1013872598 1447592019 10 Physicians DEVASSY CINDY M 999999999 107 Will 0 0 General Psychiatry Residency 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 0 142 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 3506.58 0 0 0 0 0 0 3506.58 0 0 1013872631 1952503807 10 Physicians YOUNG ZACHARY TIMOTHY 999999999 96 St Clair 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 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 1679.2 0 0 0 0 0 0 1679.2 0 0 1013872727 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 3092.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3092.87 0 0 1013872976 1477668093 89 Physician Assistant Only(Encounter Only) CUTLER DARRELL S 999999999 108 Williamson 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 0 307 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 2602.09 0 0 0 0 0 0 2602.09 0 0 1013872984 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 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 0 164.35 0 0 0 0 0 0 164.35 0 0 1013873171 1336798677 16 Nurse Practitioners ROSKA CAMLINH NGUYEN 999999999 80 Peoria 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 0 100 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 1531.34 0 0 0 0 0 0 1531.34 0 0 1013873966 1528408960 10 Physicians GIOVANNETTI ANDRES E 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 0 175 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 5778.14 0 0 0 0 0 0 5778.14 0 0 1013873998 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11483.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11483.06 0 0 1013874068 1407302607 10 Physicians GOSAI FALGUN 999999999 80 Peoria 0 0 Internal Medicine 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 0 228 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 3972.64 0 0 0 0 0 0 3972.64 0 0 1013874245 1396214201 23 Occupational Therapists DERRIG LARA 999999999 200 Cook 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 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36192.65 36192.65 0 0 1013874543 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 0 126 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 11713.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11713.6 0 0 1013874615 1427477710 10 Physicians KAHN ADAM J 999999999 30 DuPage 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 7 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.02 0 1460.9 0 0 0 0 0 0 1502.92 0 0 1013874629 1518514066 89 Physician Assistant Only(Encounter Only) MOORE VICTORIA 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 0 162.97 0 0 0 0 0 0 162.97 0 0 1013874758 89 Physician Assistant Only(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 18.21 0 0 0 0 0 0 18.21 0 0 1013874812 1801440045 16 Nurse Practitioners SENAS CARIZZA U 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 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 2651.89 0 0 0 0 0 0 2651.89 0 0 1013875038 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24184.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24184.64 0 0 1013875075 1831548478 16 Nurse Practitioners SCHLICHTING SARA 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 0 430 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 2343.5 0 0 0 0 0 0 2343.5 0 0 1013875275 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 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 0 954.8 0 0 0 0 0 0 0 0 0 0 0 0 0 954.8 0 0 1013875438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013875526 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5887.05 0 0 0 0 0 0 0 0 0 0 0 0 0 5887.05 0 0 1013875556 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 61.78 0 0 0 0 0 0 0 0 61.78 0 0 1013875597 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 0 0 0 0 0 0 0 0 0 0 1013875598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7339.52 0 0 0 0 0 0 0 0 0 0 0 0 0 7339.52 0 0 1013875709 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 4756.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4756.64 0 0 1013875856 1295186492 10 Physicians AIYASH OMAR Z 999999999 53 Kane 0 0 0 0 0 11 0 0 0 0 0 0 1 0 87 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1 0 236 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1 0 236 0 0 0 0 0 0 0 0 0 877.56 0 0 0 0 0 0 2.18 0 5734.36 0 0 0 0 0 0 6614.1 0 0 1013875965 87 Psychologist(Encounter Only) 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 1013876926 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32768.6 0 0 0 0 0 0 0 0 0 0 0 0 0 32768.6 0 0 1013877101 10 Physicians 80 Peoria 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 1013877240 1205474087 33 Nursing Facilities ELEVATE CARE IRVING PARK 999999999 200 Cook 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 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4821 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575899.82 0 0 0 0 0 0 0 575899.82 0 0 1013877651 55 Early Intervention Services 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 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 0 911.82 0 0 0 0 0 0 911.82 0 0 1013877714 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316.16 0 0 0 0 0 0 316.16 0 0 1013877808 1336633494 25 Audiologists SCHWED ALLISON 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 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 0 246.68 246.68 0 0 1013877869 11 Dentists 80 Peoria 0 0 General Dentistry 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 0 419.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419.07 0 0 1013877949 1063893949 10 Physicians THU MAUNG H L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.29 0 3868.77 0 0 0 0 0 0 3887.06 0 0 1013878049 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 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 0 190.6 0 0 0 0 0 0 190.6 0 0 1013878527 1184278301 33 Nursing Facilities HALLMARK HEALTHCARE OF CARLINV 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3010 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275810.5 0 0 0 0 0 0 0 275810.5 0 0 1013878536 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013878606 1114568367 16 Nurse Practitioners ESPOSITO CANDACE J 999999999 53 Kane 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 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 0 724.65 0 0 0 0 0 0 724.65 0 0 1013878612 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.88 0 0 0 0 0 0 14.88 0 0 1013879020 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2007.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2007.62 0 0 1013879202 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 57907.54 0 0 0 0 0 0 0 0 0 0 0 0 0 57907.54 0 0 1013879369 1396200382 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 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 0 166 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 0 600.27 0 0 0 0 0 0 0 0 600.27 0 0 1013879432 1790169126 10 Physicians MARKS LAUREN A 999999999 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 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 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 1218.75 0 0 0 0 0 0 1218.75 0 0 1013879463 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19147.79 0 0 0 0 0 0 0 0 0 0 0 0 0 19147.79 0 0 1013879883 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 846.3 0 0 0 0 0 0 0 0 0 0 0 0 0 846.3 0 0 1013879888 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 0 216.33 0 0 0 0 0 0 216.33 0 0 1013880197 1326422841 10 Physicians ROSE ALEXANDER 999999999 96 St Clair 0 0 Psychiatry 0 0 0 0 0 0 0 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 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1232.9 0 0 0 0 0 0 1232.9 0 0 1013880211 1942687603 10 Physicians CASNER TEYA C 999999999 200 Cook 0 0 Emergency Medicine 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 0 174 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 5867.5 0 0 0 0 0 0 5867.5 0 0 1013880755 1346794070 16 Nurse Practitioners CASTALDO CHANDRA 999999999 57 Lake 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 0 163 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 2418.05 0 0 0 0 0 0 2418.05 0 0 1013880858 1629545595 16 Nurse Practitioners LAWRENCE EMILY 999999999 107 Will 0 0 0 0 0 1 0 0 0 0 0 0 0 0 129 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 46.75 0 0 0 0 0 0 0 0 5666.4 0 0 0 0 0 0 5713.15 0 0 1013881224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 239.62 0 0 0 0 0 0 0 0 0 0 0 0 0 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Practitioners HOGAN MARY 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 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 1006.55 0 0 0 0 0 0 1006.55 0 0 1013883221 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 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 6996.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6996.33 0 0 1013883359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 573.35 0 0 0 0 0 0 0 0 0 0 0 0 0 573.35 0 0 1013883387 10 Physicians 200 Cook 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 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 0 135.08 0 0 0 0 0 0 135.08 0 0 1013883588 4013883588 90 Waiver service provider--Elderly (DOA) MEDTEC HLTHCRE PRIVATE DUTY 999999999 200 Cook 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138121.92 0 0 0 0 0 0 0 0 0 0 0 0 0 138121.92 0 0 1013883594 10 Physicians 47 Jackson 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 3.69 0 0 0 0 0 0 3.69 0 0 1013883740 1003336785 10 Physicians LAINE RANDY 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 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 0 561.07 0 0 0 0 0 0 561.07 0 0 1013883792 1861887358 10 Physicians KAPLAN TYLER 999999999 200 Cook 0 0 Neurology 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 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 0 623.31 0 0 0 0 0 0 623.31 0 0 1013883839 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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 12998.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12998.82 0 0 1013889018 1194036269 89 Physician Assistant Only(Encounter Only) ELLIOTT AMELIA 999999999 91 Sangamon 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 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 1908.08 0 0 0 0 0 0 1908.08 0 0 1013889246 1285138172 10 Physicians BRUCE MATTHEW J 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 0 139.76 0 0 0 0 0 0 139.76 0 0 1013889347 4013889347 72 Taxicabs and Livery Companies ETA TRANS LLC 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 3690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44579.73 0 0 0 0 0 0 44579.73 0 0 1013889644 1831757103 16 Nurse Practitioners PLACHER TRACIE 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Physicians PHYO ZAW W 999999999 63 Macon 0 0 Internal Medicine 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 0 218 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 2760.44 0 0 0 0 0 0 2760.44 0 0 1013893652 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26190.45 0 0 0 0 0 0 0 0 0 0 0 0 0 26190.45 0 0 1013894201 1962630830 10 Physicians STREET LINDA 999999999 88 Richland 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 25 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577.61 0 523.66 0 0 0 0 0 0 1101.27 0 0 1013894399 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1519 0 0 0 0 0 0 0 0 0 0 0 0 0 1519 0 0 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Physicians SHAKHSHEER BADDR 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 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 6087.74 0 0 0 0 0 0 6087.74 0 0 1013895690 1477103273 33 Nursing Facilities WASHINGTON SENIOR LIVING 999999999 98 Tazewell 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 0 234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 728104.95 0 0 0 0 0 0 0 728104.95 0 0 1013895706 1902194269 10 Physicians KURNIT KATHERINE C 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 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 0 746.43 0 0 0 0 0 0 746.43 0 0 1013895721 1104487826 11 Dentists AHMAD AHMAD 999999999 35 Ford 0 0 General Dentistry 0 0 55 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 8076.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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JOHN'S COMMUNITY PHAR 999999999 91 Sangamon 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 0 791 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169410.11 0 0 0 169410.11 0 0 1013897081 1952832750 10 Physicians GAVIN JORDAN L 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 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 0 332.92 0 0 0 0 0 0 332.92 0 0 1013897094 1639526320 10 Physicians RING CHRISTOPHER C 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 4238.1 0 0 0 0 0 0 4259.42 0 0 1013897144 1467848283 10 Physicians YOKELL MICHAEL 999999999 30 DuPage 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 0 170 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 5306.95 0 0 0 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Physician Assistant Only(Encounter Only) SNOWDEN RYAN T 999999999 19 Champaign 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 0 282 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 4040.23 0 0 0 0 0 0 4040.23 0 0 1013904366 1104897974 89 Physician Assistant Only(Encounter Only) WIGGINS LAWRENCE 999999999 200 Cook 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 0 712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9869.74 0 0 0 0 0 0 9869.74 0 0 1013904558 1932758968 16 Nurse Practitioners DOTSON SAMANTHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4858.52 0 0 0 0 0 0 4858.52 0 0 1013904900 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 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 38.66 0 0 0 0 0 0 0 0 38.66 0 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Physicians 10 Adams 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 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 1013907151 1952819310 24 Speech Therapists RAY AMBER T 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 0 508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 508 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32767.71 32767.71 0 0 1013907164 1043248503 10 Physicians MICHAELIDES ELIAS M 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 0 296 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 5678.52 0 0 0 0 0 0 5678.52 0 0 1013907271 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 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 1013908001 1427402494 10 Physicians KOWALSKI LEIGH ANN 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 18 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 833.87 0 6293.74 0 0 0 0 0 0 7127.61 0 0 1013908050 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6727.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6727.6 0 0 1013908120 1235773540 16 Nurse Practitioners ROBINSON JUDY 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 0 104.39 0 0 0 0 0 0 104.39 0 0 1013908162 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 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 1697.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1697.4 0 0 1013908172 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 13218.61 0 0 0 0 0 0 0 0 0 0 0 0 0 13218.61 0 0 1013908874 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 1013908883 1174801724 10 Physicians ZYSKOWSKI NOELIA 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1013909098 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 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 12987.44 0 0 0 0 0 0 0 0 0 0 0 0 0 12987.44 0 0 1013909307 10 Physicians 80 Peoria 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 73.4 0 0 0 0 0 0 73.4 0 0 1013909345 1073959565 10 Physicians BADAMI AMI U 999999999 200 Cook 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 0 205 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 2552.86 0 0 0 0 0 0 2552.86 0 0 1013910028 1083097695 10 Physicians MINARDI BRENDAN D 999999999 80 Peoria 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 0 157 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 5966.95 0 0 0 0 0 0 5966.95 0 0 1013910813 1679988521 10 Physicians MICHAELS JASON R 999999999 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 15 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766.78 0 572.36 0 0 0 0 0 0 1339.14 0 0 1013910901 1588048375 10 Physicians BESANTE JAMES S 999999999 19 Champaign 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 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 1441.84 0 0 0 0 0 0 1441.84 0 0 1013910976 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4632.87 0 0 0 0 0 0 0 0 0 0 0 0 0 4632.87 0 0 1013910996 10 Physicians 10 Adams 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013911572 22 Physical Therapists 54 Kankakee 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 0 993.88 993.88 0 0 1013911599 1740495654 10 Physicians BEESON DONN 999999999 89 Rock Island 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 647.99 0 0 0 0 0 0 0 0 647.99 0 0 1013911662 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 13947.67 0 0 0 0 0 0 0 0 0 0 0 0 0 13947.67 0 0 1013911679 1831755024 23 Occupational Therapists WORKMAN SUZANNE R 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 0 110 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 1874.36 1874.36 0 0 1013912076 86 Clinical Social Worker(Encounter Only) 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 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 0 150.93 0 0 0 0 0 0 150.93 0 0 1013912309 1205362977 87 Psychologist(Encounter Only) SUING KRISTEN 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 0 326 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 10099.32 0 0 0 0 0 0 10099.32 0 0 1013912384 1093241499 10 Physicians WHELAN DUSTIN 999999999 102 Warren 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 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 0 689.61 0 0 0 0 0 0 689.61 0 0 1013912498 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 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 0 210.79 0 0 0 0 0 0 210.79 0 0 1013912580 1497221543 48 Rural Health Clinics UNITYPOINT CLINIC FAMILY MEDIC 999999999 67 Marshall 0 0 0 35 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3183.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3183.94 0 0 1013912606 1649729732 10 Physicians WALAYAT SAQIB 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 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 0 234.76 0 0 0 0 0 0 234.76 0 0 1013912802 13 Podiatrists 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27.59 0 0 0 0 0 0 27.59 0 0 1013913024 1518417872 75 Department of Alcohol and Substance Abuse Provider LEYDEN FAMILY SERVICE AND MENT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54940.43 0 0 54940.43 0 0 1013913148 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22364.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22364.35 0 0 1013913549 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25781.52 0 0 0 0 0 0 0 0 0 0 0 0 0 25781.52 0 0 1013914108 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355.31 0 0 0 0 0 0 355.31 0 0 1013914165 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 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 0 695 695 0 0 1013914580 1962865675 10 Physicians RAZZAQ HUMA 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 9 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.5 0 770.21 0 0 0 0 0 0 795.71 0 0 1013914818 1811549579 33 Nursing Facilities "TERRACE, THE" 999999999 57 Lake 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462178.78 0 0 0 0 0 0 0 462178.78 0 0 1013915082 1861058950 22 Physical Therapists LYFORD PAIGE A 999999999 109 Winnebago 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 0 196 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 2079.38 2079.38 0 0 1013915217 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 1013915282 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 47.77 0 0 0 0 0 0 47.77 0 0 1013915978 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 23526.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23526.2 0 0 1013916818 1134765738 89 Physician Assistant Only(Encounter Only) LETKO CHELSY 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 93.3 0 0 0 0 0 0 93.3 0 0 1013917020 1679724058 10 Physicians SINGH ALBERT G 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 0 411 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 3919.77 0 0 0 0 0 0 3919.77 0 0 1013917132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1519.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1519.74 0 0 1013917494 1376191981 16 Nurse Practitioners STEPHENS SARA 999999999 200 Cook 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 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149321.86 0 0 0 0 0 0 149321.86 0 0 1013917720 1699248526 89 Physician Assistant Only(Encounter Only) DZIERZANOWSKI MONIKA 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 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 0 279.08 0 0 0 0 0 0 279.08 0 0 1013918456 10 Physicians 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 62.74 0 0 0 0 0 0 62.74 0 0 1013918467 1124678529 30 General Hospitals DIALYZE DIRECT IL- SHELBYVILLE 999999999 94 Shelby DIALYSIS Outpatient dialysis centers. 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13781.52 0 0 0 0 0 13781.52 0 0 1013918549 1295140820 10 Physicians JANJUA MUHAMMAD 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 1 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6150.09 0 0 0 0 0 0 6150.09 0 0 1013918567 1407288996 10 Physicians BERBARI BACHIR 999999999 47 Jackson 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 0 298 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 3512.51 0 0 0 0 0 0 3512.51 0 0 1013918615 1922093731 10 Physicians PARKS FRANK B 999999999 91 Sangamon 0 0 Emergency 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 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 2789.43 0 0 0 0 0 0 2789.43 0 0 1013918843 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 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 8627.34 0 0 0 0 0 0 0 0 0 0 0 0 0 8627.34 0 0 1013919192 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2153.04 2153.04 0 0 1013919230 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 1861.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1861.86 0 0 1013919985 1134462377 10 Physicians ARAIN ERUM A 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 2 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4784.81 0 0 0 0 0 0 4784.81 0 0 1013920302 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 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 11899.44 0 0 0 0 0 0 0 0 0 0 0 0 0 11899.44 0 0 1013920349 1891352126 16 Nurse Practitioners ACKERMAN EMILY 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 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 1304.71 0 0 0 0 0 0 1304.71 0 0 1013920559 4013920559 72 Taxicabs and Livery Companies LIFE TRANSPORTATION COMPANY 999999999 96 St Clair 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 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28170.16 0 0 0 0 0 0 28170.16 0 0 1013920790 1346686649 10 Physicians MANNARINO CANDACE 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 0 263 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 45724.17 0 0 0 0 0 0 45724.17 0 0 1013920937 1366092876 89 Physician Assistant Only(Encounter Only) CURTIN MARGARET A 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 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 1508.71 0 0 0 0 0 0 1508.71 0 0 1013921206 1952867681 16 Nurse Practitioners VITALE MELISSA M 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 0 103 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 2831.04 0 0 0 0 0 0 2831.04 0 0 1013921324 1821645664 16 Nurse Practitioners QUEZADA JESSICA M 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 0 139 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 0 443.75 0 0 0 0 0 0 443.75 0 0 1013921528 1407086283 10 Physicians JOHNSON CHRISTOPHER K 999999999 24 Coles 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5849.36 0 0 0 0 0 0 5849.36 0 0 1013921657 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 0 232 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 15103.77 0 0 0 0 0 0 0 0 0 0 0 0 0 15103.77 0 0 1013921742 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 0 114.67 0 0 0 0 0 0 0 0 0 0 0 0 0 114.67 0 0 1013921802 1588014716 10 Physicians FERNANDEZ DANIEL 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 577.35 0 0 0 0 0 0 577.35 0 0 1013921926 1902946759 89 Physician Assistant Only(Encounter Only) VANVOOREN MARIANNE 999999999 89 Rock Island 0 0 0 0 0 7 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 411.63 0 0 0 0 0 0 0 0 895.45 0 0 0 0 0 0 1307.08 0 0 1013922006 10 Physicians 80 Peoria 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 1013922341 1982040069 10 Physicians MCILWEE BRIDGET 999999999 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.52 0 0 0 0 0 0 62.52 0 0 1013922779 55 Early Intervention Services 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.72 0 0 0 0 0 0 105.72 0 0 1013922935 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 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 8801.12 0 0 0 0 0 0 0 0 0 0 0 0 0 8801.12 0 0 1013923134 1992153142 10 Physicians PATEL DHAVAL K 999999999 30 DuPage 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 0 235 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 1379.95 0 0 0 0 0 0 1379.95 0 0 1013923298 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 15480.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15480.6 0 0 1013923321 1669031597 16 Nurse Practitioners ROBINSON JENNIFER L 999999999 57 Lake 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 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 48.79 0 0 0 0 0 0 48.79 0 0 1013923358 1407201940 10 Physicians CRAWFORD ALYSSA F 999999999 37 Fulton 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4191.96 0 0 0 0 0 0 4191.96 0 0 1013923485 1205210150 10 Physicians MURALA SAMUEL S 999999999 108 Williamson 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 102.21 0 0 0 0 0 0 102.21 0 0 1013923777 1235593476 10 Physicians ANSELIN EMMA 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 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 2896.69 0 0 0 0 0 0 2896.69 0 0 1013923827 87 Psychologist(Encounter Only) 51 Jo Daviess 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1013923895 1104287028 10 Physicians SHEAR TALIA 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 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 1469.67 0 0 0 0 0 0 1469.67 0 0 1013924489 21 Licensed Practical Nurses 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 0 119.71 0 0 0 0 0 0 119.71 0 0 1013924621 1538586904 10 Physicians PUROHIT REEGA 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 2317 0 0 0 0 0 0 2317 0 0 1013924658 1144712100 30 General Hospitals FRESENIUS MEDICAL CARE SPRINGF 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3996.79 0 0 0 0 0 3996.79 0 0 1013924684 1194108712 10 Physicians TAIWO OLUFEYISAYO 999999999 49 Jefferson 0 0 0 0 0 2 0 0 0 0 0 0 95 0 63 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 238 0 85 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 238 0 85 0 0 0 0 0 0 0 0 0 85.17 0 0 0 0 0 0 8800.56 0 13400.14 0 0 0 0 0 0 22285.87 0 0 1013924728 1588112940 24 Speech Therapists SUVEG JACLYN ALYSSE 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30878.88 30878.88 0 0 1013924757 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11713.46 0 0 0 0 0 0 0 0 0 0 0 0 0 11713.46 0 0 1013924820 1265894711 10 Physicians WOJCIECHOWSKI AMANDA J 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 2 0 38 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 2 0 74 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 2 0 74 0 0 0 0 0 0 0 0 0 534.88 0 0 0 0 0 0 7.35 0 2279.04 0 0 0 0 0 0 2821.27 0 0 1013924947 1730421561 10 Physicians TSAMBARLIS PETER 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 4 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.36 0 4562.12 0 0 0 0 0 0 4566.48 0 0 1013924963 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 625.18 0 0 0 0 0 0 0 0 0 0 0 0 0 625.18 0 0 1013924981 1215409438 16 Nurse Practitioners PRETTO TAYLOR 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 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 89.99 0 0 0 0 0 0 89.99 0 0 1013925308 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 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 1013925371 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1013925456 1235344433 10 Physicians LILLIG MATHIAS J 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 19 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 8402.96 0 0 0 0 0 0 8402.96 0 0 1013925485 1528315959 10 Physicians HASAN RIM 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.07 0 0 0 0 0 0 93.07 0 0 1013925514 1578129987 16 Nurse Practitioners PALMER TRACY A 999999999 80 Peoria 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 84.62 0 0 0 0 0 0 0 0 635.37 0 0 0 0 0 0 719.99 0 0 1013925528 1558637124 10 Physicians DAVILA DANIEL G 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 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 1189.8 0 0 0 0 0 0 1189.8 0 0 1013925587 1649624644 10 Physicians MARCUS ZACHARY ALESSANDRO 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 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 0 120.22 0 0 0 0 0 0 0 0 294.98 0 0 0 0 0 0 415.2 0 0 1013925765 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 0 150 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 15650.04 0 0 0 0 0 0 0 0 0 0 0 0 0 15650.04 0 0 1013925908 1598228488 16 Nurse Practitioners DEMEULENAERE KATHERINE 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 0 198 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 5855.52 0 0 0 0 0 0 5855.52 0 0 1013926088 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 0 124 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 15808.48 0 0 0 0 0 0 0 0 0 0 0 0 0 15808.48 0 0 1013926179 1275038226 89 Physician Assistant Only(Encounter Only) ALLISON ROBERT 999999999 62 Logan 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 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 1087.14 0 0 0 0 0 0 1087.14 0 0 1013926212 1649736174 16 Nurse Practitioners RUEFF MANDY 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 64.7 0 0 0 0 0 0 64.7 0 0 1013926430 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1013926452 10 Physicians 30 DuPage 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 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 1013926732 1568800183 10 Physicians PURAM SIDHARTH 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 15 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 8505.63 0 0 0 0 0 0 8505.63 0 0 1013927142 1225296411 10 Physicians SALHAB SAMER 999999999 107 Will 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 241.54 0 0 0 0 0 0 0 0 241.54 0 0 1013927914 1831745058 55 Early Intervention Services GANDY SHARON 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 3105.56 0 0 0 0 0 0 3105.56 0 0 1013928102 1477113348 16 Nurse Practitioners FRECKLETON ABBY G 999999999 60 Lee 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 0 101 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 1738.47 0 0 0 0 0 0 1738.47 0 0 1013928331 1861834152 10 Physicians EL KOUZI AHMAD L 999999999 19 Champaign 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 0 214 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 7473.08 0 0 0 0 0 0 7473.08 0 0 1013928695 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 0 213 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 28849.81 0 0 0 0 0 0 0 0 0 0 0 0 0 28849.81 0 0 1013929019 4013929019 90 Waiver service provider--Elderly (DOA) ASSYRIAN UNIVERSAL ALLIANCE FO 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 1497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111304.05 0 0 0 0 0 0 0 0 0 0 0 0 0 111304.05 0 0 1013929029 1730735879 16 Nurse Practitioners THOMAS PATRICIA 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 80.23 0 0 0 0 0 0 80.23 0 0 1013929053 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19471.43 0 0 0 0 0 0 0 0 0 0 0 0 0 19471.43 0 0 1013929230 1790028801 10 Physicians NICHOLS JENNIFER L 999999999 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 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 0 779.64 0 0 0 0 0 0 779.64 0 0 1013929391 1336799683 22 Physical Therapists JURCIK DYLAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156 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 1319.37 1319.37 0 0 1013929645 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 57.77 0 0 0 0 0 0 57.77 0 0 1013929734 1215235411 16 Nurse Practitioners FRICK MELISSA 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 0 165 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 5440.07 0 0 0 0 0 0 5440.07 0 0 1013929961 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.44 149.44 0 0 1013930618 1407235021 91 Waiver service provider--Adults (DHS/DDD) JORDAN SAMUEL 999999999 91 Sangamon 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 0 555 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 46592.09 0 0 0 0 0 0 0 0 0 0 0 0 0 46592.09 0 0 1013930972 1295057610 10 Physicians OFISI JOSEPH 999999999 200 Cook 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 3279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11966.59 0 0 0 0 0 0 11966.59 0 0 1013931415 10 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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 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 5742.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5742.77 0 0 1013932090 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 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 0 278.4 0 0 0 0 0 0 278.4 0 0 1013932326 1821645607 16 Nurse Practitioners MCNAUGHT MA BENIROSE 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 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 162.49 0 0 0 0 0 0 0 0 317.58 0 0 0 0 0 0 480.07 0 0 1013932588 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20202.9 0 0 0 0 0 0 0 0 0 0 0 0 0 20202.9 0 0 1013932828 94 Waiver service provider--Children's 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2219.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2219.55 0 0 1013942321 1225697634 16 Nurse Practitioners VENEZIA KATHERYN 999999999 46 Iroquois 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 0 151 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 2210.76 0 0 0 0 0 0 2210.76 0 0 1013942594 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 16431.55 0 0 0 0 0 0 0 0 0 0 0 0 0 16431.55 0 0 1013942769 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14910.63 0 0 0 0 0 0 0 0 0 0 0 0 0 14910.63 0 0 1013942923 1932740305 16 Nurse Practitioners FRERICHS JANICE 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 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 0 993.59 0 0 0 0 0 0 993.59 0 0 1013943638 1134684715 16 Nurse Practitioners BARKER ASHLEY R 999999999 19 Champaign 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 0 135 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 6763.05 0 0 0 0 0 0 6763.05 0 0 1013944067 1174096028 60 Pharmacies POLO PHARMACY 999999999 79 Ogle 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 0 466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13161.97 0 0 0 13161.97 0 0 1013944086 1548518665 16 Nurse Practitioners BELL LINDSEY 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 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 0 412.72 0 0 0 0 0 0 412.72 0 0 1013944124 1164884227 10 Physicians SINGH NAMRATA 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 0 179 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 3912.36 0 0 0 0 0 0 3912.36 0 0 1013944317 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18200.23 0 0 0 0 0 0 0 0 0 0 0 0 0 18200.23 0 0 1013944640 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 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 2002.99 2002.99 0 0 1013944807 1295091270 10 Physicians YOO TAEHWAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.45 0 2183.63 0 0 0 0 0 0 2219.08 0 0 1013944821 1265081681 16 Nurse Practitioners CULLOR JUDY L 999999999 97 Stephenson 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 0 103 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 1389.65 0 0 0 0 0 0 1389.65 0 0 1013945358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23637.23 0 0 0 0 0 0 0 0 0 0 0 0 0 23637.23 0 0 1013945511 1518433663 48 Rural Health Clinics UNITYPOINT CLINIC FAMILY MEDIC 999999999 80 Peoria 0 0 0 103 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10395.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10395.56 0 0 1013945534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24325.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24325.7 0 0 1013945803 1841385184 10 Physicians FRALEY ALEXANDER 999999999 200 Cook 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 10 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.21 0 4340.58 0 0 0 0 0 0 4358.79 0 0 1013945982 1912240466 10 Physicians CATARINICCHIA SALVATORE P 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 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 0 747.82 0 0 0 0 0 0 747.82 0 0 1013946303 1962452755 63 Other Providers of Medical Equipment/Supplies (Non-registered) ATOS MEDICAL INC 999999999 852 Wisconsin 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 0 323 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 15905.05 0 0 0 0 0 0 15905.05 0 0 1013946354 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39605.44 0 0 0 0 0 0 0 0 0 0 0 0 0 39605.44 0 0 1013946599 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 1013946857 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14793.94 0 0 0 0 0 0 0 0 0 0 0 0 0 14793.94 0 0 1013946998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8500.77 0 0 0 0 0 0 0 0 0 0 0 0 0 8500.77 0 0 1013947240 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17032.95 0 0 0 0 0 0 0 0 0 0 0 0 0 17032.95 0 0 1013947449 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 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 1013947520 1841585809 10 Physicians DOMBROWSKI MICHAEL M 999999999 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.09 0 3667.49 0 0 0 0 0 0 3789.58 0 0 1013947574 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013947679 1558918409 16 Nurse Practitioners MALINOWSKI CHAD 999999999 19 Champaign 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 0 148 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 3250.97 0 0 0 0 0 0 3250.97 0 0 1013947892 1962054619 33 Nursing Facilities JOLIET TERRACE 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 3032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287724.02 0 0 0 0 0 0 0 287724.02 0 0 1013948377 1659767838 10 Physicians TIU JONATHAN 999999999 91 Sangamon 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 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 0 738.19 0 0 0 0 0 0 738.19 0 0 1013948454 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11851.32 0 0 0 0 0 0 0 0 0 0 0 0 0 11851.32 0 0 1013948847 10 Physicians 53 Kane 0 0 Vascular 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 5.27 0 0 0 0 0 0 5.27 0 0 1013948908 1295180016 10 Physicians MUSTAQUE TAHSIN 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 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 0 308.16 0 0 0 0 0 0 308.16 0 0 1013948934 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 437.5 0 0 0 0 0 0 0 0 0 0 0 0 0 437.5 0 0 1013949300 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 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 1259.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1259.35 0 0 1013949302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.35 0 0 0 0 0 0 0 0 0 0 0 0 0 156.35 0 0 1013949582 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16545.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16545.66 0 0 1013949646 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15889.28 0 0 0 0 0 0 0 0 0 0 0 0 0 15889.28 0 0 1013950157 1730748575 33 Nursing Facilities FAIRVIEW REHAB & HEALTHCARE 999999999 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134007.82 0 0 0 0 0 0 0 134007.82 0 0 1013950871 1336659523 16 Nurse Practitioners JONES JENNIFER L 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 0 132 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 0 628.32 0 0 0 0 0 0 628.32 0 0 1013951023 1629495676 10 Physicians KRINGS JAMES G 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 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 0 886.8 0 0 0 0 0 0 886.8 0 0 1013951638 1841765765 89 Physician Assistant Only(Encounter Only) ROUNDS KATHERINE A 999999999 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 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 0 396.33 0 0 0 0 0 0 396.33 0 0 1013952119 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 12306.91 0 0 0 0 0 0 0 0 0 0 0 0 0 12306.91 0 0 1013952137 1437706876 16 Nurse Practitioners JEPSON KELLI 999999999 106 Whiteside 0 0 0 0 0 1 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 1 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 1246.51 0 0 0 0 0 0 1246.51 0 0 1013952317 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 0 948.21 0 0 0 0 0 0 948.21 0 0 1013952501 1528621265 16 Nurse Practitioners SHUTT TARA 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377.45 0 0 0 0 0 0 377.45 0 0 1013952531 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22069.71 0 0 0 0 0 0 0 0 0 0 0 0 0 22069.71 0 0 1013952622 1043528540 10 Physicians YOON RACHEL W 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 80.51 0 798.21 0 0 0 0 0 0 878.72 0 0 1013952853 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11949.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11949.52 0 0 1013953489 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 0 177 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 14212.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14212.44 0 0 1013953719 10 Physicians 96 St Clair 0 0 Ophthalmology 0 0 0 0 0 0 0 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 19 0 0 0 0 0 0 19 0 0 1013953763 1801258454 10 Physicians DAHL LISA D 999999999 200 Cook 0 0 0 0 0 10 0 0 0 0 0 0 3 0 56 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 3 0 80 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 3 0 80 0 0 0 0 0 0 0 0 0 672.2 0 0 0 0 0 0 12.94 0 1780.37 0 0 0 0 0 0 2465.51 0 0 1013953857 1124253935 10 Physicians STEY ANNE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.96 0 6765.8 0 0 0 0 0 0 6829.76 0 0 1013953940 1285294835 89 Physician Assistant Only(Encounter Only) MCCAULEY TYLER 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 0 702.57 0 0 0 0 0 0 702.57 0 0 1013954107 1881253490 91 Waiver service provider--Adults (DHS/DDD) HOLLIE JOSHUA R 999999999 91 Sangamon 0 0 0 0 0 0 0 19 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 19099.2 0 0 0 0 0 0 0 0 0 0 0 0 0 19099.2 0 0 1013954476 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 0 224.68 0 0 0 0 0 0 224.68 0 0 1013954556 10 Physicians 56 Knox 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 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3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132 0 0 0 0 0 0 1132 0 0 1013956211 10 Physicians 19 Champaign 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 67.22 0 0 0 0 0 0 67.22 0 0 1013956473 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1993.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1993.98 0 0 1013956574 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013956659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3439.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3439.62 0 0 1013956803 1508156803 10 Physicians HSIEH LILY BAI 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 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 4760.43 0 0 0 0 0 0 4760.43 0 0 1013956823 1093102683 10 Physicians HUTCHERSON LORI 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 1464.28 0 0 0 0 0 0 1464.28 0 0 1013956850 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013957131 10 Physicians 30 DuPage 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 0.44 0 0 0 0 0 0 0.44 0 0 1013957201 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861.12 0 0 0 0 0 0 0 0 0 0 0 0 0 861.12 0 0 1013957417 1699234195 16 Nurse Practitioners MARVIN HEATHER 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 293.61 0 0 0 0 0 0 0 0 1677.85 0 0 0 0 0 0 1971.46 0 0 1013957649 1841686789 10 Physicians DORFMAN JULIE R 999999999 30 DuPage 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 13 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 221.62 0 0 0 0 0 0 0 0 308.31 0 0 0 0 0 0 529.93 0 0 1013957853 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24346.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24346.57 0 0 1013957880 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23619.87 0 0 0 0 0 0 0 0 0 0 0 0 0 23619.87 0 0 1013958588 1457913683 16 Nurse Practitioners JONES ASHLEY K 999999999 72 McLean 0 0 0 0 0 5 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 8 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 23 0 0 0 0 0 0 0 0 0 207.5 0 0 0 0 0 0 0 0 1628.99 0 0 0 0 0 0 1836.49 0 0 1013958851 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 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 0 676.86 676.86 0 0 1013958871 1497012694 10 Physicians ROXBURY CHRISTOPHER 999999999 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 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 1788.09 0 0 0 0 0 0 1788.09 0 0 1013959028 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5564.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5564.58 0 0 1013959039 10 Physicians 80 Peoria 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 0 0 0 0 0 0 0 0 0 0 1013959249 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5535.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5535.2 0 0 1013959744 1780231134 16 Nurse Practitioners RODRIGUEZ LINDSAY 999999999 106 Whiteside 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 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 0 190.71 0 0 0 0 0 0 190.71 0 0 1013960343 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 0 188 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 5394.22 0 0 0 0 0 0 0 0 0 0 0 0 0 5394.22 0 0 1013960402 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 0 553.05 0 0 0 0 0 0 0 0 0 0 0 0 0 553.05 0 0 1013960772 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6147.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6147.24 0 0 1013960853 1568843209 10 Physicians HAMOUDAH THAYER 999999999 53 Kane 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 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 1174 0 0 0 0 0 0 1174 0 0 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1225455942 16 Nurse Practitioners ASHTON LORYN A 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 113.86 0 0 0 0 0 0 0 0 1321.88 0 0 0 0 0 0 1435.74 0 0 1013961567 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24464.47 0 0 0 0 0 0 0 0 0 0 0 0 0 24464.47 0 0 1013961948 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 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 0 138.94 138.94 0 0 1013961982 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1177.72 0 0 1013962094 1750843322 16 Nurse Practitioners TAYLOR CAROL 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 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 0 163.31 0 0 0 0 0 0 163.31 0 0 1013962182 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13867.15 0 0 0 0 0 0 0 0 0 0 0 0 0 13867.15 0 0 1013962346 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 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 7112.65 0 0 0 0 0 0 0 0 0 0 0 0 0 7112.65 0 0 1013962356 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1013962619 10 Physicians 200 Cook 0 0 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1013964988 1669025672 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6480.5 0 0 6480.5 0 0 1013965645 1588925515 10 Physicians BUCHOLZ ELEANOR 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 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 4423.42 0 0 0 0 0 0 4423.42 0 0 1013966187 1801351952 48 Rural Health Clinics COMMUNITY MEDICAL CLINIC OF TA 999999999 37 Fulton 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2192.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2192.31 0 0 1013966294 1114376423 55 Early Intervention Services BORMANN ELIZABETH A 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 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46269.68 0 0 0 0 0 0 46269.68 0 0 1013966324 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 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 1644.1 1644.1 0 0 1013966524 1437210341 10 Physicians CHERNECKY RICHARD 999999999 200 Cook 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 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 0 798.86 0 0 0 0 0 0 798.86 0 0 1013966780 1265903876 30 General Hospitals DIALYZE DIRECT IL-GLEN ELLYN 999999999 30 DuPage DIALYSIS Outpatient dialysis centers. 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 0 568 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5971 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67791.32 0 0 0 0 0 67791.32 0 0 1013967073 1598020174 10 Physicians DOUGLAS JASON K 999999999 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 4844.48 0 0 0 0 0 0 4844.48 0 0 1013967250 1215581848 16 Nurse Practitioners PIATIGORSKY LISA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 12.88 0 0 0 0 0 0 0 0 1970.47 0 0 0 0 0 0 1983.35 0 0 1013967272 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23970.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23970.1 0 0 1013967864 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 1013968032 1790063949 10 Physicians KANG HEESUNG 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 0 101 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 8153.93 0 0 0 0 0 0 8153.93 0 0 1013968154 10 Physicians 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 1013968337 1023372380 10 Physicians GROVER PRATEEK 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 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 0 217.83 0 0 0 0 0 0 217.83 0 0 1013968529 1780078337 10 Physicians FILIPPO MATTHEW J 999999999 200 Cook 0 0 Psychiatry 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 0 246 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 7549.04 0 0 0 0 0 0 7549.04 0 0 1013968714 30 General Hospitals 30 DuPage 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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Physicians GAZI SADIA K 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 0 206 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 1776.98 0 0 0 0 0 0 1776.98 0 0 1013970287 1699201160 10 Physicians SAID MOHAMED A 999999999 80 Peoria 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 0 111 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 1845.89 0 0 0 0 0 0 1845.89 0 0 1013970862 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24878.45 0 0 0 0 0 0 0 0 0 0 0 0 0 24878.45 0 0 1013971013 1417361072 10 Physicians KOPECKY BENJAMIN 999999999 109 Winnebago 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 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.67 0 0 0 0 0 0 0 0 20.67 0 0 1013971039 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25062.6 0 0 0 0 0 0 0 0 0 0 0 0 0 25062.6 0 0 1013971118 1437602430 10 Physicians HUBBARD ELIZABETH L 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 0 196 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 1681.76 0 0 0 0 0 0 1681.76 0 0 1013971124 1619514353 16 Nurse Practitioners SPATA HOLLI 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 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 3842.83 0 0 0 0 0 0 3842.83 0 0 1013971965 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15221.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15221.8 0 0 1013972075 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8250.04 0 0 0 0 0 0 0 0 0 0 0 0 0 8250.04 0 0 1013972303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5094.05 0 0 0 0 0 0 0 0 0 0 0 0 0 5094.05 0 0 1013972984 1467925149 89 Physician Assistant Only(Encounter Only) HOEPFNER BREANNA L 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 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 79.56 0 0 0 0 0 0 79.56 0 0 1013973116 1356793459 10 Physicians ONI OMOMENGBE 999999999 80 Peoria 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 278.85 0 0 0 0 0 0 0 0 899.34 0 0 0 0 0 0 1178.19 0 0 1013973223 1225687734 16 Nurse Practitioners PINGER TIFFANY K 999999999 80 Peoria 0 0 0 0 0 21 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 1824.01 0 0 0 0 0 0 0 0 1173.92 0 0 0 0 0 0 2997.93 0 0 1013973242 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5426.82 0 0 0 0 0 0 0 0 0 0 0 0 0 5426.82 0 0 1013973753 1700429362 16 Nurse Practitioners BROWN LISA 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 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 0 458.66 0 0 0 0 0 0 458.66 0 0 1013974237 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4286.28 0 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0 0 0 0 0 0 0 0 0 0 0 19.85 0 0 0 0 0 0 19.85 0 0 1013975203 1700231420 10 Physicians AZMAT SHAZIA 999999999 30 DuPage 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 0 101 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 2051.29 0 0 0 0 0 0 2051.29 0 0 1013975350 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.62 0 0 0 0 0 0 130.62 0 0 1013975354 1245882992 33 Nursing Facilities FRANKFORT TERRACE 999999999 107 Will 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 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4786 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 465010.74 0 0 0 0 0 0 0 465010.74 0 0 1013975625 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 0 586.7 0 0 0 0 0 0 586.7 0 0 1013975858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2726.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2726.9 0 0 1013976198 1184945206 10 Physicians LARA REBECCA 999999999 53 Kane 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 1 0 65 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 153 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 153 0 0 0 0 0 0 0 0 0 305.48 0 0 0 0 0 0 5.22 0 1995.75 0 0 0 0 0 0 2306.45 0 0 1013976623 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 0 278 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 32983.28 0 0 0 0 0 0 0 0 0 0 0 0 0 32983.28 0 0 1013976878 1184126732 89 Physician Assistant Only(Encounter Only) WATKINS SHEILA R 999999999 24 Coles 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 0 115 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 3695.96 0 0 0 0 0 0 3695.96 0 0 1013977189 1073163465 30 General Hospitals DIALYZE DIRECT IL - OAK PARK 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 529 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 5826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99803.51 0 0 0 0 0 99803.51 0 0 1013977288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 527.11 0 0 0 0 0 0 0 0 0 0 0 0 0 527.11 0 0 1013977633 24 Speech Therapists 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 10910.6 10910.6 0 0 1013977728 1578117339 11 Dentists DANIEL ALEX 999999999 200 Cook 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 889 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 889 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 28732.77 0 0 0 0 0 0 0 0 0 0 0 7150.65 0 0 0 0 35883.42 0 0 1013977861 1447808928 22 Physical Therapists KERR JESSICA A 999999999 200 Cook 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 0 183 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 12833.03 12833.03 0 0 1013977930 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 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 1782.15 1782.15 0 0 1013978031 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.31 0 0 0 0 0 0 0 0 102.31 0 0 1013978070 1194190975 16 Nurse Practitioners YOHALEM OLGA 999999999 200 Cook 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 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584.1 0 0 0 0 0 0 584.1 0 0 1013978548 4013978548 72 Taxicabs and Livery Companies AIG TRANSPORTATION LLC 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 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4956.7 0 0 0 0 0 0 4956.7 0 0 1013978949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4170.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4170.74 0 0 1013978984 1790240489 60 Pharmacies ST. JUDE PHARMACY 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 21399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327.11 0 0 21501.76 0 0 0 21828.87 0 0 1013979337 1972152874 16 Nurse Practitioners ZIMMERMANN AMANDA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 0 402.54 0 0 0 0 0 0 402.54 0 0 1013979798 1093110827 89 Physician Assistant Only(Encounter Only) MILLS JENNIFER 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 0 0 0 0 0 0 0 0 0 0 1013979982 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1013980065 1982163085 16 Nurse Practitioners BABAWALE BASHIRU 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 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 0 737.91 0 0 0 0 0 0 737.91 0 0 1013980294 1851504211 16 Nurse Practitioners VOTAPKA LAURA 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 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 54.23 0 0 0 0 0 0 54.23 0 0 1013980758 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 23352.01 0 0 0 0 0 0 0 0 0 0 0 0 0 23352.01 0 0 1013981044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 933.1 0 0 0 0 0 0 0 0 0 0 0 0 0 933.1 0 0 1013981067 1871955914 10 Physicians PARIKH VRATI 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Cook 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 769.19 0 0 0 0 0 0 0 0 1501.85 0 0 0 0 0 0 2271.04 0 0 1013981501 1144755208 55 Early Intervention Services SANCES BETH C 999999999 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 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23546.86 0 0 0 0 0 0 23546.86 0 0 1013981586 55 Early Intervention Services 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4149.05 0 0 0 0 0 0 4149.05 0 0 1013981765 1275095176 16 Nurse Practitioners LEWIS FAITH A 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 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 0 366.04 0 0 0 0 0 0 366.04 0 0 1013981779 1588229413 25 Audiologists VOKAC SHANNON R 999999999 57 Lake 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 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 48.13 48.13 0 0 1013982164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25564.66 0 0 0 0 0 0 0 0 0 0 0 0 0 25564.66 0 0 1013982901 1437593613 10 Physicians ADEBAYO-ADONIS OLUWAFUNMILAYO 999999999 31 Edgar 0 0 Anesthesiology 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 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 3158.8 0 0 0 0 0 0 3158.8 0 0 1013982975 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16061.42 0 0 0 0 0 0 0 0 0 0 0 0 0 16061.42 0 0 1013983158 1487031068 10 Physicians CHEUNG KHENYIAN 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 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 0 244.03 0 0 0 0 0 0 244.03 0 0 1013983600 1316386733 10 Physicians CHOY BONNIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 89 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1828.9 0 147.46 0 0 0 0 0 0 1976.36 0 0 1013983880 1255782082 10 Physicians SAMRA TSAHI 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 0 146 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 2148.57 0 0 0 0 0 0 2148.57 0 0 1013984361 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 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 0 710.43 0 0 0 0 0 0 710.43 0 0 1013984499 1346702669 60 Pharmacies HOWARD BROWN HEALTH 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25503.01 0 0 0 25503.01 0 0 1013984665 55 Early Intervention Services 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1173.1 0 0 0 0 0 0 1173.1 0 0 1013984920 1730658147 16 Nurse Practitioners BURNETTE SUSAN 999999999 106 Whiteside 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 0 128 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 2148.3 0 0 0 0 0 0 2212.6 0 0 1013984948 1417334087 10 Physicians HOSAIN YASER SAJID 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 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 0 703.14 0 0 0 0 0 0 703.14 0 0 1013984968 1306407861 16 Nurse Practitioners ESPARZA JULIO 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 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 1148.42 0 0 0 0 0 0 1148.42 0 0 1013985468 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 92.5 0 0 0 0 0 0 92.5 0 0 1013986426 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 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 0 938.64 0 0 0 0 0 0 0 0 0 0 0 0 0 938.64 0 0 1013986474 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16578.8 0 0 0 0 0 0 0 0 0 0 0 0 0 16578.8 0 0 1013986550 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 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 7602.68 0 0 0 0 0 0 0 0 0 0 0 0 0 7602.68 0 0 1013986645 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 0 293.38 0 0 0 0 0 0 293.38 0 0 1013986666 11 Dentists 200 Cook 0 0 General Dentistry 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 0 152.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.92 0 0 1013986897 1023662095 91 Waiver service provider--Adults (DHS/DDD) TWEEDY RICHARD G 999999999 99 Union 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 1771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1771 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152211.5 0 0 0 0 0 0 0 0 0 0 0 0 0 152211.5 0 0 1013986909 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.47 0 0 0 0 0 0 52.47 0 0 1013987144 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4158.15 0 0 0 0 0 0 0 0 0 0 0 0 0 4158.15 0 0 1013987248 10 Physicians 30 DuPage 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 0 149.84 0 0 0 0 0 0 149.84 0 0 1013987395 1790346526 86 Clinical Social Worker(Encounter Only) AUKSTUOLIS MARTYNAS 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 0 159 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 0 482.96 0 0 0 0 0 0 482.96 0 0 1013987755 1174059612 10 Physicians COURI FELICIA S 999999999 80 Peoria 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 0 103 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 2307.21 0 0 0 0 0 0 2307.21 0 0 1013987859 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 0 107.97 0 0 0 0 0 0 107.97 0 0 1013988126 1689818577 16 Nurse Practitioners LONDRES JOSEPHINE 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 51.52 0 0 0 0 0 0 0 0 906.43 0 0 0 0 0 0 957.95 0 0 1013988350 1548788342 16 Nurse Practitioners WILSON LAURA A 999999999 91 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 5 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 49.6 0 0 0 0 0 0 0 0 953.03 0 0 0 0 0 0 1002.63 0 0 1013988444 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 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1013992649 1508218751 11 Dentists PATEL KRUSHAN 999999999 63 Macon 0 0 General Dentistry 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 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1980 0 0 1013992778 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25491.84 0 0 0 0 0 0 0 0 0 0 0 0 0 25491.84 0 0 1013993390 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 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 0 217.98 217.98 0 0 1013993552 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6906.21 0 0 0 0 0 0 0 0 0 0 0 0 0 6906.21 0 0 1013993834 1891345518 16 Nurse Practitioners SPARENBERG KIMBERLY 999999999 200 Cook 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 0 904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 904 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6908.66 0 0 0 0 0 0 6908.66 0 0 1013994011 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.4 0 0 0 0 0 0 141.4 0 0 1013994345 1780232926 16 Nurse Practitioners ARTNER REBECCA 999999999 109 Winnebago 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 0 278 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 5372.9 0 0 0 0 0 0 5372.9 0 0 1013994712 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 47.62 0 0 0 0 0 0 47.62 0 0 1013994807 1780141234 16 Nurse Practitioners WILLBARGER MORGAN T 999999999 54 Kankakee 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 6483.55 0 0 0 0 0 0 6483.55 0 0 1014002238 1265931562 23 Occupational Therapists LINES EVAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512.74 512.74 0 0 1014002404 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 1014002720 1154784809 10 Physicians ADEYEMI ADETOUN 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 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4433.49 0 0 0 0 0 0 4433.49 0 0 1014002788 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.27 0 0 0 0 0 0 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JANEY E 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 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 1474.45 0 0 0 0 0 0 1474.45 0 0 1014004716 1396195988 10 Physicians O''MARRO MAUREEN B 999999999 91 Sangamon 0 0 Neurology 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 0 160 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 3669.47 0 0 0 0 0 0 3669.47 0 0 1014005015 1790120012 89 Physician Assistant Only(Encounter Only) AHSAN SUNDUS 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.93 0 0 0 0 0 0 279.93 0 0 1014005051 10 Physicians 30 DuPage 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 0 133.81 0 0 0 0 0 0 133.81 0 0 1014005542 1598241994 89 Physician Assistant Only(Encounter Only) SCHULMAN RACHEL 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 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 0 117.91 0 0 0 0 0 0 117.91 0 0 1014006318 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.39 0 0 0 0 0 0 105.39 0 0 1014006513 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38420.61 0 0 0 0 0 0 0 0 0 0 0 0 0 38420.61 0 0 1014006830 1003466269 89 Physician Assistant Only(Encounter Only) WARD LUKAS J 999999999 47 Jackson 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 0 194.38 0 0 0 0 0 0 194.38 0 0 1014006860 16 Nurse Practitioners 80 Peoria 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 66.47 0 0 0 0 0 0 66.47 0 0 1014006936 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5229.7 0 0 0 0 0 0 0 0 0 0 0 0 0 5229.7 0 0 1014007124 89 Physician Assistant Only(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 270.32 0 0 0 0 0 0 270.32 0 0 1014007194 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 74.95 0 0 0 0 0 0 74.95 0 0 1014007372 1639522063 10 Physicians SEWNARINE RACHEL 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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 3254.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3254.67 0 0 1014010939 1821630666 16 Nurse Practitioners JOST LEESA K 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 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 2081.06 0 0 0 0 0 0 2081.06 0 0 1014011022 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 41.6 0 0 0 0 0 0 41.6 0 0 1014011316 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24106.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24106.53 0 0 1014011639 1548467459 10 Physicians BHATIA SUMITA 999999999 53 Kane 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 15 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 2222.43 0 0 0 0 0 0 2222.43 0 0 1014011756 1699169631 10 Physicians KAHN EMILY R 999999999 200 Cook 0 0 Pediatrics 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 0 140 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 1912.27 0 0 0 0 0 0 1912.27 0 0 1014011864 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 78.09 0 0 0 0 0 0 78.09 0 0 1014011982 1053763664 13 Podiatrists SWANSON KYLE D 999999999 60 Lee 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 0 785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5351.56 0 0 0 0 0 0 5351.56 0 0 1014011997 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10785.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10785.5 0 0 1014013242 1851949283 23 Occupational Therapists SHRINGARPURE JYOTI V 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 0 105 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 7674.55 7674.55 0 0 1014013251 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22906.89 0 0 0 0 0 0 0 0 0 0 0 0 0 22906.89 0 0 1014013614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6349.62 0 0 0 0 0 0 0 0 0 0 0 0 0 6349.62 0 0 1014013659 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 9488.32 0 0 0 0 0 0 0 0 0 0 0 0 0 9488.32 0 0 1014013786 1588159404 10 Physicians LIU SHIYUAN 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 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 1014014198 1437513470 10 Physicians NEBHRAJANI JAI 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 276.92 0 0 0 0 0 0 0 0 1280.9 0 0 0 0 0 0 1557.82 0 0 1014014258 10 Physicians 80 Peoria 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 0 129.8 0 0 0 0 0 0 129.8 0 0 1014014295 1861972515 39 Hospice LIFECHOICE HOSPICE AND PALLIAT 999999999 200 Cook 0 0 0 0 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 0 734 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130195.21 0 0 0 0 0 0 0 0 0 0 0 130195.21 0 0 1014014702 4014014702 72 Taxicabs and Livery Companies C & A ACCOUNTABLE TRANSPORTATI 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 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5719.12 0 0 0 0 0 0 5719.12 0 0 1014014876 1992280598 89 Physician Assistant Only(Encounter Only) FARRIS CORRIE L 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 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1173.31 0 0 0 0 0 0 1173.31 0 0 1014015084 1043856701 89 Physician Assistant Only(Encounter Only) STIMAC MALLORY 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 0 163 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 1231.47 0 0 0 0 0 0 1231.47 0 0 1014015290 12 Optometrists 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 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Medicine/Rehabilitation 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 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2720.71 0 0 0 0 0 0 2720.71 0 0 1014017952 1811309065 16 Nurse Practitioners MUHORO ROSEMARY 999999999 24 Coles 0 0 0 0 0 0 0 0 0 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 0 468.32 0 0 0 0 0 0 468.32 0 0 1014018024 1740632454 12 Optometrists WANG ANNA S 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 934 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 934 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8664.26 0 1179.33 0 0 0 0 9843.59 0 0 1014018123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10041.96 0 0 0 0 0 0 0 0 0 0 0 0 0 10041.96 0 0 1014018361 10 Physicians 200 Cook 0 0 0 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1821641952 55 Early Intervention Services HAAS JAYME 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 0 222 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 12547.78 0 0 0 0 0 0 12547.78 0 0 1014019577 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23753.76 0 0 0 0 0 0 0 0 0 0 0 0 0 23753.76 0 0 1014019866 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 17848.51 0 0 0 0 0 0 0 0 0 0 0 0 0 17848.51 0 0 1014020275 1689093015 10 Physicians PANDITA SHRUTI 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 66.4 0 0 0 0 0 0 66.4 0 0 1014020445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8092.86 0 0 0 0 0 0 0 0 0 0 0 0 0 8092.86 0 0 1014020447 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 0 763.81 0 0 0 0 0 0 763.81 0 0 1014020570 1336612738 89 Physician Assistant Only(Encounter Only) ADAMS BRIDGET F 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 0 709.24 0 0 0 0 0 0 709.24 0 0 1014020574 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.03 0 0 0 0 0 0 0 0 7.03 0 0 1014020826 94 Waiver service provider--Children's support 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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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390.6 0 0 0 0 0 0 0 0 0 0 0 0 0 390.6 0 0 1014023287 1649824079 33 Nursing Facilities BELLA TERRA STREAMWOOD 999999999 200 Cook 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 0 301 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178181.35 0 0 0 0 0 0 0 1178181.35 0 0 1014023491 1093197220 10 Physicians VIOLLT ANNE 999999999 200 Cook 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 24 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.67 0 0 0 0 0 0 97.67 0 0 1014023756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2667.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2667.36 0 0 1014024002 91 Waiver service provider--Adults (DHS/DDD) 91 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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 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 1575.57 0 0 0 0 0 0 1575.57 0 0 1014025957 1386115350 89 Physician Assistant Only(Encounter Only) WALSH MARISSA 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 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 0 349.06 0 0 0 0 0 0 349.06 0 0 1014026305 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 0 0 0 0 0 0 0 0 0 0 1014026544 1538352059 10 Physicians NGO THANG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 265 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6230.58 0 664.93 0 0 0 0 0 0 6895.51 0 0 1014026597 10 Physicians 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 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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 1014027331 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 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 0 101.32 0 0 0 0 0 0 101.32 0 0 1014027552 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9401.7 0 0 0 0 0 0 0 0 0 0 0 0 0 9401.7 0 0 1014027607 1902276272 11 Dentists KAUR BALPREET 999999999 200 Cook 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 12269.19 0 0 0 0 0 0 0 0 0 0 0 3010.8 0 0 0 0 15279.99 0 0 1014027618 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10926.89 0 0 0 0 0 0 0 0 0 0 0 0 0 10926.89 0 0 1014027664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 45395.76 0 0 0 0 0 0 0 0 0 0 0 0 0 45395.76 0 0 1014027739 1700316031 10 Physicians WHELAN AVIVA 999999999 80 Peoria 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 5 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 1252.14 0 0 0 0 0 0 1274.14 0 0 1014028150 1588207294 97 Waiver service provider--Children's residential (DHS/DDD) RAMOS ARLETTE 600674791 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 0 158 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 12809.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12809.58 0 0 1014028780 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 0 147.14 0 0 0 0 0 0 147.14 0 0 1014028869 1982259479 16 Nurse Practitioners ENGELING KASTIN I 999999999 91 Sangamon 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 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 1636.2 0 0 0 0 0 0 1636.2 0 0 1014029075 1992146500 10 Physicians RUIZ-QUINTERO SORY J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1084.62 0 0 0 0 0 0 0 0 1084.62 0 0 1014029099 1922460070 10 Physicians BOSMAN MITCHELL 999999999 57 Lake 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 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.07 0 0 0 0 0 0 1162.07 0 0 1014029135 1871056283 16 Nurse Practitioners MCKAY ABIGAIL 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 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 0 701.56 0 0 0 0 0 0 701.56 0 0 1014029307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12498.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12498.97 0 0 1014029342 1235785106 22 Physical Therapists COTSONES MEGHAN L 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 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 3934.71 3934.71 0 0 1014029368 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 948.31 0 0 0 0 0 0 0 0 0 0 0 0 0 948.31 0 0 1014029430 1235330309 23 Occupational Therapists REUL SARAH 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3033.84 3033.84 0 0 1014030655 1205223906 10 Physicians YU MINYONG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 71 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 7.35 0 2760.25 0 0 0 0 0 0 2767.6 0 0 1014030787 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22596.72 0 0 0 0 0 0 0 0 0 0 0 0 0 22596.72 0 0 1014030792 1033767736 16 Nurse Practitioners ABASI-KLING NADIA 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 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 0 334.12 0 0 0 0 0 0 334.12 0 0 1014030966 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 0 607.6 0 0 0 0 0 0 0 0 0 0 0 0 0 607.6 0 0 1014030991 1447560818 10 Physicians SHABBIR MUHAMMAD I 999999999 91 Sangamon 0 0 0 0 0 8 0 0 0 0 0 0 3 0 91 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 4 0 145 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 4 0 145 0 0 0 0 0 0 0 0 0 627.8 0 0 0 0 0 0 28.24 0 2311.22 0 0 0 0 0 0 2967.26 0 0 1014031199 1619986387 10 Physicians SHEIKHA MOUHAMMED 999999999 200 Cook 0 0 Internal Medicine 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 7 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.86 0 1080.97 0 0 0 0 0 0 1093.83 0 0 1014031337 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 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 72.54 72.54 0 0 1014031577 1689233033 89 Physician Assistant Only(Encounter Only) JONES BRITTANY 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 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 78.34 0 0 0 0 0 0 78.34 0 0 1014031614 1497318950 16 Nurse Practitioners GANDHI KHUSHABU 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 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 0 406.75 0 0 0 0 0 0 406.75 0 0 1014031696 1962630574 16 Nurse Practitioners BLEVINS MIRANDA E 999999999 88 Richland 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 0 190 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 5000.63 0 0 0 0 0 0 5000.63 0 0 1014033036 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20757 0 0 0 0 0 0 0 0 0 0 0 0 0 20757 0 0 1014033086 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 8.8 0 320.03 0 0 0 0 0 0 328.83 0 0 1014033107 1629497557 10 Physicians YU MINGXI DENNIS 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 0 103 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 0 924.51 0 0 0 0 0 0 924.51 0 0 1014033379 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 5723.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5723.8 0 0 1014033601 1326525304 89 Physician Assistant Only(Encounter Only) PETERS KEVIN P 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 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 0 368.31 0 0 0 0 0 0 368.31 0 0 1014033731 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 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 5464.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5464.29 0 0 1014034024 1497123806 11 Dentists TORRES DIANA M 999999999 200 Cook 0 0 Orthodontist 0 0 79 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 27300.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27300.2 0 0 1014034573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25931.5 0 0 0 0 0 0 0 0 0 0 0 0 0 25931.5 0 0 1014034656 1396119079 55 Early Intervention Services JONES VERA 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 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24192.39 0 0 0 0 0 0 24192.39 0 0 1014034770 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22490.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22490.13 0 0 1014035326 1770145278 16 Nurse Practitioners AMORANBINI BIMBOLA 999999999 200 Cook 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 1071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1071 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5567.36 0 0 0 0 0 0 5567.36 0 0 1014035547 1295255420 10 Physicians CHIEN NICHOLAS 999999999 200 Cook 0 0 Emergency 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 0 141 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 2603.11 0 0 0 0 0 0 2603.11 0 0 1014035582 1386100287 89 Physician Assistant Only(Encounter Only) STEINARD DERICK J 999999999 200 Cook 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 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.23 0 0 0 0 0 0 233.23 0 0 1014035603 1942600820 16 Nurse Practitioners BOLLENBACHER VALERIE 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 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 0 694.5 0 0 0 0 0 0 694.5 0 0 1014035783 1942857222 16 Nurse Practitioners PACKER TRACY M 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 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 0 340.91 0 0 0 0 0 0 340.91 0 0 1014035803 1063972776 16 Nurse Practitioners SHARKO ANITA 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 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 0 802.92 0 0 0 0 0 0 802.92 0 0 1014035984 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.08 0 0 0 0 0 0 18.08 0 0 1014036124 1164076386 33 Nursing Facilities HIGHLAND HEALTH CARE CENTER 999999999 65 Madison 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 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4570 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 439022.86 0 0 0 0 0 0 0 439022.86 0 0 1014036139 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14539 0 0 0 0 0 0 0 0 0 0 0 0 0 14539 0 0 1014036565 72 Taxicabs and Livery Companies 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.48 0 0 0 0 0 0 39.48 0 0 1014036736 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 0 593.93 0 0 0 0 0 0 593.93 0 0 1014036815 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 0 161 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 26305.72 0 0 0 0 0 0 0 0 0 0 0 0 0 26305.72 0 0 1014036895 1033775945 16 Nurse Practitioners SAFFAR VALERIE R 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 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 1056.11 0 0 0 0 0 0 1056.11 0 0 1014036911 1538720008 16 Nurse Practitioners VAN HOVELN KATHERINE A 999999999 54 Kankakee 0 0 0 0 0 5 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 258.91 0 0 0 0 0 0 0 0 1985.47 0 0 0 0 0 0 2244.38 0 0 1014037144 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13254.71 0 0 0 0 0 0 0 0 0 0 0 0 0 13254.71 0 0 1014037370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18658.35 0 0 0 0 0 0 0 0 0 0 0 0 0 18658.35 0 0 1014037452 1053892547 89 Physician Assistant Only(Encounter Only) GHOUSE ZAINAB 999999999 200 Cook 0 0 0 0 0 81 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 231 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 8855.08 0 0 0 0 0 0 0 0 3346.02 0 0 0 0 0 0 12201.1 0 0 1014037545 1013471150 89 Physician Assistant Only(Encounter Only) MCKEOUGH KATHERINE A 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 0 847.7 0 0 0 0 0 0 847.7 0 0 1014037721 12 Optometrists 30 DuPage 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 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.27 0 87.58 0 0 0 0 186.85 0 0 1014037844 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 0 571.01 0 0 0 0 0 0 571.01 0 0 1014037889 25 Audiologists 109 Winnebago 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 0 0 0 0 1014038588 1851889331 16 Nurse Practitioners HILL MELISSA 999999999 96 St Clair 0 0 0 0 0 11 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 420.68 0 0 0 0 0 0 0 0 2240.19 0 0 0 0 0 0 2660.87 0 0 1014038891 1124524467 10 Physicians SHAH NUPUR 999999999 200 Cook 0 0 Emergency 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 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 1123.91 0 0 0 0 0 0 1123.91 0 0 1014039153 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 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 5906.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5906.01 0 0 1014039167 1609258755 23 Occupational Therapists CONNOLLY EMILY 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 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 3762.36 3762.36 0 0 1014039168 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24021.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24021.64 0 0 1014039726 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8412.62 0 0 0 0 0 0 0 0 0 0 0 0 0 8412.62 0 0 1014040037 1801249115 10 Physicians HENRY JANNA 999999999 80 Peoria 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 0 298 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 2788.97 0 0 0 0 0 0 2788.97 0 0 1014040220 1770125817 16 Nurse Practitioners MARTIN JILL 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 475.7 0 0 0 0 0 0 475.7 0 0 1014040255 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15255.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15255.1 0 0 1014040269 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48217.62 0 0 0 0 0 0 0 0 0 0 0 0 0 48217.62 0 0 1014040331 1437705829 89 Physician Assistant Only(Encounter Only) PAPPAS ELMORE CARLI 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 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 0 273.07 0 0 0 0 0 0 273.07 0 0 1014040383 1275989808 10 Physicians SHASTRY JENNIFER L 999999999 200 Cook 0 0 Dermatology 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 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 1065.4 0 0 0 0 0 0 1065.4 0 0 1014040593 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13305.3 0 0 0 0 0 0 0 0 0 0 0 0 0 13305.3 0 0 1014040750 1477915759 10 Physicians CORMIER STEPHANIE 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 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 1360.79 0 0 0 0 0 0 1360.79 0 0 1014040964 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.04 0 0 0 0 0 0 72.04 0 0 1014041172 1508398397 16 Nurse Practitioners BUSCEMI MICHELLE 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 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 0 194.26 0 0 0 0 0 0 194.26 0 0 1014041304 1568844652 16 Nurse Practitioners WINTERS OLIVIA MARIE 999999999 64 Macoupin 0 0 General Psychiatry Residency 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 0 190 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 9635.42 0 0 0 0 0 0 9635.42 0 0 1014041329 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 112.29 0 0 0 0 0 0 0 0 0 0 0 0 0 112.29 0 0 1014041505 1962609768 10 Physicians KNUDSON MATTHEW J 999999999 92 Schuyler 0 0 Urology 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 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.31 0 3531.77 0 0 0 0 0 0 3533.08 0 0 1014041730 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 27 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 12183.23 0 0 0 0 0 12183.23 0 0 1014042162 1184086381 10 Physicians PHELPS NICOLE L 999999999 53 Kane 0 0 0 0 0 3 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 401.98 0 0 0 0 0 0 0 0 521.07 0 0 0 0 0 0 923.05 0 0 1014042183 1841858230 11 Dentists SHEHADA KAMEL 999999999 200 Cook 0 0 0 0 93 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 10288.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10288.76 0 0 1014042342 1922649821 16 Nurse Practitioners MUDIE KRISTI 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 97.42 0 0 0 0 0 0 97.42 0 0 1014042420 1164877882 10 Physicians BRODERICK STEVEN 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 2 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 15 0 0 0 0 0 0 0 0 0 2 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 18.56 0 257.46 0 0 0 0 0 0 276.02 0 0 1014042426 1568021434 16 Nurse Practitioners KILSDONK LINDSEY 999999999 200 Cook 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 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 0 817.14 0 0 0 0 0 0 817.14 0 0 1014042445 1548615750 10 Physicians JACOBS RYAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.47 0 372.94 0 0 0 0 0 0 464.41 0 0 1014042746 1083185391 89 Physician Assistant Only(Encounter Only) ELDERSVELD RACHEL 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 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 0 606.64 0 0 0 0 0 0 606.64 0 0 1014043232 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22269.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22269.1 0 0 1014043269 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2900.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2900.11 0 0 1014043291 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 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 0 215.95 0 0 0 0 0 0 215.95 0 0 1014043522 1396389482 16 Nurse Practitioners CROSS PATRICE 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 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 0 106.05 0 0 0 0 0 0 106.05 0 0 1014043560 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10319.1 0 0 0 0 0 0 0 0 0 0 0 0 0 10319.1 0 0 1014044003 1932589942 10 Physicians PROGRAIS SHANNON S 999999999 200 Cook 0 0 Emergency Medicine 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 2909.83 0 0 0 0 0 0 2909.83 0 0 1014044127 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33670.06 0 0 0 0 0 0 0 0 0 0 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1014045218 1023663614 89 Physician Assistant Only(Encounter Only) KEATING SETH 999999999 200 Cook 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 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 729 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18807.41 0 0 0 0 0 0 18807.41 0 0 1014045357 1548821283 89 Physician Assistant Only(Encounter Only) SAULNIER MATTHEW 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 0 109 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 1143.64 0 0 0 0 0 0 1143.64 0 0 1014046024 1386634202 10 Physicians UYESUGI WALTER 999999999 107 Will 0 0 Radiology Diagnosis 0 0 0 0 0 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 20.27 0 0 0 0 0 0 0 0 20.27 0 0 1014046297 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014046364 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 0 144 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 13789.16 0 0 0 0 0 0 0 0 0 0 0 0 0 13789.16 0 0 1014047026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2985.43 0 0 0 0 0 0 0 0 0 0 0 0 0 2985.43 0 0 1014047439 1770147480 16 Nurse Practitioners SAFAROV RUSTAM 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 0 323.63 0 0 0 0 0 0 323.63 0 0 1014047451 1780762815 10 Physicians WEST MELISSA A 999999999 66 Marion 0 0 Psychiatry 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 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 4144.42 0 0 0 0 0 0 4144.42 0 0 1014047775 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 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 0 148.32 0 0 0 0 0 0 148.32 0 0 1014047848 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 81.59 0 0 0 0 0 0 81.59 0 0 1014047900 1821440801 10 Physicians RAMIREZ VELAZQUEZ RAUL J 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 1079.92 0 0 0 0 0 0 1079.92 0 0 1014048005 1386201465 75 Department of Alcohol and Substance Abuse Provider KENNETH YOUNG CENTER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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0 0 6 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229.74 0 4590.1 0 0 0 0 0 0 4819.84 0 0 1014050492 1063932184 16 Nurse Practitioners DOMINGO MARIANE 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 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 0 958.67 0 0 0 0 0 0 958.67 0 0 1014050756 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 4542.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4542.72 0 0 1014050852 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.2 0 0 0 0 0 0 0 0 24.2 0 0 1014051189 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 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 12333.92 0 0 0 0 0 0 0 0 0 0 0 0 0 12333.92 0 0 1014051776 71 Medicar Provider 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 0 131 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 1100.41 0 0 0 0 0 0 1100.41 0 0 1014052437 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13063.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13063.4 0 0 1014052460 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 29.94 29.94 0 0 1014053605 22 Physical Therapists 109 Winnebago 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 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 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0 0 0 0 0 0 0 306.57 0 0 0 0 0 0 306.57 0 0 1014054246 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.35 0 0 0 2083.35 0 0 1014054881 1164831186 10 Physicians SAMUEL ESHAN M 999999999 91 Sangamon 0 0 Pediatrics 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 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 11069.5 0 0 0 0 0 0 11069.5 0 0 1014055013 1518318005 10 Physicians TAYLOR JASON T 999999999 80 Peoria 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 0 115 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 1460.45 0 0 0 0 0 0 1460.45 0 0 1014055219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20736.29 0 0 0 0 0 0 0 0 0 0 0 0 0 20736.29 0 0 1014055349 1770128175 89 Physician Assistant Only(Encounter Only) SNYDER BRITTANY 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 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 0 877.21 0 0 0 0 0 0 877.21 0 0 1014055414 10 Physicians 30 DuPage 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014055569 1336794510 89 Physician Assistant Only(Encounter Only) WISE ELISABETH 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 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 1014055794 1639223571 89 Physician Assistant Only(Encounter Only) ZAIZ THOMAS 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 0 162 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 0 992.7 0 0 0 0 0 0 992.7 0 0 1014056014 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3370.94 0 0 0 0 0 0 0 0 0 0 0 0 0 3370.94 0 0 1014056216 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22844.91 0 0 0 0 0 0 0 0 0 0 0 0 0 22844.91 0 0 1014056524 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 129.67 0 0 0 0 0 0 0 0 0 0 0 0 0 129.67 0 0 1014056811 1780038315 10 Physicians YOUNG DAVID 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 0 221 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 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BENJAMIN R 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1682.05 0 0 0 0 0 0 1682.05 0 0 1014058437 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21581.87 0 0 0 0 0 0 0 0 0 0 0 0 0 21581.87 0 0 1014058557 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23457.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23457.7 0 0 1014059006 1164583084 10 Physicians HENDRICKS SEAN D 999999999 10 Adams 0 0 Ophthalmology 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 0 316 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 29373.39 0 0 0 0 0 0 29373.39 0 0 1014059285 91 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YOUSUF MUHAMMAD 999999999 91 Sangamon 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 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7777.54 0 0 0 0 0 0 7777.54 0 0 1014059865 1699018028 10 Physicians TALATI CHIRAG 999999999 200 Cook 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 0 220 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 32039.91 0 0 0 0 0 0 32039.91 0 0 1014060175 1891268991 16 Nurse Practitioners FAUKE-HAVENER KIMBERLY S 999999999 91 Sangamon 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 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 2056.87 0 0 0 0 0 0 2056.87 0 0 1014060534 1841851060 22 Physical Therapists PADHIAR RUPALI G 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435 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 1.5 0 0 0 0 0 0 1.5 0 0 1014061805 4014061805 90 Waiver service provider--Elderly (DOA) ILLINOIS SENIOR SERVICES INC 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 2322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229105.89 0 0 0 0 0 0 0 0 0 0 0 0 0 229105.89 0 0 1014061895 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1953 0 0 0 0 0 0 0 0 0 0 0 0 0 1953 0 0 1014062122 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1132.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.44 0 0 1014062275 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 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 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0 0 0 0 0 0 0 0 0 0 0 67.84 0 0 0 0 0 0 67.84 0 0 1014064764 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16133.43 0 0 0 0 0 0 0 0 0 0 0 0 0 16133.43 0 0 1014064909 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 96.54 0 0 0 0 0 0 96.54 0 0 1014065722 1982024642 10 Physicians YANG SARAH T 999999999 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 4 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.68 0 1264.92 0 0 0 0 0 0 1354.6 0 0 1014065822 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 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 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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 0 146 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 16249.14 0 0 0 0 0 0 0 0 0 0 0 0 0 16249.14 0 0 1014068052 1295293306 16 Nurse Practitioners GADJEV KRASTINA G 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 0 118 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 2686.26 0 0 0 0 0 0 2686.26 0 0 1014068306 71 Medicar Provider 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 442.71 0 0 0 0 0 0 442.71 0 0 1014068550 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6490.87 0 0 0 0 0 0 0 0 0 0 0 0 0 6490.87 0 0 1014069049 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 0 157 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 8560.92 0 0 0 0 0 0 0 0 0 0 0 0 0 8560.92 0 0 1014069156 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 32.73 32.73 0 0 1014069356 1073162384 11 Dentists ROUEL FADI 999999999 53 Kane 0 0 General Dentistry 0 0 10 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 2274.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2274.3 0 0 1014069629 1225493364 16 Nurse Practitioners LEMON GAIL 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279.13 0 0 0 0 0 0 279.13 0 0 1014070076 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2560.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2560.42 0 0 1014071394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14245.38 0 0 0 0 0 0 0 0 0 0 0 0 0 14245.38 0 0 1014071404 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14730.84 0 0 0 0 0 0 0 0 0 0 0 0 0 14730.84 0 0 1014071658 10 Physicians 30 DuPage 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 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 0 498.41 0 0 0 0 0 0 498.41 0 0 1014072475 10 Physicians 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 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 0 400.78 0 0 0 0 0 0 400.78 0 0 1014072744 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23174.58 0 0 0 0 0 0 0 0 0 0 0 0 0 23174.58 0 0 1014072750 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 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 0 322.53 322.53 0 0 1014072966 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2436.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2436.33 0 0 1014073147 1124135843 10 Physicians LIN KEVIN M 999999999 91 Sangamon 0 0 Internal 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 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5913.94 0 0 0 0 0 0 5913.94 0 0 1014073262 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 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 2642.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2642.33 0 0 1014073500 10 Physicians 57 Lake 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 44.1 0 0 0 0 0 0 44.1 0 0 1014073655 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19798.9 0 0 0 0 0 0 0 0 0 0 0 0 0 19798.9 0 0 1014073675 1720510597 10 Physicians GARZA CASTILLON JR RAFAEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 88 0 0 0 0 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 0 0 6198.92 0 0 0 0 0 0 6198.92 0 0 1014073765 1649832536 16 Nurse Practitioners DILDAY KATHLEEN 999999999 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 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 0 219.77 0 0 0 0 0 0 219.77 0 0 1014074607 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 293.04 0 0 0 0 0 0 0 0 0 0 0 0 0 293.04 0 0 1014075126 1003479122 16 Nurse Practitioners SCHLESINGER HAILEY N 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 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 0 344.28 0 0 0 0 0 0 344.28 0 0 1014075778 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24206.29 0 0 0 0 0 0 0 0 0 0 0 0 0 24206.29 0 0 1014075898 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 27.02 27.02 0 0 1014075950 1770048282 87 Psychologist(Encounter Only) ANDREWS CARYN P 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 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 4473.57 0 0 0 0 0 0 4473.57 0 0 1014076208 1689651010 10 Physicians PROHASKA DENNIS 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 16 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.08 0 83.61 0 0 0 0 0 0 179.69 0 0 1014076351 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 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 0 549.06 0 0 0 0 0 0 549.06 0 0 1014076372 1386006724 10 Physicians DINH QUOC-DUY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2357.42 0 0 0 0 0 0 2357.42 0 0 1014076800 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24466.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24466.75 0 0 1014077083 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 11522.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11522.1 0 0 1014077176 1700239332 13 Podiatrists JAMES TIPHANI V 999999999 109 Winnebago 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 0 125 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 1178.64 0 0 0 0 0 0 1178.64 0 0 1014077287 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5453.98 0 0 0 0 0 0 0 0 0 0 0 0 0 5453.98 0 0 1014077721 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6883.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6883.98 0 0 1014077869 86 Clinical Social Worker(Encounter Only) 816 Iowa 0 0 0 0 0 0 0 0 0 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 2104.01 0 0 0 0 0 0 2104.01 0 0 1014078438 1972984169 10 Physicians SHOLTES DAVID 999999999 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 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 0 264 0 0 0 0 0 0 264 0 0 1014078724 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 0 337.7 0 0 0 0 0 0 337.7 0 0 1014078763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22848.98 0 0 0 0 0 0 0 0 0 0 0 0 0 22848.98 0 0 1014079237 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 0 148 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 19540.85 0 0 0 0 0 0 0 0 0 0 0 0 0 19540.85 0 0 1014079594 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16917.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16917.56 0 0 1014079998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14842.35 0 0 0 0 0 0 0 0 0 0 0 0 0 14842.35 0 0 1014080086 1487001822 10 Physicians CHOVATIYA RAJ JITENDRA 999999999 200 Cook 0 0 Dermatology 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 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 0 871.02 0 0 0 0 0 0 871.02 0 0 1014080259 1154978740 16 Nurse Practitioners VLIET ANGELA 999999999 88 Richland 0 0 0 0 0 0 0 0 0 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 0 641.07 0 0 0 0 0 0 641.07 0 0 1014080999 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6609.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6609.76 0 0 1014081033 1902070519 10 Physicians SHKUROVICH SERGEY 999999999 24 Coles 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 227.87 0 0 0 0 0 0 0 0 227.87 0 0 1014081531 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1888.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.48 0 0 1014082086 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22363.77 0 0 0 0 0 0 0 0 0 0 0 0 0 22363.77 0 0 1014082426 1417369323 10 Physicians AYANO CHALTU B 999999999 10 Adams 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 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 2776.79 0 0 0 0 0 0 2776.79 0 0 1014082462 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 8.13 0 0 0 0 0 0 8.13 0 0 1014082732 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21292.1 0 0 0 0 0 0 0 0 0 0 0 0 0 21292.1 0 0 1014082911 1336585132 10 Physicians KHATRI FARIHA 999999999 200 Cook 0 0 Internal 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 0 389 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 122120.43 0 0 0 0 0 0 122120.43 0 0 1014083526 1174065080 55 Early Intervention Services MALLARD MCKENZIE L 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 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27915.46 0 0 0 0 0 0 27915.46 0 0 1014083638 75 Department of Alcohol and Substance Abuse Provider 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7458.51 0 0 7458.51 0 0 1014083736 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23003.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23003.64 0 0 1014084304 1013579226 11 Dentists SARGESON JESSICA 999999999 200 Cook 0 0 General Dentistry 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 3046.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3046.37 0 0 1014084307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19681.88 0 0 0 0 0 0 0 0 0 0 0 0 0 19681.88 0 0 1014084345 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 0 0 0 0 0 0 0 0 0 0 1014084435 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12808.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12808.75 0 0 1014084503 1689810855 10 Physicians SABATINO MARC 999999999 49 Jefferson 0 0 Physical Medicine/Rehabilitation 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 0 297 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 2215.59 0 0 0 0 0 0 2215.59 0 0 1014084571 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21609.53 0 0 0 0 0 0 0 0 0 0 0 0 0 21609.53 0 0 1014084596 1912553892 16 Nurse Practitioners HALL KELLY R 999999999 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 550.7 0 0 0 0 0 0 550.7 0 0 1014084732 1558618587 86 Clinical Social Worker(Encounter Only) GILMORE KAREN L 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 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 0 958.32 0 0 0 0 0 0 958.32 0 0 1014084765 1659751998 10 Physicians MAGNUSON ALLISON 999999999 30 DuPage 0 0 Anesthesiology 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 0 109 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 5313.44 0 0 0 0 0 0 5313.44 0 0 1014085088 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23418.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23418.78 0 0 1014085164 1992359954 11 Dentists KIM MOOCHAN 999999999 200 Cook 0 0 General Dentistry 0 0 263 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1331 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 1331 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 36957.15 0 0 0 0 0 0 0 0 0 0 0 6397.95 0 0 0 0 43355.1 0 0 1014085266 86 Clinical Social Worker(Encounter Only) 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 914.28 0 0 0 0 0 0 914.28 0 0 1014085403 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 0 182.82 0 0 0 0 0 0 182.82 0 0 1014085471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11250.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11250.12 0 0 1014085741 1124497698 89 Physician Assistant Only(Encounter Only) CHOKSHI BONNIE J 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 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 1014085872 1700432887 22 Physical Therapists GIANNUZZI KELSEY J 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 0 161 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 1566.94 1566.94 0 0 1014085979 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 0 777.22 0 0 0 0 0 0 777.22 0 0 1014086121 1326503764 63 Other Providers of Medical Equipment/Supplies (Non-registered) FAMILY HOME MEDICAL 999999999 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13574.62 0 444.16 0 0 0 0 14018.78 0 0 1014086223 1720432115 10 Physicians MUSA MUTAZ 999999999 47 Jackson 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 0 136 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 4081.83 0 0 0 0 0 0 4081.83 0 0 1014086332 10 Physicians 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 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 0 290.4 0 0 0 0 0 0 290.4 0 0 1014086340 22 Physical Therapists 96 St Clair 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 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 3417.16 3417.16 0 0 1014086760 1275946345 10 Physicians ROSSI DANIEL S 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 23 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.37 0 1887.03 0 0 0 0 0 0 2038.4 0 0 1014086877 1073904256 10 Physicians EWBANKS ANDREW 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 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 3934.21 0 0 0 0 0 0 3934.21 0 0 1014087097 1619318235 10 Physicians IRISH JOHN 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 129 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155 0 445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764.92 0 5404.81 0 0 0 0 0 0 6169.73 0 0 1014087110 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28561.64 0 0 0 0 0 0 0 0 0 0 0 0 0 28561.64 0 0 1014087190 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 87.08 0 0 0 0 0 0 87.08 0 0 1014087271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6758.71 0 0 0 0 0 0 0 0 0 0 0 0 0 6758.71 0 0 1014087287 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10573.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10573.92 0 0 1014087350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11583.46 0 0 0 0 0 0 0 0 0 0 0 0 0 11583.46 0 0 1014087471 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 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 44.29 0 0 0 0 0 0 44.29 0 0 1014087733 1457747479 10 Physicians METZLER ROBERT T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.32 0 64.6 0 0 0 0 0 0 154.92 0 0 1014087806 1336783067 91 Waiver service provider--Adults (DHS/DDD) MOTA JUAN L 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 1217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74048.01 0 0 0 0 0 0 0 0 0 0 0 0 0 74048.01 0 0 1014088038 1194082446 10 Physicians SADANA NISHANT 999999999 109 Winnebago 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 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 1835.81 0 0 0 0 0 0 1835.81 0 0 1014088052 1689841082 16 Nurse Practitioners MANNING KAREN 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 434.52 0 0 0 0 0 0 0 0 225.75 0 0 0 0 0 0 660.27 0 0 1014088054 55 Early Intervention Services 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 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 1308.3 0 0 0 0 0 0 1308.3 0 0 1014088481 1992275069 91 Waiver service provider--Adults (DHS/DDD) WOODS KYLA 999999999 91 Sangamon 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 1078 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1078 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56667.76 0 0 0 0 0 0 0 0 0 0 0 0 0 56667.76 0 0 1014088506 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 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 43293.76 0 0 0 0 0 0 0 0 0 0 0 0 0 43293.76 0 0 1014088565 1508408220 55 Early Intervention Services KURHELA DANIELLE 999999999 91 Sangamon 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 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29205.48 0 0 0 0 0 0 29205.48 0 0 1014088647 1649513094 10 Physicians BIANCO MONICA E 999999999 200 Cook 0 0 Pediatrics 0 0 0 3 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 37 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 32.38 0 0 0 0 0 0 0 0 2728.6 0 0 0 0 0 0 2760.98 0 0 1014088699 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 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 1822.5 0 0 1822.5 0 0 1014088809 1386986537 10 Physicians WANTA KAITLIN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.68 0 1401.28 0 0 0 0 0 0 1413.96 0 0 1014089697 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 7830.68 0 0 0 0 0 0 0 0 0 0 0 0 0 7830.68 0 0 1014090269 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014090290 1629639695 16 Nurse Practitioners RABURN NICHOLAS JAMES 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.62 0 0 0 0 0 0 656.62 0 0 1014090519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24065.29 0 0 0 0 0 0 0 0 0 0 0 0 0 24065.29 0 0 1014090813 1639739055 60 Pharmacies "COMMUNITY, A WALGREENS PHARMAC" 999999999 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20361.56 0 0 0 20361.56 0 0 1014090948 1356903637 16 Nurse Practitioners MCCORMICK CARRIE A 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 0 142 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 1822.28 0 0 0 0 0 0 1822.28 0 0 1014091009 1679121743 16 Nurse Practitioners SAUNDERS ANDREA 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 0 100 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 3736.59 0 0 0 0 0 0 3736.59 0 0 1014091032 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23973.88 0 0 0 0 0 0 0 0 0 0 0 0 0 23973.88 0 0 1014091384 1730696469 89 Physician Assistant Only(Encounter Only) PERRI STEVEN 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 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 0 169.18 0 0 0 0 0 0 169.18 0 0 1014091683 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 1014091846 1780064782 10 Physicians ROSSEN JENNIFER 999999999 200 Cook 0 0 Internal Medicine 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 2 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.02 0 5742.76 0 0 0 0 0 0 5840.78 0 0 1014091934 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 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 26509.18 0 0 0 0 0 0 0 0 0 0 0 0 0 26509.18 0 0 1014092264 1467806000 10 Physicians MAIORELLA ROSE MARIE 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 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 1818.97 0 0 0 0 0 0 1818.97 0 0 1014092447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26128.91 0 0 0 0 0 0 0 0 0 0 0 0 0 26128.91 0 0 1014092791 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 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 64.08 0 0 0 0 0 0 64.08 0 0 1014093314 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22920.41 0 0 0 0 0 0 0 0 0 0 0 0 0 22920.41 0 0 1014093317 1710521984 28 Waiver service provider--Supportive living facility (HFS) "COTTAGES AT CARLINVILLE, INC." 999999999 64 Macoupin 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97236.36 0 0 0 0 0 0 0 0 0 0 0 0 0 97236.36 0 0 1014093597 1023105301 10 Physicians GUARIN MARGARITA 999999999 80 Peoria 0 0 Pediatrics 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 0 173 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 17573.4 0 0 0 0 0 0 17573.4 0 0 1014093897 55 Early Intervention Services 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.44 0 0 0 0 0 0 132.44 0 0 1014094214 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 2997.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2997.84 0 0 1014094859 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24190.49 0 0 0 0 0 0 0 0 0 0 0 0 0 24190.49 0 0 1014095107 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 78.09 0 0 0 0 0 0 78.09 0 0 1014095132 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21818.65 0 0 0 0 0 0 0 0 0 0 0 0 0 21818.65 0 0 1014095328 1366098188 89 Physician Assistant Only(Encounter Only) KINDRED ALEXANDRA 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 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 1870.04 0 0 0 0 0 0 1870.04 0 0 1014096367 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 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 3811.11 3811.11 0 0 1014096539 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25919.51 0 0 0 0 0 0 0 0 0 0 0 0 0 25919.51 0 0 1014096583 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3965.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3965.67 0 0 1014096587 1649684200 10 Physicians ABBOUD RAMZI 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 1801.72 0 0 0 0 0 0 1801.72 0 0 1014097146 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11748.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11748.6 0 0 1014097240 98 Waiver service provider--TBI (DHS/DRS) 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 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 3070.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3070.75 0 0 1014097266 1972025781 55 Early Intervention Services YOUNGBLOOD TIMBERLY N 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 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25705.77 0 0 0 0 0 0 25705.77 0 0 1014097299 10 Physicians 30 DuPage 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 1014097385 1003467341 89 Physician Assistant Only(Encounter Only) ESCUE ERICA R 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 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 0 168.56 0 0 0 0 0 0 168.56 0 0 1014097413 1003461831 16 Nurse Practitioners LEE JESSICA L 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 0 273 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 1138.44 0 0 0 0 0 0 1138.44 0 0 1014097607 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4412.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4412.69 0 0 1014098039 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32819.67 0 0 0 0 0 0 0 0 0 0 0 0 0 32819.67 0 0 1014098207 1285087858 55 Early Intervention Services FACIANO MARIA G 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 0 804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46653.5 0 0 0 0 0 0 46653.5 0 0 1014098913 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25063.45 0 0 0 0 0 0 0 0 0 0 0 0 0 25063.45 0 0 1014098927 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014099035 1346779386 10 Physicians BAMPOE AUDREY 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 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 1858.72 0 0 0 0 0 0 1858.72 0 0 1014099586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4529.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4529.03 0 0 1014099825 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24976.31 0 0 0 0 0 0 0 0 0 0 0 0 0 24976.31 0 0 1014099988 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16858.23 0 0 0 0 0 0 0 0 0 0 0 0 0 16858.23 0 0 1014100347 1750734612 10 Physicians DURKIN CHRISTOPHER S 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 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 0 425.68 0 0 0 0 0 0 425.68 0 0 1014100731 1851825863 10 Physicians LAHOOD ANTHONY J 999999999 80 Peoria 0 0 Emergency Medicine 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 0 192 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 6264.04 0 0 0 0 0 0 6264.04 0 0 1014100825 1396707147 89 Physician Assistant Only(Encounter Only) STAUB MARY M 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 836.58 0 0 0 0 0 0 836.58 0 0 1014100945 1689138448 60 Pharmacies FRIEND HEALTH PHARMACY 999999999 200 Cook 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 1003 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40939.25 0 0 0 40939.25 0 0 1014101250 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4146.65 0 0 0 0 0 0 0 0 0 0 0 0 0 4146.65 0 0 1014101340 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11772.37 0 0 0 0 0 0 0 0 0 0 0 0 0 11772.37 0 0 1014101576 1912357070 10 Physicians UZONYI JANOS A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.11 0 4286.26 0 0 0 0 0 0 4304.37 0 0 1014101720 1316381924 10 Physicians BOYNE KATHLEEN L 999999999 200 Cook 0 0 Pediatrics 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 3823.68 0 0 0 0 0 0 3823.68 0 0 1014102303 10 Physicians 37 Fulton 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 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 0 107.84 0 0 0 0 0 0 107.84 0 0 1014102311 1609286509 10 Physicians ROOSE BENJAMIN P 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 706.92 0 0 0 0 0 0 706.92 0 0 1014102312 1023659711 89 Physician Assistant Only(Encounter Only) MOODY ERIN R 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 3345.41 0 0 0 0 0 0 3377.56 0 0 1014103096 1518315464 10 Physicians BARWEGEN CORBIN 999999999 109 Winnebago 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5493.07 0 0 0 0 0 0 5493.07 0 0 1014103134 1386206795 16 Nurse Practitioners ELLERMAN LUKE A 999999999 10 Adams 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 0 191 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 1806.92 0 0 0 0 0 0 1806.92 0 0 1014103266 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Practitioners ROARK BRITINI 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 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 0 242.55 0 0 0 0 0 0 242.55 0 0 1014104251 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 0 371.24 0 0 0 0 0 0 371.24 0 0 1014104683 1396000287 10 Physicians PATEL JAY M 999999999 30 DuPage 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 0 230 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 2048.67 0 0 0 0 0 0 2048.67 0 0 1014104726 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 3849.76 0 0 0 0 0 0 0 0 0 0 0 0 0 3849.76 0 0 1014105143 1023363082 10 Physicians LI SHIHONG 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service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24425.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24425.68 0 0 1014105462 1790163848 16 Nurse Practitioners NOWATZKI HESPER B 999999999 56 Knox 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 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 0 379.31 0 0 0 0 0 0 379.31 0 0 1014105541 1255985438 16 Nurse Practitioners WIELAND STACY S 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 385.51 0 0 0 0 0 0 471.16 0 0 1014105579 10 Physicians 53 Kane 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 2286.7 0 0 0 0 0 0 2286.7 0 0 1014106156 23 Occupational Therapists 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.65 175.65 0 0 1014106200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47544.58 0 0 0 0 0 0 0 0 0 0 0 0 0 47544.58 0 0 1014106239 1316473804 10 Physicians FLORIDO MELISSA M 999999999 80 Peoria 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 0 130 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 2538.28 0 0 0 0 0 0 2538.28 0 0 1014106476 10 Physicians 80 Peoria 0 0 Vascular 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 1014106880 10 Physicians 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.15 0 0 0 0 0 0 0 0 14.15 0 0 1014107544 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.4 0 0 1014107802 10 Physicians 200 Cook 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 0.83 0 0 0 0 0 0 0.83 0 0 1014108263 1841578457 10 Physicians ALHAJJAT AMIR 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 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 10855.59 0 0 0 0 0 0 10855.59 0 0 1014108382 1164809737 16 Nurse Practitioners WILLIAMS DANIELLE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 326.12 0 0 0 0 0 0 326.12 0 0 1014108392 1194297879 16 Nurse Practitioners HAYS JESSICA 999999999 47 Jackson 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 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 1066.87 0 0 0 0 0 0 1066.87 0 0 1014108799 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3558.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3558.8 0 0 1014109062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 763.04 0 0 0 0 0 0 0 0 0 0 0 0 0 763.04 0 0 1014109145 13 Podiatrists 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014109190 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19318.62 0 0 0 0 0 0 0 0 0 0 0 0 0 19318.62 0 0 1014109395 1669022752 16 Nurse Practitioners BICKETT ANGELA M 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 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 0 604.14 0 0 0 0 0 0 604.14 0 0 1014109699 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 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 0 428.25 0 0 0 0 0 0 428.25 0 0 1014109728 1124434014 89 Physician Assistant Only(Encounter Only) ROSS KATHRYN 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 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 0 0 0 0 0 0 0 0 0 0 1014109852 88 Other behavior health professional 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.16 0 0 0 0 0 0 37.16 0 0 1014109960 24 Speech Therapists 72 McLean 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 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 1427.23 1427.23 0 0 1014110132 1710544762 11 Dentists PEREZ REYNALDO 999999999 200 Cook 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 658 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 658 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 20299.15 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 22933.6 0 0 1014110248 1821645110 89 Physician Assistant Only(Encounter Only) GEARY MADELYN 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 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 0 291.27 0 0 0 0 0 0 291.27 0 0 1014110369 1376189167 23 Occupational Therapists MUSTERED MALINDA 999999999 46 Iroquois 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 0 193 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 13547.88 13547.88 0 0 1014111164 1013565308 89 Physician Assistant Only(Encounter Only) DUFOUR KELLEY E 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 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 0 199.3 0 0 0 0 0 0 199.3 0 0 1014111851 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6581.61 0 0 0 0 0 0 0 0 0 0 0 0 0 6581.61 0 0 1014112395 1174009245 61 Independent Laboratories VIKOR SCIENTIFIC LLC 999999999 842 South Carolina 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 0 362 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 19111.96 0 0 0 0 0 0 0 0 19111.96 0 0 1014112507 1689198863 48 Rural Health Clinics FAMILY HEALTH CARE OF MAHOMET 999999999 19 Champaign 0 0 0 24 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1985.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1985.67 0 0 1014112866 1225349822 10 Physicians ROSTAMBEIGI NASSIR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 8 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.06 0 3723.05 0 0 0 0 0 0 3837.11 0 0 1014112993 1902447790 16 Nurse Practitioners RICE HEATHER R 999999999 20 Christian 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 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 1450.76 0 0 0 0 0 0 1450.76 0 0 1014113630 1669017752 23 Occupational Therapists KRUSZYNSKI KATELYN A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90217.26 0 0 90217.26 0 0 1014118564 1871766493 10 Physicians SPILDE TROY L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 11350.07 0 0 0 0 0 0 11350.07 0 0 1014118904 11 Dentists 200 Cook 0 0 Orthodontist 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.5 0 0 1014119106 1366485005 10 Physicians MICHELENA MIA FM 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 0 218 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 2866.77 0 0 0 0 0 0 2866.77 0 0 1014119311 1427412261 10 Physicians SALMAN JACOB G 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 0 255 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 4608.9 0 0 0 0 0 0 4608.9 0 0 1014119444 1831488568 10 Physicians RAJARAM PRIYANKA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 357 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4125.9 0 0 0 0 0 0 4125.9 0 0 1014119457 1841305463 89 Physician Assistant Only(Encounter Only) SMITH ROGER 999999999 108 Williamson 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 0 219 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 2143.62 0 0 0 0 0 0 2143.62 0 0 1014119472 1952759516 10 Physicians DWYER RICHARD C 999999999 200 Cook 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 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2609.85 0 0 0 0 0 0 2609.85 0 0 1014119540 10 Physicians 30 DuPage 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.04 0 0 0 0 0 0 0 0 0 0 0 0 0 61.04 0 0 1014120201 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1286.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1286.12 0 0 1014120506 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14540.38 0 0 0 0 0 0 0 0 0 0 0 0 0 14540.38 0 0 1014120682 1518320191 16 Nurse Practitioners POLZ CHRISTINE 999999999 79 Ogle 0 0 0 0 0 0 0 0 0 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 0 502.08 0 0 0 0 0 0 502.08 0 0 1014121199 1831517671 10 Physicians LIU KEVIN C 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 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 0 541.12 0 0 0 0 0 0 541.12 0 0 1014121295 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13096.28 0 0 0 0 0 0 0 0 0 0 0 0 0 13096.28 0 0 1014121788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13276.8 0 0 0 0 0 0 0 0 0 0 0 0 0 13276.8 0 0 1014121789 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.56 0 0 0 0 0 0 100.56 0 0 1014121809 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1014121852 1578199220 16 Nurse Practitioners GRISETA KELI S 999999999 109 Winnebago 0 0 0 0 0 3 0 0 0 0 0 0 0 0 35 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 1149.43 0 0 0 0 0 0 1245.88 0 0 1014121891 1669004370 87 Psychologist(Encounter Only) HUBBERT CHRISTINA 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 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 0 509.14 0 0 0 0 0 0 509.14 0 0 1014122229 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 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 8862.89 0 0 0 0 0 0 0 0 0 0 0 0 0 8862.89 0 0 1014122413 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23358.93 0 0 0 0 0 0 0 0 0 0 0 0 0 23358.93 0 0 1014122567 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7594.1 0 0 0 0 0 0 0 0 0 0 0 0 0 7594.1 0 0 1014122631 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 889.9 0 0 0 0 0 0 0 0 0 0 0 0 0 889.9 0 0 1014122670 1164048567 55 Early Intervention Services MIRANDA ELLEIS 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 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27126.12 0 0 0 0 0 0 27126.12 0 0 1014122737 1235235458 10 Physicians FOX JASON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 80 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1119.72 0 0 0 0 0 0 0 0 1119.72 0 0 1014122754 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 966.17 0 0 0 0 0 0 0 0 0 0 0 0 0 966.17 0 0 1014123032 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 26.66 0 0 0 0 0 0 26.66 0 0 1014123069 1750990495 89 Physician Assistant Only(Encounter Only) WENZEL STEVEN 999999999 80 Peoria 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 0 135 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 3745.5 0 0 0 0 0 0 3745.5 0 0 1014123109 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18049.08 0 0 0 0 0 0 0 0 0 0 0 0 0 18049.08 0 0 1014123122 10 Physicians 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301.05 0 0 0 0 0 0 301.05 0 0 1014123124 1306133376 10 Physicians MEHTA AMEE 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 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 0 213.43 0 0 0 0 0 0 213.43 0 0 1014123285 1528600434 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE JACKSONVILLE 999999999 77 Morgan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 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 10426.5 0 0 0 0 0 0 10426.5 0 0 1014123431 1598746869 10 Physicians FURIGAY PAUL J 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 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 13238.39 0 0 0 0 0 0 13238.39 0 0 1014123686 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 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 50.38 0 0 0 0 0 0 50.38 0 0 1014123726 1467719716 10 Physicians KARNIK RASIKA 999999999 30 DuPage 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 0 142 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 1573.47 0 0 0 0 0 0 1573.47 0 0 1014123731 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22925.62 0 0 0 0 0 0 0 0 0 0 0 0 0 22925.62 0 0 1014123759 1508475419 22 Physical Therapists MCREAVY COLIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 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 2559.09 2559.09 0 0 1014124233 1871029421 10 Physicians CZAJKOWSKI ERIC 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 0 254 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 4018.16 0 0 0 0 0 0 4018.16 0 0 1014124250 1659448967 10 Physicians MILLARE GIOVANNI 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 54 0 1 0 0 0 0 0 0 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 76 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.6 0 0 0 0 0 0 0 0 546.6 0 0 1014124370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3645.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3645.59 0 0 1014124387 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3115.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3115.04 0 0 1014124533 1982214847 91 Waiver service provider--Adults (DHS/DDD) MCMULLAN JESSE T 999999999 200 Cook 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 1393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80402.6 0 0 0 0 0 0 0 0 0 0 0 0 0 80402.6 0 0 1014124598 1932215548 33 Nursing Facilities PRAIRIE CITY REHAB AND HC 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177214.18 0 0 0 0 0 0 0 177214.18 0 0 1014124602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8928.12 0 0 0 0 0 0 0 0 0 0 0 0 0 8928.12 0 0 1014124620 1992356265 22 Physical Therapists JANUSEVIC MADELINE J 999999999 109 Winnebago 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 0 228 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 2435.46 2435.46 0 0 1014124728 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.71 0 0 0 0 0 0 59.71 0 0 1014124895 1689817389 90 Waiver service provider--Elderly (DOA) EVEREST HEALTHCARE SOLUTIONS 605048150 30 DuPage 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 5439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5439 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604313.97 0 0 0 0 0 0 0 0 0 0 0 0 0 604313.97 0 0 1014125068 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18043.22 0 0 0 0 0 0 0 0 0 0 0 0 0 18043.22 0 0 1014125106 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.8 0 0 0 0 0 0 203.8 0 0 1014125148 1316119837 10 Physicians GUIMONT RODNEY 999999999 91 Sangamon 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 6 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.67 0 292.6 0 0 0 0 0 0 491.27 0 0 1014125333 10 Physicians 107 Will 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 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 0 377.78 0 0 0 0 0 0 377.78 0 0 1014125439 1710349089 10 Physicians BOYES SHAUN 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 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 0 223.13 0 0 0 0 0 0 0 0 223.13 0 0 1014125445 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 0 0 0 0 0 0 0 0 0 0 1014125601 1841460029 28 Waiver service provider--Supportive living facility (HFS) LEGACY ESTATES OF MONMOUTH 999999999 102 Warren 0 0 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 2947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277451.82 0 0 0 0 0 0 0 0 0 0 0 0 0 277451.82 0 0 1014125936 10 Physicians 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 69.55 0 0 0 0 0 0 69.55 0 0 1014125989 1679177026 16 Nurse Practitioners CLINTON TIMOTHY 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 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 1641.62 0 0 0 0 0 0 1641.62 0 0 1014126003 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 16000.96 0 0 0 0 0 0 0 0 0 0 0 0 0 16000.96 0 0 1014126105 1154940153 91 Waiver service provider--Adults (DHS/DDD) BILY-LUTON ERIN E 999999999 66 Marion 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 2449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122551.42 0 0 0 0 0 0 0 0 0 0 0 0 0 122551.42 0 0 1014126138 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18888.87 0 0 0 0 0 0 0 0 0 0 0 0 0 18888.87 0 0 1014126227 86 Clinical Social Worker(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014126251 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 27431.23 0 0 0 0 0 0 0 0 0 0 0 0 0 27431.23 0 0 1014126299 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10000.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10000.93 0 0 1014126380 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 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 3971.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3971.01 0 0 1014126417 1679121396 24 Speech Therapists PALMA BLAIR VALENTINE 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 0 202 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 14232.33 14232.33 0 0 1014126487 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6886.44 0 0 0 0 0 0 0 0 0 0 0 0 0 6886.44 0 0 1014126663 1114344322 10 Physicians ZIDER BRIAN JOSHUA 999999999 30 DuPage 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 2341.36 0 0 0 0 0 0 2341.36 0 0 1014126693 86 Clinical Social Worker(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 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 1291.04 0 0 0 0 0 0 1291.04 0 0 1014126967 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2414 0 0 0 0 0 0 0 0 0 0 0 0 0 2414 0 0 1014126995 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1590.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1590.04 0 0 1014127271 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 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 2951.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2951.64 0 0 1014127310 1710398664 10 Physicians PANCHOLI NEEL 999999999 53 Kane 0 0 Orthopedic Surgery 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 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 2503.93 0 0 0 0 0 0 2503.93 0 0 1014127531 1548796683 10 Physicians O''NEILL JORDAN 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 96.04 0 0 0 0 0 0 0 0 290.04 0 0 0 0 0 0 386.08 0 0 1014127532 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19181.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19181.91 0 0 1014127574 1508429705 86 Clinical Social Worker(Encounter Only) ISKRA ANNETTTE 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 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 0 735.01 0 0 0 0 0 0 735.01 0 0 1014127597 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31088.57 0 0 0 0 0 0 0 0 0 0 0 0 0 31088.57 0 0 1014127768 97 Waiver service provider--Children's residential (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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.7 0 0 0 0 0 0 0 0 0 0 0 0 0 78.7 0 0 1014127883 1265532022 33 Nursing Facilities COLLINSVILLE REHAB HEALTH CC 999999999 65 Madison 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 2223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230213.37 0 0 0 0 0 0 0 230213.37 0 0 1014127891 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15573.88 0 0 0 0 0 0 0 0 0 0 0 0 0 15573.88 0 0 1014127958 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2471.49 0 0 0 0 0 0 0 0 0 0 0 0 0 2471.49 0 0 1014127981 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 0 250 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 32569.44 0 0 0 0 0 0 0 0 0 0 0 0 0 32569.44 0 0 1014128185 1275765174 10 Physicians LAI SUEYI 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 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 1427.65 0 0 0 0 0 0 1427.65 0 0 1014128195 1750919478 16 Nurse Practitioners GAHIMER LAUREN 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 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 0 197.79 0 0 0 0 0 0 197.79 0 0 1014128260 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3288.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3288.56 0 0 1014128384 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17451.7 0 0 0 0 0 0 0 0 0 0 0 0 0 17451.7 0 0 1014128496 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3857.91 0 0 0 0 0 0 0 0 0 0 0 0 0 3857.91 0 0 1014128565 1831684729 10 Physicians ANDRE CHRISTINA 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 13 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 59.99 0 516.37 0 0 0 0 0 0 653.2 0 0 1014128608 1346864469 91 Waiver service provider--Adults (DHS/DDD) RAMIREZ ALEXA L 999999999 30 DuPage 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 3084 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3084 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128916.41 0 0 0 0 0 0 0 0 0 0 0 0 0 128916.41 0 0 1014128615 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 8.9 0 0 0 0 0 0 8.9 0 0 1014128830 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 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 11360.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11360.96 0 0 1014128869 1225474612 10 Physicians UCEDA ARRIOLA MONICA J 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 54 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.14 0 5160.65 0 0 0 0 0 0 5235.79 0 0 1014128891 1730705732 22 Physical Therapists CARLSON KRISTA L 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 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 1334.57 1334.57 0 0 1014128955 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632.01 0 0 0 0 0 0 0 0 0 0 0 0 0 632.01 0 0 1014129549 1922619824 30 General Hospitals DIALYSIS CARE CENTER EVERGREEN 999999999 200 Cook 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 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21651.49 0 0 0 0 0 21651.49 0 0 1014129622 1245856046 10 Physicians SHAHI JEEVIN 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 356.94 0 0 0 0 0 0 356.94 0 0 1014129707 1033741756 55 Early Intervention Services AGNEW BRITTANY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 12034.43 0 0 0 0 0 0 12034.43 0 0 1014129732 1053897025 91 Waiver service provider--Adults (DHS/DDD) JOHNSON-DUNLOP BRITT E 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 1267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52344.04 0 0 0 0 0 0 0 0 0 0 0 0 0 52344.04 0 0 1014129909 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 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 3020.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3020.88 0 0 1014129985 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2261.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2261.3 0 0 1014130059 1013536804 16 Nurse Practitioners MANN AMY 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.56 0 0 0 0 0 0 297.56 0 0 1014130263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27522.69 0 0 0 0 0 0 0 0 0 0 0 0 0 27522.69 0 0 1014130346 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 0 122 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 0 844.78 844.78 0 0 1014130522 1912492448 10 Physicians IMIG MARY K 999999999 98 Tazewell 0 0 Family Practice 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 16.07 0 0 0 0 0 0 0 0 96.99 0 0 0 0 0 0 113.06 0 0 1014130583 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25847.3 0 0 0 0 0 0 0 0 0 0 0 0 0 25847.3 0 0 1014130662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3216.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3216.6 0 0 1014130669 1811507742 11 Dentists SHIM JI HYUN 999999999 200 Cook 0 0 0 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36640.99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36640.99 0 0 1014130670 1972917334 10 Physicians PEREZ MARTA J 999999999 88 Richland 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 236.94 0 0 0 0 0 0 266.42 0 0 1014130773 10 Physicians 200 Cook 0 0 Orthopedic Surgery 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 72.44 0 0 0 0 0 0 72.44 0 0 1014130830 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17002.55 0 0 0 0 0 0 0 0 0 0 0 0 0 17002.55 0 0 1014130865 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.62 0 0 0 0 0 0 130.62 0 0 1014130911 1578176418 25 Audiologists MEYER JENNIFER 999999999 98 Tazewell 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.29 178.29 0 0 1014131087 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 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 8099.32 0 0 0 0 0 0 0 0 0 0 0 0 0 8099.32 0 0 1014131199 1255381000 10 Physicians PURYEAR JEROME 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 118 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861.72 0 494.69 0 0 0 0 0 0 1356.41 0 0 1014131478 1215466164 10 Physicians MAKI AHMED 999999999 71 McHenry 0 0 Psychiatry 0 0 0 0 0 0 0 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 2802.74 0 0 0 0 0 0 2802.74 0 0 1014131670 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20611.68 0 0 0 0 0 0 0 0 0 0 0 0 0 20611.68 0 0 1014131683 1114378668 10 Physicians MCGHEE-WORSOWICZ EMILY K 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288.08 0 0 0 0 0 0 288.08 0 0 1014131744 1457713901 10 Physicians ZAMUDIO ALEJANDRO 999999999 24 Coles 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 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 4279.94 0 0 0 0 0 0 4279.94 0 0 1014131816 1598390809 22 Physical Therapists MOORMAN BRIANA J 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 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 4569.83 4569.83 0 0 1014131835 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 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 6971.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6971.1 0 0 1014131871 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 0 131 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 31500.1 0 0 0 0 0 0 0 0 0 0 0 0 0 31500.1 0 0 1014131992 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3664.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3664.69 0 0 1014132008 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6145.44 0 0 0 0 0 0 0 0 0 0 0 0 0 6145.44 0 0 1014132033 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 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 7171.34 0 0 0 0 0 0 0 0 0 0 0 0 0 7171.34 0 0 1014132064 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432.02 0 0 0 0 0 0 432.02 0 0 1014132072 1437544749 10 Physicians RONCA RICHARD D 999999999 91 Sangamon 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 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 96.9 0 0 0 0 0 0 96.9 0 0 1014132261 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18353.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18353.28 0 0 1014132377 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6599.97 0 0 0 0 0 0 0 0 0 0 0 0 0 6599.97 0 0 1014132494 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3748.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3748.47 0 0 1014132640 1740882331 16 Nurse Practitioners HAMBLOCK SUZANA 999999999 109 Winnebago 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 66 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 483.9 0 0 0 0 0 0 0 0 2113.87 0 0 0 0 0 0 2597.77 0 0 1014132687 1518305457 10 Physicians DIVI SRIKANTH N 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 17 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.26 0 3105.2 0 0 0 0 0 0 3491.46 0 0 1014132999 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20723.51 0 0 0 0 0 0 0 0 0 0 0 0 0 20723.51 0 0 1014133285 1487632261 10 Physicians LAU JAMES 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 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 2535.13 0 0 0 0 0 0 2535.13 0 0 1014133321 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.33 0 0 0 0 0 0 99.33 0 0 1014133403 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23337.88 0 0 0 0 0 0 0 0 0 0 0 0 0 23337.88 0 0 1014133416 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 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 6522.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6522.79 0 0 1014133523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7234.13 0 0 0 0 0 0 0 0 0 0 0 0 0 7234.13 0 0 1014133548 25 Audiologists 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 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 14.81 14.81 0 0 1014133600 10 Physicians 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014133711 10 Physicians 19 Champaign 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.99 0 0 0 0 0 0 201.99 0 0 1014133747 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7032.96 0 0 0 0 0 0 0 0 0 0 0 0 0 7032.96 0 0 1014133976 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 0 102 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 21196.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21196.5 0 0 1014134179 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26187.95 0 0 0 0 0 0 0 0 0 0 0 0 0 26187.95 0 0 1014134322 1801834387 33 Nursing Facilities MCLEANSBORO REHAB & HEALTH CC 628591012 41 Hamilton 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93803.89 0 0 0 0 0 0 0 93803.89 0 0 1014134562 1407297435 12 Optometrists WOJCIK MCNICHOLAS LAUREN P 999999999 107 Will 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 14 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 881.74 0 292.8 0 0 0 0 1174.54 0 0 1014134604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3793.53 0 0 0 0 0 0 0 0 0 0 0 0 0 3793.53 0 0 1014134675 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 1014134895 1790810448 10 Physicians BLUM ALFONSO A 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 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 0 877.37 0 0 0 0 0 0 877.37 0 0 1014134986 1730526260 10 Physicians LAU SAMUEL 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 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 1150.31 0 0 0 0 0 0 1150.31 0 0 1014134992 1619456548 16 Nurse Practitioners ROBINSON CHARLETTE 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 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 3487.59 0 0 0 0 0 0 3487.59 0 0 1014135128 1700260965 10 Physicians CASTELLI ANTHONY 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 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 2054.7 0 0 0 0 0 0 2054.7 0 0 1014135210 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 51.76 0 0 0 0 0 0 51.76 0 0 1014135296 1114542347 16 Nurse Practitioners BREZDEN OLGA 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 5663.16 0 0 0 0 0 0 5798.16 0 0 1014135389 1891393039 16 Nurse Practitioners SHTOYKO IRYNA 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 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 0 808.83 0 0 0 0 0 0 808.83 0 0 1014135729 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24308 0 0 0 0 0 0 0 0 0 0 0 0 0 24308 0 0 1014135788 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 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 0 383.68 0 0 0 0 0 0 383.68 0 0 1014135834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1296.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1296.33 0 0 1014135923 1174933022 10 Physicians CHATMAN CLELLAND 999999999 200 Cook 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 21 0 1 0 0 0 0 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 0 152.94 0 0 0 0 0 0 0 0 152.94 0 0 1014136062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35881.71 0 0 0 0 0 0 0 0 0 0 0 0 0 35881.71 0 0 1014136242 1578197513 16 Nurse Practitioners KELLY TRACIE R 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 121 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 2336.91 0 0 0 0 0 0 2369.06 0 0 1014136255 1275186579 16 Nurse Practitioners ODELL LYDIA E 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 0 186.3 0 0 0 0 0 0 186.3 0 0 1014136355 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 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 3283.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3283.65 0 0 1014136356 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 0 225 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 22934.45 0 0 0 0 0 0 0 0 0 0 0 0 0 22934.45 0 0 1014136637 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24358.01 0 0 0 0 0 0 0 0 0 0 0 0 0 24358.01 0 0 1014136778 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24922.59 0 0 0 0 0 0 0 0 0 0 0 0 0 24922.59 0 0 1014136792 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6297.36 0 0 0 0 0 0 0 0 0 0 0 0 0 6297.36 0 0 1014136802 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11159.07 0 0 0 0 0 0 0 0 0 0 0 0 0 11159.07 0 0 1014136948 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2223.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2223.99 0 0 1014136958 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30139.16 0 0 0 0 0 0 0 0 0 0 0 0 0 30139.16 0 0 1014136962 1942712997 23 Occupational Therapists BLASCHAK ELIZABETH 999999999 53 Kane 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 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 4072.59 4072.59 0 0 1014137337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8688.28 0 0 0 0 0 0 0 0 0 0 0 0 0 8688.28 0 0 1014137530 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16841.99 0 0 0 0 0 0 0 0 0 0 0 0 0 16841.99 0 0 1014137706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8539.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8539.76 0 0 1014137761 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24643.85 0 0 0 0 0 0 0 0 0 0 0 0 0 24643.85 0 0 1014137796 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 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 20773.9 0 0 0 0 0 0 0 0 0 0 0 0 0 20773.9 0 0 1014138005 1033728951 16 Nurse Practitioners PTASINSKI DONNA 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 0 282 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 4114.8 0 0 0 0 0 0 4114.8 0 0 1014138150 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 33.22 0 0 0 0 0 0 33.22 0 0 1014138360 1659904233 16 Nurse Practitioners COLLINS HEATHER 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 85.59 0 0 0 0 0 0 0 0 220.85 0 0 0 0 0 0 306.44 0 0 1014138380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3001.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3001.36 0 0 1014138461 1609976869 33 Nursing Facilities TUSCOLA HEALTH CARE CENTER 999999999 29 Douglas 0 0 0 0 0 0 0 0 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 1279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85934.47 0 0 0 0 0 0 0 85934.47 0 0 1014138485 1386154847 89 Physician Assistant Only(Encounter Only) MAZUR KELSEY 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 0 159.65 0 0 0 0 0 0 159.65 0 0 1014138496 1245869437 16 Nurse Practitioners GASTMAN AMY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 566.21 0 0 0 0 0 0 566.21 0 0 1014138602 1194338160 16 Nurse Practitioners EGWU QUEENETH N 999999999 54 Kankakee 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 0 172 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 2416.38 0 0 0 0 0 0 2416.38 0 0 1014138633 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 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 0 525.33 0 0 0 0 0 0 525.33 0 0 1014138717 1881292019 16 Nurse Practitioners YEDNOCK DANA 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 0 118 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 20258.14 0 0 0 0 0 0 20258.14 0 0 1014138770 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22595.03 0 0 0 0 0 0 0 0 0 0 0 0 0 22595.03 0 0 1014138836 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 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 7259.72 0 0 0 0 0 0 0 0 0 0 0 0 0 7259.72 0 0 1014138881 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 65.1 0 0 0 0 0 0 0 0 0 0 0 0 0 65.1 0 0 1014138953 1861051773 12 Optometrists GRIDER ANDREA 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 0 106.84 0 0 0 0 0 0 106.84 0 0 1014139002 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 287.75 0 0 0 0 0 0 0 0 0 0 0 0 0 287.75 0 0 1014139031 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 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 0 0 0 0 0 0 0 0 0 0 1014139105 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14702.94 0 0 0 0 0 0 0 0 0 0 0 0 0 14702.94 0 0 1014139279 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15671.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15671.52 0 0 1014139438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20293.84 0 0 0 0 0 0 0 0 0 0 0 0 0 20293.84 0 0 1014139471 1497377121 11 Dentists DILO MARINELA 999999999 200 Cook 0 0 General Dentistry 0 0 49 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 10718.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10718.3 0 0 1014139484 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25076.6 0 0 0 0 0 0 0 0 0 0 0 0 0 25076.6 0 0 1014139551 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15970.38 0 0 0 0 0 0 0 0 0 0 0 0 0 15970.38 0 0 1014139599 1043864028 91 Waiver service provider--Adults (DHS/DDD) JORDAN KIBIBI 627621000 91 Sangamon 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 1581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60386.2 0 0 0 0 0 0 0 0 0 0 0 0 0 60386.2 0 0 1014139614 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18837.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18837.4 0 0 1014139705 1053711283 22 Physical Therapists CHAVKA JENNA 999999999 30 DuPage 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 0 118 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 0 688.27 688.27 0 0 1014139728 1285029348 10 Physicians YARLAGADDA JAY 999999999 53 Kane 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 0 124 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 2091.86 0 0 0 0 0 0 2091.86 0 0 1014139733 1073809737 10 Physicians WASSERLAUF JEREMIAH 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 14 0 801 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1308 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.84 0 7848.92 0 0 0 0 0 0 7870.76 0 0 1014139745 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22751.3 0 0 0 0 0 0 0 0 0 0 0 0 0 22751.3 0 0 1014139791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36496.8 0 0 0 0 0 0 0 0 0 0 0 0 0 36496.8 0 0 1014140100 1134751332 16 Nurse Practitioners SITTON KATELYNNE 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 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 60.35 0 0 0 0 0 0 60.35 0 0 1014140135 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13699.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13699.4 0 0 1014140287 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12195.36 0 0 0 0 0 0 0 0 0 0 0 0 0 12195.36 0 0 1014140350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19054.77 0 0 0 0 0 0 0 0 0 0 0 0 0 19054.77 0 0 1014140362 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 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 6758.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6758.34 0 0 1014140367 1275175184 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE HIGHWOOD 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 0 126 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 20687.5 0 0 0 0 0 0 20687.5 0 0 1014140963 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 795.2 0 0 0 0 0 0 0 0 0 0 0 0 0 795.2 0 0 1014141059 11 Dentists 71 McHenry 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.6 0 0 1014141118 1174888945 10 Physicians KABBANY MOHAMMAD TAREK 999999999 200 Cook 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 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1259.67 0 0 0 0 0 0 1259.67 0 0 1014141207 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13705.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13705.75 0 0 1014141246 1265827117 10 Physicians BARTELS STEVEN 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7374.26 0 0 0 0 0 0 7374.26 0 0 1014141494 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.4 0 0 0 0 0 0 0 0 0 0 0 0 0 260.4 0 0 1014141542 1619577657 16 Nurse Practitioners STEPHENS NATALIE A 999999999 80 Peoria 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 78 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1714.83 0 0 0 0 0 0 1746.98 0 0 1014141555 1235744228 94 Waiver service provider--Children's support (DHS/DDD) ABURROMAN CHELSEA 608052224 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 0 159 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 12809.47 0 0 0 0 0 0 0 0 0 0 0 0 0 12809.47 0 0 1014141594 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.24 0 0 0 0 0 0 2.24 0 0 1014141640 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10047.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10047.93 0 0 1014141933 1750983045 89 Physician Assistant Only(Encounter Only) FLAVAN LAUREN 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 0 127 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 1875.85 0 0 0 0 0 0 1875.85 0 0 1014142566 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3059.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3059.21 0 0 1014142608 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29854.12 0 0 0 0 0 0 0 0 0 0 0 0 0 29854.12 0 0 1014142742 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 367.56 0 0 0 0 0 0 0 0 0 0 0 0 0 367.56 0 0 1014142899 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15309.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15309.52 0 0 1014142925 1932581683 10 Physicians HOFER ERIN LYN 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 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 6287.14 0 0 0 0 0 0 6287.14 0 0 1014142930 1326492018 10 Physicians ROACH JOSHUA 999999999 53 Kane 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 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 0 548.77 0 0 0 0 0 0 548.77 0 0 1014143025 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 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 1074.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.48 0 0 1014143113 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 0 0 0 0 0 0 0 0 0 0 1014143178 1588282156 12 Optometrists PATEL VRAJIKA V 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714.33 0 263.52 0 0 0 0 977.85 0 0 1014143247 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 0 0 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 13674.54 0 0 0 0 0 0 0 0 0 0 0 0 0 13674.54 0 0 1014143250 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20020.63 0 0 0 0 0 0 0 0 0 0 0 0 0 20020.63 0 0 1014143486 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3274.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3274.24 0 0 1014143688 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16044.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16044.7 0 0 1014143739 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 43.73 0 0 0 0 0 0 43.73 0 0 1014144102 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 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 0 167.06 167.06 0 0 1014144148 1699366252 16 Nurse Practitioners WALTON RACHEL E 999999999 63 Macon 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 36 0 0 0 0 0 0 0 0 0 1 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 1004.79 0 0 0 0 0 0 1004.79 0 0 1014144275 1366988024 10 Physicians TULPULE SUNIL 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 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 2437.25 0 0 0 0 0 0 2437.25 0 0 1014144283 1447851472 16 Nurse Practitioners SULAIMAN BASIRAT O 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 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 0 419.6 0 0 0 0 0 0 419.6 0 0 1014144464 1083142152 10 Physicians DUENAS VINCENT 999999999 200 Cook 0 0 Family Practice 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 0 282 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 2927.63 0 0 0 0 0 0 2927.63 0 0 1014144488 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15719.33 0 0 0 0 0 0 0 0 0 0 0 0 0 15719.33 0 0 1014144574 1770199051 16 Nurse Practitioners DESCORBETH ASHLEY L 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 0 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575 0 0 0 0 0 0 0 0 0 0 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1807 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 2936.05 0 0 1014145258 72 Taxicabs and Livery Companies 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.38 0 0 0 0 0 0 139.38 0 0 1014145342 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 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 5.4 0 0 0 0 0 0 5.4 0 0 1014145352 1730630740 16 Nurse Practitioners SCHULTE KRISTA 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 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 1069.13 0 0 0 0 0 0 1069.13 0 0 1014145479 1699191700 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC" 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 5996.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5996.27 0 0 1014146023 22 Physical Therapists 54 Kankakee 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 0 792.39 792.39 0 0 1014146153 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 6489.26 0 0 0 0 0 0 0 0 0 0 0 0 0 6489.26 0 0 1014146358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26244.66 0 0 0 0 0 0 0 0 0 0 0 0 0 26244.66 0 0 1014146512 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 1014146527 1568005072 16 Nurse Practitioners GILMAN LAUREN D 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 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 0 215.39 0 0 0 0 0 0 215.39 0 0 1014146585 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 24900.71 0 0 0 0 0 0 0 0 0 0 0 0 0 24900.71 0 0 1014146796 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9985.46 0 0 0 0 0 0 0 0 0 0 0 0 0 9985.46 0 0 1014146878 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 2601.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2601.69 0 0 1014146957 1639719834 89 Physician Assistant Only(Encounter Only) SABRY COURTNEY 999999999 200 Cook 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 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 2907.63 0 0 0 0 0 0 2907.63 0 0 1014147073 1083230585 12 Optometrists GROENNERT JUSTIN F 999999999 96 St Clair 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 16 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.41 0 116.76 0 0 0 0 663.17 0 0 1014147127 1386178259 10 Physicians MEHTA SAUMYA A 999999999 30 DuPage 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 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8137.16 0 0 0 0 0 0 8137.16 0 0 1014147376 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 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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0 0 21110.97 0 0 0 0 0 0 0 0 0 0 0 0 0 21110.97 0 0 1014148337 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14471.7 0 0 0 0 0 0 0 0 0 0 0 0 0 14471.7 0 0 1014148549 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 4 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 6616.82 6616.82 0 0 1014148587 1881049666 10 Physicians JACKSON TIPHANY 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 3903.77 0 0 0 0 0 0 3903.77 0 0 1014148946 1760777320 10 Physicians MANKAL PAVAN 999999999 19 Champaign 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 0 184 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 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provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2294.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2294.02 0 0 1014149487 1467985051 10 Physicians PATEL JAY 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 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 0 154.9 0 0 0 0 0 0 154.9 0 0 1014149635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26040 0 0 0 0 0 0 0 0 0 0 0 0 0 26040 0 0 1014149636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12751.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12751.1 0 0 1014149731 10 Physicians 80 Peoria 0 0 0 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 0 198 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 17403.81 0 0 0 0 0 0 0 0 0 0 0 0 0 17403.81 0 0 1014151790 1255841748 16 Nurse Practitioners MOTTES THERESA 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 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 1232.8 0 0 0 0 0 0 1232.8 0 0 1014151807 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30092.63 0 0 0 0 0 0 0 0 0 0 0 0 0 30092.63 0 0 1014151974 1073122594 16 Nurse Practitioners STROHM MEGAN E 999999999 91 Sangamon 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 0 128 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 6011.19 0 0 0 0 0 0 6011.19 0 0 1014152055 13 Podiatrists 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 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 27.41 0 0 0 0 0 0 27.41 0 0 1014152201 10 Physicians 89 Rock Island 0 0 General 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 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 0 101.69 0 0 0 0 0 0 101.69 0 0 1014152245 1114216363 10 Physicians MENDEZ BERNARDINO 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 63.01 0 0 0 0 0 0 63.01 0 0 1014152384 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5018.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5018.96 0 0 1014152386 25 Audiologists 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 0 0 0 0 1014152412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2643.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2643.81 0 0 1014152475 4014152475 71 Medicar Provider SOUTHERN ILLINOIS MEDICAL TRAN 999999999 96 St Clair 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 2185 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 39626.48 0 0 0 0 0 0 39626.48 0 0 1014152608 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2346.52 2346.52 0 0 1014152655 1891334280 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELEVATE CARE NILES 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 0 290 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 47953.62 0 0 0 0 0 0 47953.62 0 0 1014152657 75 Department of Alcohol and Substance Abuse Provider 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 676.08 0 0 676.08 0 0 1014152747 10 Physicians 50 Jersey 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 89.29 0 0 0 0 0 0 89.29 0 0 1014152769 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1891.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1891.68 0 0 1014152949 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 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 23.72 0 0 0 0 0 0 23.72 0 0 1014153034 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2352.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2352.46 0 0 1014153049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14478.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14478.53 0 0 1014153456 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22905.96 0 0 0 0 0 0 0 0 0 0 0 0 0 22905.96 0 0 1014153480 1538447628 10 Physicians ABARCA-ROJAS EDUARDO 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 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 0 108.82 0 0 0 0 0 0 108.82 0 0 1014153530 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 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 3143.82 0 0 0 0 0 0 3143.82 0 0 1014153575 1679835284 10 Physicians CHEN XUESONG 999999999 19 Champaign 0 0 Allergy-Immunization 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 0 148 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 4992.61 0 0 0 0 0 0 4992.61 0 0 1014153648 1245850767 89 Physician Assistant Only(Encounter Only) BARNETT ZACHARY M 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247.73 0 0 0 0 0 0 247.73 0 0 1014153778 1831703321 16 Nurse Practitioners GONZALES KATHLEEN 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 192.9 0 0 0 0 0 0 0 0 5840.73 0 0 0 0 0 0 6033.63 0 0 1014153859 1043845027 16 Nurse Practitioners MAMARIL ROSS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 874 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3394 0 0 0 0 0 0 3394 0 0 1014153954 1366962417 10 Physicians RANA AMAAD 999999999 826 Missouri 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 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 1014153965 1659518967 10 Physicians LAND ANNA M 999999999 200 Cook 0 0 Family Practice 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 31 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 378.29 0 0 0 0 0 0 388.29 0 0 1014154153 1689225138 16 Nurse Practitioners KHAZARAN AMENA 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 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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 7634.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7634.25 0 0 1014154710 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 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 0 137.94 0 0 0 0 0 0 137.94 0 0 1014154743 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7438.48 0 0 0 0 0 0 0 0 0 0 0 0 0 7438.48 0 0 1014154750 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22233.99 0 0 0 0 0 0 0 0 0 0 0 0 0 22233.99 0 0 1014154779 1245465566 10 Physicians HOSSEINIAN LEILA 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 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6000 0 0 0 0 0 0 0 0 0 0 0 0 0 6000 0 0 1014155249 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 80.63 0 0 0 0 0 0 80.63 0 0 1014155693 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 0 147 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 26190.45 0 0 0 0 0 0 0 0 0 0 0 0 0 26190.45 0 0 1014155724 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 602.36 0 0 0 0 0 0 0 0 0 0 0 0 0 602.36 0 0 1014155882 1396716569 87 Psychologist(Encounter Only) DRISCOLL PAUL F 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 1752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 656.86 0 0 0 0 0 0 656.86 0 0 1014155901 1942734405 10 Physicians LEVINE MICAH Z 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 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 2.28 0 0 0 0 0 0 2.28 0 0 1014156350 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 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 5397.87 0 0 0 0 0 0 0 0 0 0 0 0 0 5397.87 0 0 1014156353 1548456122 16 Nurse Practitioners DANSBY ROBERT D 999999999 11 Alexander 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.95 0 0 0 0 0 0 18.95 0 0 1014156604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1195.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1195.08 0 0 1014156711 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14110.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14110.14 0 0 1014156784 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 4 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 2802.52 2802.52 0 0 1014156908 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25471.73 0 0 0 0 0 0 0 0 0 0 0 0 0 25471.73 0 0 1014157111 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23809.97 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.97 0 0 1014157177 1124559117 10 Physicians PATEL MAULIK V 999999999 200 Cook 0 0 Internal Medicine 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 0 225 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 4923.35 0 0 0 0 0 0 4923.35 0 0 1014157249 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13579.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13579.2 0 0 1014157299 1093372187 70 Ambulance Service Providers VITAL AMBULANCE SERVICES LLC 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1864 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1864 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164734.83 0 0 0 0 0 0 164734.83 0 0 1014157443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24136.76 0 0 0 0 0 0 0 0 0 0 0 0 0 24136.76 0 0 1014157446 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014157918 1235635269 16 Nurse Practitioners STEFANI MEGAN J 999999999 107 Will 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 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 795 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3368.98 0 0 0 0 0 0 3368.98 0 0 1014158088 1063915882 16 Nurse Practitioners STEELE STEPHANIE 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 0 154 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 1363.13 0 0 0 0 0 0 1363.13 0 0 1014158110 1336672906 10 Physicians SHAH SONIA S 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 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 0 642.64 0 0 0 0 0 0 642.64 0 0 1014158206 1568993657 10 Physicians SIRAJ KHAJA MEHMOODUDDIN 999999999 200 Cook 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338.58 0 0 0 0 0 0 338.58 0 0 1014158220 25 Audiologists 30 DuPage 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 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 23.08 23.08 0 0 1014158565 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23817.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23817.64 0 0 1014158598 1285230425 11 Dentists HEZARKHANI ARMITA A 999999999 200 Cook 0 0 General Dentistry 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 0 637.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637.1 0 0 1014158641 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4102.51 0 0 0 0 0 0 0 0 0 0 0 0 0 4102.51 0 0 1014158764 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 553.35 0 0 0 0 0 0 0 0 0 0 0 0 0 553.35 0 0 1014158772 10 Physicians 30 DuPage 0 0 0 0 0 0 0 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 0 0 1014158861 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 4311.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4311.72 0 0 1014158880 1730798588 91 Waiver service provider--Adults (DHS/DDD) TOBIAS AILEEN 999999999 91 Sangamon 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67277.9 0 0 0 0 0 0 0 0 0 0 0 0 0 67277.9 0 0 1014158935 1841719259 16 Nurse Practitioners ROLLYSON CATHERINE D 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 505.26 0 0 0 0 0 0 505.26 0 0 1014159041 1871159053 48 Rural Health Clinics MID ILLINOIS QUICK CARE 624481249 48 Jasper 0 0 0 53 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4885.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4885.23 0 0 1014159172 1881224921 16 Nurse Practitioners TORRES TOMAS 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 0 281 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 1755.1 0 0 0 0 0 0 1755.1 0 0 1014159187 1942649470 10 Physicians MASOM CLIFFORD P 999999999 31 Edgar 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 0 346.86 0 0 0 0 0 0 346.86 0 0 1014159190 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 2.27 0 0 0 0 0 0 2.27 0 0 1014159191 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7376.17 0 0 0 0 0 0 0 0 0 0 0 0 0 7376.17 0 0 1014159201 1659635811 23 Occupational Therapists HAURI HEATHER 999999999 98 Tazewell 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 0 216 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 14822.48 14822.48 0 0 1014159310 86 Clinical Social Worker(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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.83 0 0 0 0 0 0 217.83 0 0 1014159389 1356962120 89 Physician Assistant Only(Encounter Only) SAMUDOVSKY HEATHER 999999999 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 0 100 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 0 611.52 0 0 0 0 0 0 611.52 0 0 1014159501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2582.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2582.63 0 0 1014159736 1922539923 10 Physicians DUKE JESSICA 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 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 0 290.62 0 0 0 0 0 0 290.62 0 0 1014159746 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 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 0 548.12 0 0 0 0 0 0 548.12 0 0 1014159790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26059.95 0 0 0 0 0 0 0 0 0 0 0 0 0 26059.95 0 0 1014159818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 460.17 0 0 0 0 0 0 0 0 0 0 0 0 0 460.17 0 0 1014160001 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15319.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15319.85 0 0 1014160015 1235665811 13 Podiatrists QURESHI ASIM 999999999 87 Randolph 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 0 233 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 2271.97 0 0 0 0 0 0 2271.97 0 0 1014160024 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 0 129 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 8778.99 0 0 0 0 0 0 0 0 0 0 0 0 0 8778.99 0 0 1014160127 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16589.54 0 0 0 0 0 0 0 0 0 0 0 0 0 16589.54 0 0 1014160265 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3311.16 0 0 0 0 0 0 0 0 0 0 0 0 0 3311.16 0 0 1014160339 1902324841 22 Physical Therapists STEVENSON COURTNEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014.52 1014.52 0 0 1014160375 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 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 0 158.71 158.71 0 0 1014160454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762.32 0 0 0 0 0 0 0 0 0 0 0 0 0 762.32 0 0 1014160506 1659722262 10 Physicians ISHAQUE SANDAL F 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 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 0 548.14 0 0 0 0 0 0 548.14 0 0 1014160677 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14701.74 0 0 0 0 0 0 0 0 0 0 0 0 0 14701.74 0 0 1014160778 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 996.62 0 0 0 0 0 0 0 0 0 0 0 0 0 996.62 0 0 1014160811 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 3572.89 0 0 0 0 0 0 0 0 0 0 0 0 0 3572.89 0 0 1014160823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9328.62 0 0 0 0 0 0 0 0 0 0 0 0 0 9328.62 0 0 1014161048 1225322522 10 Physicians ABRAHAM JUSTIN 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 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 47.18 0 0 0 0 0 0 47.18 0 0 1014161132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8843.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8843.97 0 0 1014161192 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 0 172 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 20887.06 0 0 0 0 0 0 0 0 0 0 0 0 0 20887.06 0 0 1014161210 1164062196 16 Nurse Practitioners MULLEN TIARA J 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 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 1052.65 0 0 0 0 0 0 1052.65 0 0 1014161212 1942388335 87 Psychologist(Encounter Only) FORSTER CINDY J 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 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 1014161339 1467040022 86 Clinical Social Worker(Encounter Only) TAYLOR STACEY 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 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 25 0 0 0 0 0 0 25 0 0 1014161457 1649236449 33 Nursing Facilities KEWANEE CARE HOME 999999999 45 Henry 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453153.99 0 0 0 0 0 0 0 453153.99 0 0 1014161664 1447889852 89 Physician Assistant Only(Encounter Only) CERVENY STEPHANIE 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 1078.04 0 0 0 0 0 0 1078.04 0 0 1014161674 1801202114 10 Physicians MEEKER JARED W 999999999 80 Peoria 0 0 Internal 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 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12043.04 0 0 0 0 0 0 12043.04 0 0 1014161736 1386140457 10 Physicians KIRK REBECCA K 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 343.68 0 0 0 0 0 0 0 0 147.66 0 0 0 0 0 0 491.34 0 0 1014161870 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23597.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23597.04 0 0 1014161876 1477024347 63 Other Providers of Medical Equipment/Supplies (Non-registered) "KARMA7 MEDICAL SUPPLY, LLC" 999999999 57 Lake 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 1993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1993 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148835.91 0 0 0 0 0 0 148835.91 0 0 1014161941 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.85 0 1893 0 0 0 0 0 0 2000.85 0 0 1014162031 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16581.63 0 0 0 0 0 0 0 0 0 0 0 0 0 16581.63 0 0 1014162076 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 939.72 0 0 0 0 0 0 0 0 0 0 0 0 0 939.72 0 0 1014162085 1770921694 10 Physicians WHITCOMB TYLER J 999999999 89 Rock Island 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 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 0 330.53 0 0 0 0 0 0 330.53 0 0 1014162293 1548243090 10 Physicians REINER ERIC H 999999999 200 Cook 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 18 0 0 0 0 0 0 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 11.33 0 1021.93 0 0 0 0 0 0 1033.26 0 0 1014162414 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 149.82 0 0 0 0 0 0 149.82 0 0 1014162443 1114461175 28 Waiver service provider--Supportive living facility (HFS) FOXES GROVE SUPPORTING LIVING 999999999 65 Madison 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 0 163 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 405641.29 0 0 0 0 0 0 0 0 0 0 0 0 0 405641.29 0 0 1014162614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3557.49 0 0 0 0 0 0 0 0 0 0 0 0 0 3557.49 0 0 1014162655 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 425.08 0 0 0 0 0 0 425.08 0 0 1014162705 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15881.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15881.49 0 0 1014162791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23142.38 0 0 0 0 0 0 0 0 0 0 0 0 0 23142.38 0 0 1014162850 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 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 1047.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1047.02 0 0 1014162946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15457.53 0 0 0 0 0 0 0 0 0 0 0 0 0 15457.53 0 0 1014162977 91 Waiver service provider--Adults (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 0 230 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 23178.65 0 0 0 0 0 0 0 0 0 0 0 0 0 23178.65 0 0 1014163159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16763.25 0 0 0 0 0 0 0 0 0 0 0 0 0 16763.25 0 0 1014163188 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014163425 89 Physician Assistant Only(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.7 0 0 0 0 0 0 133.7 0 0 1014163891 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 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 6208.99 0 0 0 0 0 0 0 0 0 0 0 0 0 6208.99 0 0 1014164053 1598398455 60 Pharmacies WASHINGTON UNIVERSITY PHYSICIA 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137045.18 0 0 0 137045.18 0 0 1014164244 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8700.93 0 0 0 0 0 0 0 0 0 0 0 0 0 8700.93 0 0 1014164289 1861768152 10 Physicians PATEL TEJAS 999999999 71 McHenry 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 24 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.13 0 950.38 0 0 0 0 0 0 1097.51 0 0 1014164368 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1014164428 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 4992.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4992.61 0 0 1014164569 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21097.13 0 0 0 0 0 0 0 0 0 0 0 0 0 21097.13 0 0 1014164679 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.82 0 0 0 0 0 0 45.82 0 0 1014165179 1720686280 33 Nursing Facilities AVANTARA AURORA 605061452 53 Kane 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3543 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436892.6 0 0 0 0 0 0 0 436892.6 0 0 1014165884 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11158.18 0 0 0 0 0 0 0 0 0 0 0 0 0 11158.18 0 0 1014165889 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 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 10419.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10419.92 0 0 1014166045 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8921.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8921.44 0 0 1014166175 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20218.36 0 0 0 0 0 0 0 0 0 0 0 0 0 20218.36 0 0 1014166227 1790258473 16 Nurse Practitioners TRIVEDE PUNAM H 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 1 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 763 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 763 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 493.18 0 0 3092.4 0 0 0 0 0 0 3585.58 0 0 1014166299 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 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 4884 0 0 0 0 0 0 0 0 0 0 0 0 0 4884 0 0 1014166443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32286.34 0 0 0 0 0 0 0 0 0 0 0 0 0 32286.34 0 0 1014166521 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1368.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1368.24 0 0 1014166523 1932442456 10 Physicians PEALY ELIZABETH S 999999999 30 DuPage 0 0 Anesthesiology 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 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 7864.76 0 0 0 0 0 0 7864.76 0 0 1014166683 1467803452 16 Nurse Practitioners ATKINSON ADRIENNE RENEE 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 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 0 282.52 0 0 0 0 0 0 282.52 0 0 1014166971 1932715570 16 Nurse Practitioners LONG JULIE R 999999999 53 Kane 0 0 0 0 0 2 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 51.35 0 0 0 0 0 0 0 0 1193.85 0 0 0 0 0 0 1245.2 0 0 1014167094 1609307685 10 Physicians TRENHAILE JAMES 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 0 122 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 0 981.22 0 0 0 0 0 0 981.22 0 0 1014167173 1548877400 89 Physician Assistant Only(Encounter Only) MILHAUSER SHAWN 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 2.35 0 0 0 0 0 0 2.35 0 0 1014167700 1003305368 10 Physicians PATEL AKASH 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 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 2532.59 0 0 0 0 0 0 2532.59 0 0 1014167940 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 2606.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2606.53 0 0 1014167993 1548808801 16 Nurse Practitioners MEFFO TIAM ARLETTE 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 0 318 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 57.98 0 0 0 0 0 0 57.98 0 0 1014168194 1518110725 16 Nurse Practitioners RUSSELL ELEANOR 999999999 71 McHenry 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 0 262 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 1370.21 0 0 0 0 0 0 1370.21 0 0 1014168199 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29835.63 0 0 0 0 0 0 0 0 0 0 0 0 0 29835.63 0 0 1014168200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4122.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4122.8 0 0 1014168411 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9517.31 0 0 0 0 0 0 0 0 0 0 0 0 0 9517.31 0 0 1014168440 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12451.66 0 0 0 0 0 0 0 0 0 0 0 0 0 12451.66 0 0 1014168483 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1293.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1293.19 0 0 1014168564 1720619232 89 Physician Assistant Only(Encounter Only) BLASINGAME JACOB 999999999 19 Champaign 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 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 1058.83 0 0 0 0 0 0 1058.83 0 0 1014168594 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22218.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22218.13 0 0 1014168740 1861954786 16 Nurse Practitioners HICKS STEPHEN D 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 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 0 301.74 0 0 0 0 0 0 301.74 0 0 1014168743 1467713248 10 Physicians AVRAHAM JACOB BARUCH 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1028.46 0 0 0 0 0 0 1028.46 0 0 1014168846 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1968.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1968.71 0 0 1014168886 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 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 1017.96 1017.96 0 0 1014169043 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 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 0 593.92 593.92 0 0 1014169221 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014169331 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 81.59 0 0 0 0 0 0 81.59 0 0 1014169386 1215530100 86 Clinical Social Worker(Encounter Only) WALDMAN RACHAEL 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 0 139 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 0 960.75 0 0 0 0 0 0 960.75 0 0 1014169436 10 Physicians 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014169528 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1171.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1171.79 0 0 1014169551 10 Physicians 71 McHenry 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1014169571 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 33.95 0 0 0 0 0 0 33.95 0 0 1014169642 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17084.64 0 0 0 0 0 0 0 0 0 0 0 0 0 17084.64 0 0 1014169762 1831629856 10 Physicians MULLEN STEPHANIE CIHLAR 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 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 2464.29 0 0 0 0 0 0 2464.29 0 0 1014169889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1110.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1110.11 0 0 1014169911 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 1198.7 0 0 0 0 0 0 1198.7 0 0 1014169926 1972541225 65 Independent Diagnostic Testing Facility (IDTF) STAND UP MRI OF DEERFIELD LLC 999999999 200 Cook 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 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 2722.92 0 0 0 0 0 0 0 0 2722.92 0 0 1014170247 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 1014170256 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 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 1014170284 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6205.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6205.77 0 0 1014170344 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 876 0 0 0 0 0 0 0 0 0 0 0 0 0 876 0 0 1014170355 1851592299 10 Physicians SCHOELCH BARRY A 999999999 98 Tazewell 0 0 0 0 0 0 0 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 1133.47 0 0 0 0 0 0 0 0 1133.47 0 0 1014170383 1992110126 10 Physicians KAISER NEHA V 999999999 53 Kane 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 0 202 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 6274.82 0 0 0 0 0 0 6274.82 0 0 1014170572 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 268.7 0 0 0 0 0 0 0 0 0 0 0 0 0 268.7 0 0 1014170858 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6414.43 0 0 0 0 0 0 0 0 0 0 0 0 0 6414.43 0 0 1014170874 1275199309 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELEVATE CARE RIVERWOODS 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 6951 0 0 0 0 0 0 6951 0 0 1014171092 1548211584 10 Physicians VAZQUEZ-BAUZA JUAN J 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 0 171 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 2657.68 0 0 0 0 0 0 2657.68 0 0 1014171157 1417573734 16 Nurse Practitioners MEDINA SCHERRIE 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 744.46 0 0 0 0 0 0 744.46 0 0 1014171242 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23330.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23330.96 0 0 1014171382 1770026312 33 Nursing Facilities INVERNESS HEALTH & REHAB 999999999 200 Cook 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 0 281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942315.1 0 0 0 0 0 0 0 942315.1 0 0 1014171530 1548623507 10 Physicians PAVICIC MEREDITH 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 6 0 69 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 93 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 93 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 50.73 0 10545.78 0 0 0 0 0 0 10682.16 0 0 1014171543 73 Other Transportation Providers ( Non-Registered) 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 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 75.9 0 0 0 0 0 0 75.9 0 0 1014171675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4251.24 0 0 0 0 0 0 0 0 0 0 0 0 0 4251.24 0 0 1014171724 1164054011 16 Nurse Practitioners GAWNE ELIZABETH A 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 0 214 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 4851.69 0 0 0 0 0 0 4851.69 0 0 1014171767 1558595934 16 Nurse Practitioners SMITH MARCIA C 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 0 100 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 1590.3 0 0 0 0 0 0 1590.3 0 0 1014171854 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3319.63 0 0 0 0 0 0 0 0 0 0 0 0 0 3319.63 0 0 1014171861 1104479724 11 Dentists GONUGUNTLA KAMMA PRAVEEN KUMAR 999999999 91 Sangamon 0 0 General Dentistry 0 0 41 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 6807.57 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 7560.27 0 0 1014171945 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1050.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1050.72 0 0 1014172157 1255923371 16 Nurse Practitioners COSTEA ANGELA 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 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 0 378.88 0 0 0 0 0 0 378.88 0 0 1014172192 1578673281 10 Physicians INBORIBOON PHOLAPHAT 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.46 0 5681.98 0 0 0 0 0 0 5726.44 0 0 1014172288 10 Physicians 53 Kane 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 1014172302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1795.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1795.27 0 0 1014172338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797.98 0 0 0 0 0 0 0 0 0 0 0 0 0 797.98 0 0 1014172612 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 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 2065.27 0 0 0 0 0 0 0 0 0 0 0 0 0 2065.27 0 0 1014172743 1790723492 10 Physicians COLTON ERIC 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 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 0 408.41 0 0 0 0 0 0 408.41 0 0 1014172798 1073045498 10 Physicians CHAFFIN BRIAN J 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 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 1294.07 0 0 0 0 0 0 1294.07 0 0 1014172911 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.14 0 0 0 0 0 0 74.14 0 0 1014172996 1962012583 33 Nursing Facilities SERENITY OF MOLINE 999999999 89 Rock Island 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 614464.87 0 0 0 0 0 0 0 614464.87 0 0 1014173006 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 20136.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20136.66 0 0 1014173390 1043436132 10 Physicians MORGAN JEFFREY 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 0 194 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 0 309.41 0 0 0 0 0 0 309.41 0 0 1014173433 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1974.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1974.04 0 0 1014173488 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21513.99 0 0 0 0 0 0 0 0 0 0 0 0 0 21513.99 0 0 1014173545 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22769.58 0 0 0 0 0 0 0 0 0 0 0 0 0 22769.58 0 0 1014173681 1609499060 16 Nurse Practitioners QUAINE KELLY 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 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 0 118.7 0 0 0 0 0 0 118.7 0 0 1014173720 1821482274 10 Physicians ZIEGLER ANDREA 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2199.36 0 0 0 0 0 0 2199.36 0 0 1014173749 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7956.49 0 0 0 0 0 0 0 0 0 0 0 0 0 7956.49 0 0 1014173933 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13551.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13551.63 0 0 1014174052 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1983.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1983.88 0 0 1014174329 1316565773 57 Home Nursing Agency GLOBAL HERITAGE HOME HEALTHCAR 999999999 200 Cook 0 0 0 0 0 0 0 7 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164437.71 89446.53 0 0 0 0 0 0 0 0 0 0 0 0 253884.24 0 0 1014174366 1215048574 10 Physicians TIWARI SUMIT 999999999 200 Cook 0 0 Internal Medicine 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 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6246.82 0 0 0 0 0 0 6246.82 0 0 1014174398 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8468.37 0 0 0 0 0 0 0 0 0 0 0 0 0 8468.37 0 0 1014174511 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12298.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12298.2 0 0 1014174538 1548600224 10 Physicians PANDAMOUZ ALI 999999999 19 Champaign 0 0 Family Practice 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 0 277 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 5267.12 0 0 0 0 0 0 5267.12 0 0 1014174622 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.6 0 0 0 0 0 0 0 0 0 0 0 0 0 173.6 0 0 1014174642 10 Physicians 200 Cook 0 0 Vascular 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 5.27 0 0 0 0 0 0 5.27 0 0 1014174656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8625.21 0 0 0 0 0 0 0 0 0 0 0 0 0 8625.21 0 0 1014174666 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21059.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21059.85 0 0 1014174951 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 2380.05 0 0 0 0 0 0 0 0 0 0 0 2380.05 0 0 0 0 0 0 4760.1 0 0 1014175005 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17782.3 0 0 0 0 0 0 0 0 0 0 0 0 0 17782.3 0 0 1014175096 1730799651 16 Nurse Practitioners MEYER RUBY N 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 0 227.08 0 0 0 0 0 0 227.08 0 0 1014175298 1700350170 16 Nurse Practitioners MITCHELL KIMBERLY 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 0 726 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 3026.93 0 0 0 0 0 0 3026.93 0 0 1014175398 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6886.44 0 0 0 0 0 0 0 0 0 0 0 0 0 6886.44 0 0 1014175571 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 11.81 0 0 0 0 0 0 11.81 0 0 1014175757 1861771149 89 Physician Assistant Only(Encounter Only) CONWAY ERIC 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 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 4389.89 0 0 0 0 0 0 4389.89 0 0 1014175833 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23911.17 0 0 0 0 0 0 0 0 0 0 0 0 0 23911.17 0 0 1014175865 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 0 101 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 15682.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15682.49 0 0 1014176075 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 72.91 0 0 0 0 0 0 72.91 0 0 1014176264 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 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 0 349.78 0 0 0 0 0 0 349.78 0 0 1014176271 1083203202 16 Nurse Practitioners TURNER LORI A 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 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 838.69 0 0 0 0 0 0 870.84 0 0 1014176381 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 0 139.78 0 0 0 0 0 0 139.78 0 0 1014176468 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9960.94 0 0 0 0 0 0 0 0 0 0 0 0 0 9960.94 0 0 1014176749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12416.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12416.42 0 0 1014176846 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28321.9 0 0 0 0 0 0 0 0 0 0 0 0 0 28321.9 0 0 1014176849 1255952123 16 Nurse Practitioners REYNOLDS AMY G 999999999 107 Will 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 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 1004.65 0 0 0 0 0 0 1004.65 0 0 1014177057 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9325.66 0 0 0 0 0 0 0 0 0 0 0 0 0 9325.66 0 0 1014177402 1851934871 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 999999999 20 Christian 0 0 0 122 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 513 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20365.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20365.42 0 0 1014177525 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1014177629 94 Waiver service provider--Children's support (DHS/DDD) 108 Williamson 0 0 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 7171.85 0 0 0 0 0 0 0 0 0 0 0 0 0 7171.85 0 0 1014177637 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16692 0 0 0 0 0 0 0 0 0 0 0 0 0 16692 0 0 1014177891 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7916.22 0 0 0 0 0 0 0 0 0 0 0 0 0 7916.22 0 0 1014178026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13463.56 0 0 0 0 0 0 0 0 0 0 0 0 0 13463.56 0 0 1014178059 1114531936 16 Nurse Practitioners KENTNER ALEXANDER T 999999999 80 Peoria 0 0 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 64 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 956.09 0 0 0 0 0 0 1040.71 0 0 1014178172 1316544067 16 Nurse Practitioners MUSOLF VALERIE 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 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 0 356.72 0 0 0 0 0 0 356.72 0 0 1014178195 1346880275 16 Nurse Practitioners LOPEZ ERICA J 999999999 200 Cook 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 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 0 104.96 0 0 0 0 0 0 0 0 1258.22 0 0 0 0 0 0 1363.18 0 0 1014178342 1003236753 10 Physicians ALLEN-PROCTOR MARY K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 123 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 312 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2515.39 0 174.62 0 0 0 0 0 0 2690.01 0 0 1014178465 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 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 6419.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6419.2 0 0 1014178483 1730139114 10 Physicians FORREST GRAEME N 999999999 200 Cook 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 0 152 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 1214.53 0 0 0 0 0 0 1214.53 0 0 1014178531 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5422.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5422.32 0 0 1014178559 1861768566 10 Physicians SWONG KEVIN 999999999 200 Cook 0 0 Neurology 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 2140.38 0 0 0 0 0 0 2140.38 0 0 1014178569 1073029351 86 Clinical Social Worker(Encounter Only) DABROWSKI EMILY 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 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 0 406.85 0 0 0 0 0 0 406.85 0 0 1014178578 1073975132 10 Physicians JOHANSEN WILLIAM B 999999999 200 Cook 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 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 1890.47 0 0 0 0 0 0 1890.47 0 0 1014178608 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23774.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23774.52 0 0 1014178907 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12209.46 0 0 0 0 0 0 0 0 0 0 0 0 0 12209.46 0 0 1014178912 1639602543 10 Physicians SHAREEF MUHAMMAD 999999999 71 McHenry 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 0 171 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 3269.16 0 0 0 0 0 0 3269.16 0 0 1014178944 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 5137.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5137.47 0 0 1014178984 1457961328 16 Nurse Practitioners CRAVEN AMBER 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 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 0 323.06 0 0 0 0 0 0 323.06 0 0 1014179076 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14226.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14226.15 0 0 1014179384 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014179443 1669835393 10 Physicians LANDY NOAH COOPER 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 0 130 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 1996.55 0 0 0 0 0 0 1996.55 0 0 1014179521 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 0 153 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 6333.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6333.55 0 0 1014179761 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14586.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14586.44 0 0 1014179894 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 4179.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4179.36 0 0 1014179900 1245729128 10 Physicians MOTAMARRI SEETHAL 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 107.97 0 0 0 0 0 0 0 0 234.17 0 0 0 0 0 0 342.14 0 0 1014179991 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 4 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 4168.82 4168.82 0 0 1014180047 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798.82 0 0 0 0 0 0 0 0 0 0 0 0 0 798.82 0 0 1014180074 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 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 0 391.19 0 0 0 0 0 0 391.19 0 0 1014180081 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 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 0 0 0 0 0 0 0 0 0 0 1014180131 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17845.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17845.57 0 0 1014180219 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 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 62379.23 0 0 0 0 0 0 0 0 0 0 0 0 0 62379.23 0 0 1014180266 1639440506 10 Physicians MOLINA CAMILO A 999999999 200 Cook 0 0 Neurology 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 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 6498.08 0 0 0 0 0 0 6498.08 0 0 1014180352 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 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 90.2 0 0 0 0 0 0 90.2 0 0 1014180537 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 84.28 0 0 0 0 0 0 84.28 0 0 1014180612 1396369112 11 Dentists CHUG MANAS 999999999 107 Will 0 0 General Dentistry 0 0 160 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 835 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 835 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 27252.16 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 27628.51 0 0 1014180631 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12294.57 0 0 0 0 0 0 0 0 0 0 0 0 0 12294.57 0 0 1014180644 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20766.14 0 0 0 0 0 0 0 0 0 0 0 0 0 20766.14 0 0 1014180752 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 5724.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5724.68 0 0 1014181301 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15781.3 0 0 0 0 0 0 0 0 0 0 0 0 0 15781.3 0 0 1014181443 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8514.42 0 0 0 0 0 0 0 0 0 0 0 0 0 8514.42 0 0 1014181613 1205437142 16 Nurse Practitioners CISNEROS JESSICA 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 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 1176.96 0 0 0 0 0 0 1176.96 0 0 1014181616 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 0 417.2 0 0 0 0 0 0 417.2 0 0 1014181738 1447814405 48 Rural Health Clinics CROSSROADS INTERNAL MEDICINE 999999999 49 Jefferson 0 0 0 343 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13135.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13135.28 0 0 1014181800 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 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 0 107.62 0 0 0 0 0 0 107.62 0 0 1014181820 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8194.86 0 0 0 0 0 0 0 0 0 0 0 0 0 8194.86 0 0 1014181923 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1572.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1572.01 0 0 1014181955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10182.69 0 0 0 0 0 0 0 0 0 0 0 0 0 10182.69 0 0 1014182128 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11322.43 0 0 0 0 0 0 0 0 0 0 0 0 0 11322.43 0 0 1014182204 1982068375 10 Physicians NEMANICH ANTONIA 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 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 7116.12 0 0 0 0 0 0 7116.12 0 0 1014182207 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2385.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2385.02 0 0 1014182212 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 49.22 0 0 0 0 0 0 49.22 0 0 1014182377 1114956885 10 Physicians PICCONE CONNIE 999999999 19 Champaign 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 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 2054.37 0 0 0 0 0 0 2054.37 0 0 1014182497 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 35.4 0 0 0 0 0 0 35.4 0 0 1014182535 1578171211 16 Nurse Practitioners QUINTERO JAZMINE 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 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 1360.31 0 0 0 0 0 0 1360.31 0 0 1014182547 1285629667 10 Physicians HANSEN THOMAS D 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 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 0 947.14 0 0 0 0 0 0 947.14 0 0 1014182577 23 Occupational Therapists 40 Grundy 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 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 0 341.38 341.38 0 0 1014182641 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 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 1014182681 1457964108 16 Nurse Practitioners CUMMINGS DANYELLE 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 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 1596.7 0 0 0 0 0 0 1596.7 0 0 1014182751 1326682378 16 Nurse Practitioners DRAKE CARI A 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 0 142 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 0 829.89 0 0 0 0 0 0 829.89 0 0 1014182852 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26835.25 0 0 0 0 0 0 0 0 0 0 0 0 0 26835.25 0 0 1014183308 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 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 3858.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3858.36 0 0 1014183338 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 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 0 103.22 0 0 0 0 0 0 103.22 0 0 1014183476 1083956494 10 Physicians DROZ NATHAN 999999999 826 Missouri 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221.1 0 2251.13 0 0 0 0 0 0 2472.23 0 0 1014183529 1053932236 16 Nurse Practitioners UFERT BRANDON 999999999 47 Jackson 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 0 891.05 0 0 0 0 0 0 891.05 0 0 1014183558 1518371079 10 Physicians SHAH NEEL 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 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 4435.01 0 0 0 0 0 0 4435.01 0 0 1014183839 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 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 1199.36 1199.36 0 0 1014183886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13320.57 0 0 0 0 0 0 0 0 0 0 0 0 0 13320.57 0 0 1014183960 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 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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 0 221 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 15087.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15087.49 0 0 1014188721 1003456369 87 Psychologist(Encounter Only) RUBIN RACHAEL 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1155.41 0 0 0 0 0 0 1155.41 0 0 1014188827 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 720.1 0 0 0 0 0 0 0 0 0 0 0 0 0 720.1 0 0 1014188886 1336466895 10 Physicians HERSCHAP BRIDGET T 999999999 49 Jefferson 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 2138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16032.6 0 0 0 0 0 0 0 0 16032.6 0 0 1014188891 92 Waiver service 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MUHAMMAD AMJAD 999999999 47 Jackson 0 0 Neurology 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 0 154 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 2387.05 0 0 0 0 0 0 2387.05 0 0 1014189822 1649894791 16 Nurse Practitioners WELTY JAMIE Y 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 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 0 261.24 0 0 0 0 0 0 261.24 0 0 1014190362 1881233344 22 Physical Therapists JASPER JENNIFER 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118 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 1643.65 1643.65 0 0 1014190379 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6261.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6261.5 0 0 1014190411 87 Psychologist(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014190494 1962011080 11 Dentists PRIYA NIDHI 999999999 80 Peoria 0 0 General Dentistry 0 0 111 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 719 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 26238.25 0 0 0 0 0 0 0 0 0 0 0 1141.51 0 0 0 0 27379.76 0 0 1014190532 1790344018 16 Nurse Practitioners NGUEMEGNI GUYSELA 999999999 53 Kane 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 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 1462.71 0 0 0 0 0 0 1462.71 0 0 1014190720 1982066254 10 Physicians SAJJAD AHMAR 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.27 0 2655.44 0 0 0 0 0 0 2673.71 0 0 1014190733 10 Physicians 19 Champaign 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 52.94 0 0 0 0 0 0 0 0 52.94 0 0 1014190817 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14533.97 0 0 0 0 0 0 0 0 0 0 0 0 0 14533.97 0 0 1014190873 1437773454 87 Psychologist(Encounter Only) SMITH ALPHONSO 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 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 1837.91 0 0 0 0 0 0 1837.91 0 0 1014190981 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 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 12459.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12459.37 0 0 1014191239 1003085796 89 Physician Assistant Only(Encounter Only) ALI ROSE F 999999999 200 Cook 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 0 551 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 84101.07 0 0 0 0 0 0 84101.07 0 0 1014191450 1154639508 10 Physicians LANE KATHRYN 999999999 19 Champaign 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 21 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 1184.78 0 0 0 0 0 0 1184.78 0 0 1014191598 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6347.23 0 0 0 0 0 0 0 0 0 0 0 0 0 6347.23 0 0 1014191627 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 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 31018.03 0 0 0 0 0 0 0 0 0 0 0 0 0 31018.03 0 0 1014191670 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2227.88 0 0 0 0 0 0 0 0 0 0 0 0 0 2227.88 0 0 1014191734 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 22.62 0 0 0 0 0 0 22.62 0 0 1014191793 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.04 0 0 0 0 0 0 0 0 0 0 0 0 0 293.04 0 0 1014192001 1750908992 11 Dentists KAUSER ASFIA 999999999 98 Tazewell 0 0 General Dentistry 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13256.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13256.12 0 0 1014192172 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9866.05 0 0 0 0 0 0 0 0 0 0 0 0 0 9866.05 0 0 1014192267 4014192267 90 Waiver service provider--Elderly (DOA) "ANGELS HOMECARE SERVICES, INC." 999999999 30 DuPage 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129497.94 0 0 0 0 0 0 0 0 0 0 0 0 0 129497.94 0 0 1014192417 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19719.13 0 0 0 0 0 0 0 0 0 0 0 0 0 19719.13 0 0 1014192471 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 31.01 0 0 0 0 0 0 31.01 0 0 1014192629 1538101886 10 Physicians CHANDRASEKARAN RAVI 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 0 110.28 0 0 0 0 0 0 110.28 0 0 1014192740 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 20810.3 0 0 0 0 0 0 0 0 0 0 0 0 0 20810.3 0 0 1014192856 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 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 1806.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1806.52 0 0 1014192886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4646.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4646.85 0 0 1014193160 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 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 9888.95 0 0 0 0 0 0 0 0 0 0 0 0 0 9888.95 0 0 1014193163 1750982021 55 Early Intervention Services MUSLEH LISA S 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 0 778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43964.64 0 0 0 0 0 0 43964.64 0 0 1014193181 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28381.8 0 0 0 0 0 0 0 0 0 0 0 0 0 28381.8 0 0 1014193210 1215986948 10 Physicians HORNER JOSEPH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 46 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1807.51 0 0 0 0 0 0 0 0 1807.51 0 0 1014193318 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21157.49 0 0 0 0 0 0 0 0 0 0 0 0 0 21157.49 0 0 1014193404 1952928277 22 Physical Therapists TIANGSON KEVIN V 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 0 111 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 1153.86 1153.86 0 0 1014193415 1821478520 10 Physicians RAJAKUMAR PRIYA 999999999 200 Cook 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 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 0 272.87 0 0 0 0 0 0 272.87 0 0 1014193450 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20435.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20435.86 0 0 1014193459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11726.15 0 0 0 0 0 0 0 0 0 0 0 0 0 11726.15 0 0 1014193530 4014193530 90 Waiver service provider--Elderly (DOA) ACTIVECARE HOME CARE 999999999 200 Cook 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 634 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67766.4 0 0 0 0 0 0 0 0 0 0 0 0 0 67766.4 0 0 1014193648 1982970836 87 Psychologist(Encounter Only) LEE EUN YEOP 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 3226.01 0 0 0 0 0 0 3226.01 0 0 1014193670 1134759731 89 Physician Assistant Only(Encounter Only) RUZEVICH RACHEL A 999999999 200 Cook 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 1699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12532.07 0 0 0 0 0 0 12532.07 0 0 1014193842 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1130.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1130.33 0 0 1014193889 1437596186 10 Physicians LEW FRANKLIN 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 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 1345.87 0 0 0 0 0 0 1345.87 0 0 1014193917 1205464187 16 Nurse Practitioners INTUD JEFFREY 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 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 0 866.42 0 0 0 0 0 0 866.42 0 0 1014194021 1538761861 22 Physical Therapists TAUL JESSICA 999999999 65 Madison 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 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 0 538.95 538.95 0 0 1014194140 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6153 0 0 0 0 0 0 0 0 0 0 0 0 0 6153 0 0 1014194328 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18034.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18034.4 0 0 1014194375 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 23.46 0 0 0 0 0 0 23.46 0 0 1014194528 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 9116.96 0 0 0 0 0 0 0 0 0 0 0 0 0 9116.96 0 0 1014194614 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1014194684 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672.21 0 0 0 0 0 0 672.21 0 0 1014194722 1841796448 10 Physicians TUKAN ANDREA 999999999 200 Cook 0 0 0 0 0 5 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 442.38 0 0 0 0 0 0 4.4 0 772.39 0 0 0 0 0 0 1219.17 0 0 1014194757 1396753018 10 Physicians BHUTTO SHADAB MUHAMMAD 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 47 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 516.1 0 0 0 0 0 0 601.75 0 0 1014194824 1790125367 10 Physicians PEREIRA RODRIGUES OTAVIO 999999999 109 Winnebago 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 0 186 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 2186.34 0 0 0 0 0 0 2186.34 0 0 1014194907 1538782172 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEMORIAL HOME MEDICAL EQUIPMEN 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1243 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27701.87 0 2457.77 0 0 0 0 30159.64 0 0 1014194930 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14426.16 0 0 0 0 0 0 0 0 0 0 0 0 0 14426.16 0 0 1014194935 1609121219 10 Physicians PATEL MIKIN V 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 747 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7694.12 0 3472.85 0 0 0 0 0 0 11166.97 0 0 1014195022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1970.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1970.89 0 0 1014195221 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20305.74 0 0 0 0 0 0 0 0 0 0 0 0 0 20305.74 0 0 1014195332 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1822.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1822.8 0 0 1014195650 1659919389 16 Nurse Practitioners LENHART KELLY 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 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1014195686 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20701.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20701.8 0 0 1014195931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3745.05 0 0 0 0 0 0 0 0 0 0 0 0 0 3745.05 0 0 1014196261 1881040087 10 Physicians GOSLAWSKI MELISSA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 14 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267.38 0 1823.76 0 0 0 0 0 0 2091.14 0 0 1014196297 1023497617 89 Physician Assistant Only(Encounter Only) STAKEMAN ASHLEY 999999999 31 Edgar 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 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 0 124.72 0 0 0 0 0 0 124.72 0 0 1014196339 4014196339 90 Waiver service provider--Elderly (DOA) ADVANTAGE IN-HOME SERVICES 999999999 826 Missouri 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 3117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247807.95 0 0 0 0 0 0 0 0 0 0 0 0 0 247807.95 0 0 1014196347 1447868344 11 Dentists SALEH HASSAN LINA 999999999 200 Cook 0 0 General Dentistry 0 0 32 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 4790.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4790.94 0 0 1014196359 1528186004 10 Physicians CHAE SANDERS H 999999999 109 Winnebago 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 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 2029.94 0 0 0 0 0 0 2029.94 0 0 1014196363 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1638.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1638.04 0 0 1014196383 1205436052 16 Nurse Practitioners LIEBBE PENNY 999999999 89 Rock Island 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 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 0 639.08 0 0 0 0 0 0 639.08 0 0 1014196398 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9478.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9478.34 0 0 1014196476 1790218527 10 Physicians KNAPP LUKE 999999999 80 Peoria 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 0 127 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 4776.14 0 0 0 0 0 0 4776.14 0 0 1014196654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6512.47 0 0 0 0 0 0 0 0 0 0 0 0 0 6512.47 0 0 1014196674 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17569 0 0 0 0 0 0 0 0 0 0 0 0 0 17569 0 0 1014196812 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7334.6 0 0 0 0 0 0 0 0 0 0 0 0 0 7334.6 0 0 1014196871 61 Independent Laboratories 834 North Carolina 0 0 0 0 0 0 0 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 1639.97 0 0 0 0 0 0 0 0 1639.97 0 0 1014197018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1321.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1321.53 0 0 1014197025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18497.87 0 0 0 0 0 0 0 0 0 0 0 0 0 18497.87 0 0 1014197113 1639609852 16 Nurse Practitioners FUNK MARY K 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 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 0 300.44 0 0 0 0 0 0 300.44 0 0 1014197141 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2828.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2828.74 0 0 1014197162 1184272411 16 Nurse Practitioners O'DONNELL ALISON 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 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 2960.84 0 0 0 0 0 0 2960.84 0 0 1014197488 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 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 88.38 0 120.95 0 0 0 0 0 0 209.33 0 0 1014197674 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1014197843 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 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 0 320.66 320.66 0 0 1014197895 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26428.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26428.27 0 0 1014198000 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 0 696.12 0 0 0 0 0 0 0 0 0 0 0 0 0 696.12 0 0 1014198085 1144871120 16 Nurse Practitioners SCHNOEKER DANIELLE 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 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 0 969.02 0 0 0 0 0 0 969.02 0 0 1014198187 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 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 28496.37 0 0 0 0 0 0 28496.37 0 0 1014198510 1215391107 10 Physicians CREED CLAIRE E 999999999 200 Cook 0 0 Pediatrics 0 0 0 11 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 1265.16 0 0 0 0 0 0 0 0 905.88 0 0 0 0 0 0 2171.04 0 0 1014198522 1346653656 10 Physicians GRAHAM KEVIN A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 10874.06 0 0 0 0 0 0 10874.06 0 0 1014198603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12910.04 0 0 0 0 0 0 0 0 0 0 0 0 0 12910.04 0 0 1014198671 1558990960 16 Nurse Practitioners GREGORY LAUREN 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 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 1015.17 0 0 0 0 0 0 1015.17 0 0 1014198812 1245771534 10 Physicians REDMON HOLLIS 999999999 200 Cook 0 0 Pediatrics 0 0 0 9 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 900.92 0 0 0 0 0 0 0 0 1136 0 0 0 0 0 0 2036.92 0 0 1014199069 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014199165 1518571546 16 Nurse Practitioners DURST AMY E 999999999 10 Adams 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 0 139 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 0 933.93 0 0 0 0 0 0 933.93 0 0 1014199417 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 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 1014199454 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 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 1014199463 1235450420 10 Physicians GORESHI RENATO C 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 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 1080.6 0 0 0 0 0 0 1080.6 0 0 1014199552 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 0 306 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 19634.16 0 0 0 0 0 0 0 0 0 0 0 0 0 19634.16 0 0 1014199689 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1943.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1943.03 0 0 1014199834 1891291886 10 Physicians OROSKAR GAUTHAM ANIL 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 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 0 249.69 0 0 0 0 0 0 249.69 0 0 1014199850 1174064596 10 Physicians ELSAYED-ALI OMAR H 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 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 0 400.1 0 0 0 0 0 0 400.1 0 0 1014199996 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27870.58 0 0 0 0 0 0 0 0 0 0 0 0 0 27870.58 0 0 1014199999 1598318404 25 Audiologists SCHMITT BRIANNA M 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 18097.44 18097.44 0 0 1014200041 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39178.98 0 0 0 0 0 0 0 0 0 0 0 0 0 39178.98 0 0 1014200172 1740636356 10 Physicians ANKOLA MONICA 999999999 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 1 1 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.72 31.35 0 9520.9 0 0 0 0 0 0 9658.97 0 0 1014200205 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 0 109.26 0 0 0 0 0 0 109.26 0 0 1014200289 1134549058 10 Physicians LEVINE MATTHEW B 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 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 0 231.69 0 0 0 0 0 0 231.69 0 0 1014200476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 220.73 0 0 0 0 0 0 0 0 0 0 0 0 0 220.73 0 0 1014200508 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 1014200722 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 306.76 0 0 0 0 0 0 306.76 0 0 1014200729 1780663609 10 Physicians IRVINE HENRY 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 68 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.71 0 33.15 0 0 0 0 0 0 1394.86 0 0 1014200774 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10958.68 0 0 0 0 0 0 0 0 0 0 0 0 0 10958.68 0 0 1014200860 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.97 0 0 0 0 0 0 0 0 0 0 0 0 0 266.97 0 0 1014200974 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1016.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1016.2 0 0 1014201179 1952821993 10 Physicians MOHAMMAD DIMA S 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2735.32 0 0 0 0 0 0 2735.32 0 0 1014201277 1578665279 10 Physicians JAPANWALLA MAHEJABEEN 999999999 19 Champaign 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 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575.79 0 0 0 0 0 0 0 0 575.79 0 0 1014201380 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 107.41 0 0 0 0 0 0 0 0 0 0 0 0 0 107.41 0 0 1014201443 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 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 11264.02 0 0 0 0 0 0 0 0 0 0 0 0 0 11264.02 0 0 1014201500 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 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 4802.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4802.6 0 0 1014201584 1780101204 48 Rural Health Clinics CARLE EUREKA FAMILY MEDICINE - 999999999 110 Woodford 0 0 0 196 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12215.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12215.91 0 0 1014201654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6139.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6139.77 0 0 1014201750 1053974493 91 Waiver service provider--Adults (DHS/DDD) GARVEY KATHRYN 999999999 91 Sangamon 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 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59946.24 0 0 0 0 0 0 0 0 0 0 0 0 0 59946.24 0 0 1014201953 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 16.01 0 0 0 0 0 0 16.01 0 0 1014202133 1407418619 16 Nurse Practitioners LOWERY ANNIE 999999999 31 Edgar 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 0 144 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 1066.61 0 0 0 0 0 0 1066.61 0 0 1014202362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10227.91 0 0 0 0 0 0 0 0 0 0 0 0 0 10227.91 0 0 1014202412 1295259059 88 Other behavior health professional MELCHIORI KRISTEN 601157109 27 Dekalb 0 0 0 0 0 0 0 0 0 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 0 285.35 0 0 0 0 0 0 285.35 0 0 1014202547 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21971.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21971.25 0 0 1014202598 1962720482 10 Physicians KOHLITZ PATRICK 999999999 19 Champaign 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 0 206 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 2708.44 0 0 0 0 0 0 2708.44 0 0 1014202625 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16941.32 0 0 0 0 0 0 0 0 0 0 0 0 0 16941.32 0 0 1014202768 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 62.74 0 0 0 0 0 0 62.74 0 0 1014202772 1225681455 16 Nurse Practitioners JOSS JINU 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 0 383 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 4101.07 0 0 0 0 0 0 4101.07 0 0 1014202861 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 35.65 0 0 0 0 0 0 35.65 0 0 1014202930 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5631.85 0 0 0 0 0 0 0 0 0 0 0 0 0 5631.85 0 0 1014203014 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 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 6007.32 0 0 0 0 0 0 0 0 0 0 0 0 0 6007.32 0 0 1014203154 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 634.92 0 0 0 0 0 0 0 0 0 0 0 0 0 634.92 0 0 1014203396 1841824752 16 Nurse Practitioners WITT LAUREN 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 0 651.6 0 0 0 0 0 0 651.6 0 0 1014203450 1962034488 27 Behavioral Health Clinic GLOBAL EXECUTIVE COUNCIL SERVI 999999999 200 Cook 0 0 83 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 59 0 0 377 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 90 0 0 377 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 90 0 0 40759.88 0 0 0 0 0 0 0 0 233.48 0 0 0 0 0 0 6812.59 0 0 47805.95 0 0 1014203454 1740629583 10 Physicians OSTWANI WESAM 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 11 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745.8 0 1756.73 0 0 0 0 0 0 2502.53 0 0 1014203498 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.42 0 0 0 0 0 0 96.42 0 0 1014203657 1316917172 10 Physicians CHAN SHEEYIP J 999999999 88 Richland 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 0 158 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 1046.81 0 0 0 0 0 0 1046.81 0 0 1014203707 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24479.23 0 0 0 0 0 0 0 0 0 0 0 0 0 24479.23 0 0 1014203981 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 0 233.13 0 0 0 0 0 0 233.13 0 0 1014204052 1841614666 89 Physician Assistant Only(Encounter Only) CHIZHIK MASHA 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 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 0 110.11 0 0 0 0 0 0 110.11 0 0 1014204120 1154748366 10 Physicians GLUSKIN ADAM 999999999 57 Lake 0 0 Internal Medicine 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 0 185 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 5729.11 0 0 0 0 0 0 5729.11 0 0 1014204189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1074.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1074.48 0 0 1014204589 1194339283 91 Waiver service provider--Adults (DHS/DDD) HERRERA ALEXIS 999999999 91 Sangamon 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1950 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114125.22 0 0 0 0 0 0 0 0 0 0 0 0 0 114125.22 0 0 1014204620 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1471.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1471.73 0 0 1014204627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5031.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5031.95 0 0 1014204772 1124297361 10 Physicians DEDAJ REJMON 999999999 0 0 0 0 0 0 0 0 0 0 0 0 5 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.32 0 2450.83 0 0 0 0 0 0 2467.15 0 0 1014204868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 252.87 0 0 0 0 0 0 0 0 0 0 0 0 0 252.87 0 0 1014204906 1578184164 12 Optometrists KUBY NORA C 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 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 0 956.5 0 0 0 0 0 0 956.5 0 0 1014204969 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360.74 0 0 0 0 0 0 0 0 0 0 0 0 0 360.74 0 0 1014205120 1730422569 10 Physicians BUTLER DAVID F 999999999 30 DuPage 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 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 4986.32 0 0 0 0 0 0 4986.32 0 0 1014205144 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1406.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1406.71 0 0 1014205368 1124655931 16 Nurse Practitioners JOSEPH TIMMY 999999999 57 Lake 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 2143.55 0 0 0 0 0 0 2143.55 0 0 1014205558 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11706.93 0 0 0 0 0 0 0 0 0 0 0 0 0 11706.93 0 0 1014205729 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 6815.25 0 0 0 0 0 0 0 0 0 0 0 0 0 6815.25 0 0 1014205755 1841889037 16 Nurse Practitioners TAYLOR JULIAN P 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 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 1684.24 0 0 0 0 0 0 1684.24 0 0 1014205763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2109.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2109.14 0 0 1014205895 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21592.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21592.48 0 0 1014205960 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7624.05 0 0 0 0 0 0 0 0 0 0 0 0 0 7624.05 0 0 1014205981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13911.33 0 0 0 0 0 0 0 0 0 0 0 0 0 13911.33 0 0 1014205982 1346734050 10 Physicians AHMED FARAH 999999999 200 Cook 0 0 Family Practice 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 0 270 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 2033.95 0 0 0 0 0 0 2033.95 0 0 1014206007 1710549613 16 Nurse Practitioners PENDEGRAFT AMBER 999999999 46 Iroquois 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 0 100 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 2533.43 0 0 0 0 0 0 2533.43 0 0 1014206116 1851822282 23 Occupational Therapists WRIGHT TAYLOR L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 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 1801.99 1801.99 0 0 1014206231 1568001337 86 Clinical Social Worker(Encounter Only) NAVARRO ERICA 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 0 0 0 0 0 0 0 0 0 0 1014206259 1619381191 10 Physicians ROGERS BENJAMIN D 999999999 91 Sangamon 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 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 0 242.46 0 0 0 0 0 0 242.46 0 0 1014206269 1215561089 16 Nurse Practitioners KIRCHGESSNER ANNE C 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 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 5097.47 0 0 0 0 0 0 5097.47 0 0 1014206409 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 1014206444 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9487 0 0 0 0 0 0 0 0 0 0 0 0 0 9487 0 0 1014206527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2241.27 0 0 0 0 0 0 0 0 0 0 0 0 0 2241.27 0 0 1014206603 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2616.37 0 0 0 0 0 0 0 0 0 0 0 0 0 2616.37 0 0 1014206611 1992306211 16 Nurse Practitioners SCHAEFER CHRISTINA 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 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 1168.39 0 0 0 0 0 0 1168.39 0 0 1014206750 1295143725 10 Physicians HEGDE SHRUTI S 999999999 91 Sangamon 0 0 Internal Medicine 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 0 357 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 10237.28 0 0 0 0 0 0 10237.28 0 0 1014206924 1356534994 10 Physicians DAVIS CEDRIC E 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 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 0 172.21 0 0 0 0 0 0 172.21 0 0 1014207012 1528673076 11 Dentists RAMNANI POOJA 999999999 30 DuPage 0 0 General Dentistry 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 0 158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4030.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4030.3 0 0 1014207163 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23347.35 0 0 0 0 0 0 0 0 0 0 0 0 0 23347.35 0 0 1014207492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 420.64 0 0 0 0 0 0 0 0 0 0 0 0 0 420.64 0 0 1014207523 1538363114 10 Physicians REDDY VENKAT P 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 64 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310.09 0 66.6 0 0 0 0 0 0 376.69 0 0 1014207539 1962939538 10 Physicians KHAMOO JOHNNY 999999999 57 Lake 0 0 Internal Medicine 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 0 251 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 3963.22 0 0 0 0 0 0 3963.22 0 0 1014207873 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8723.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8723.4 0 0 1014208028 1770894735 10 Physicians LOWELL DOROTHY ANNE 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 14 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.05 0 908.75 0 0 0 0 0 0 1012.8 0 0 1014208078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 961.74 0 0 0 0 0 0 0 0 0 0 0 0 0 961.74 0 0 1014208348 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 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 5397.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5397.5 0 0 1014208425 16 Nurse Practitioners 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014208514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8086.74 0 0 0 0 0 0 0 0 0 0 0 0 0 8086.74 0 0 1014208518 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 0 0 0 0 0 0 0 0 0 0 1014208524 21 Licensed Practical Nurses 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 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 0 588.28 0 0 0 0 0 0 588.28 0 0 1014208640 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12177.18 0 0 0 0 0 0 0 0 0 0 0 0 0 12177.18 0 0 1014208645 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 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 0 103.92 103.92 0 0 1014208817 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4768.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4768.84 0 0 1014208906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2019.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2019.57 0 0 1014208948 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3216.43 0 0 0 0 0 0 0 0 0 0 0 0 0 3216.43 0 0 1014208961 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26217.22 0 0 0 0 0 0 0 0 0 0 0 0 0 26217.22 0 0 1014209062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2236.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2236.05 0 0 1014209081 1497007363 89 Physician Assistant Only(Encounter Only) ANDERSON COURTNEY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 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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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 495.89 0 0 0 0 0 0 0 0 0 0 0 0 0 495.89 0 0 1014211242 1164952347 10 Physicians FOREMAN MICHAEL 999999999 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 1 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 233.1 0 0 1380.57 0 0 0 0 0 0 1613.67 0 0 1014211308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28547.02 0 0 0 0 0 0 0 0 0 0 0 0 0 28547.02 0 0 1014211676 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 32.73 32.73 0 0 1014211713 1689179061 16 Nurse Practitioners SHAW ERICA 999999999 65 Madison 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 0 205 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 8013.37 0 0 0 0 0 0 8013.37 0 0 1014211747 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21291.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21291.48 0 0 1014211796 1164839213 11 Dentists LEE JUEI 999999999 57 Lake 0 0 0 0 9 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 1956.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1956.73 0 0 1014211804 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15081.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15081.49 0 0 1014211838 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 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 20455.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20455.5 0 0 1014212305 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11387.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11387.78 0 0 1014212414 1962784165 10 Physicians BEG RANA 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 577.55 0 0 0 0 0 0 577.55 0 0 1014212593 1497263792 16 Nurse Practitioners HARDIMAN JENNA 999999999 25 Crawford 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014212631 50 Home Health Agencies - In Home 59 Lawrence 0 0 0 0 0 0 0 0 0 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 2442 0 0 0 0 0 0 2442 0 0 1014212690 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2370.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2370.03 0 0 1014212728 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 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 2577.84 2577.84 0 0 1014212754 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 41.27 0 0 0 0 0 0 41.27 0 0 1014212899 1871139766 16 Nurse Practitioners DELGADO JOANNA 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 0 151 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 0 870.13 0 0 0 0 0 0 870.13 0 0 1014212907 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265.36 265.36 0 0 1014212940 1760434609 89 Physician Assistant Only(Encounter Only) WINKLEMAN JENNIFER 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 7.87 0 0 0 0 0 0 7.87 0 0 1014213001 1568705622 10 Physicians DADARLAT IUNIA 999999999 200 Cook 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 0 317 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 9680.78 0 0 0 0 0 0 9680.78 0 0 1014213012 1639798390 11 Dentists MONIN DAVID 999999999 200 Cook 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 8079.78 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 9585.18 0 0 1014213272 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14925.23 0 0 0 0 0 0 0 0 0 0 0 0 0 14925.23 0 0 1014213486 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24236.85 0 0 0 0 0 0 0 0 0 0 0 0 0 24236.85 0 0 1014213500 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 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 7749 0 0 0 0 0 0 0 0 0 0 0 0 0 7749 0 0 1014213620 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 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5225.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5225.15 0 0 1014213831 1306233945 10 Physicians KUSPER TERESA 999999999 200 Cook 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 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2215.25 0 0 0 0 0 0 2215.25 0 0 1014213863 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 0.27 0 0 0 0 0 0 0.27 0 0 1014214010 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 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 0 328.82 328.82 0 0 1014214023 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 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 0 286.87 0 0 0 0 0 0 0 0 0 0 0 0 0 286.87 0 0 1014214224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29225.34 0 0 0 0 0 0 0 0 0 0 0 0 0 29225.34 0 0 1014214437 1730146408 16 Nurse Practitioners LUMBLEY DEBRA S 999999999 47 Jackson 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 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1063.82 0 0 0 0 0 0 1063.82 0 0 1014214463 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 5 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 4491.01 4491.01 0 0 1014214660 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3282.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3282.07 0 0 1014214679 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40814.1 0 0 0 0 0 0 0 0 0 0 0 0 0 40814.1 0 0 1014214685 1164062832 16 Nurse Practitioners NWACHUKWU LOIS 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 0 119 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 19539.9 0 0 0 0 0 0 19539.9 0 0 1014214705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 42700 0 0 0 0 0 0 0 0 0 0 0 0 0 42700 0 0 1014214712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 242.78 0 0 0 0 0 0 0 0 0 0 0 0 0 242.78 0 0 1014215099 10 Physicians 92 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0 0 0 0 0 0 0 0 0 0 0 0 0 223.92 0 0 0 0 0 0 0 0 223.92 0 0 1014215931 89 Physician Assistant Only(Encounter Only) 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 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 1014216046 10 Physicians 42 Hancock 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.8 0 0 1014216188 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821.83 0 0 0 0 0 0 0 0 0 0 0 0 0 821.83 0 0 1014216222 16 Nurse Practitioners 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.57 0 0 0 0 0 0 88.57 0 0 1014216326 1043525520 10 Physicians BADSHAH MAAZ B 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 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 4983.37 0 0 0 0 0 0 4983.37 0 0 1014216357 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 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 0 299.12 299.12 0 0 1014216732 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19725.26 0 0 0 0 0 0 0 0 0 0 0 0 0 19725.26 0 0 1014217050 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21490.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21490.47 0 0 1014217119 87 Psychologist(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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014217457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22404.77 0 0 0 0 0 0 0 0 0 0 0 0 0 22404.77 0 0 1014217528 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26441.38 0 0 0 0 0 0 0 0 0 0 0 0 0 26441.38 0 0 1014217686 1417308065 10 Physicians DAKKAK WAEL 999999999 91 Sangamon 0 0 Internal 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 0 416 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 14900.47 0 0 0 0 0 0 14900.47 0 0 1014217782 10 Physicians 109 Winnebago 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 0 673.12 0 0 0 0 0 0 673.12 0 0 1014217797 1265064612 16 Nurse Practitioners LEYSAHT ROBERT 999999999 80 Peoria 0 0 0 0 0 7 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 225.05 0 0 0 0 0 0 0 0 1844.07 0 0 0 0 0 0 2069.12 0 0 1014217951 60 Pharmacies 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 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 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.39 0 0 0 24.39 0 0 1014218059 1467816652 10 Physicians ALLRED JONATHAN JACOB 999999999 200 Cook 0 0 Radiology Diagnosis 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 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 0 397.67 0 0 0 0 0 0 0 0 397.67 0 0 1014218155 24 Speech Therapists 86 Putnam 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 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 3594.18 3594.18 0 0 1014218244 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22352.43 0 0 0 0 0 0 0 0 0 0 0 0 0 22352.43 0 0 1014218307 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 255.29 0 0 0 0 0 0 0 0 0 0 0 0 0 255.29 0 0 1014218571 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5556.02 0 0 0 0 0 0 0 0 0 0 0 0 0 5556.02 0 0 1014218642 1811254592 10 Physicians MEHTA AJEET S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 146 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4896.4 0 214.53 0 0 0 0 0 0 5110.93 0 0 1014218807 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 0 418.5 0 0 0 0 0 0 418.5 0 0 1014218975 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 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 50383.65 0 0 0 0 0 0 0 0 0 0 0 0 0 50383.65 0 0 1014219003 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2025.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2025.54 0 0 1014219024 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6189.95 0 0 0 0 0 0 0 0 0 0 0 0 0 6189.95 0 0 1014220108 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 14.29 0 0 0 0 0 0 14.29 0 0 1014220355 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20379.28 0 0 0 0 0 0 0 0 0 0 0 0 0 20379.28 0 0 1014220409 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13901.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13901.99 0 0 1014220453 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9927.32 0 0 0 0 0 0 0 0 0 0 0 0 0 9927.32 0 0 1014220476 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23521.79 0 0 0 0 0 0 0 0 0 0 0 0 0 23521.79 0 0 1014220650 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19605.25 0 0 0 0 0 0 0 0 0 0 0 0 0 19605.25 0 0 1014220660 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10277.09 0 0 0 0 0 0 0 0 0 0 0 0 0 10277.09 0 0 1014220806 1982086161 10 Physicians OTESILE ADETOLA A 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 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 0 428.97 0 0 0 0 0 0 428.97 0 0 1014220836 1568097079 55 Early Intervention Services REGAN JULIA 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 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20893.69 0 0 0 0 0 0 20893.69 0 0 1014220861 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 0 0 0 0 0 0 0 0 0 0 1014220866 1598859852 10 Physicians MALIK JUNAID 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 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 3053.7 0 0 0 0 0 0 3053.7 0 0 1014220979 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16789.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16789.56 0 0 1014221130 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 45165.16 0 0 0 0 0 0 0 0 0 0 0 0 0 45165.16 0 0 1014221240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.75 0 0 0 0 0 0 0 0 0 0 0 0 0 230.75 0 0 1014221307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17129.37 0 0 0 0 0 0 0 0 0 0 0 0 0 17129.37 0 0 1014221325 55 Early Intervention Services 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 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 2392.45 0 0 0 0 0 0 2392.45 0 0 1014221347 1720619547 23 Occupational Therapists CONWAY KAITLIN 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 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 0 311.76 311.76 0 0 1014221470 1053794859 13 Podiatrists MALIK ALI A 999999999 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 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 0 542.97 0 0 0 0 0 0 542.97 0 0 1014221547 1508940842 10 Physicians SHAIKH AISHA 999999999 89 Rock Island 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 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 0 598.02 0 0 0 0 0 0 598.02 0 0 1014221670 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.85 0 0 0 0 0 0 0.85 0 0 1014221726 1700089414 10 Physicians GYAMFI RICHMOND 999999999 200 Cook 0 0 Internal 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 0 128 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 0 145.63 0 0 0 0 0 0 145.63 0 0 1014221879 1326686577 16 Nurse Practitioners MIARA CARISSA 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 0 640.99 0 0 0 0 0 0 640.99 0 0 1014221982 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23915.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23915.32 0 0 1014222135 1740692839 10 Physicians WILLIAMS ROBERT C 999999999 40 Grundy 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 31 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301.72 0 2275.74 0 0 0 0 0 0 2577.46 0 0 1014222172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8888.46 0 0 0 0 0 0 0 0 0 0 0 0 0 8888.46 0 0 1014222182 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 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 20369.38 0 0 0 0 0 0 0 0 0 0 0 0 0 20369.38 0 0 1014222393 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 4544.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4544.4 0 0 1014222516 1699313825 16 Nurse Practitioners ROUSHIA SHANA 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 0 334 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 3802.13 0 0 0 0 0 0 3802.13 0 0 1014222664 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0 0 0 0 0 0 0 22830.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22830.57 0 0 1014223287 1427360601 10 Physicians SODHI SANDEEP S 999999999 53 Kane 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 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 0 509.74 0 0 0 0 0 0 509.74 0 0 1014223323 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21804.1 0 0 0 0 0 0 0 0 0 0 0 0 0 21804.1 0 0 1014223478 1760746440 10 Physicians CHELSE ANA BARBARA T 999999999 107 Will 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 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 0 508.29 0 0 0 0 0 0 508.29 0 0 1014223602 1285098517 10 Physicians ERFANI SINA 999999999 200 Cook 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 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 0 0 2335.98 0 0 0 0 0 0 2335.98 0 0 1014223620 1154784486 13 Podiatrists GEORGE NATHANIEL 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 0 198 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 3142.27 0 0 0 0 0 0 3142.27 0 0 1014223662 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 0 104 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 21399.93 0 0 0 0 0 0 0 0 0 0 0 0 0 21399.93 0 0 1014223682 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4062.24 0 0 0 0 0 0 0 0 0 0 0 0 0 4062.24 0 0 1014223834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2978.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2978.78 0 0 1014223905 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7290.24 0 0 0 0 0 0 0 0 0 0 0 0 0 7290.24 0 0 1014223978 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.63 0 0 0 0 0 0 2.63 0 0 1014224032 1770002578 10 Physicians WALI NEEHAL 999999999 91 Sangamon 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 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6734.87 0 0 0 0 0 0 6734.87 0 0 1014224194 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12662.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12662.9 0 0 1014224319 20 Registered nurse 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 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 0 489.67 0 0 0 0 0 0 489.67 0 0 1014224533 1750729976 10 Physicians FRANKEL JASON K 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.26 0 2071.91 0 0 0 0 0 0 2076.17 0 0 1014224643 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.16 0 0 0 0 0 0 223.16 0 0 1014224644 86 Clinical Social Worker(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 0 144.13 0 0 0 0 0 0 144.13 0 0 1014224797 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4339.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4339.2 0 0 1014224822 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.69 0 0 0 0 0 0 1.69 0 0 1014225006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1045.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1045.22 0 0 1014225016 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1213.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1213.33 0 0 1014225037 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 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0 51 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 7 0 71 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 7 0 71 0 0 0 0 0 0 0 0 0 1645.04 0 0 0 0 0 0 55.18 0 4824.73 0 0 0 0 0 0 6524.95 0 0 1014225661 1366064057 70 Ambulance Service Providers MORRIS FIRE PROTECTION AND AMB 999999999 40 Grundy 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 0 894 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 114575.97 0 0 0 0 0 0 114575.97 0 0 1014225666 1104393115 16 Nurse Practitioners THOMAS LAURALEA 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 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 79 0 0 0 0 0 0 79 0 0 1014225772 1992812473 61 Independent Laboratories THERANOSTIX INC. 999999999 821 Maryland 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 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15529.16 0 0 0 0 0 0 0 0 15529.16 0 0 1014225875 98 Waiver service 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12500.64 0 0 0 0 0 0 0 0 0 0 0 0 0 12500.64 0 0 1014226308 86 Clinical Social Worker(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 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 1014226335 1417069592 50 Home Health Agencies - In Home OSF HOME HEALTH 604533617 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 0 100 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 6993 0 0 0 0 0 0 6993 0 0 1014226366 1396239273 10 Physicians ABUGHNAIM TAMATHOR 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1346.43 0 0 0 0 0 0 1346.43 0 0 1014226383 91 Waiver 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19600.55 0 0 0 0 0 0 0 0 0 0 0 0 0 19600.55 0 0 1014226822 1770109506 11 Dentists SHAFI SHAMIL 999999999 57 Lake 0 0 General Dentistry 0 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17680.69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17680.69 0 0 1014226862 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 1014226973 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 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 1375.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1375.66 0 0 1014226994 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18608.04 0 0 0 0 0 0 0 0 0 0 0 0 0 18608.04 0 0 1014227027 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22872.59 0 0 0 0 0 0 0 0 0 0 0 0 0 22872.59 0 0 1014227214 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 0 271.79 0 0 0 0 0 0 271.79 0 0 1014227217 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 49.22 0 0 0 0 0 0 49.22 0 0 1014227317 1770193864 16 Nurse Practitioners HUFF SALLY 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 5425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5425 0 0 1014228047 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 30.47 0 0 0 0 0 0 30.47 0 0 1014228340 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 0 138 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 14777.7 0 0 0 0 0 0 0 0 0 0 0 0 0 14777.7 0 0 1014228529 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 0 142.54 0 0 0 0 0 0 142.54 0 0 1014228724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 741.95 0 0 0 0 0 0 0 0 0 0 0 0 0 741.95 0 0 1014228903 1477095156 16 Nurse Practitioners NOVAK TRACY 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 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 1379.56 0 0 0 0 0 0 1379.56 0 0 1014229167 10 Physicians 200 Cook 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 72.95 0 0 0 0 0 0 72.95 0 0 1014229206 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12044.69 0 0 0 0 0 0 0 0 0 0 0 0 0 12044.69 0 0 1014229214 1922340405 10 Physicians DELCAMPO DANILO C 999999999 200 Cook 0 0 Dermatology 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 0 507 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 0 817.81 0 0 0 0 0 0 817.81 0 0 1014229271 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7627.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7627.18 0 0 1014229306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.39 0 0 1014229324 1295922995 10 Physicians HENAO URIBE ALICIA M 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 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 93.51 0 0 0 0 0 0 93.51 0 0 1014229496 4014229496 72 Taxicabs and Livery Companies SCE TRANSPORT 999999999 109 Winnebago 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 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9100.08 0 0 0 0 0 0 9100.08 0 0 1014229748 1962817916 13 Podiatrists MOTA NATALIE 999999999 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 0 473 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 1087.81 0 0 0 0 0 0 1087.81 0 0 1014229805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7279.55 0 0 0 0 0 0 0 0 0 0 0 0 0 7279.55 0 0 1014229813 1215544754 87 Psychologist(Encounter Only) NEESE ANGELA L 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 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 1230.3 0 0 0 0 0 0 1230.3 0 0 1014229850 1003458100 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELEVATE CARE IRVING PARK 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 5461.62 0 0 0 0 0 0 5461.62 0 0 1014229857 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 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 2481.12 2481.12 0 0 1014229925 1699980615 10 Physicians MARLOWE KIMBERLY J 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 75 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 5 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 0 871.4 0 0 1014230050 1326534413 11 Dentists PLESH DANIELLE J 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 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 2356.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2356.45 0 0 1014230079 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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110.38 0 0 1014230530 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 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 0 759.49 0 0 0 0 0 0 0 0 0 0 0 0 0 759.49 0 0 1014230591 1730534066 10 Physicians LOREEN AMY 999999999 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3070.4 0 0 0 0 0 0 3070.4 0 0 1014230675 1871197855 16 Nurse Practitioners BISCH ABBY M 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 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 0 354.81 0 0 0 0 0 0 354.81 0 0 1014230788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1801.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1801.75 0 0 1014230992 1871117937 40 Federally Qualified Health Centers PRIMECARE YOUNG FAMILY HEALTH 999999999 200 Cook 0 0 0 234 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649 0 268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65843.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65843.82 0 0 1014231090 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2996.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2996.77 0 0 1014231198 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5309.79 0 0 0 0 0 0 0 0 0 0 0 0 0 5309.79 0 0 1014231201 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 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014233644 86 Clinical Social Worker(Encounter Only) 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 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 0 151 0 0 0 0 0 0 151 0 0 1014234138 1619567997 16 Nurse Practitioners RILEY SEAN 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 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 59.22 0 0 0 0 0 0 59.22 0 0 1014234463 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 21.75 0 0 0 0 0 0 21.75 0 0 1014234490 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1837.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1837.98 0 0 1014234645 1497137699 10 Physicians PLITT MAX 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 9 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.6 0 0 0 0 0 0 186.6 0 0 1014234803 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1437.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1437.33 0 0 1014234842 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 3265.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3265.64 0 0 1014234910 1790247849 89 Physician Assistant Only(Encounter Only) HOFFSTEIN JESSICA 999999999 200 Cook 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 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 2218.47 0 0 0 0 0 0 2218.47 0 0 1014235086 1003348293 10 Physicians VANATTA ANNA M 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 366.56 0 0 0 0 0 0 366.56 0 0 1014235099 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14582.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14582.4 0 0 1014235190 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21425.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21425.85 0 0 1014235321 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 0 118 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 12448.14 0 0 0 0 0 0 0 0 0 0 0 0 0 12448.14 0 0 1014235387 10 Physicians 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 42 0 0 1014235752 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5160.76 0 0 0 0 0 0 0 0 0 0 0 0 0 5160.76 0 0 1014235768 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14740.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14740.45 0 0 1014236020 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2451.71 0 0 0 0 0 0 0 0 0 0 0 0 0 2451.71 0 0 1014236449 1588200364 16 Nurse Practitioners WEEMS MATTHEW E 999999999 34 Fayette 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 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 0 122.18 0 0 0 0 0 0 122.18 0 0 1014236486 1629123468 16 Nurse Practitioners MAULE 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 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 0 127.31 0 0 0 0 0 0 127.31 0 0 1014236542 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12746.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12746.56 0 0 1014236703 1104423094 16 Nurse Practitioners MCMAHON CORRIE 999999999 57 Lake 0 0 0 0 0 17 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 1541.1 0 0 0 0 0 0 0 0 4582.53 0 0 0 0 0 0 6123.63 0 0 1014236762 4014236762 72 Taxicabs and Livery Companies ALL AROUND TRANSPORTATION SERV 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 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7661.59 0 0 0 0 0 0 7661.59 0 0 1014236917 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 0 0 0 0 0 0 0 0 0 0 1014237177 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2737.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2737.25 0 0 1014237193 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2349.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2349.02 0 0 1014237216 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26634.09 0 0 0 0 0 0 0 0 0 0 0 0 0 26634.09 0 0 1014237225 16 Nurse Practitioners 49 Jefferson 0 0 0 0 0 0 0 0 0 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 78.09 0 0 0 0 0 0 78.09 0 0 1014237279 1235755372 48 Rural Health Clinics "MDH FAMILY MEDICINE, CONVENIEN" 999999999 70 McDonough 0 0 0 650 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1975 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1975 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32000.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32000.86 0 0 1014237367 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12574.77 0 0 0 0 0 0 0 0 0 0 0 0 0 12574.77 0 0 1014237425 1902403298 16 Nurse Practitioners GORE VERONICA 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 0 135 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 3949.28 0 0 0 0 0 0 3949.28 0 0 1014237563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29930.5 0 0 0 0 0 0 0 0 0 0 0 0 0 29930.5 0 0 1014237591 1952692717 10 Physicians KOKOSIS GEORGIOS 999999999 200 Cook 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 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 1707.63 0 0 0 0 0 0 1737.63 0 0 1014237606 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.3 0 0 0 0 0 0 0 0 16.3 0 0 1014237692 1508275181 10 Physicians KAPOOR ROHAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.24 0 2071.33 0 0 0 0 0 0 2112.57 0 0 1014237802 1841712536 11 Dentists MITSOS JAMES R 999999999 200 Cook 0 0 Pedodontics 0 0 44 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 13119.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13119.24 0 0 1014237916 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26213.21 0 0 0 0 0 0 0 0 0 0 0 0 0 26213.21 0 0 1014238052 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18355.7 0 0 0 0 0 0 0 0 0 0 0 0 0 18355.7 0 0 1014238124 10 Physicians 109 Winnebago 0 0 Anesthesiology 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 3098.61 0 0 0 0 0 0 3098.61 0 0 1014238534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12038.87 0 0 0 0 0 0 0 0 0 0 0 0 0 12038.87 0 0 1014238988 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 0 936.23 0 0 0 0 0 0 0 0 0 0 0 0 0 936.23 0 0 1014239293 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 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 5830.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5830.14 0 0 1014239469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2041.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2041.76 0 0 1014239480 1760006126 23 Occupational Therapists BEGEMAN BREANNE 999999999 10 Adams 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 0 143 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 2214.07 2214.07 0 0 1014239531 1376594978 10 Physicians EISENBERG DANNY 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 119 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2020.19 0 86.57 0 0 0 0 0 0 2106.76 0 0 1014239604 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 1014239736 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19477.1 0 0 0 0 0 0 0 0 0 0 0 0 0 19477.1 0 0 1014239915 57 Home Nursing Agency 200 Cook 0 0 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 0 990 0 0 0 0 0 0 0 0 0 0 0 0 0 990 0 0 1014239955 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 0 164 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 8712.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8712.55 0 0 1014239969 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5593.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5593.14 0 0 1014239989 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 0 234.27 0 0 0 0 0 0 234.27 0 0 1014240018 1578922449 22 Physical Therapists HOWELL JANELLE 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 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 0 195.15 195.15 0 0 1014240033 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 0 322.35 0 0 0 0 0 0 322.35 0 0 1014240168 1851938476 16 Nurse Practitioners STANLEY NICHOLE S 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 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 1930.27 0 0 0 0 0 0 1930.27 0 0 1014240190 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1664.65 0 0 0 0 0 0 0 0 0 0 0 0 0 1664.65 0 0 1014240218 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.83 59.83 0 0 1014240310 1043749211 10 Physicians NADELLA DEEPA 999999999 57 Lake 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1999.07 0 0 0 0 0 0 1999.07 0 0 1014240364 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 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 25631.66 0 0 0 0 0 0 0 0 0 0 0 0 0 25631.66 0 0 1014240437 1144871658 16 Nurse Practitioners LEGER KATHERINE 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 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 1684.68 0 0 0 0 0 0 1684.68 0 0 1014240443 1447889886 33 Nursing Facilities LACON REHAB AND NURSING 999999999 67 Marshall 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295087.55 0 0 0 0 0 0 0 295087.55 0 0 1014240474 1326498593 10 Physicians YEMM RICHARD W 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.48 0 10773.17 0 0 0 0 0 0 10782.65 0 0 1014240570 1750989620 16 Nurse Practitioners PENA RODNEY 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 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 1014240744 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.6 0 0 0 0 0 0 147.6 0 0 1014247587 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18324.25 0 0 0 0 0 0 0 0 0 0 0 0 0 18324.25 0 0 1014248027 10 Physicians 63 Macon 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 0 189.56 0 0 0 0 0 0 189.56 0 0 1014248084 1689265373 12 Optometrists GARCIA AZALEA I 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 0 111 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 1322.79 0 0 0 0 0 0 1322.79 0 0 1014248297 1447885355 63 Other Providers of Medical Equipment/Supplies (Non-registered) ARCADIA CARE DANVILLE 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 7944 0 0 0 0 0 0 7944 0 0 1014248704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4570.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4570.08 0 0 1014248786 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29866.48 0 0 0 0 0 0 0 0 0 0 0 0 0 29866.48 0 0 1014248789 1598395360 16 Nurse Practitioners HAMILL JAMIE 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 607.97 0 0 0 0 0 0 607.97 0 0 1014248811 1477189025 16 Nurse Practitioners PLUMER CLAUDIA A 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 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 3216.97 0 0 0 0 0 0 3216.97 0 0 1014248859 1215563143 16 Nurse Practitioners LAWRENCE ANDREA 999999999 30 DuPage 0 0 0 0 0 1 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 98 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 98 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 1211.32 0 0 0 0 0 0 1380.56 0 0 1014249030 1598183378 10 Physicians SIMPSON STEPHANIE 999999999 47 Jackson 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 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 1143.66 0 0 0 0 0 0 1143.66 0 0 1014249065 1598918385 28 Waiver service provider--Supportive living facility (HFS) COURTYARD ESTATES OF SULLIVAN 619517001 78 Moultrie 0 0 0 0 0 0 0 13 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 0 854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83083.97 0 0 0 0 0 0 0 0 0 0 0 0 0 83083.97 0 0 1014249106 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 0 191.52 0 0 0 0 0 0 191.52 0 0 1014249116 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 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 0.51 0 0 0 0 0 0 0.51 0 0 1014249127 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 805.44 0 0 0 0 0 0 0 0 0 0 0 0 0 805.44 0 0 1014249170 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 156.18 0 0 1014249443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28944.33 0 0 0 0 0 0 0 0 0 0 0 0 0 28944.33 0 0 1014249639 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1002.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1002.08 0 0 1014249649 1215466974 10 Physicians JURKOVIC JENNA THERESE 999999999 200 Cook 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 0 128 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 5560.42 0 0 0 0 0 0 5560.42 0 0 1014249711 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 0 198 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 16659.98 0 0 0 0 0 0 0 0 0 0 0 0 0 16659.98 0 0 1014249870 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 30893.5 0 0 0 0 0 0 0 0 0 0 0 0 0 30893.5 0 0 1014249899 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11347.16 0 0 0 0 0 0 0 0 0 0 0 0 0 11347.16 0 0 1014249949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3800.87 0 0 0 0 0 0 0 0 0 0 0 0 0 3800.87 0 0 1014249950 12 Optometrists 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 1014250177 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 11592.55 0 0 0 0 0 0 0 0 0 0 0 0 0 11592.55 0 0 1014250345 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15067.97 0 0 0 0 0 0 0 0 0 0 0 0 0 15067.97 0 0 1014250444 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014250481 1194345967 23 Occupational Therapists ALIMI ELNAZ 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304 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 21824.55 21824.55 0 0 1014250489 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33856.43 0 0 0 0 0 0 0 0 0 0 0 0 0 33856.43 0 0 1014250778 1427555937 22 Physical Therapists HARRAR BROOKE E 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 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 0 945.06 945.06 0 0 1014250810 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 22.67 0 0 0 0 0 0 22.67 0 0 1014250912 88 Other behavior health professional 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1014250961 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2949.51 0 0 0 0 0 0 0 0 0 0 0 0 0 2949.51 0 0 1014251418 1144459124 10 Physicians CARL KEVIN 999999999 109 Winnebago 0 0 Psychiatry 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 0 119 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 5961.71 0 0 0 0 0 0 5961.71 0 0 1014251572 1265426787 10 Physicians ODEKE SYLVESTER 999999999 19 Champaign 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 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 0 508.31 0 0 0 0 0 0 508.31 0 0 1014251573 1558599530 10 Physicians MCCARTHY JENNIFER LOUISE 999999999 200 Cook 0 0 Emergency Medicine 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 0 109 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 5648.42 0 0 0 0 0 0 5648.42 0 0 1014251578 1528515954 16 Nurse Practitioners YURK MOLLY 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 0 260.14 0 0 0 0 0 0 260.14 0 0 1014251642 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014251861 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 0 137 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 15038.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15038.1 0 0 1014251932 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1406.28 0 0 0 0 0 0 0 0 0 0 0 0 0 1406.28 0 0 1014251978 1679921381 10 Physicians ROTHBAUM ROBERT 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 1 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 1548.36 0 0 0 0 0 0 1595.98 0 0 1014251986 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 0 0 0 0 0 0 0 0 0 0 1014251998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.9 0 0 0 0 0 0 0 0 0 0 0 0 0 168.9 0 0 1014252035 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22214.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22214.06 0 0 1014252078 1053912188 16 Nurse Practitioners CLARY JANIE 999999999 80 Peoria 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 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 32.15 0 0 0 0 0 0 0 0 150.32 0 0 0 0 0 0 182.47 0 0 1014252143 1801153952 10 Physicians HAN FRANK Y 999999999 80 Peoria 0 0 Pediatrics 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 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20365.3 0 0 0 0 0 0 20365.3 0 0 1014252175 1518075001 10 Physicians CHO-STEINBERG HYUN M 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 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 0 496.3 0 0 0 0 0 0 496.3 0 0 1014252480 16 Nurse Practitioners 200 Cook 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 0 132.6 0 0 0 0 0 0 132.6 0 0 1014252483 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.23 0 0 0 0 0 0 80.23 0 0 1014252761 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 1014252914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1099.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1099.97 0 0 1014252949 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 11442.48 0 0 0 0 0 0 0 0 0 0 0 0 0 11442.48 0 0 1014253252 13 Podiatrists 87 Randolph 0 0 0 0 0 0 0 0 0 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 20.82 0 0 0 0 0 0 20.82 0 0 1014253310 1124650353 89 Physician Assistant Only(Encounter Only) STRICKLIN JESSICA N 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 0 101 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 2063.59 0 0 0 0 0 0 2063.59 0 0 1014253402 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3071.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3071.04 0 0 1014253469 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22327.98 0 0 0 0 0 0 0 0 0 0 0 0 0 22327.98 0 0 1014253506 1811953532 33 Nursing Facilities WATSEKA REHAB HEALTH CC 609709730 46 Iroquois 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310497.88 0 0 0 0 0 0 0 310497.88 0 0 1014253722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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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0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 405.35 0 0 0 0 0 0 0 0 644.54 0 0 0 0 0 0 1049.89 0 0 1014266217 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20713.74 0 0 0 0 0 0 0 0 0 0 0 0 0 20713.74 0 0 1014266281 1174142525 11 Dentists SHACHAT MATTHEW 999999999 200 Cook 0 0 General Dentistry 0 0 81 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 445 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 13405.25 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 14157.95 0 0 1014266328 1598357188 16 Nurse Practitioners EBERHARDT SHANIKA 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 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 2108.32 0 0 0 0 0 0 2108.32 0 0 1014266400 1629598081 10 Physicians CHIRAYIL NIMI 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0 0 0 7139.4 0 0 1014266849 10 Physicians 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 75.01 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 122.63 0 0 1014267144 10 Physicians 65 Madison 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014267207 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21913.23 0 0 0 0 0 0 0 0 0 0 0 0 0 21913.23 0 0 1014267304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8205.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8205.2 0 0 1014267332 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5608.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5608.91 0 0 1014267359 1962761809 10 Physicians DHANANI MUHAMMAD 999999999 200 Cook 0 0 Internal Medicine 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 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 0 697.39 0 0 0 0 0 0 697.39 0 0 1014267657 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1739.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.86 0 0 1014267698 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.24 0 0 0 0 0 0 0 0 0 0 0 0 0 236.24 0 0 1014267856 1871131953 27 Behavioral Health Clinic TCRC 999999999 98 Tazewell 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2357 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2357 0 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190747.56 0 0 190890.56 0 0 1014267974 10 Physicians 88 Richland 0 0 Family Practice 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 45.8 0 31.01 0 0 0 0 0 0 76.81 0 0 1014267980 1871940585 10 Physicians SHETH BHAKTA DHARA 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 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 9385.95 0 0 0 0 0 0 9385.95 0 0 1014268175 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 243.44 0 0 0 0 0 0 0 0 0 0 0 0 0 243.44 0 0 1014268280 1962041830 89 Physician Assistant Only(Encounter Only) STACEY AMY L 999999999 10 Adams 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 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 0 979.79 0 0 0 0 0 0 979.79 0 0 1014268353 1992169304 10 Physicians HSU DIANE D 999999999 200 Cook 0 0 Emergency Medicine 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 0 139 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 2697.31 0 0 0 0 0 0 2697.31 0 0 1014268401 1164942066 10 Physicians DOKIC DANIJELA 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 0 100 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 0 865.24 0 0 0 0 0 0 865.24 0 0 1014268434 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 6009.16 0 0 0 0 0 0 0 0 0 0 0 0 0 6009.16 0 0 1014268487 1790170678 10 Physicians KODALI AHALYA 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 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 3032.76 0 0 0 0 0 0 3032.76 0 0 1014268816 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 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 1014268944 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 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 40281.43 0 0 0 0 0 0 0 0 0 0 0 0 0 40281.43 0 0 1014269033 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 0 258.63 0 0 0 0 0 0 258.63 0 0 1014269128 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20610.63 0 0 0 0 0 0 0 0 0 0 0 0 0 20610.63 0 0 1014269204 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7273.53 0 0 0 0 0 0 0 0 0 0 0 0 0 7273.53 0 0 1014269219 1467090308 16 Nurse Practitioners TREVINO LISA 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 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 0 224.6 0 0 0 0 0 0 224.6 0 0 1014269273 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 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 5009.36 0 0 0 0 0 0 0 0 0 0 0 0 0 5009.36 0 0 1014269540 87 Psychologist(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 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 0 905.82 0 0 0 0 0 0 905.82 0 0 1014269568 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 0 0 0 0 0 0 0 0 0 0 1014269733 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 998.2 0 0 0 0 0 0 0 0 0 0 0 0 0 998.2 0 0 1014269771 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 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 1258.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1258.6 0 0 1014269779 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11949.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11949.3 0 0 1014269808 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22363.21 0 0 0 0 0 0 0 0 0 0 0 0 0 22363.21 0 0 1014270040 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 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 7315.62 0 0 0 0 0 0 0 0 0 0 0 0 0 7315.62 0 0 1014270090 10 Physicians 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.26 0 0 0 0 0 0 55.26 0 0 1014270122 1366071797 16 Nurse Practitioners HUNDMAN KELLY 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 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 1257.72 0 0 0 0 0 0 1257.72 0 0 1014270392 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 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 3156.14 0 0 0 0 0 0 3156.14 0 0 1014270394 1881073708 10 Physicians SATSANGI ANURAG 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 541.13 0 0 0 0 0 0 541.13 0 0 1014270502 10 Physicians 19 Champaign 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.42 0 0 0 0 0 0 209.42 0 0 1014270776 10 Physicians 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 43.54 0 0 0 0 0 0 43.54 0 0 1014270931 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 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 3092.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3092.25 0 0 1014271058 1689060188 10 Physicians NUNLEY LOREN 999999999 200 Cook 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 0 414 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 3979.74 0 0 0 0 0 0 3979.74 0 0 1014271255 10 Physicians 109 Winnebago 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 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 0 296.13 0 0 0 0 0 0 296.13 0 0 1014271351 1730797119 11 Dentists OWENS JARVIS 999999999 96 St Clair 0 0 General Dentistry 0 0 107 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 508 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 508 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 14167.29 0 0 0 0 0 0 0 0 0 0 0 4139.85 0 0 0 0 18307.14 0 0 1014271550 1215968698 10 Physicians ARCHINARD TOMMEKA 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 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 0 108.82 0 0 0 0 0 0 108.82 0 0 1014271555 1881083558 10 Physicians RECHT HANNAH S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 129 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1823.04 0 0 0 0 0 0 0 0 1823.04 0 0 1014271558 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 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 5116.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5116.8 0 0 1014271621 1649636804 16 Nurse Practitioners SCHACKE CHRISTOPHER J 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 0 330.39 0 0 0 0 0 0 330.39 0 0 1014271686 1093351413 16 Nurse Practitioners LEECH MEGAN 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 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 3600.17 0 0 0 0 0 0 3600.17 0 0 1014272093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.19 0 0 0 0 0 0 0 0 0 0 0 0 0 163.19 0 0 1014272136 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21098.36 0 0 0 0 0 0 0 0 0 0 0 0 0 21098.36 0 0 1014272171 1003465162 16 Nurse Practitioners RHOADES EMILY 999999999 91 Sangamon 0 0 0 0 0 8 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 989.51 0 0 0 0 0 0 0 0 419.41 0 0 0 0 0 0 1408.92 0 0 1014272250 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8634.71 0 0 0 0 0 0 0 0 0 0 0 0 0 8634.71 0 0 1014272360 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 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 0 111.27 0 0 0 0 0 0 111.27 0 0 1014272410 1255758454 10 Physicians MAKKANI SARWAT 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 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 0 200.49 0 0 0 0 0 0 200.49 0 0 1014272453 1528680097 12 Optometrists WALKER KATIE L 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 33 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 649.76 0 363.09 0 0 0 0 1012.85 0 0 1014272460 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389.15 0 0 0 0 0 0 0 0 0 0 0 0 0 389.15 0 0 1014272565 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5679.28 0 0 0 0 0 0 0 0 0 0 0 0 0 5679.28 0 0 1014272700 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 409.4 0 0 0 0 0 0 0 0 0 0 0 0 0 409.4 0 0 1014272741 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24280.72 0 0 0 0 0 0 0 0 0 0 0 0 0 24280.72 0 0 1014272783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 366.15 0 0 0 0 0 0 0 0 0 0 0 0 0 366.15 0 0 1014272906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 974.92 0 0 0 0 0 0 0 0 0 0 0 0 0 974.92 0 0 1014272962 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24335.61 0 0 0 0 0 0 0 0 0 0 0 0 0 24335.61 0 0 1014273016 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 1212.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1212.35 0 0 1014273035 1467676627 10 Physicians SINGLA SANDEEP 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 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 2766.62 0 0 0 0 0 0 2766.62 0 0 1014273039 1114560695 89 Physician Assistant Only(Encounter Only) ELLSTROM ALEXIS 999999999 200 Cook 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 1746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4366.21 0 0 0 0 0 0 4366.21 0 0 1014273451 1063892396 61 Independent Laboratories OTOGENETICS CORPORATION 999999999 811 Georgia 0 0 0 0 0 0 0 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 8818.36 0 0 0 0 0 0 0 0 8818.36 0 0 1014273458 86 Clinical Social Worker(Encounter Only) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429.51 0 0 0 0 0 0 429.51 0 0 1014273567 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3009.44 0 0 0 0 0 0 0 0 0 0 0 0 0 3009.44 0 0 1014273598 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 11671.68 0 0 0 0 0 0 0 0 0 0 0 0 0 11671.68 0 0 1014273715 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 0 0 0 0 0 0 0 0 0 0 1014273747 1881293348 16 Nurse Practitioners NAFEES SALMAN 999999999 57 Lake 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 1680.35 0 0 0 0 0 0 1680.35 0 0 1014273788 1598899700 89 Physician Assistant Only(Encounter Only) WILLIAMS ANTHONY N 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 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 0 221.56 0 0 0 0 0 0 221.56 0 0 1014273861 10 Physicians 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 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 1014274185 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1605.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1605.71 0 0 1014274253 1225677677 16 Nurse Practitioners MCGRAW MARTHA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.83 0 0 0 0 0 0 386.83 0 0 1014274261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15588.41 0 0 0 0 0 0 0 0 0 0 0 0 0 15588.41 0 0 1014274356 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 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 0 279.95 0 0 279.95 0 0 1014274454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 900.71 0 0 0 0 0 0 0 0 0 0 0 0 0 900.71 0 0 1014274485 1356968176 12 Optometrists BAHMANI DELARAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1220 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18526.63 0 1259.04 0 0 0 0 19785.67 0 0 1014274772 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 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 3159 0 0 0 0 0 0 0 0 0 0 0 0 0 3159 0 0 1014274811 86 Clinical Social Worker(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014275011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24917.73 0 0 0 0 0 0 0 0 0 0 0 0 0 24917.73 0 0 1014275018 1205466364 16 Nurse Practitioners KIM GINA 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1014275090 10 Physicians 10 Adams 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 0 0 0 0 0 0 0 0 0 0 1014275107 1275997652 10 Physicians MATHEW MERRIN REBECCA 999999999 200 Cook 0 0 Emergency Medicine 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 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2201.91 0 0 0 0 0 0 2201.91 0 0 1014275192 1497380547 16 Nurse Practitioners CURTIS LISA 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 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 0 879.31 0 0 0 0 0 0 879.31 0 0 1014275410 1497168314 10 Physicians LAUCIS ZACHARY 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 0 172.69 0 0 0 0 0 0 172.69 0 0 1014275549 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19682.71 0 0 0 0 0 0 0 0 0 0 0 0 0 19682.71 0 0 1014275678 10 Physicians 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 84.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.27 0 0 1014275877 1821637190 89 Physician Assistant Only(Encounter Only) RATHBURN COLENA M 999999999 80 Peoria 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 79 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 2506.55 0 0 0 0 0 0 2591.17 0 0 1014276020 1457762841 16 Nurse Practitioners ORF LAUREN 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 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 0 670.09 0 0 0 0 0 0 670.09 0 0 1014276240 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 67.3 0 0 0 0 0 0 67.3 0 0 1014276280 1972125185 11 Dentists PATEL NOLAN D 999999999 200 Cook 0 0 General Dentistry 0 0 157 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 566 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 566 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 18044.91 0 0 0 0 0 0 0 0 0 0 0 4892.55 0 0 0 0 22937.46 0 0 1014276318 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13413.15 0 0 0 0 0 0 0 0 0 0 0 0 0 13413.15 0 0 1014276407 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15575.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15575.96 0 0 1014276431 1689130742 86 Clinical Social Worker(Encounter Only) SWENSON JAMIE 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 4577 0 0 0 0 0 0 4577 0 0 1014276465 1417019878 22 Physical Therapists HOFMAN CHRISTINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 431.06 431.06 0 0 1014276523 1063465920 10 Physicians TODORA MICHAEL 999999999 24 Coles 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 36 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546.95 0 51.15 0 0 0 0 0 0 598.1 0 0 1014276823 1891778254 89 Physician Assistant Only(Encounter Only) BAILEY SAMUEL A 999999999 36 Franklin 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 0 113 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 2577.97 0 0 0 0 0 0 2577.97 0 0 1014276824 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 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 7786.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7786.5 0 0 1014276870 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4921.29 0 0 0 0 0 0 0 0 0 0 0 0 0 4921.29 0 0 1014276899 1194359562 16 Nurse Practitioners ASHMORE NICHOL A 999999999 200 Cook 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 0 124 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 4701.34 0 0 0 0 0 0 4701.34 0 0 1014276967 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 1302 0 0 0 0 0 0 0 0 0 0 0 0 0 1302 0 0 1014276981 1467899278 10 Physicians SCHAEFER AMANDA R 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 450 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 590 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 590 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9553.37 0 72.57 0 0 0 0 0 0 9625.94 0 0 1014277269 1821523622 10 Physicians JOSHI RUPAL 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 451.14 0 0 0 0 0 0 158.33 0 335.3 0 0 0 0 0 0 944.77 0 0 1014277283 1891858585 10 Physicians HALL GREGORY 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 61 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498.13 0 0 0 0 0 0 0 0 498.13 0 0 1014277285 10 Physicians 80 Peoria 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 0 0 0 0 0 0 0 0 0 0 1014277319 90 Waiver service provider--Elderly (DOA) 55 Kendall 0 0 0 0 0 0 0 4 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 12260.04 0 0 0 0 0 0 0 0 0 0 0 0 0 12260.04 0 0 1014277366 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1014277579 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 47.71 0 0 0 0 0 0 47.71 0 0 1014277585 1811504087 16 Nurse Practitioners MCKINNEY DYLAN 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 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 0 444.55 0 0 0 0 0 0 444.55 0 0 1014277851 1316233513 10 Physicians KRISHNAMOORTHY SAMBHAVI 999999999 30 DuPage 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 0 191 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 1014.83 0 0 0 0 0 0 1014.83 0 0 1014277943 1366051237 11 Dentists BANIPAL AMRIT 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 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 0 710.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 710.55 0 0 1014277948 1831724137 16 Nurse Practitioners PRESS ANNA GISELA 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 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 0 183.54 0 0 0 0 0 0 183.54 0 0 1014278107 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22158.89 0 0 0 0 0 0 0 0 0 0 0 0 0 22158.89 0 0 1014278188 1154975340 60 Pharmacies "TARRYTOWN EXPOCARE IL, LLC" 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35959.85 0 0 0 35959.85 0 0 1014278224 1215918891 10 Physicians BERTRAND BRUCE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 80 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236.54 0 731.89 0 0 0 0 0 0 968.43 0 0 1014278300 1205259330 10 Physicians ABDULFATTAH OMAR Z 999999999 91 Sangamon 0 0 Internal 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 0 378 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 10998.12 0 0 0 0 0 0 10998.12 0 0 1014278380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13729.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13729.2 0 0 1014278398 1093365678 89 Physician Assistant Only(Encounter Only) SHRIER KELSEY E 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 1429.4 0 0 0 0 0 0 1429.4 0 0 1014278403 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1014278489 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11582.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11582.12 0 0 1014278678 1013925593 63 Other Providers of Medical Equipment/Supplies (Non-registered) OSF HEALTHCARE HOME MEDICAL EQ 611071821 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2263 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2263 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37353.16 0 1291.91 0 0 0 0 38645.07 0 0 1014278769 1487815148 16 Nurse Practitioners PAGE JACOB B 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 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 1046.26 0 0 0 0 0 0 1046.26 0 0 1014278775 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16046.32 0 0 0 0 0 0 0 0 0 0 0 0 0 16046.32 0 0 1014279278 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8840.04 0 0 0 0 0 0 0 0 0 0 0 0 0 8840.04 0 0 1014279279 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419.67 0 0 0 0 0 0 0 0 0 0 0 0 0 419.67 0 0 1014279586 1053738518 10 Physicians SELF CHELSEA 999999999 200 Cook 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 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 1642.47 0 0 0 0 0 0 1642.47 0 0 1014279595 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 0 331.74 0 0 0 0 0 0 331.74 0 0 1014279813 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22293.56 0 0 0 0 0 0 0 0 0 0 0 0 0 22293.56 0 0 1014279899 1396265070 10 Physicians GODBOLD TRACEY L 631600352 200 Cook 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 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 0 334.53 0 0 0 0 0 0 334.53 0 0 1014280039 1659374262 10 Physicians PETERS BRADLEY 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 25 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285.25 0 26.98 0 0 0 0 0 0 1312.23 0 0 1014280049 1538668520 16 Nurse Practitioners WARN LAUREN 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 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 3689.8 0 0 0 0 0 0 3689.8 0 0 1014280154 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21888.46 0 0 0 0 0 0 0 0 0 0 0 0 0 21888.46 0 0 1014280337 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23667.47 0 0 0 0 0 0 0 0 0 0 0 0 0 23667.47 0 0 1014280482 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24282.3 0 0 0 0 0 0 0 0 0 0 0 0 0 24282.3 0 0 1014280841 1790321693 16 Nurse Practitioners HAMILTON ABIGAIL 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 0 147 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 2733.79 0 0 0 0 0 0 2733.79 0 0 1014281010 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.73 0 0 0 0 0 0 2.73 0 0 1014281022 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 14551.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14551.8 0 0 1014281053 1548885536 22 Physical Therapists CHAU VIVIAN K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 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 28889.3 28889.3 0 0 1014281298 1225056252 65 Independent Diagnostic Testing Facility (IDTF) NEUROTECH LLC 999999999 200 Cook 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 0 296 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 21382.73 0 0 0 0 0 0 0 0 21382.73 0 0 1014281313 1407047913 10 Physicians COLBY KARNA D 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 226 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 389 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732.87 0 104.67 0 0 0 0 0 0 1837.54 0 0 1014281335 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3480.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3480.68 0 0 1014281425 1235584079 10 Physicians JOHNSTONE ANDREW 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 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 0 810.98 0 0 0 0 0 0 810.98 0 0 1014281560 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 1739.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1739.74 0 0 1014281602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8559.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8559.4 0 0 1014281764 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 0 573.07 0 0 0 0 0 0 0 0 0 0 0 0 0 573.07 0 0 1014281776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467.79 0 0 0 0 0 0 0 0 0 0 0 0 0 467.79 0 0 1014282162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 54938.43 0 0 0 0 0 0 0 0 0 0 0 0 0 54938.43 0 0 1014282303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31718.35 0 0 0 0 0 0 0 0 0 0 0 0 0 31718.35 0 0 1014282304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19211.97 0 0 0 0 0 0 0 0 0 0 0 0 0 19211.97 0 0 1014282333 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13433.87 0 0 0 0 0 0 0 0 0 0 0 0 0 13433.87 0 0 1014282586 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24598 0 0 0 0 0 0 0 0 0 0 0 0 0 24598 0 0 1014282719 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22730.7 0 0 0 0 0 0 0 0 0 0 0 0 0 22730.7 0 0 1014282884 1356874150 13 Podiatrists SAKLA JOHN 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 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 0 258.74 0 0 0 0 0 0 258.74 0 0 1014282895 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7652.41 0 0 0 0 0 0 0 0 0 0 0 0 0 7652.41 0 0 1014283033 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.43 0 0 0 0 0 0 0 0 0 0 0 0 0 183.43 0 0 1014283122 1750925079 60 Pharmacies MARYVILLE PHARMACY 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 7260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.58 0 0 18912.08 0 0 0 19199.66 0 0 1014283273 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10098.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10098.92 0 0 1014283281 1952823197 11 Dentists CHUNG YOONJIN 999999999 98 Tazewell 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5750.68 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 6503.38 0 0 1014283378 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5644.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5644.19 0 0 1014283578 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24856.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24856.4 0 0 1014283820 1245626183 10 Physicians PEJIC MARIJAN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 229 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4591.77 0 256.45 0 0 0 0 0 0 4848.22 0 0 1014284018 10 Physicians 200 Cook 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 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 0 975.02 0 0 0 0 0 0 975.02 0 0 1014284082 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17794 0 0 0 0 0 0 0 0 0 0 0 0 0 17794 0 0 1014284104 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25947.72 0 0 0 0 0 0 0 0 0 0 0 0 0 25947.72 0 0 1014284152 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 84.28 0 0 0 0 0 0 84.28 0 0 1014284251 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 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 0 252.3 0 0 0 0 0 0 252.3 0 0 1014284387 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 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 2954.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2954.02 0 0 1014284429 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4571.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4571.22 0 0 1014284467 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21248.39 0 0 0 0 0 0 0 0 0 0 0 0 0 21248.39 0 0 1014284674 1841450574 10 Physicians YU JANE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9570.64 0 0 0 0 0 0 9570.64 0 0 1014284702 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1621.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1621.02 0 0 1014284947 1457854630 89 Physician Assistant Only(Encounter Only) FRANCE HALLIE A 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 0 147 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 1483.69 0 0 0 0 0 0 1483.69 0 0 1014285074 1750927661 16 Nurse Practitioners ADEDUNTAN AZEEZAT 999999999 91 Sangamon 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 0 177 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 1874.17 0 0 0 0 0 0 1874.17 0 0 1014285111 1033777156 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 109 Winnebago 0 0 0 0 0 0 0 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 0 121 0 0 0 0 0 0 0 0 121 0 0 1014285120 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 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 0 216.78 0 0 0 0 0 0 216.78 0 0 1014285175 1538672449 60 Pharmacies WEAR LTC 999999999 42 Hancock 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 0 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9586 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6444.88 0 0 0 6444.88 0 0 1014285330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014285558 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2067.23 0 0 0 0 0 0 0 0 0 0 0 0 0 2067.23 0 0 1014285614 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 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 1014285668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.76 0 0 0 0 0 0 0 0 0 0 0 0 0 163.76 0 0 1014285731 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 0 119.62 0 0 0 0 0 0 119.62 0 0 1014285793 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 0 280 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 21164 0 0 0 0 0 0 0 0 0 0 0 0 0 21164 0 0 1014285921 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22243.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22243.04 0 0 1014286129 1285262907 89 Physician Assistant Only(Encounter Only) PAZMINO ADLIN B 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 2.61 0 0 0 0 0 0 2.61 0 0 1014286295 1609462514 16 Nurse Practitioners VALENTINE BRANDON J 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 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 1006.09 0 0 0 0 0 0 1006.09 0 0 1014286349 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13361.76 0 0 0 0 0 0 0 0 0 0 0 0 0 13361.76 0 0 1014286430 1609109883 10 Physicians ZABAD MOHAMMAD NOUR 999999999 96 St Clair 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 0 306 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 2119.92 0 0 0 0 0 0 2119.92 0 0 1014286676 1407241656 10 Physicians MURPHY JOEL D 999999999 200 Cook 0 0 0 0 0 0 0 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 0 559.68 0 0 0 0 0 0 0 0 559.68 0 0 1014286860 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 930.24 0 0 0 0 0 0 0 0 0 0 0 0 0 930.24 0 0 1014287118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1905.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1905.08 0 0 1014287178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26204.31 0 0 0 0 0 0 0 0 0 0 0 0 0 26204.31 0 0 1014287189 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 13939.53 0 0 0 0 0 0 0 0 0 0 0 0 0 13939.53 0 0 1014287409 1093084907 10 Physicians PATEL HITEN D 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 578.67 0 0 0 0 0 0 581.27 0 0 1014287435 1851737779 10 Physicians LEUTHNER JOHN 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 1009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1009 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3863.62 0 0 0 0 0 0 3863.62 0 0 1014287437 1821477829 10 Physicians SALUJA RASLEEN 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 848.87 0 0 0 0 0 0 0 0 848.87 0 0 1014287452 89 Physician Assistant Only(Encounter Only) 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014287463 1982160313 89 Physician Assistant Only(Encounter Only) FLEXSENHAR MEGAN 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 0 0 0 0 0 0 0 0 0 0 1014287501 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 189.59 0 0 0 0 0 0 189.59 0 0 1014287535 1376579078 10 Physicians PADMANABHAN VIJAYALAKSHMI 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 32 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687.89 0 70.9 0 0 0 0 0 0 758.79 0 0 1014287537 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 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 16153.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16153.56 0 0 1014287612 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 0 0 0 0 0 0 0 0 0 0 1014287875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 437.36 0 0 0 0 0 0 0 0 0 0 0 0 0 437.36 0 0 1014287939 1114569415 16 Nurse Practitioners ALTEPETER DANIELLE 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 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 0 157.1 0 0 0 0 0 0 157.1 0 0 1014287985 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 31.01 0 0 0 0 0 0 31.01 0 0 1014288041 1467555961 57 Home Nursing Agency MAXIM HEALTHCARE SERVICES INC 611075911 109 Winnebago 0 0 0 0 0 0 0 23 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5435 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5435 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2027454.34 131352.11 0 0 0 0 0 0 0 0 0 0 0 0 2158806.45 0 0 1014288158 1710446885 16 Nurse Practitioners CROMWELL EUNICE OTUWA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 891 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16244.26 0 0 0 0 0 0 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health professional 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 352.66 0 0 0 0 0 0 352.66 0 0 1014289191 1154854958 10 Physicians MURRAY KELSEY R 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 190.55 0 0 0 0 0 0 0 0 3077.26 0 0 0 0 0 0 3267.81 0 0 1014289222 1659901106 16 Nurse Practitioners GUILLEN GLORIA 999999999 88 Richland 0 0 0 0 0 0 0 0 0 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 87.27 0 0 0 0 0 0 87.27 0 0 1014289232 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 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 0 115.79 115.79 0 0 1014289239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 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0 0 0 0 0 0 0 0 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 0 743.71 0 0 0 0 0 0 743.71 0 0 1014289988 1548891690 16 Nurse Practitioners CELESTINO FISCHER APRIL 999999999 106 Whiteside 0 0 0 0 0 3 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 128.6 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 656.6 0 0 1014290134 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2357.78 2357.78 0 0 1014290360 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31203.87 0 0 0 0 0 0 0 0 0 0 0 0 0 31203.87 0 0 1014290480 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.61 0 0 0 0 0 0 0 0 0 0 0 0 0 18413.61 0 0 1014292951 1972913838 10 Physicians NAQVI AMIR S 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2957.03 0 0 0 0 0 0 2957.03 0 0 1014292959 10 Physicians 70 McDonough 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 49.22 0 0 0 0 0 0 49.22 0 0 1014293102 1275972176 10 Physicians NEUBECK ANGELA 999999999 91 Sangamon 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 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 8469.82 0 0 0 0 0 0 8469.82 0 0 1014293130 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2248.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2248.83 0 0 1014293313 1649763475 11 Dentists VACCA MADALYN E 999999999 200 Cook 0 0 0 0 52 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 7643.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7643.82 0 0 1014293381 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 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 3565.32 0 0 0 0 0 0 0 0 0 0 0 0 0 3565.32 0 0 1014293399 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 3 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 3172.02 3172.02 0 0 1014293437 1396913885 89 Physician Assistant Only(Encounter Only) ARNESEN MICHELLE M 999999999 200 Cook 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 0 310 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 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JORDAN 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7277.78 0 0 0 0 0 0 7277.78 0 0 1014296694 1780685743 10 Physicians WELLS WAYNE 999999999 36 Franklin 0 0 Family 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 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 78.09 0 0 0 0 0 0 78.09 0 0 1014296854 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20928.48 0 0 0 0 0 0 0 0 0 0 0 0 0 20928.48 0 0 1014296896 1154707693 10 Physicians CHENG JUDY 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 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 0 243.57 0 0 0 0 0 0 243.57 0 0 1014297059 1073148920 33 Nursing Facilities HALLMARK HEALTHCARE OF PEKIN 999999999 98 Tazewell 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 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549250.04 0 0 0 0 0 0 0 549250.04 0 0 1014297226 1811938590 10 Physicians GIULIANO ANNE 999999999 70 McDonough 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 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 0 625.54 0 0 0 0 0 0 0 0 625.54 0 0 1014297403 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 0 381.79 0 0 0 0 0 0 381.79 0 0 1014297494 1326542903 48 Rural Health Clinics EFFINGHAM EXPRESS CARE 999999999 33 Effingham 0 0 0 56 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 187 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 5742.45 0 0 0 0 0 0 0 91.15 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 148.38 0 0 0 0 0 0 148.38 0 0 1014299201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6399.16 0 0 0 0 0 0 0 0 0 0 0 0 0 6399.16 0 0 1014299301 1013544543 16 Nurse Practitioners ANDERSON MEREDITH 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 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 0 565.6 0 0 0 0 0 0 565.6 0 0 1014299302 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.6 0 0 0 0 0 0 0 0 0 0 0 0 0 90.6 0 0 1014299608 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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1014308820 1649805706 89 Physician Assistant Only(Encounter Only) TREAT SARAH 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 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 12.03 0 0 0 0 0 0 12.03 0 0 1014308916 1699386284 16 Nurse Practitioners GOCKMAN JOHN E 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 0 448.98 0 0 0 0 0 0 448.98 0 0 1014309017 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 64.08 0 0 0 0 0 0 64.08 0 0 1014309050 1780116590 10 Physicians THIBEAULT DINAH KATE H 999999999 200 Cook 0 0 0 0 0 11 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 1111.62 0 0 0 0 0 0 0 0 427.08 0 0 0 0 0 0 1538.7 0 0 1014309242 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 539.86 0 0 0 0 0 0 539.86 0 0 1014309346 1548798911 10 Physicians SANTIAGO ANNAIS A 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 269.85 0 0 0 0 0 0 6.82 0 201.78 0 0 0 0 0 0 478.45 0 0 1014309461 1033717954 89 Physician Assistant Only(Encounter Only) HERNANDEZ HECTOR 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 0 294.98 0 0 0 0 0 0 294.98 0 0 1014309623 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24231.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24231.64 0 0 1014309850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14380.54 0 0 0 0 0 0 0 0 0 0 0 0 0 14380.54 0 0 1014309984 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 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 0 209.95 0 0 0 0 0 0 209.95 0 0 1014309985 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 473.4 0 0 0 0 0 0 0 0 0 0 0 0 0 473.4 0 0 1014310072 89 Physician Assistant Only(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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014310160 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21613.17 0 0 0 0 0 0 0 0 0 0 0 0 0 21613.17 0 0 1014310286 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23394.39 0 0 0 0 0 0 0 0 0 0 0 0 0 23394.39 0 0 1014310323 1841533254 10 Physicians SHAHAB DANISH 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 63 0 0 0 0 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 0 246.6 0 3144.11 0 0 0 0 0 0 3390.71 0 0 1014310393 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23508.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23508.32 0 0 1014310523 1114176773 10 Physicians MOHAN GEETIKA 60612 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 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 0 0 0 0 0 0 0 0 0 0 1014310574 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 7389.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7389.2 0 0 1014310604 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 79.04 0 0 0 0 0 0 79.04 0 0 1014310747 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 585.67 0 0 0 0 0 0 0 0 0 0 0 0 0 585.67 0 0 1014310881 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 0 108.56 0 0 0 0 0 0 108.56 0 0 1014310918 1154511046 10 Physicians BROWNE RONALD 999999999 200 Cook 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 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 29.62 0 73.97 0 0 0 0 0 0 103.59 0 0 1014310998 1588251144 16 Nurse Practitioners PATEL LISA A 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 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 2219.61 0 0 0 0 0 0 2219.61 0 0 1014311169 1225304652 10 Physicians GOLSHANI BEHRAD 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 749 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 923 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 923 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9500.86 0 341.71 0 0 0 0 0 0 9842.57 0 0 1014311285 1437798899 16 Nurse Practitioners HORN AUDRA M 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 0 109 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 0 779.81 0 0 0 0 0 0 779.81 0 0 1014311336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2229.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2229.97 0 0 1014311348 1295116374 10 Physicians BRANHAM DAPHNE 999999999 826 Missouri 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 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 0 373.1 0 0 0 0 0 0 373.1 0 0 1014311351 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 0 359.64 0 0 0 0 0 0 359.64 0 0 1014311379 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13738 0 0 0 0 0 0 0 0 0 0 0 0 0 13738 0 0 1014311418 1447894613 91 Waiver service provider--Adults (DHS/DDD) COMPASSIONATE LIVING HOME INC 999999999 30 DuPage 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142631.59 0 0 0 0 0 0 0 0 0 0 0 0 0 142631.59 0 0 1014311451 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11955.11 0 0 0 0 0 0 0 0 0 0 0 0 0 11955.11 0 0 1014311452 1023322567 10 Physicians BAWEJA PRIYANKA 999999999 47 Jackson 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 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 1014311462 1871080663 10 Physicians SALAZAR LEON MARIANI V 999999999 200 Cook 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 0 127 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 1812.95 0 0 0 0 0 0 1812.95 0 0 1014311525 1679190235 23 Occupational Therapists SHEEDY KELSEY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262 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 18200.89 18200.89 0 0 1014311627 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.56 0 0 0 0 0 0 212.56 0 0 1014311664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12504.49 0 0 0 0 0 0 0 0 0 0 0 0 0 12504.49 0 0 1014311745 89 Physician Assistant Only(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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.01 0 0 0 0 0 0 12.01 0 0 1014311926 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 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 11083.01 0 0 0 0 0 0 0 0 0 0 0 0 0 11083.01 0 0 1014311931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15534.68 0 0 0 0 0 0 0 0 0 0 0 0 0 15534.68 0 0 1014311981 1376182238 33 Nursing Facilities PAUL HOUSE & HEALTHCARE CENTER 999999999 200 Cook 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828670.16 0 0 0 0 0 0 0 828670.16 0 0 1014312048 1831711506 36 Community mental health 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 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 0 984.49 0 0 984.49 0 0 1014312386 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 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 0 344.47 0 0 0 0 0 0 344.47 0 0 1014312390 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19894.44 0 0 0 0 0 0 0 0 0 0 0 0 0 19894.44 0 0 1014312497 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5639.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5639.16 0 0 1014312532 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 130.24 0 0 0 0 0 0 0 0 0 0 0 0 0 130.24 0 0 1014312828 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 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 0 261.24 0 0 0 0 0 0 261.24 0 0 1014313079 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3214.91 0 0 0 0 0 0 0 0 0 0 0 0 0 3214.91 0 0 1014313093 1245458595 10 Physicians YUAN HARRY 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 0 136 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 7163.98 0 0 0 0 0 0 7163.98 0 0 1014313237 1447885090 23 Occupational Therapists ROJEK LOUIS B 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 869 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5847.92 5847.92 0 0 1014313279 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11779.85 0 0 0 0 0 0 0 0 0 0 0 0 0 11779.85 0 0 1014313417 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.62 0 0 0 0 0 0 36.62 0 0 1014313680 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1250.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1250.04 0 0 1014313736 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.07 0 0 0 0 0 0 0 0 0 0 0 0 0 319.07 0 0 1014313758 1285900423 10 Physicians ABRAHAM ASHLEY 999999999 91 Sangamon 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 0 165 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 5512.72 0 0 0 0 0 0 5512.72 0 0 1014313818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2616.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2616.57 0 0 1014313986 1336555994 10 Physicians NEAL TYLER 999999999 19 Champaign 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.74 0 192.18 0 0 0 0 0 0 234.92 0 0 1014314005 1508956459 33 Nursing Facilities CHARLESTON REHAB HEALTH CARE 619202382 24 Coles 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261607.36 0 0 0 0 0 0 0 261607.36 0 0 1014314487 94 Waiver service provider--Children's support (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 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 0 787.2 0 0 0 0 0 0 0 0 0 0 0 0 0 787.2 0 0 1014314660 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7724.11 0 0 0 0 0 0 0 0 0 0 0 0 0 7724.11 0 0 1014314855 1265042287 16 Nurse Practitioners SMITH ARLYN D 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 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 1386.25 0 0 0 0 0 0 1386.25 0 0 1014314866 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18319.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18319.5 0 0 1014314931 1306195680 10 Physicians ABOU-RASS FAKHR EDDINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.9 0 586.52 0 0 0 0 0 0 624.42 0 0 1014314976 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 7.21 0 0 0 0 0 0 7.21 0 0 1014315056 1922606201 16 Nurse Practitioners TACCONA RYAN J 999999999 53 Kane 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1014315269 1295115079 10 Physicians FENTON GREGORY 999999999 200 Cook 0 0 Neurology 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 0 212 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 2881.49 0 0 0 0 0 0 2881.49 0 0 1014315304 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 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 1014315363 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12526.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12526.42 0 0 1014315365 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21766.36 0 0 0 0 0 0 0 0 0 0 0 0 0 21766.36 0 0 1014315751 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1014315802 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 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 10303.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10303.5 0 0 1014315895 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14684.56 0 0 0 0 0 0 0 0 0 0 0 0 0 14684.56 0 0 1014315949 1578094090 10 Physicians FISHER MARYANN C 999999999 80 Peoria 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 7 0 19 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 9 0 31 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 9 0 31 0 0 0 0 0 0 0 0 0 297.5 0 0 0 0 0 0 124.03 0 963.66 0 0 0 0 0 0 1385.19 0 0 1014315964 1245850924 23 Occupational Therapists MCADAMS COLLEEN 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 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 1120.8 1120.8 0 0 1014316127 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6618.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6618.5 0 0 1014316168 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6544.72 0 0 0 0 0 0 0 0 0 0 0 0 0 6544.72 0 0 1014316347 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15709.67 0 0 0 0 0 0 0 0 0 0 0 0 0 15709.67 0 0 1014316396 1265030019 16 Nurse Practitioners MCLEAN ANDREA A 999999999 80 Peoria 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 0 124 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 1703.98 0 0 0 0 0 0 1703.98 0 0 1014316434 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3955.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3955.09 0 0 1014316444 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 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 18754.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18754.28 0 0 1014316526 1760987598 10 Physicians HAFZAH HUSAM 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 23 0 0 0 0 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 0 0 124.67 0 0 0 0 0 0 124.67 0 0 1014316650 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2530.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2530.47 0 0 1014316883 1285285189 24 Speech Therapists MATUSZEWSKI ALLISON 999999999 91 Sangamon 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 0 749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54464.16 54464.16 0 0 1014316989 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1578.94 0 0 0 0 0 0 0 0 0 0 0 0 0 1578.94 0 0 1014317000 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2408.89 0 0 0 0 0 0 0 0 0 0 0 0 0 2408.89 0 0 1014317022 1083095814 10 Physicians SWEIS FARES W 999999999 53 Kane 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 364.92 0 0 0 0 0 0 51.31 0 1050.54 0 0 0 0 0 0 1466.77 0 0 1014317152 1245868975 16 Nurse Practitioners PREHM ELISABETH 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 0 628.76 0 0 0 0 0 0 628.76 0 0 1014317509 1972910404 10 Physicians BIEBER DAVID 999999999 200 Cook 0 0 Neurology 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 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 6669.78 0 0 0 0 0 0 6669.78 0 0 1014317542 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 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 0 270.13 270.13 0 0 1014317768 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390.6 0 0 0 0 0 0 0 0 0 0 0 0 0 390.6 0 0 1014317857 1518367333 10 Physicians SYED SADIA 999999999 200 Cook 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 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13134.04 0 0 0 0 0 0 13134.04 0 0 1014317882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18.59 0 0 0 0 0 0 0 0 0 0 0 0 0 18.59 0 0 1014317981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3481.85 0 0 0 0 0 0 0 0 0 0 0 0 0 3481.85 0 0 1014318119 1417274200 10 Physicians RUSSELL JOSHUA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 43.54 0 0 0 0 0 0 43.54 0 0 1014318299 1568061778 16 Nurse Practitioners BAEZ DANIELA 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 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 0 558.06 0 0 0 0 0 0 558.06 0 0 1014318359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200.55 0 0 0 0 0 0 0 0 0 0 0 0 0 200.55 0 0 1014318501 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.41 0 0 0 0 0 0 0 0 0 0 0 0 0 106.41 0 0 1014318520 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 0 198.66 0 0 0 0 0 0 198.66 0 0 1014318579 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16850.5 0 0 0 0 0 0 0 0 0 0 0 0 0 16850.5 0 0 1014318845 86 Clinical Social Worker(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 1014319148 1164022901 60 Pharmacies OSCO PHARMACY #3198 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1267.04 0 0 0 1267.04 0 0 1014319245 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.91 0 0 0 0 0 0 0 0 0 0 0 0 0 878.91 0 0 1014319330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.24 0 0 0 0 0 0 0 0 0 0 0 0 0 70.24 0 0 1014319406 1063867885 10 Physicians GOMES GLENN C 999999999 53 Kane 0 0 Emergency 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 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 1887.9 0 0 0 0 0 0 1887.9 0 0 1014319412 1750894747 16 Nurse Practitioners ARIAS ANDREA 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 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 1473.31 0 0 0 0 0 0 1473.31 0 0 1014319466 1275161903 23 Occupational Therapists GRUNTLER SYDNEY 999999999 200 Cook 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 0 320 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 23527.49 23527.49 0 0 1014319843 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 14796.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14796.5 0 0 1014320159 1659751121 10 Physicians KLEINFELDER RAYMOND E 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 0 119 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 0 474.56 0 0 0 0 0 0 474.56 0 0 1014320699 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 0 126 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 16074.21 0 0 0 0 0 0 0 0 0 0 0 0 0 16074.21 0 0 1014321003 1922493204 10 Physicians CHEN LITING 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1530.56 0 0 0 0 0 0 1530.56 0 0 1014321100 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31501.82 0 0 0 0 0 0 0 0 0 0 0 0 0 31501.82 0 0 1014321141 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1315.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1315.33 0 0 1014321218 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 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 1014321235 1043417819 10 Physicians PALERU VIJAYASREE 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 2 0 298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2912.86 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 15987.45 0 0 1014322329 10 Physicians 30 DuPage 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 31.01 0 0 0 0 0 0 31.01 0 0 1014322368 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17146.49 0 0 0 0 0 0 0 0 0 0 0 0 0 17146.49 0 0 1014322573 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 0 110.52 0 0 0 0 0 0 110.52 0 0 1014322580 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13298.65 0 0 0 0 0 0 0 0 0 0 0 0 0 13298.65 0 0 1014322815 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8878.81 0 0 0 0 0 0 0 0 0 0 0 0 0 8878.81 0 0 1014322848 1649705153 10 Physicians STARKS EMILY 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 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 1447.25 0 0 0 0 0 0 1447.25 0 0 1014323129 10 Physicians 19 Champaign 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 1014323238 1922609437 16 Nurse Practitioners HUDDLESTON ALEXANDRA L 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 152 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 4783.71 0 0 0 0 0 0 4880.31 0 0 1014323432 1083018428 10 Physicians XIE YUAN YUAN 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 363 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5219.77 0 33.11 0 0 0 0 0 0 5252.88 0 0 1014323489 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 87.08 0 0 0 0 0 0 87.08 0 0 1014323649 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1033.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1033.78 0 0 1014323707 1861670176 33 Nursing Facilities MARIGOLD REHABILITATION HCC 614011249 56 Knox 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 0 171 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 606950.86 0 0 0 0 0 0 0 606950.86 0 0 1014323934 1700437118 11 Dentists MOMIN FARHAN ABBAS A 999999999 71 McHenry 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2891.17 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 3643.87 0 0 1014324313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 515.11 0 0 0 0 0 0 0 0 0 0 0 0 0 515.11 0 0 1014324323 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 4298.47 0 0 0 0 0 0 0 0 0 0 0 0 0 4298.47 0 0 1014324329 1205471893 23 Occupational Therapists CUSACK MARGARET M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 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 12191.4 12191.4 0 0 1014324483 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6488.48 0 0 0 0 0 0 0 0 0 0 0 0 0 6488.48 0 0 1014324543 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16468.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16468.56 0 0 1014324561 1720608557 89 Physician Assistant Only(Encounter Only) HIRPARA PAYAL 999999999 200 Cook 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 0 330 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 0 939.88 0 0 0 0 0 0 939.88 0 0 1014324570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24170.82 0 0 0 0 0 0 0 0 0 0 0 0 0 24170.82 0 0 1014324751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27048.39 0 0 0 0 0 0 0 0 0 0 0 0 0 27048.39 0 0 1014324976 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 4960.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4960.74 0 0 1014325002 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 389.59 0 0 0 0 0 0 0 0 0 0 0 0 0 389.59 0 0 1014325039 1992159313 10 Physicians NISIMOVA LIANA 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 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 1027.94 0 0 0 0 0 0 1027.94 0 0 1014325077 1902292493 10 Physicians GRIFFETH VALERIE E 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 0 131 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 2886.27 0 0 0 0 0 0 2886.27 0 0 1014325195 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7001.84 0 0 0 0 0 0 0 0 0 0 0 0 0 7001.84 0 0 1014325333 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14799.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14799.4 0 0 1014325348 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 0 108 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 8597.54 0 0 0 0 0 0 0 0 0 0 0 0 0 8597.54 0 0 1014325350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16438.73 0 0 0 0 0 0 0 0 0 0 0 0 0 16438.73 0 0 1014325351 1619395431 10 Physicians WERMERS JOSHUA D 999999999 98 Tazewell 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 128 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7285.97 0 390.35 0 0 0 0 0 0 7676.32 0 0 1014325393 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1243.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1243.76 0 0 1014325617 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 10342.74 0 0 0 0 0 0 0 0 0 0 0 0 0 10342.74 0 0 1014325821 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3336.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3336.72 0 0 1014325907 1629592258 16 Nurse Practitioners COLLINS SANDRA B 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 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 1476.28 0 0 0 0 0 0 1476.28 0 0 1014325948 1184144727 13 Podiatrists BISBY DONALD C 999999999 101 Wabash 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 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 1317.15 0 0 0 0 0 0 1317.15 0 0 1014326070 1538523626 10 Physicians PARK ALBERT 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1117.31 0 0 0 0 0 0 1117.31 0 0 1014326119 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 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 33322.32 0 0 0 0 0 0 0 0 0 0 0 0 0 33322.32 0 0 1014326295 10 Physicians 65 Madison 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 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 0 477.2 0 0 0 0 0 0 477.2 0 0 1014326662 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 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 52.75 0 0 0 0 0 0 52.75 0 0 1014326737 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21945.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21945.44 0 0 1014326744 1417223447 10 Physicians SHPIGEL ADAM A 999999999 91 Sangamon 0 0 Internal Medicine 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 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5777.61 0 0 0 0 0 0 5777.61 0 0 1014326783 1346406113 10 Physicians BURKE ALLISON 999999999 30 DuPage 0 0 Emergency 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 0 138 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 0 307.76 0 0 0 0 0 0 307.76 0 0 1014326810 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.61 0 0 0 0 0 0 1.61 0 0 1014326904 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4146.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4146.6 0 0 1014326963 1063928315 39 Hospice TRANSITIONS HOSPICE CENTRAL IL 999999999 19 Champaign 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 376595.75 0 0 0 0 0 0 0 0 0 0 0 376595.75 0 0 1014326972 1588139802 16 Nurse Practitioners NORRIS CHRISTINA 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 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 0 441.75 0 0 0 0 0 0 441.75 0 0 1014327185 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 1014327241 1235789827 36 Community mental health provider CLEARBROOK CMHC 999999999 71 McHenry 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 621 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 621 0 0 145.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45439.59 0 0 45584.76 0 0 1014327433 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213.44 0 0 0 0 0 0 213.44 0 0 1014327565 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30375.45 0 0 0 0 0 0 0 0 0 0 0 0 0 30375.45 0 0 1014327985 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 0 103 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 5815.59 0 0 0 0 0 0 0 0 0 0 0 0 0 5815.59 0 0 1014328029 1669014569 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE WILMINGTON 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8771.5 0 0 0 0 0 0 8771.5 0 0 1014328129 1932170800 10 Physicians RONCHI MARK 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 96 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.94 0 0 0 0 0 0 0 0 686.94 0 0 1014328320 1114563368 16 Nurse Practitioners HULTGREN JAMIE M 999999999 47 Jackson 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 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 1408.91 0 0 0 0 0 0 1408.91 0 0 1014328512 1144540584 10 Physicians MURPHEY DONA K 999999999 80 Peoria 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 0 178.07 0 0 0 0 0 0 178.07 0 0 1014328514 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 9244.46 0 0 0 0 0 0 0 0 0 0 0 0 0 9244.46 0 0 1014328542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1846.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1846.44 0 0 1014328635 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4708.91 0 0 0 0 0 0 0 0 0 0 0 0 0 4708.91 0 0 1014328694 1174943666 10 Physicians BECKER AMANDA C 999999999 200 Cook 0 0 Pediatrics 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 0 241 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 37849.48 0 0 0 0 0 0 37849.48 0 0 1014328761 1851884894 10 Physicians TESMER PAWEL 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 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11844.41 0 0 0 0 0 0 11844.41 0 0 1014328839 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15056.68 0 0 0 0 0 0 0 0 0 0 0 0 0 15056.68 0 0 1014328877 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.6 0 0 0 0 0 0 0 0 0 0 0 0 0 24.6 0 0 1014328886 65 Independent Diagnostic Testing Facility (IDTF) 30 DuPage 0 0 0 0 0 0 0 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 1014329032 1316329857 10 Physicians CZECZOK THOMAS W 999999999 91 Sangamon 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 0 327 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 4620.92 0 0 0 0 0 0 0 0 4620.92 0 0 1014329035 1154733889 24 Speech Therapists GOOCH KAYLA M 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 0 308 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 22006.91 22006.91 0 0 1014329048 1477173847 61 Independent Laboratories AUGUSTUS LABS LLC 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 22 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 5731.5 0 0 0 0 0 0 0 0 5731.5 0 0 1014329188 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 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 5274.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5274.72 0 0 1014329253 1013195650 10 Physicians WILLIAMS JONATHAN F 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26.98 0 1488.6 0 0 0 0 0 0 1515.58 0 0 1014329345 1073123055 16 Nurse Practitioners WHITE CHRISTINA 999999999 91 Sangamon 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 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 1565.97 0 0 0 0 0 0 1565.97 0 0 1014329403 10 Physicians 10 Adams 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 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 1014329533 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15708.66 0 0 0 0 0 0 0 0 0 0 0 0 0 15708.66 0 0 1014329570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10251.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10251.56 0 0 1014329587 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2975.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2975.17 0 0 1014329643 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 14659.37 0 0 0 0 0 0 0 0 0 0 0 0 0 14659.37 0 0 1014329714 1912448952 10 Physicians KRUEGER CODY 999999999 53 Kane 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 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 0 930.39 0 0 0 0 0 0 930.39 0 0 1014329913 1326335928 10 Physicians VLAHU TEDI 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 32106.89 0 0 1014330230 90 Waiver service provider--Elderly (DOA) 80 Peoria 0 0 0 0 0 0 0 4 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 42756.54 0 0 0 0 0 0 0 0 0 0 0 0 0 42756.54 0 0 1014330252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11505 0 0 0 0 0 0 0 0 0 0 0 0 0 11505 0 0 1014330375 1699054601 10 Physicians GOYAL PRADEEP 999999999 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.88 0 0 0 0 0 0 0 0 37.88 0 0 1014330422 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2429.06 0 0 0 0 0 0 0 0 0 0 0 0 0 2429.06 0 0 1014330605 24 Speech Therapists 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 56.24 56.24 0 0 1014330706 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18452.54 0 0 0 0 0 0 0 0 0 0 0 0 0 18452.54 0 0 1014330728 1609160464 10 Physicians SRISUWANANUKORN MICHELLE 999999999 80 Peoria 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 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 1150.69 0 0 0 0 0 0 1150.69 0 0 1014330770 1689112492 16 Nurse Practitioners SCHMITZ AMBER 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 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 0 240.99 0 0 0 0 0 0 240.99 0 0 1014331011 1740636497 10 Physicians AHMED IHAB SYED 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 0 126 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 0 324.31 0 0 0 0 0 0 324.31 0 0 1014331458 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 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 37133.34 0 0 0 0 0 0 0 0 0 0 0 0 0 37133.34 0 0 1014331534 1659754588 89 Physician Assistant Only(Encounter Only) KLINGER DONNA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572.81 0 0 0 0 0 0 572.81 0 0 1014331580 1447284807 10 Physicians MUNOZ DAVID 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 0 0 0 0 0 0 0 0 0 0 1014331627 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21873.54 0 0 0 0 0 0 0 0 0 0 0 0 0 21873.54 0 0 1014331740 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18538.85 0 0 0 0 0 0 0 0 0 0 0 0 0 18538.85 0 0 1014331970 1396365326 89 Physician Assistant Only(Encounter Only) THOMAS STEPHANIE 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 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 1511.58 0 0 0 0 0 0 1511.58 0 0 1014332243 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 0 367 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 33213.67 0 0 0 0 0 0 0 0 0 0 0 0 0 33213.67 0 0 1014332319 1144237025 10 Physicians RUBENSTEIN RONALD C 999999999 200 Cook 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 0 107 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 6065.27 0 0 0 0 0 0 6065.27 0 0 1014332578 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 0 718.7 0 0 0 0 0 0 718.7 0 0 1014332702 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 1014332852 1265737464 16 Nurse Practitioners HANLINE LAUREN 999999999 88 Richland 0 0 0 0 0 9 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 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2181.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2181.52 0 0 1014333115 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 8.62 0 0 0 0 0 0 8.62 0 0 1014333164 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 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 0 190.33 0 0 0 0 0 0 0 0 190.33 0 0 1014333170 1104432020 16 Nurse Practitioners GIFFORD LINDSAY 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 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 0 362.48 0 0 0 0 0 0 362.48 0 0 1014333281 1073115556 55 Early Intervention Services WRIGHT HANNAH 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 0 150 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 8471.93 0 0 0 0 0 0 8471.93 0 0 1014333456 1063808079 10 Physicians ZOZULA ALEXANDER 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 1 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 100 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 0 0 2873.69 0 0 0 0 0 0 2873.69 0 0 1014333471 1457385668 46 Ambulatory Surgical Treatment Centers RAVINE WAY SURGERY CENTER LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014333751 1669941555 22 Physical Therapists TOENNIES COLLIN 999999999 65 Madison 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 0 245 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 5452.59 5452.59 0 0 1014333829 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5074.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5074.19 0 0 1014333871 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 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 1002.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1002.54 0 0 1014333913 1265093033 16 Nurse Practitioners ASIMAKOPOULOS ANGELA 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 0 220.9 0 0 0 0 0 0 220.9 0 0 1014334135 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23280.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23280.4 0 0 1014334154 1144751751 10 Physicians PLIKAS DIMITRI 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 19 0 0 0 0 0 0 0 0 0 186.34 0 0 0 0 0 0 15.7 0 312.55 0 0 0 0 0 0 514.59 0 0 1014334166 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 81.22 0 0 0 0 0 0 81.22 0 0 1014334177 10 Physicians 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.81 0 0 0 0 0 0 0 0 6.81 0 0 1014334412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22811.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22811.54 0 0 1014334434 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2290.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2290.15 0 0 1014334477 1912437187 10 Physicians KELLEY DANIEL 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 204.3 0 0 0 0 0 0 204.3 0 0 1014334652 1053738195 10 Physicians LOPEZ-HISIJOS NICHOLAS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 154 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4513.37 0 69.84 0 0 0 0 0 0 4583.21 0 0 1014334689 1750923298 89 Physician Assistant Only(Encounter Only) MASINI MARISSA L 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 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 0 610.92 0 0 0 0 0 0 610.92 0 0 1014335155 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26153.98 0 0 0 0 0 0 0 0 0 0 0 0 0 26153.98 0 0 1014335170 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 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 1014335186 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19356.01 0 0 0 0 0 0 0 0 0 0 0 0 0 19356.01 0 0 1014335238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19481.77 0 0 0 0 0 0 0 0 0 0 0 0 0 19481.77 0 0 1014335374 1568689396 16 Nurse Practitioners BEHYMER ASHLEY 999999999 33 Effingham 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 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 0 104.96 0 0 0 0 0 0 0 0 1221.35 0 0 0 0 0 0 1326.31 0 0 1014335398 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2165.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2165.72 0 0 1014335657 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2253.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2253.74 0 0 1014335805 1417503780 11 Dentists KANG NARU 999999999 98 Tazewell 0 0 General Dentistry 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497.46 0 0 1014335888 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 1014335914 1750929709 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1014340311 1558988592 16 Nurse Practitioners NELSON LISA MARIE 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 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 43.54 0 0 0 0 0 0 43.54 0 0 1014340555 1306476445 89 Physician Assistant Only(Encounter Only) HAAS LAUREN E 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 0 258.79 0 0 0 0 0 0 258.79 0 0 1014340598 1083134118 10 Physicians ALAM BUSHRA A 999999999 54 Kankakee 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 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 0 829.91 0 0 0 0 0 0 829.91 0 0 1014340629 1023650033 89 Physician Assistant Only(Encounter Only) HEMRIC JESSIE 999999999 19 Champaign 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 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 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Physicians SUN FANG 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 967.89 0 0 0 0 0 0 967.89 0 0 1014343926 1023472560 10 Physicians SHAH CHIRAG 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4321.97 0 0 0 0 0 0 4321.97 0 0 1014343987 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15238.08 0 0 0 0 0 0 0 0 0 0 0 0 0 15238.08 0 0 1014344103 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 17761.97 0 0 0 0 0 0 0 0 0 0 0 0 0 17761.97 0 0 1014344166 91 Waiver 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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 1014346184 1194107102 10 Physicians ANNAM RADHIKA 999999999 91 Sangamon 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 0 112 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 1317.79 0 0 0 0 0 0 1317.79 0 0 1014346227 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1789.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1789.54 0 0 1014346265 1508279522 10 Physicians REYES GENERE JUAN P 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 851.71 0 0 0 0 0 0 851.71 0 0 1014346489 1326664111 16 Nurse Practitioners PEDTKE NICOLE B 999999999 30 DuPage 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 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1690.71 0 0 0 0 0 0 1690.71 0 0 1014346617 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1969.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1969.29 0 0 1014346704 1548604440 10 Physicians O'KEEFE JOHN J 999999999 91 Sangamon 0 0 0 0 0 0 0 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 0 166.28 0 0 0 0 0 0 0 0 166.28 0 0 1014346769 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 644.31 0 0 0 0 0 0 0 0 0 0 0 0 0 644.31 0 0 1014346915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11921.95 0 0 0 0 0 0 0 0 0 0 0 0 0 11921.95 0 0 1014347329 1942843644 16 Nurse Practitioners MENDEZ STEPHANIE 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 0 161.65 0 0 0 0 0 0 161.65 0 0 1014347433 1376154203 91 Waiver service provider--Adults (DHS/DDD) SHORT TIFFANY A 999999999 99 Union 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 1517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71334.6 0 0 0 0 0 0 0 0 0 0 0 0 0 71334.6 0 0 1014347439 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20792.27 0 0 0 0 0 0 0 0 0 0 0 0 0 20792.27 0 0 1014347501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 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 10801.18 0 0 0 0 0 0 0 0 0 0 0 0 0 10801.18 0 0 1014349362 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10035.78 0 0 0 0 0 0 0 0 0 0 0 0 0 10035.78 0 0 1014349374 1811559321 16 Nurse Practitioners COLEMAN NATALIE 999999999 21 Clark 0 0 0 0 0 0 0 0 0 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 0 477.49 0 0 0 0 0 0 477.49 0 0 1014349705 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 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 50.26 0 0 0 0 0 0 50.26 0 0 1014349760 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290 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 6570.89 0 0 0 0 0 0 0 0 0 0 0 0 0 6570.89 0 0 1014349790 1740803816 16 Nurse Practitioners CHILDS AMBER 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 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 0 123.52 0 0 0 0 0 0 123.52 0 0 1014349823 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7216.55 0 0 0 0 0 0 0 0 0 0 0 0 0 7216.55 0 0 1014349890 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15236.99 0 0 0 0 0 0 0 0 0 0 0 0 0 15236.99 0 0 1014350015 1730775966 16 Nurse Practitioners BRENNAN PAIGE 999999999 72 McLean 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 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 1125.25 0 0 0 0 0 0 1125.25 0 0 1014350080 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24396.17 0 0 0 0 0 0 0 0 0 0 0 0 0 24396.17 0 0 1014350082 1437794765 16 Nurse Practitioners SCHWARTZ AMANDA 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 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 0 479.98 0 0 0 0 0 0 479.98 0 0 1014350237 1053761221 10 Physicians CHEN JUSTIN C 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1014350314 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 16554.89 0 0 0 0 0 0 0 0 0 0 0 0 0 16554.89 0 0 1014350680 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 0 697.85 0 0 0 0 0 0 697.85 0 0 1014350770 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12924.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12924.6 0 0 1014350777 1740844232 16 Nurse Practitioners MAZZEFFI 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 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 0 765.18 0 0 0 0 0 0 765.18 0 0 1014350807 1457954026 11 Dentists PANDE SUCHI 999999999 19 Champaign 0 0 0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37145.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37145.19 0 0 1014350929 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3711.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3711.34 0 0 1014350960 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10763.45 0 0 0 0 0 0 0 0 0 0 0 0 0 10763.45 0 0 1014351194 89 Physician Assistant Only(Encounter Only) 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 80.35 0 0 0 0 0 0 80.35 0 0 1014351243 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 0 707.74 0 0 0 0 0 0 0 0 0 0 0 0 0 707.74 0 0 1014351299 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 564.87 0 0 0 0 0 0 0 0 0 0 0 0 0 564.87 0 0 1014351309 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 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 2519.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2519.33 0 0 1014351380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23776.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23776.29 0 0 1014351440 87 Psychologist(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 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 0 333.86 0 0 0 0 0 0 333.86 0 0 1014351465 1194129692 10 Physicians OKASH MAHMOUD 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 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 17.84 0 0 0 0 0 0 17.84 0 0 1014351492 4014351492 90 Waiver service provider--Elderly (DOA) ILLINOIS HOMECARE AND TRAINING 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 0 396 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 37557 0 0 0 0 0 0 0 0 0 0 0 0 0 37557 0 0 1014351710 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9943.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9943.99 0 0 1014351786 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 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 0 688.8 0 0 0 0 0 0 0 0 0 0 0 0 0 688.8 0 0 1014351789 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 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 53.25 0 0 0 0 0 0 53.25 0 0 1014352101 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 1992.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1992.98 0 0 1014352283 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 1014352427 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1962.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1962.39 0 0 1014352613 1780207308 16 Nurse Practitioners GILLESPIE JILL D 999999999 46 Iroquois 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014352865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37500.05 0 0 0 0 0 0 0 0 0 0 0 0 0 37500.05 0 0 1014352898 1033474333 89 Physician Assistant Only(Encounter Only) TSEMUNHU NYARADZO 999999999 19 Champaign 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 0 152 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 4627.94 0 0 0 0 0 0 4627.94 0 0 1014353568 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 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 2658.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2658.25 0 0 1014353614 1750812822 10 Physicians MORREALE CHAD V 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 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 0 719.75 0 0 0 0 0 0 719.75 0 0 1014353624 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 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 8625.75 0 0 0 0 0 0 0 0 0 0 0 0 0 8625.75 0 0 1014353704 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 0 227.83 0 0 0 0 0 0 227.83 0 0 1014353707 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3679.16 0 0 0 0 0 0 0 0 0 0 0 0 0 3679.16 0 0 1014353710 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 0 0 0 0 0 0 0 0 0 0 1014353743 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 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 8262.53 0 0 0 0 0 0 0 0 0 0 0 0 0 8262.53 0 0 1014353769 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10351.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10351.84 0 0 1014353952 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 413.06 0 0 0 0 0 0 0 0 0 0 0 0 0 413.06 0 0 1014353991 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2939.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2939.14 0 0 1014354132 1538574207 10 Physicians JAWAHAR ANUGAYATHRI 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 428 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8646.72 0 338.48 0 0 0 0 0 0 8985.2 0 0 1014354144 1972918142 10 Physicians PEREZ ERIC 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 33 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 584.29 0 4873.59 0 0 0 0 0 0 5457.88 0 0 1014354318 1184251415 55 Early Intervention Services MOSIER SARAH 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 10566.52 0 0 0 0 0 0 10566.52 0 0 1014354624 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.8 0 0 0 0 0 0 34.8 0 0 1014354666 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.08 0 0 0 128.08 0 0 1014354695 1831509314 10 Physicians EAST LAUREN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 16 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.54 0 1826.44 0 0 0 0 0 0 1977.98 0 0 1014354727 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1430.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1430.11 0 0 1014354778 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 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 6202.68 0 0 0 0 0 0 0 0 0 0 0 0 0 6202.68 0 0 1014354893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5190.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5190.94 0 0 1014355075 1598308389 16 Nurse Practitioners PARKS SHANNON D 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 124.16 0 0 0 0 0 0 0 0 1803.4 0 0 0 0 0 0 1927.56 0 0 1014355225 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 7875.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7875.45 0 0 1014355233 1205280294 10 Physicians HAIDAR MOHAMMAD 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 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 1590.78 0 0 0 0 0 0 1590.78 0 0 1014355370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22296.87 0 0 0 0 0 0 0 0 0 0 0 0 0 22296.87 0 0 1014355408 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.08 0 0 0 0 0 0 0 0 0 0 0 0 0 67.08 0 0 1014355478 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16839.95 0 0 0 0 0 0 0 0 0 0 0 0 0 16839.95 0 0 1014355492 60 Pharmacies 823 Michigan 0 0 0 0 0 0 0 0 0 0 0 0 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 0 397.41 0 0 0 397.41 0 0 1014355511 1376521773 10 Physicians CHESS DAVID M 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 0 162 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 1241.89 0 0 0 0 0 0 1241.89 0 0 1014355582 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28255.39 0 0 0 0 0 0 0 0 0 0 0 0 0 28255.39 0 0 1014355636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10622.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10622.7 0 0 1014355638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25687.64 0 0 0 0 0 0 0 0 0 0 0 0 0 25687.64 0 0 1014355710 1104243070 10 Physicians ALEXANDER JAIME B 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 0 112 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 1327.49 0 0 0 0 0 0 1327.49 0 0 1014355798 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22476.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22476.15 0 0 1014355828 1841671799 10 Physicians ZAMAN RUJMAN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 160 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 243 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2915.11 0 81.49 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24761.88 0 0 0 0 0 0 0 0 0 0 0 0 0 24761.88 0 0 1014357899 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13396.76 0 0 0 0 0 0 0 0 0 0 0 0 0 13396.76 0 0 1014358030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 951.73 0 0 0 0 0 0 0 0 0 0 0 0 0 951.73 0 0 1014358081 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23174.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23174.4 0 0 1014358096 92 Waiver service 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Edgar 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 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 1247.15 0 0 0 0 0 0 1247.15 0 0 1014358702 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36545.3 0 0 0 0 0 0 0 0 0 0 0 0 0 36545.3 0 0 1014358707 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8079.22 0 0 0 0 0 0 0 0 0 0 0 0 0 8079.22 0 0 1014358806 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7763.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7763.09 0 0 1014358988 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6254.13 0 0 0 0 0 0 0 0 0 0 0 0 0 6254.13 0 0 1014358989 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34568.18 0 0 0 0 0 0 0 0 0 0 0 0 0 34568.18 0 0 1014359049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13703.64 0 0 0 0 0 0 0 0 0 0 0 0 0 13703.64 0 0 1014359156 1326656497 91 Waiver service provider--Adults (DHS/DDD) JACOBS RACHEL 627621000 91 Sangamon 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 0 841 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 841 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19945.69 0 0 0 0 0 0 0 0 0 0 0 0 0 19945.69 0 0 1014359207 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11730.98 0 0 0 0 0 0 0 0 0 0 0 0 0 11730.98 0 0 1014359218 1053758524 10 Physicians ATLURI MAHESH G 999999999 98 Tazewell 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 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 0 671.71 0 0 0 0 0 0 0 0 671.71 0 0 1014359220 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 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 5291.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5291.01 0 0 1014359281 10 Physicians 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 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 0 152.11 0 0 0 0 0 0 152.11 0 0 1014359420 16 Nurse Practitioners 63 Macon 0 0 0 0 0 0 0 0 0 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 0 183.39 0 0 0 0 0 0 183.39 0 0 1014359462 1891308060 16 Nurse Practitioners LYDON KELLY 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 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 2516.39 0 0 0 0 0 0 2516.39 0 0 1014359749 10 Physicians 53 Kane 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 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 0 716.73 0 0 0 0 0 0 716.73 0 0 1014359788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3786.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3786.72 0 0 1014359804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2936.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2936.1 0 0 1014360041 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 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 1820.5 0 0 0 0 0 0 1820.5 0 0 1014360098 16 Nurse Practitioners 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359.02 0 0 0 0 0 0 359.02 0 0 1014360135 1518516533 61 Independent Laboratories LABCORP INDIANA INC 999999999 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.13 0 0 0 0 0 0 0 0 4554.13 0 0 1014360294 1942896923 23 Occupational Therapists KRISTY EVELINA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67609.88 67609.88 0 0 1014360544 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1868.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1868.58 0 0 1014360679 1750997227 22 Physical Therapists METEVIER MICHELLE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6446.47 6446.47 0 0 1014360684 1649581570 10 Physicians WOODS KENDRA S 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 18305.82 0 0 0 0 0 0 18305.82 0 0 1014360819 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4536.97 0 0 0 0 0 0 0 0 0 0 0 0 0 4536.97 0 0 1014360832 1285264523 16 Nurse Practitioners LEMAN DANIEL 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 346.22 0 0 0 0 0 0 0 0 1316.49 0 0 0 0 0 0 1662.71 0 0 1014360879 1104233006 10 Physicians TILLU NUPOOR D 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2142.58 0 0 0 0 0 0 2142.58 0 0 1014360932 1184967747 10 Physicians ALFANO SUZANNE F 999999999 200 Cook 0 0 Pediatrics 0 0 0 8 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 813.04 0 0 0 0 0 0 0 0 341.26 0 0 0 0 0 0 1154.3 0 0 1014361336 1376930115 10 Physicians REDDY SONYA 999999999 200 Cook 0 0 Anesthesiology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.7 0 0 0 0 0 0 184.7 0 0 1014361440 1497835946 10 Physicians SACKS JUSTIN M 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 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 0 710.58 0 0 0 0 0 0 710.58 0 0 1014361506 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21138.84 0 0 0 0 0 0 0 0 0 0 0 0 0 21138.84 0 0 1014361513 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 824.66 0 0 0 0 0 0 0 0 0 0 0 0 0 824.66 0 0 1014361557 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18024.62 0 0 0 0 0 0 0 0 0 0 0 0 0 18024.62 0 0 1014361698 1235748773 87 Psychologist(Encounter Only) KRIETSCH KENDRA 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 0 685.52 0 0 0 0 0 0 685.52 0 0 1014361739 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 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 0 586.08 0 0 0 0 0 0 0 0 0 0 0 0 0 586.08 0 0 1014361865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7726.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7726.63 0 0 1014362010 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1478.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1478.31 0 0 1014362300 1467075200 11 Dentists SROUR REAMA 999999999 30 DuPage 0 0 General Dentistry 0 0 34 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 6173.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6173.32 0 0 1014362370 1215323571 10 Physicians AUNG SANDI 999999999 80 Peoria 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 0 212 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 3219.35 0 0 0 0 0 0 3219.35 0 0 1014362384 1376131003 16 Nurse Practitioners ROBERTS CHELSEA M 999999999 80 Peoria 0 0 0 0 0 5 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 160.75 0 0 0 0 0 0 0 0 2158.41 0 0 0 0 0 0 2319.16 0 0 1014362443 1851739403 10 Physicians LIM SUNGHO 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 9 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.78 0 3790.47 0 0 0 0 0 0 3839.25 0 0 1014362504 1740664499 10 Physicians TYSON BRIAN J 999999999 24 Coles 0 0 Internal 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 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 464 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3003.49 0 0 0 0 0 0 3003.49 0 0 1014362587 10 Physicians 30 DuPage 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 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 1080.26 0 0 0 0 0 0 1080.26 0 0 1014362599 1114535903 16 Nurse Practitioners CHAVIRA JAZIEL 999999999 106 Whiteside 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 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 1444.2 0 0 0 0 0 0 1444.2 0 0 1014362669 1811545338 16 Nurse Practitioners VATH MARY R 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112.71 0 0 0 0 0 0 112.71 0 0 1014362771 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21476.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21476.32 0 0 1014362892 10 Physicians 109 Winnebago 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 73.4 0 0 0 0 0 0 73.4 0 0 1014363111 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 1283.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1283.3 0 0 1014363183 1326668047 91 Waiver service provider--Adults (DHS/DDD) RODMAN EMILY 999999999 91 Sangamon 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 0 352 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 20462.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20462.79 0 0 1014363324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20067.03 0 0 0 0 0 0 0 0 0 0 0 0 0 20067.03 0 0 1014363350 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2140.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2140.5 0 0 1014363435 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 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 2857.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2857.35 0 0 1014363476 1972957975 10 Physicians PATEL KISHAN 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 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 2066.23 0 0 0 0 0 0 2066.23 0 0 1014363540 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 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 3261.55 0 0 0 0 0 0 0 0 0 0 0 0 0 3261.55 0 0 1014363571 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1302.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1302.4 0 0 1014363645 10 Physicians 80 Peoria 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 0 0 0 0 0 0 0 0 0 0 0 0 1014364020 1568086676 16 Nurse Practitioners QUIDORT MICHAEL D 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 0 595.37 0 0 0 0 0 0 595.37 0 0 1014364085 1255844197 89 Physician Assistant Only(Encounter Only) MARTIN PHILEASE 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 0 181 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 2546.25 0 0 0 0 0 0 2546.25 0 0 1014364101 1053853937 16 Nurse Practitioners WHITE DAVID 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 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 0 356.26 0 0 0 0 0 0 356.26 0 0 1014364107 1801330527 89 Physician Assistant Only(Encounter Only) ZARNEK LAUREN 999999999 91 Sangamon 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 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 4755.48 0 0 0 0 0 0 4755.48 0 0 1014364118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4999.47 0 0 0 0 0 0 0 0 0 0 0 0 0 4999.47 0 0 1014364363 1780106971 13 Podiatrists FERRARI MICHAEL 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 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 0 286.71 0 0 0 0 0 0 286.71 0 0 1014364545 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3603.78 0 0 0 0 0 0 0 0 0 0 0 0 0 3603.78 0 0 1014364562 1013301605 10 Physicians RAMADORAI ANAND 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 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4814.6 0 0 0 0 0 0 4814.6 0 0 1014364566 1104426428 16 Nurse Practitioners IKEMIRE CASEY 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 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 22.94 0 0 0 0 0 0 22.94 0 0 1014364827 1447504402 10 Physicians GHADAI AHMED 999999999 30 DuPage 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 0 137 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 5497.89 0 0 0 0 0 0 5497.89 0 0 1014364897 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19026.56 0 0 0 0 0 0 0 0 0 0 0 0 0 19026.56 0 0 1014364925 16 Nurse Practitioners 106 Whiteside 0 0 0 0 0 0 0 0 0 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 78.34 0 0 0 0 0 0 78.34 0 0 1014364961 10 Physicians 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 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 1014365115 1669004081 16 Nurse Practitioners JOHNSON ELIZABETH A 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 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 3332.44 0 0 0 0 0 0 3332.44 0 0 1014365143 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1530.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1530.86 0 0 1014365395 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 0 301.8 0 0 0 0 0 0 0 0 0 0 0 0 0 301.8 0 0 1014365844 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 16572.63 0 0 0 0 0 0 0 0 0 0 0 0 0 16572.63 0 0 1014365941 1184287302 16 Nurse Practitioners WALSH JODI 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 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 1287.92 0 0 0 0 0 0 1287.92 0 0 1014366020 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18077.17 0 0 0 0 0 0 0 0 0 0 0 0 0 18077.17 0 0 1014366131 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3869.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3869.9 0 0 1014366186 1164083143 12 Optometrists TAYLOR SARA E 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 269.81 0 0 0 0 0 0 269.81 0 0 1014366231 1659969921 91 Waiver service provider--Adults (DHS/DDD) WOODS SARAH M 999999999 91 Sangamon 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 1033 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 72400.67 0 0 0 0 0 0 0 0 0 0 0 0 0 72400.67 0 0 1014366338 1396363297 11 Dentists EUN SUNG 999999999 109 Winnebago 0 0 General Dentistry 0 0 48 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 169 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 7057.01 0 0 0 0 0 0 0 0 0 0 0 1576.35 0 0 0 0 8633.36 0 0 1014366399 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 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 9385.23 0 0 0 0 0 0 0 0 0 0 0 0 0 9385.23 0 0 1014366410 1821352428 10 Physicians NOTTINGHAM CHARLES U 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 364.26 0 0 0 0 0 0 364.26 0 0 1014366420 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 15079.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15079.35 0 0 1014366443 1184244717 16 Nurse Practitioners CARR NICOLE 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 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 0 250.96 0 0 0 0 0 0 250.96 0 0 1014366509 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4848.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4848.25 0 0 1014366532 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 0 189.84 0 0 0 0 0 0 189.84 0 0 1014366578 1588107122 33 Nursing Facilities RIVER CROSSING OF JOLIET 999999999 107 Will 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 0 220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552228.1 0 0 0 0 0 0 0 552228.1 0 0 1014366730 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4542.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4542.12 0 0 1014366740 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13990.54 0 0 0 0 0 0 0 0 0 0 0 0 0 13990.54 0 0 1014366779 1306290549 10 Physicians SIRANDAS HEMANTH 999999999 57 Lake 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 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3101.14 0 0 0 0 0 0 3101.14 0 0 1014367123 1215560784 23 Occupational Therapists WILLIS JALYN 999999999 53 Kane 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 0 154 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 10895.58 10895.58 0 0 1014367201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7464.03 0 0 0 0 0 0 0 0 0 0 0 0 0 7464.03 0 0 1014367325 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10568.58 0 0 0 0 0 0 0 0 0 0 0 0 0 10568.58 0 0 1014367418 1508420233 63 Other Providers of Medical Equipment/Supplies (Non-registered) LEHAN'S MEDICAL EQUIPMENT 999999999 97 Stephenson 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 0 482 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 8844.82 0 0 0 0 0 0 8844.82 0 0 1014367457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7087.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7087.15 0 0 1014367627 1063947067 10 Physicians EDWARDS JOANNA G 999999999 25 Crawford 0 0 0 0 0 0 0 0 0 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 1586.22 0 0 0 0 0 0 1586.22 0 0 1014367644 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29613.35 0 0 0 0 0 0 0 0 0 0 0 0 0 29613.35 0 0 1014367707 1407491319 16 Nurse Practitioners DAESCH JOSEPH D 999999999 96 St Clair 0 0 0 0 0 10 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 935.8 0 0 0 0 0 0 0 0 1494.56 0 0 0 0 0 0 2430.36 0 0 1014367716 1699129932 10 Physicians BAIRD MARIE M 999999999 200 Cook 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 0 160 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 3452.49 0 0 0 0 0 0 3452.49 0 0 1014367849 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21037.94 0 0 0 0 0 0 0 0 0 0 0 0 0 21037.94 0 0 1014367897 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25152.6 0 0 0 0 0 0 0 0 0 0 0 0 0 25152.6 0 0 1014367913 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014368005 1104489244 27 Behavioral Health Clinic CHILDREN'S ADVOCATE LLC 999999999 200 Cook 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 125.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12658.05 0 0 12783.09 0 0 1014368012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1031.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.51 0 0 1014368263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390.77 0 0 0 0 0 0 0 0 0 0 0 0 0 390.77 0 0 1014368272 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16931.2 0 0 0 0 0 0 0 0 0 0 0 0 0 16931.2 0 0 1014368522 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24548.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24548.64 0 0 1014368807 1326646209 33 Nursing Facilities PARIS HEALTH AND REHAB CENTER 619441145 31 Edgar 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 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250488.6 0 0 0 0 0 0 0 250488.6 0 0 1014368821 1629689096 16 Nurse Practitioners MEEHAN SARAH 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 0 146.72 0 0 0 0 0 0 146.72 0 0 1014369112 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 409.27 0 0 0 0 0 0 0 0 0 0 0 0 0 409.27 0 0 1014369454 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.77 0 0 0 0 0 0 126.77 0 0 1014369512 1063823763 10 Physicians LEONBERGER PATRICK 999999999 47 Jackson 0 0 Internal Medicine 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 0 254 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 3645.49 0 0 0 0 0 0 3645.49 0 0 1014369551 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 0 149.24 0 0 0 0 0 0 149.24 0 0 1014369646 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25951.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25951.2 0 0 1014370117 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23652.98 0 0 0 0 0 0 0 0 0 0 0 0 0 23652.98 0 0 1014370184 1750347555 33 Nursing Facilities ROBINGS MANOR REHAB AND HC 999999999 64 Macoupin 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2477 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313736.73 0 0 0 0 0 0 0 313736.73 0 0 1014370377 60 Pharmacies 818 Kentucky 0 0 0 0 0 0 0 0 0 0 0 0 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 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 570.72 0 0 0 570.72 0 0 1014370471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2375.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2375.38 0 0 1014370488 1285951723 10 Physicians LEWALLEN LAURA 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 23 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 5817.1 0 0 0 0 0 0 5817.1 0 0 1014370562 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26476.08 0 0 0 0 0 0 0 0 0 0 0 0 0 26476.08 0 0 1014370954 1548791478 10 Physicians YOUNG SARAH 999999999 200 Cook 0 0 Pediatrics 0 0 0 7 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 668.01 0 0 0 0 0 0 89.51 0 960.64 0 0 0 0 0 0 1718.16 0 0 1014371058 1053384644 10 Physicians WILLIAMS JOSEPH P 999999999 10 Adams 0 0 0 0 0 0 0 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 0 284.3 0 0 0 0 0 0 0 0 284.3 0 0 1014371206 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14447.37 0 0 0 0 0 0 0 0 0 0 0 0 0 14447.37 0 0 1014371420 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12852.76 0 0 0 0 0 0 0 0 0 0 0 0 0 12852.76 0 0 1014371585 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 623.87 0 0 0 0 0 0 0 0 0 0 0 0 0 623.87 0 0 1014371800 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23802.95 0 0 0 0 0 0 0 0 0 0 0 0 0 23802.95 0 0 1014371970 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 5285.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5285.74 0 0 1014371986 1720196983 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNIVERSALMED SUPPLY 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50087.1 0 152.29 0 0 0 0 50239.39 0 0 1014372107 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 0 106.55 106.55 0 0 1014372185 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 1014372784 1215578109 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 999999999 10 Adams 0 0 0 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8708.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8708.18 0 0 1014372828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 969.94 0 0 0 0 0 0 0 0 0 0 0 0 0 969.94 0 0 1014372835 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27405.94 0 0 0 0 0 0 0 0 0 0 0 0 0 27405.94 0 0 1014372939 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7134.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7134.51 0 0 1014372981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2398.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2398.58 0 0 1014373003 1699188623 10 Physicians PALLA JOHN B 999999999 200 Cook 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 181 0 0 0 0 0 0 0 0 0 25.6 0 0 0 0 0 0 0 0 9841.67 0 0 0 0 0 0 9867.27 0 0 1014373034 1386038677 16 Nurse Practitioners RUBIO-COCKROFT HEATHER F 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 0 151.26 0 0 0 0 0 0 151.26 0 0 1014373223 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22352.44 0 0 0 0 0 0 0 0 0 0 0 0 0 22352.44 0 0 1014373238 1144632506 10 Physicians HANG MILES 999999999 57 Lake 0 0 Family Practice 0 0 0 0 0 0 0 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 0 176.06 0 0 0 0 0 0 176.06 0 0 1014373345 1366934176 16 Nurse Practitioners SAM SUNIL 999999999 200 Cook 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 0 168 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 2327.41 0 0 0 0 0 0 2327.41 0 0 1014373451 1407482573 89 Physician Assistant Only(Encounter Only) RIVA ANNMARIE 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 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 0 275.3 0 0 0 0 0 0 275.3 0 0 1014373452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.29 0 0 0 0 0 0 0 0 0 0 0 0 0 195.29 0 0 1014373493 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 0 0 0 0 0 0 0 0 0 0 1014373687 1811981590 10 Physicians TOWNSEND DWIGHT 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 93 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1127.37 0 2.27 0 0 0 0 0 0 1129.64 0 0 1014373747 1316507288 24 Speech Therapists BATREZ RAQUEL 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 0 172 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 0 432.74 432.74 0 0 1014373760 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 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 0 523.21 523.21 0 0 1014373792 1407447220 89 Physician Assistant Only(Encounter Only) SAVARESE DIANE 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 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 73.4 0 0 0 0 0 0 73.4 0 0 1014373832 1194369884 16 Nurse Practitioners GWALTNEY LINDSAY 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 408.57 0 0 0 0 0 0 408.57 0 0 1014373967 4014373967 72 Taxicabs and Livery Companies IRON KLAD TRANSPO LLC 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 0 162 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 1764.49 0 0 0 0 0 0 1764.49 0 0 1014374313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15727.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15727.52 0 0 1014374348 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25769.4 0 0 0 0 0 0 0 0 0 0 0 0 0 25769.4 0 0 1014374508 1750743233 10 Physicians DANIEL KAYLA ELIZABETH 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 1280.03 0 0 0 0 0 0 1280.03 0 0 1014374520 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22564.08 0 0 0 0 0 0 0 0 0 0 0 0 0 22564.08 0 0 1014374642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23296.68 0 0 0 0 0 0 0 0 0 0 0 0 0 23296.68 0 0 1014374813 1063029247 16 Nurse Practitioners PFOUTZ VALARIE A 999999999 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1293.35 0 0 0 0 0 0 1293.35 0 0 1014374924 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1601.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1601.83 0 0 1014375025 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 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 0 0 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0 0 176.82 0 0 1014375299 1710510730 36 Community mental health provider LITTLE CITY FOUNDATION 999999999 200 Cook 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 53.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687.15 0 0 741.03 0 0 1014375608 1164921094 16 Nurse Practitioners BISHOP ANTONIA 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 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 0 563.79 0 0 0 0 0 0 563.79 0 0 1014375672 10 Physicians 109 Winnebago 0 0 Nuclear 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 1014375698 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 17486.31 0 0 0 0 0 0 0 0 0 0 0 0 0 17486.31 0 0 1014375720 1649652728 10 Physicians KISTNER BRIDGET 999999999 98 Tazewell 0 0 Radiology Diagnosis 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 29 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 332.1 0 0 0 0 0 0 0 0 332.1 0 0 1014375844 16 Nurse Practitioners 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 69.55 0 0 0 0 0 0 69.55 0 0 1014375856 92 Waiver service provider--Disability (DHS/DRS) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9542.1 0 0 0 0 0 0 0 0 0 0 0 0 0 9542.1 0 0 1014375946 1558892646 10 Physicians PROCHOT JEFFREY 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 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 0 278.47 0 0 0 0 0 0 278.47 0 0 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1014377686 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11461.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11461.23 0 0 1014377812 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7672.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7672.2 0 0 1014377854 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 0 100.52 0 0 0 0 0 0 100.52 0 0 1014377861 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2700.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2700.99 0 0 1014377913 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 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 4176.55 0 0 0 0 0 0 0 0 0 0 0 0 0 4176.55 0 0 1014377969 1649819178 16 Nurse Practitioners LEMAN CHERYL A 999999999 80 Peoria 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 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 32.15 0 0 0 0 0 0 0 0 1629.51 0 0 0 0 0 0 1661.66 0 0 1014377982 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 5283.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5283.95 0 0 1014378224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8235.89 0 0 0 0 0 0 0 0 0 0 0 0 0 8235.89 0 0 1014378261 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0 0 1014379074 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5201.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5201.46 0 0 1014379171 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32268.23 0 0 0 0 0 0 0 0 0 0 0 0 0 32268.23 0 0 1014379334 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37716.86 0 0 0 0 0 0 0 0 0 0 0 0 0 37716.86 0 0 1014379341 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23817.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23817.64 0 0 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KAREN 999999999 30 DuPage 0 0 0 0 0 50 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 4585.53 0 0 0 0 0 0 0 0 2734.81 0 0 0 0 0 0 7320.34 0 0 1014381755 1427698349 60 Pharmacies VITAL SPECIALTY PHARMACY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 36269.51 0 0 0 36269.51 0 0 1014382005 1801202361 10 Physicians POLANI FARAN 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 747.94 0 0 0 0 0 0 747.94 0 0 1014382093 1932612140 89 Physician Assistant Only(Encounter Only) GIPPLE AMBER 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 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 0 154.29 0 0 0 0 0 0 154.29 0 0 1014382277 1053954503 16 Nurse Practitioners FAZIL FARIAHH 999999999 47 Jackson 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 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 0 607.14 0 0 0 0 0 0 607.14 0 0 1014382410 11 Dentists 47 Jackson 0 0 General Dentistry 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014382493 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 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 11544.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11544.4 0 0 1014382557 1720601784 89 Physician Assistant Only(Encounter Only) PHAM DOROTHY V 999999999 91 Sangamon 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 0 150 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 1056.31 0 0 0 0 0 0 1056.31 0 0 1014382608 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 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 17678.76 0 0 0 0 0 0 0 0 0 0 0 0 0 17678.76 0 0 1014382721 1265963383 10 Physicians MOLITOR CHRISTOPHER 999999999 200 Cook 0 0 Family Practice 0 0 0 14 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 2 0 124 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 2 0 124 0 0 0 0 0 0 0 0 0 1495.07 0 0 0 0 0 0 7.35 0 6083.72 0 0 0 0 0 0 7586.14 0 0 1014382783 1245869502 16 Nurse Practitioners FITZGERALD HAILE 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 0 174.5 0 0 0 0 0 0 174.5 0 0 1014382968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11653.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11653.4 0 0 1014383192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15873 0 0 0 0 0 0 0 0 0 0 0 0 0 15873 0 0 1014383324 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4560.91 0 0 0 0 0 0 0 0 0 0 0 0 0 4560.91 0 0 1014383326 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 1014383379 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23989.24 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.24 0 0 1014383395 4014383395 72 Taxicabs and Livery Companies MY CUBS RIDING TRANSPORTATION 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 7025 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7025 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42663.73 0 0 0 0 0 0 42663.73 0 0 1014383500 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18530.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18530.45 0 0 1014383537 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23408.82 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.82 0 0 1014383653 1518386655 10 Physicians PROPPER REBECCA A 999999999 30 DuPage 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 0 127 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 16690.77 0 0 0 0 0 0 16690.77 0 0 1014383712 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5463.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5463.95 0 0 1014383762 1922549013 16 Nurse Practitioners SPERLING KATHLEEN 999999999 107 Will 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 0 129 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 3436.58 0 0 0 0 0 0 3436.58 0 0 1014383767 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.8 0 0 0 0 0 0 0 0 0 0 0 0 0 162.8 0 0 1014383864 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 1331.4 0 0 0 0 0 0 1331.4 0 0 1014383912 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1228.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1228.15 0 0 1014384306 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 766.53 0 0 0 0 0 0 0 0 0 0 0 0 0 766.53 0 0 1014384317 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 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 0 157.32 157.32 0 0 1014384421 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014384428 1467069823 16 Nurse Practitioners KENDRA ALICIA N 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 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 0 313.07 0 0 0 0 0 0 313.07 0 0 1014384438 10 Physicians 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.44 0 0 0 0 0 0 178.44 0 0 1014384561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6081.73 0 0 0 0 0 0 0 0 0 0 0 0 0 6081.73 0 0 1014384916 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 18.21 0 0 0 0 0 0 18.21 0 0 1014384941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39501.43 0 0 0 0 0 0 0 0 0 0 0 0 0 39501.43 0 0 1014384978 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17436.61 0 0 0 0 0 0 0 0 0 0 0 0 0 17436.61 0 0 1014385065 1265063861 55 Early Intervention Services RICHARDS HOLLY E 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 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19954.9 0 0 0 0 0 0 19954.9 0 0 1014385094 1053848622 10 Physicians MURTHY ESHWAR 999999999 200 Cook 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 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 0 773.96 0 0 0 0 0 0 773.96 0 0 1014385114 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.54 0 0 0 0 0 0 0 0 0 0 0 0 0 190.54 0 0 1014385515 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.89 76.89 0 0 1014385675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2729.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2729.42 0 0 1014386026 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014386027 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10765.32 0 0 0 0 0 0 0 0 0 0 0 0 0 10765.32 0 0 1014386040 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 0 132 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 16774.1 0 0 0 0 0 0 0 0 0 0 0 0 0 16774.1 0 0 1014386050 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3273.91 0 0 0 0 0 0 0 0 0 0 0 0 0 3273.91 0 0 1014386079 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26558.98 0 0 0 0 0 0 0 0 0 0 0 0 0 26558.98 0 0 1014386234 10 Physicians 200 Cook 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 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 0 294.48 0 0 0 0 0 0 294.48 0 0 1014386277 1578116901 61 Independent Laboratories LABORATORY CORPORATION OF AMER 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 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 0 149.29 0 0 0 0 0 0 0 0 149.29 0 0 1014386281 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1887.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1887.53 0 0 1014386812 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 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 1014387019 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13929.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13929.47 0 0 1014387067 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 0 0 0 0 0 105 0 0 1014387097 1760033492 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE BRIDGEPORT 999999999 59 Lawrence 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 7282 0 0 0 0 0 0 7282 0 0 1014387119 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981.93 0 0 0 0 0 0 0 0 0 0 0 0 0 981.93 0 0 1014387265 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 951.76 0 0 0 0 0 0 0 0 0 0 0 0 0 951.76 0 0 1014387279 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24588.17 0 0 0 0 0 0 0 0 0 0 0 0 0 24588.17 0 0 1014387280 1942801071 16 Nurse Practitioners SUNSTEDT KATHRINE L 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 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 3144.64 0 0 0 0 0 0 3144.64 0 0 1014387573 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 31435.47 0 0 0 0 0 0 0 0 0 0 0 0 0 31435.47 0 0 1014387766 1518170877 30 General Hospitals SAINT ANTHONY HOSPITAL 999999999 200 Cook 0 0 1 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146258.37 0 0 0 0 0 0 0 0 0 146258.37 0 0 1014387806 1578199980 16 Nurse Practitioners GUNTER ROBIN 999999999 30 DuPage 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 1987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9515.82 0 0 0 0 0 0 9515.82 0 0 1014387856 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 4176.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4176.28 0 0 1014387884 1467870964 10 Physicians KARAS ANATOLI F 999999999 53 Kane 0 0 Otolaryngology 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 0 196 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 9051.6 0 0 0 0 0 0 9051.6 0 0 1014387917 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1893.92 1893.92 0 0 1014387938 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 37.4 0 0 0 0 0 0 37.4 0 0 1014388032 1427605435 89 Physician Assistant Only(Encounter Only) QUINN ANNA 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 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 1014388285 1891184669 10 Physicians KANG JESSICA MINJY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 19 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.94 0 4735.2 0 0 0 0 0 0 4765.14 0 0 1014388297 1114493905 22 Physical Therapists RENICKER BRYCE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 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 1320.29 1320.29 0 0 1014388416 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 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 9493.75 0 0 0 0 0 0 0 0 0 0 0 0 0 9493.75 0 0 1014388476 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 0 249 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 10491.75 0 0 0 0 0 0 0 0 0 0 0 0 0 10491.75 0 0 1014388830 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4001.86 0 0 0 0 0 0 0 0 0 0 0 0 0 4001.86 0 0 1014388960 1790323301 16 Nurse Practitioners HUGHES LAURA 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 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 0 289.62 0 0 0 0 0 0 289.62 0 0 1014388972 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014388979 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 1014389042 1649268947 33 Nursing Facilities TAYLORVILLE CARE CENTER 625682073 20 Christian 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288753.88 0 0 0 0 0 0 0 288753.88 0 0 1014389154 1104949304 10 Physicians MARDIS NEIL 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 61 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 975.82 0 30.41 0 0 0 0 0 0 1006.23 0 0 1014389183 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722.22 0 0 0 0 0 0 0 0 0 0 0 0 0 722.22 0 0 1014389341 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 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 4966.75 0 0 0 0 0 0 0 0 0 0 0 0 0 4966.75 0 0 1014389475 1740702539 10 Physicians SYED SALMAN 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 0 438.75 0 0 0 0 0 0 438.75 0 0 1014389531 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14414.17 0 0 0 0 0 0 0 0 0 0 0 0 0 14414.17 0 0 1014389791 1952410219 10 Physicians VIYUOH NICHOLAS 999999999 70 McDonough 0 0 0 0 0 4 0 0 0 0 0 0 9 0 80 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 9 0 182 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 9 0 182 0 0 0 0 0 0 0 0 0 107.28 0 0 0 0 0 0 41.36 0 7619.45 0 0 0 0 0 0 7768.09 0 0 1014389822 1194245324 16 Nurse Practitioners MILLS SAMEKA 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 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2466.8 0 0 0 0 0 0 2466.8 0 0 1014389854 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4991 0 0 0 0 0 0 0 0 0 0 0 0 0 4991 0 0 1014389883 1912294455 10 Physicians ALRAHMANI LAYAN 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 65 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2396.03 0 2931.62 0 0 0 0 0 0 5327.65 0 0 1014390049 1316280159 10 Physicians GHODASRA JASON 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 19 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147.85 0 0 0 0 0 0 147.85 0 0 1014390082 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 0 285 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 22861.19 0 0 0 0 0 0 0 0 0 0 0 0 0 22861.19 0 0 1014390148 1851998579 89 Physician Assistant Only(Encounter Only) ZAPPALA LIA 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 1014390231 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4413.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4413.34 0 0 1014390374 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 24389.1 0 0 0 0 0 0 0 0 0 0 0 0 0 24389.1 0 0 1014390385 1235734575 16 Nurse Practitioners CORDERO NATHAN 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 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4340.41 0 0 0 0 0 0 4340.41 0 0 1014390480 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014390638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25179.62 0 0 0 0 0 0 0 0 0 0 0 0 0 25179.62 0 0 1014390681 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014390795 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 594.99 0 0 0 0 0 0 0 0 0 0 0 0 0 594.99 0 0 1014390817 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7409.58 0 0 0 0 0 0 0 0 0 0 0 0 0 7409.58 0 0 1014391064 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15400.88 0 0 0 0 0 0 0 0 0 0 0 0 0 15400.88 0 0 1014391123 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 0 333.74 0 0 0 0 0 0 0 0 0 0 0 0 0 333.74 0 0 1014391124 1295050763 10 Physicians PLANT ASHLEY S 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 989.38 0 0 0 0 0 0 989.38 0 0 1014391214 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1030.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1030.05 0 0 1014391347 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1809.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1809.61 0 0 1014391454 1598298275 10 Physicians MAXA LYNN 999999999 200 Cook 0 0 Emergency 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 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 1277.92 0 0 0 0 0 0 1277.92 0 0 1014391509 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15027.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15027.21 0 0 1014391618 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 0 307 0 0 0 0 0 0 307 0 0 1014391637 1730560517 10 Physicians HAVRYLYAN ANDRIY 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 0 229 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 3462.15 0 0 0 0 0 0 3462.15 0 0 1014391796 1265479067 33 Nursing Facilities NORTH AURORA CARE CENTER 605421260 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 2415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268110.78 0 0 0 0 0 0 0 268110.78 0 0 1014392123 1972918308 11 Dentists BANSAL SHOBHIT 999999999 71 McHenry 0 0 General Dentistry 0 0 68 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 408 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 408 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 14892.05 0 0 0 0 0 0 0 0 0 0 0 3387.15 0 0 0 0 18279.2 0 0 1014392178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13483.36 0 0 0 0 0 0 0 0 0 0 0 0 0 13483.36 0 0 1014392354 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 42.14 0 0 0 0 0 0 42.14 0 0 1014392414 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17242.82 0 0 0 0 0 0 0 0 0 0 0 0 0 17242.82 0 0 1014392634 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 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 49.1 0 0 0 0 0 0 49.1 0 0 1014392862 89 Physician Assistant Only(Encounter Only) 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.9 0 0 0 0 0 0 197.9 0 0 1014392952 1467010884 89 Physician Assistant Only(Encounter Only) SIMON MADELINE 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 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 0 343.64 0 0 0 0 0 0 343.64 0 0 1014393140 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5690.44 0 0 0 0 0 0 0 0 0 0 0 0 0 5690.44 0 0 1014393168 1356726699 10 Physicians BRIGODE WILLIAM M 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 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 0 301.48 0 0 0 0 0 0 301.48 0 0 1014393378 1063020485 16 Nurse Practitioners PRAJAPATI TARUN 999999999 57 Lake 0 0 0 0 0 1 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 118.81 0 0 0 0 0 0 0 0 551.2 0 0 0 0 0 0 670.01 0 0 1014393459 1689218190 89 Physician Assistant Only(Encounter Only) RICHMAN JENNIFER 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 304.15 0 0 0 0 0 0 304.15 0 0 1014393469 1548389851 70 Ambulance Service Providers FREEPORT RURAL FIRE PROTECTION 999999999 97 Stephenson 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 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 10567.42 0 0 0 0 0 0 10567.42 0 0 1014393726 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6730.94 0 0 0 0 0 0 0 0 0 0 0 0 0 6730.94 0 0 1014393812 10 Physicians 10 Adams 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014393874 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 13929.49 0 0 0 0 0 0 0 0 0 0 0 0 0 13929.49 0 0 1014393897 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24796.03 0 0 0 0 0 0 0 0 0 0 0 0 0 24796.03 0 0 1014394041 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22951.8 0 0 0 0 0 0 0 0 0 0 0 0 0 22951.8 0 0 1014394072 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 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 0 621.79 621.79 0 0 1014394158 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014394211 1942816665 16 Nurse Practitioners ONYEFORO STEPHANIE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 95.24 0 0 0 0 0 0 95.24 0 0 1014394230 1235739830 22 Physical Therapists MURPHY BRENNA 999999999 89 Rock Island 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 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 0 225.16 225.16 0 0 1014394240 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23924.22 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.22 0 0 1014394364 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 1014394553 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 6.8 0 0 0 0 0 0 6.8 0 0 1014394669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6575.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6575.1 0 0 1014394722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12379.34 0 0 0 0 0 0 0 0 0 0 0 0 0 12379.34 0 0 1014394758 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6633.32 0 0 0 0 0 0 0 0 0 0 0 0 0 6633.32 0 0 1014395172 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 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 41.38 41.38 0 0 1014395190 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27124.37 0 0 0 0 0 0 0 0 0 0 0 0 0 27124.37 0 0 1014395221 1568092203 23 Occupational Therapists RICHARDSON NICOLE 999999999 98 Tazewell 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27203.33 27203.33 0 0 1014395397 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 50215.63 0 0 0 0 0 0 0 0 0 0 0 0 0 50215.63 0 0 1014395492 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 16768.4 0 0 0 0 0 0 0 0 0 0 0 0 0 16768.4 0 0 1014395510 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1047.17 0 0 0 0 0 0 0 0 0 0 0 0 0 1047.17 0 0 1014395680 1932332319 10 Physicians BRODSKY JENNIE E 999999999 19 Champaign 0 0 Radiology Diagnosis 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.22 0 231.56 0 0 0 0 0 0 292.78 0 0 1014395713 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 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 2246.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2246.64 0 0 1014395759 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6640.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6640.2 0 0 1014395904 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.91 0 0 0 0 0 0 260.91 0 0 1014395916 1487258943 61 Independent Laboratories LAB ELITE LLC 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 0 323 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 11812.21 0 0 0 0 0 0 0 0 11812.21 0 0 1014396009 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24471.25 0 0 0 0 0 0 0 0 0 0 0 0 0 24471.25 0 0 1014396022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6683.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6683.6 0 0 1014396062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5537.83 0 0 0 0 0 0 0 0 0 0 0 0 0 5537.83 0 0 1014396186 1063923134 89 Physician Assistant Only(Encounter Only) SCHURDER BAILEY 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 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 0 221.87 0 0 0 0 0 0 221.87 0 0 1014396305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.36 0 0 0 0 0 0 0 0 0 0 0 0 0 30.36 0 0 1014396311 1144846106 12 Optometrists YOUNG KYLE M 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10064.01 0 0 0 0 0 0 10064.01 0 0 1014396467 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15031.46 0 0 0 0 0 0 0 0 0 0 0 0 0 15031.46 0 0 1014396572 1811949118 89 Physician Assistant Only(Encounter Only) MASON JOHN 999999999 30 DuPage 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 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6590.8 0 0 0 0 0 0 6590.8 0 0 1014396860 1770100265 55 Early Intervention Services ZEILNER PENELOPE 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 0 137 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 7945.87 0 0 0 0 0 0 7945.87 0 0 1014397073 1518580620 16 Nurse Practitioners SIRA CRISTINA 999999999 200 Cook 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 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.63 0 0 0 0 0 0 231.63 0 0 1014397092 1639451826 91 Waiver service provider--Adults (DHS/DDD) DAVIS CHRISTINE M 999999999 91 Sangamon 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 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 8462 0 0 0 0 0 0 0 0 0 0 0 0 0 8462 0 0 1014397262 1477183002 89 Physician Assistant Only(Encounter Only) HARTWIG CHARISSE 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 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 73.3 0 0 0 0 0 0 73.3 0 0 1014397389 10 Physicians 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 61.72 0 0 0 0 0 0 61.72 0 0 1014397404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.22 0 0 0 0 0 0 0 0 0 0 0 0 0 133.22 0 0 1014397500 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10757.77 0 0 0 0 0 0 0 0 0 0 0 0 0 10757.77 0 0 1014397528 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5496.05 0 0 0 0 0 0 0 0 0 0 0 0 0 5496.05 0 0 1014397697 4014397697 71 Medicar Provider TWINS MEDICAL TRANSPORTATION 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 6083 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6083 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42540.06 0 0 0 0 0 0 42540.06 0 0 1014397866 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24694.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24694.53 0 0 1014397875 4014397875 72 Taxicabs and Livery Companies "KEVLAR EXPRESS TRANSIT, LLC" 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 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 969 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8134.25 0 0 0 0 0 0 8134.25 0 0 1014397901 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 816.74 0 0 0 0 0 0 0 0 0 0 0 0 0 816.74 0 0 1014397934 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24504.67 0 0 0 0 0 0 0 0 0 0 0 0 0 24504.67 0 0 1014397979 16 Nurse Practitioners 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.9 0 0 0 0 0 0 148.9 0 0 1014398173 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.35 0 0 0 0 0 0 25.35 0 0 1014398215 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7980.11 0 0 0 0 0 0 0 0 0 0 0 0 0 7980.11 0 0 1014398219 1376006734 63 Other Providers of Medical Equipment/Supplies (Non-registered) "DAVID ROTTER PROSTHETICS, LTD." 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 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 8173.9 0 0 0 0 8173.9 0 0 1014398349 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 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 60.44 0 0 0 0 0 0 60.44 0 0 1014398455 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20708.16 0 0 0 0 0 0 0 0 0 0 0 0 0 20708.16 0 0 1014398818 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 0 0 0 0 0 0 0 0 0 0 1014398892 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10275.26 0 0 0 0 0 0 0 0 0 0 0 0 0 10275.26 0 0 1014398980 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 5 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 4803.5 0 0 0 0 0 0 4803.5 0 0 1014399010 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 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 7356.3 0 0 0 0 0 0 0 0 0 0 0 0 0 7356.3 0 0 1014399239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2390.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2390.36 0 0 1014399254 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2232.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2232.78 0 0 1014399498 1376989186 10 Physicians CAMPBELL KAITLIN MCCLENAHAN 999999999 60 Lee 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 1 0 42 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 112 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 112 0 0 0 0 0 0 0 0 0 279.43 0 0 0 0 0 0 5.22 0 1646.08 0 0 0 0 0 0 1930.73 0 0 1014399728 1649803560 16 Nurse Practitioners WESTRATE REBECCA 999999999 91 Sangamon 0 0 0 0 0 5 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 410.63 0 0 0 0 0 0 0 0 954.38 0 0 0 0 0 0 1365.01 0 0 1014399789 1386625895 10 Physicians DOOLEY JOHN T 999999999 80 Peoria 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 6 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.33 0 1578.35 0 0 0 0 0 0 1587.68 0 0 1014399899 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15888.7 0 0 0 0 0 0 0 0 0 0 0 0 0 15888.7 0 0 1014400180 1346206315 33 Nursing Facilities HAVANA HEALTH CARE CENTER 999999999 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1660 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186620.9 0 0 0 0 0 0 0 186620.9 0 0 1014400255 1942748967 87 Psychologist(Encounter Only) STEED DRAKE R 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 0 173.46 0 0 0 0 0 0 173.46 0 0 1014400367 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24108.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24108.7 0 0 1014400487 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2306.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2306.39 0 0 1014400591 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24108.7 0 0 0 0 0 0 0 0 0 0 0 0 0 24108.7 0 0 1014400632 1861021248 16 Nurse Practitioners HORAN ELIZABETH 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 0 147 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 1496.95 0 0 0 0 0 0 1496.95 0 0 1014400873 1164462420 10 Physicians WARNER FREDERICK T 999999999 200 Cook 0 0 Emergency 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 0 163.6 0 0 0 0 0 0 163.6 0 0 1014400933 1093349391 16 Nurse Practitioners NIELSEN CELESTIA 999999999 200 Cook 0 0 0 0 0 17 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 1593.39 0 0 0 0 0 0 0 0 3570.27 0 0 0 0 0 0 5163.66 0 0 1014400975 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 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 6976.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6976.55 0 0 1014401104 1558431783 89 Physician Assistant Only(Encounter Only) JUSKO JONATHAN 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 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 0 391.74 0 0 0 0 0 0 391.74 0 0 1014401254 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7540.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7540.74 0 0 1014401274 1386741163 89 Physician Assistant Only(Encounter Only) HARIRIE JONATHAN F 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 0 566.99 0 0 0 0 0 0 566.99 0 0 1014401307 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7004.47 0 0 0 0 0 0 0 0 0 0 0 0 0 7004.47 0 0 1014401316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26908.65 0 0 0 0 0 0 0 0 0 0 0 0 0 26908.65 0 0 1014401375 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6475.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6475.98 0 0 1014401507 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20431.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20431.95 0 0 1014401515 1801918396 10 Physicians WARPINSKI AMY L 999999999 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 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 61.12 0 0 0 0 0 0 0 0 61.12 0 0 1014401544 1366069270 16 Nurse Practitioners CARPENTER GNATHAN 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 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 1507.39 0 0 0 0 0 0 1507.39 0 0 1014401785 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.2 0 0 0 0 0 0 0 0 0 0 0 0 0 168.2 0 0 1014402149 1902808520 10 Physicians WATTS MICHAEL A 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 0 250 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 2590.77 0 0 0 0 0 0 2590.77 0 0 1014402238 1295361392 16 Nurse Practitioners SERAFIN AMANDA 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 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 4208.34 0 0 0 0 0 0 4208.34 0 0 1014402247 1508473349 11 Dentists KREISHEH FADI 999999999 200 Cook 0 0 General Dentistry 0 0 31 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 5448.3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5448.3 0 0 1014402302 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 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 2131.42 0 0 0 0 0 0 2131.42 0 0 1014402348 1275134165 16 Nurse Practitioners LECH MICHELLE 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 155.4 0 0 0 0 0 0 0 0 1451.15 0 0 0 0 0 0 1606.55 0 0 1014402514 1851633994 10 Physicians LEVACK ASHLEY 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 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 15596.17 0 0 0 0 0 0 15596.17 0 0 1014402634 1689109282 10 Physicians BROESS JENNIFER L 999999999 200 Cook 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 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3352.69 0 0 0 0 0 0 3352.69 0 0 1014402711 1467992636 10 Physicians SCHELBY THOMAS M 999999999 96 St Clair 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 0 123 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 1343.44 0 0 0 0 0 0 1343.44 0 0 1014402756 1902301138 10 Physicians ANTONIOS NATHALIE 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 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 0 544.96 0 0 0 0 0 0 544.96 0 0 1014402816 94 Waiver service provider--Children's support (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 0 160 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 15060.84 0 0 0 0 0 0 0 0 0 0 0 0 0 15060.84 0 0 1014402819 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 0 191 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 12085.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12085.75 0 0 1014402909 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19454.6 0 0 0 0 0 0 0 0 0 0 0 0 0 19454.6 0 0 1014402913 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20149.38 0 0 0 0 0 0 0 0 0 0 0 0 0 20149.38 0 0 1014402949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 366.27 0 0 0 0 0 0 0 0 0 0 0 0 0 366.27 0 0 1014403091 1043676109 89 Physician Assistant Only(Encounter Only) STITES AMY 999999999 72 McLean 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 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 0 544.68 0 0 0 0 0 0 544.68 0 0 1014403140 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20776.92 0 0 0 0 0 0 0 0 0 0 0 0 0 20776.92 0 0 1014403141 1093787566 12 Optometrists CHIEN JOYCE 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 1101.87 0 0 0 0 0 0 1101.87 0 0 1014403191 1912156043 89 Physician Assistant Only(Encounter Only) RICHARDS JENNIFER J 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 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 0 0 0 0 0 0 0 0 0 0 1014403220 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 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 37340.69 0 0 0 0 0 0 0 0 0 0 0 0 0 37340.69 0 0 1014403306 1710476593 10 Physicians CUADROS SUSANA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 38.55 0 0 0 0 0 0 4.82 0 191.65 0 0 0 0 0 0 235.02 0 0 1014403316 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1014403369 1477144020 16 Nurse Practitioners LOPEZ KIMBERLY 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 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 1332.61 0 0 0 0 0 0 1332.61 0 0 1014403503 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7582.84 0 0 0 0 0 0 0 0 0 0 0 0 0 7582.84 0 0 1014403847 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 58037.28 0 0 0 0 0 0 0 0 0 0 0 0 0 58037.28 0 0 1014403994 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014404046 1740711050 10 Physicians PATEL ARPIT 999999999 200 Cook 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 102.85 0 0 0 0 0 0 0 0 700.54 0 0 0 0 0 0 803.39 0 0 1014404099 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 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 17468.55 0 0 0 0 0 0 0 0 0 0 0 0 0 17468.55 0 0 1014404435 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10382.16 0 0 0 0 0 0 0 0 0 0 0 0 0 10382.16 0 0 1014404605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014405313 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 0 132 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 20712.65 0 0 0 0 0 0 0 0 0 0 0 0 0 20712.65 0 0 1014405464 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 3730.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3730.07 0 0 1014405489 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 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 34893.26 0 0 0 0 0 0 0 0 0 0 0 0 0 34893.26 0 0 1014405524 1447607965 16 Nurse Practitioners MULLANE MARY 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 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 2082.08 0 0 0 0 0 0 2082.08 0 0 1014405584 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18423.19 0 0 0 0 0 0 0 0 0 0 0 0 0 18423.19 0 0 1014405758 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13823.46 0 0 0 0 0 0 0 0 0 0 0 0 0 13823.46 0 0 1014405814 10 Physicians 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 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 0 194.7 0 0 0 0 0 0 194.7 0 0 1014405961 1013535731 11 Dentists MACKESEY BRITTANY 999999999 200 Cook 0 0 General Dentistry 0 0 61 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 288 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 8862.02 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 10367.42 0 0 1014406130 1184845422 12 Optometrists POLK ERIC E 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 96.84 0 0 0 0 0 0 96.84 0 0 1014406222 10 Physicians 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 70 0 0 1014406362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10980.47 0 0 0 0 0 0 0 0 0 0 0 0 0 10980.47 0 0 1014406395 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4708.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4708.9 0 0 1014406418 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1891.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1891.5 0 0 1014406681 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10773.77 0 0 0 0 0 0 0 0 0 0 0 0 0 10773.77 0 0 1014406726 1245218106 13 Podiatrists PARTIN JULIA 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 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 0 249.9 0 0 0 0 0 0 249.9 0 0 1014406757 1104462126 60 Pharmacies LOYOLA OUTPATIENT CENTER 999999999 200 Cook 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120082.66 0 0 0 120082.66 0 0 1014407025 1588084339 10 Physicians MOKLYAK YURIY 999999999 53 Kane 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509.94 0 0 0 0 0 0 509.94 0 0 1014407043 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.99 0 0 0 0 0 0 96.99 0 0 1014407169 1235341264 10 Physicians AMOSSON BRIANA N 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 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 4150.33 0 0 0 0 0 0 4150.33 0 0 1014407198 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 3609.46 0 0 0 0 0 0 0 0 0 0 0 0 0 3609.46 0 0 1014407317 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 265.42 0 0 0 0 0 0 0 0 0 0 0 0 0 265.42 0 0 1014407392 1003394024 16 Nurse Practitioners BRANDENBURG MARY P 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1027.22 0 0 0 0 0 0 1027.22 0 0 1014407467 1215543962 33 Nursing Facilities HOPE CREEK NURSING AND REHABIL 999999999 89 Rock Island 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 0 465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1470146.45 0 0 0 0 0 0 0 1470146.45 0 0 1014407475 1720519911 10 Physicians LINDEN DANIEL 999999999 200 Cook 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 0 178 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 1317.02 0 0 0 0 0 0 1317.02 0 0 1014407483 1508476615 16 Nurse Practitioners WALLER ADAM L 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 118.8 0 0 0 0 0 0 118.8 0 0 1014407561 1134753825 16 Nurse Practitioners WISNASKY KRYSTLE M 999999999 91 Sangamon 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 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 0 395.11 0 0 0 0 0 0 395.11 0 0 1014407566 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1063.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1063.26 0 0 1014407768 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1193.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1193.5 0 0 1014407834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5678.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5678.52 0 0 1014407890 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 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 6703.03 0 0 0 0 0 0 0 0 0 0 0 0 0 6703.03 0 0 1014407998 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 25.65 0 0 0 0 0 0 25.65 0 0 1014408065 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4222.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4222.26 0 0 1014408240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6844.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6844.14 0 0 1014408442 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 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 1.71 0 0 0 0 0 0 1.71 0 0 1014408519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11045.3 0 0 0 0 0 0 0 0 0 0 0 0 0 11045.3 0 0 1014408538 16 Nurse Practitioners 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 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 81.59 0 0 0 0 0 0 81.59 0 0 1014408602 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 0 149 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 2682.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2682.12 0 0 1014408798 1346778297 10 Physicians GREWAL JASDIP 999999999 10 Adams 0 0 Internal Medicine 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 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 0 988.68 0 0 0 0 0 0 988.68 0 0 1014409125 12 Optometrists 65 Madison 0 0 Diagnostic 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 1014409193 1104213560 10 Physicians CECIL CARA 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 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 11424.8 0 0 0 0 0 0 11424.8 0 0 1014409236 1851941702 16 Nurse Practitioners QUINN CYNTHIA A 999999999 71 McHenry 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 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 0 476.16 0 0 0 0 0 0 476.16 0 0 1014409264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4531.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4531.8 0 0 1014409292 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 0 0 0 0 0 0 0 0 0 0 1014409446 1659802270 10 Physicians AGUILAR FRANK 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 0 192 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 1321.57 0 0 0 0 0 0 1321.57 0 0 1014409583 1518288638 10 Physicians SAMRA YASSER 999999999 80 Peoria 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 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 1359.76 0 0 0 0 0 0 1359.76 0 0 1014409651 1760877385 10 Physicians SIDDIQUI FAISAL 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 169 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4744.95 0 18.3 0 0 0 0 0 0 4763.25 0 0 1014409749 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 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 3641.46 0 0 0 0 0 0 3641.46 0 0 1014409827 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3158.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3158.8 0 0 1014409841 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8685.23 0 0 0 0 0 0 0 0 0 0 0 0 0 8685.23 0 0 1014409868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25050.97 0 0 0 0 0 0 0 0 0 0 0 0 0 25050.97 0 0 1014409982 1679570030 89 Physician Assistant Only(Encounter Only) RIDER CHRISTINA 999999999 89 Rock Island 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 0 147 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 0 557.23 0 0 0 0 0 0 557.23 0 0 1014410089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1548.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1548.39 0 0 1014410271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25283.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25283.33 0 0 1014410665 1477184406 36 Community mental health provider WCYA-STALEY COUNSELING CENTER 999999999 63 Macon 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 3099.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35918.74 0 0 39018.3 0 0 1014410888 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2211.96 0 0 0 0 0 0 0 0 0 0 0 0 0 2211.96 0 0 1014410927 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 23.76 0 0 0 0 0 0 23.76 0 0 1014410950 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21676.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21676.09 0 0 1014411026 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23880.84 0 0 0 0 0 0 0 0 0 0 0 0 0 23880.84 0 0 1014411040 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6109.56 0 0 0 0 0 0 0 0 0 0 0 0 0 6109.56 0 0 1014411176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 759.1 0 0 0 0 0 0 0 0 0 0 0 0 0 759.1 0 0 1014411278 1639796626 25 Audiologists NICHOLS HALEY M 999999999 200 Cook 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 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 88.94 88.94 0 0 1014411303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18318.56 0 0 0 0 0 0 0 0 0 0 0 0 0 18318.56 0 0 1014411331 1992239974 10 Physicians SOLVANG KEITH 999999999 200 Cook 0 0 Emergency Medicine 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 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.62 0 7300.76 0 0 0 0 0 0 7369.38 0 0 1014411432 1730786161 16 Nurse Practitioners BURGESS DONNETTA 999999999 25 Crawford 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 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 1095.48 0 0 0 0 0 0 1095.48 0 0 1014411635 1619596541 27 Behavioral Health Clinic "THE TABOR THERAPY GROUP, INC." 999999999 53 Kane 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 123.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33742.19 0 0 33866.07 0 0 1014411714 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014411839 10 Physicians 57 Lake 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014411942 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22340.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22340.47 0 0 1014412189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20586.06 0 0 0 0 0 0 0 0 0 0 0 0 0 20586.06 0 0 1014412205 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 100.76 0 0 0 0 0 0 0 0 0 0 0 0 0 100.76 0 0 1014412350 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 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 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 1014412394 1568077568 16 Nurse Practitioners BALASSI JOSEPH 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 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 0 370.38 0 0 0 0 0 0 370.38 0 0 1014412409 1528454360 10 Physicians NAVALE POOJA P 999999999 200 Cook 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 0 666.9 0 0 0 0 0 0 0 0 666.9 0 0 1014412464 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 0 271 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 15042.72 0 0 0 0 0 0 0 0 0 0 0 0 0 15042.72 0 0 1014412489 1003422296 33 Nursing Facilities HELIA HEALTHCARE OF NEWTON 999999999 48 Jasper 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51083.9 0 0 0 0 0 0 0 51083.9 0 0 1014412699 1134366818 10 Physicians WITKOSKY MICHAEL E 999999999 30 DuPage 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 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 1484.59 0 0 0 0 0 0 0 0 1484.59 0 0 1014412706 1023414356 24 Speech Therapists ESKRA ALYSSA 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 0 111 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 6978.91 6978.91 0 0 1014412855 1740888221 16 Nurse Practitioners MORENO SYLVIA 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 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 0 645.72 0 0 0 0 0 0 645.72 0 0 1014412917 1750769121 10 Physicians SATTAR NADIA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 1 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 1661.32 0 0 0 0 0 0 1663.5 0 0 1014412965 1922618313 16 Nurse Practitioners SIDDONS HEATHER R 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 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 0 326.09 0 0 0 0 0 0 326.09 0 0 1014413007 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1560.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1560.96 0 0 1014413103 1083210678 16 Nurse Practitioners GESELL LAUREN 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 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 2837.5 0 0 0 0 0 0 2837.5 0 0 1014413165 1043857493 89 Physician Assistant Only(Encounter Only) JANET CALLIE LYNN 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 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 0 0 0 0 0 0 0 0 0 0 1014413166 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014413180 1396283495 16 Nurse Practitioners HARKEY KELLI L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 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 1831.3 0 0 0 0 0 0 1831.3 0 0 1014413215 1538744032 91 Waiver service provider--Adults (DHS/DDD) HUNT LISA 999999999 91 Sangamon 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62664.26 0 0 0 0 0 0 0 0 0 0 0 0 0 62664.26 0 0 1014413325 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22450.12 0 0 0 0 0 0 0 0 0 0 0 0 0 22450.12 0 0 1014413689 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 0 736.8 0 0 0 0 0 0 736.8 0 0 1014413939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18098.52 0 0 0 0 0 0 0 0 0 0 0 0 0 18098.52 0 0 1014413940 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24982.98 0 0 0 0 0 0 0 0 0 0 0 0 0 24982.98 0 0 1014414009 1194338145 16 Nurse Practitioners ELATKIN KRISTIN 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 13188.76 0 0 0 0 0 0 13188.76 0 0 1014414019 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014414083 1285281139 16 Nurse Practitioners LOWRY HEATHER R 999999999 45 Henry 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 42 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 0 0 1528.95 0 0 0 0 0 0 1620.85 0 0 1014414145 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1422.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1422.67 0 0 1014414173 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 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 13592.55 0 0 0 0 0 0 0 0 0 0 0 0 0 13592.55 0 0 1014414227 89 Physician Assistant Only(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 42.14 0 0 0 0 0 0 42.14 0 0 1014414442 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 0 158 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 16341.05 0 0 0 0 0 0 0 0 0 0 0 0 0 16341.05 0 0 1014414547 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 0 0 0 0 0 0 0 0 0 0 1014414642 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21250.76 0 0 0 0 0 0 0 0 0 0 0 0 0 21250.76 0 0 1014414647 1780142778 43 Encounter rate clinic MT. SINAI PEDIATRIC CENTER 999999999 200 Cook 0 0 0 6 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2836.75 0 405.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3242 0 0 1014414833 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25002.33 0 0 0 0 0 0 0 0 0 0 0 0 0 25002.33 0 0 1014414840 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11014.63 0 0 0 0 0 0 0 0 0 0 0 0 0 11014.63 0 0 1014415000 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 5426.61 0 0 0 0 0 0 0 0 0 0 0 0 0 5426.61 0 0 1014415310 1306208103 10 Physicians OQUIST CARDENAS MARK 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4685.31 0 0 0 0 0 0 4685.31 0 0 1014415320 1821522004 10 Physicians FAHEEM SAMAD 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 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 1341.73 0 0 0 0 0 0 1341.73 0 0 1014415454 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23903.88 0 0 0 0 0 0 0 0 0 0 0 0 0 23903.88 0 0 1014415464 1427468818 10 Physicians ASGHARI HOSSEIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 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 9.09 0 1057.06 0 0 0 0 0 0 1066.15 0 0 1014415485 1134567134 10 Physicians CHAU VIHN Q 999999999 200 Cook 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 0 349 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 1164.02 0 0 0 0 0 0 1164.02 0 0 1014415584 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 0 196.68 0 0 0 0 0 0 196.68 0 0 1014415609 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 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 0 167.39 0 0 0 0 0 0 167.39 0 0 1014415644 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19557 0 0 0 0 0 0 0 0 0 0 0 0 0 19557 0 0 1014415713 1306227137 10 Physicians HOEGGER MARK J 999999999 109 Winnebago 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 81 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1265.95 0 352.88 0 0 0 0 0 0 1618.83 0 0 1014415769 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5774.01 0 0 0 0 0 0 0 0 0 0 0 0 0 5774.01 0 0 1014415828 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21745.85 0 0 0 0 0 0 0 0 0 0 0 0 0 21745.85 0 0 1014416014 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 0 130 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 8821.32 8821.32 0 0 1014416147 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22466.4 0 0 0 0 0 0 0 0 0 0 0 0 0 22466.4 0 0 1014416281 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21477.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21477.44 0 0 1014416364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16038.19 0 0 0 0 0 0 0 0 0 0 0 0 0 16038.19 0 0 1014416421 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24797.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24797.57 0 0 1014416454 1255750279 10 Physicians OBENG REBECCA C 999999999 200 Cook 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 0 140 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 1447.27 0 0 0 0 0 0 0 0 1447.27 0 0 1014416470 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14701.97 0 0 0 0 0 0 0 0 0 0 0 0 0 14701.97 0 0 1014416548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24645.23 0 0 0 0 0 0 0 0 0 0 0 0 0 24645.23 0 0 1014416581 1396214425 11 Dentists SALEM MUSERRAH 999999999 200 Cook 0 0 0 0 25 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 7396.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7396.55 0 0 1014416636 1619515384 16 Nurse Practitioners CAUFIELD EMILY 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 1282.96 0 0 0 0 0 0 1282.96 0 0 1014416686 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 1.02 0 0 0 0 0 0 1.02 0 0 1014416733 1881121564 10 Physicians REINK JENNIFER S 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 0 316.47 0 0 0 0 0 0 316.47 0 0 1014416826 10 Physicians 109 Winnebago 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 0 0 0 0 0 0 0 0 0 0 1014416969 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 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 3852.39 0 0 0 0 0 0 0 0 0 0 0 0 0 3852.39 0 0 1014417154 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 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 2869.3 2869.3 0 0 1014417212 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2356.51 0 0 0 0 0 0 0 0 0 0 0 0 0 2356.51 0 0 1014417316 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 390.72 0 0 0 0 0 0 0 0 0 0 0 0 0 390.72 0 0 1014417405 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 671.25 0 0 0 0 0 0 0 0 0 0 0 0 0 671.25 0 0 1014417662 1023469277 13 Podiatrists SCHERGEN ROBERT K 999999999 200 Cook 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 0 674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6194.96 0 0 0 0 0 0 6194.96 0 0 1014417738 1407293756 89 Physician Assistant Only(Encounter Only) CASTELLI MICHAEL 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 20.27 0 0 0 0 0 0 20.27 0 0 1014417801 1992061584 10 Physicians CHALANA INDU K 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 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 0 286.89 0 0 0 0 0 0 286.89 0 0 1014417836 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8430 0 0 0 0 0 0 0 0 0 0 0 0 0 8430 0 0 1014418168 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.13 46.13 0 0 1014418183 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24767.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24767.64 0 0 1014418192 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9619.9 0 0 0 0 0 0 0 0 0 0 0 0 0 9619.9 0 0 1014418233 10 Physicians 91 Sangamon 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 6.2 0 0 0 0 0 0 0 0 6.2 0 0 1014418504 1235491812 10 Physicians GIACOMINO BRIA D 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 0 119 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 2209.75 0 0 0 0 0 0 2209.75 0 0 1014418524 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 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 4340.18 0 0 0 0 0 0 0 0 0 0 0 0 0 4340.18 0 0 1014418623 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6391.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6391.92 0 0 1014418637 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10516.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10516.88 0 0 1014418819 1053653279 10 Physicians COHEN DAVID GOLDSMITH 999999999 200 Cook 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 0 309 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 5112.18 0 0 0 0 0 0 5112.18 0 0 1014418851 1902456999 75 Department of Alcohol and Substance Abuse Provider "GATEWAY FOUNDATION, INC." 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 7102.2 0 0 7102.2 0 0 1014419006 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4062.92 0 0 0 0 0 0 0 0 0 0 0 0 0 4062.92 0 0 1014419346 1144857657 16 Nurse Practitioners ROSARIO YINETTE B 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 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 2500.73 0 0 0 0 0 0 2500.73 0 0 1014419375 1295366862 16 Nurse Practitioners KANJI GHAZIANI ZEHRA 999999999 200 Cook 0 0 0 0 0 2 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 90.69 0 0 0 0 0 0 0 0 98.44 0 0 0 0 0 0 189.13 0 0 1014419401 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2685.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2685.07 0 0 1014419512 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.59 0 0 0 0 0 0 0 0 0 0 0 0 0 95.59 0 0 1014419745 1821479932 10 Physicians PAPAGIANNOPOULOS TASSO 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 7 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.75 0 1395.91 0 0 0 0 0 0 1626.66 0 0 1014420014 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15656.01 0 0 0 0 0 0 0 0 0 0 0 0 0 15656.01 0 0 1014420115 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 0 102 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 6088.44 0 0 0 0 0 0 0 0 0 0 0 0 0 6088.44 0 0 1014420215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21623.26 0 0 0 0 0 0 0 0 0 0 0 0 0 21623.26 0 0 1014420296 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014420421 10 Physicians 815 Indiana 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 49.22 0 0 0 0 0 0 49.22 0 0 1014420687 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285.72 0 0 0 0 0 0 285.72 0 0 1014420718 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15877.07 0 0 0 0 0 0 0 0 0 0 0 0 0 15877.07 0 0 1014420724 1134769797 16 Nurse Practitioners CATES JENNIFER 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 0 323.15 0 0 0 0 0 0 323.15 0 0 1014420812 1164876256 10 Physicians GARG NISHA 999999999 200 Cook 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.6 0 291.48 0 0 0 0 0 0 406.08 0 0 1014421228 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 14238.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14238.12 0 0 1014421354 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 648.49 648.49 0 0 1014421679 1104429752 11 Dentists KARIYA KINNARI D 999999999 200 Cook 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1279 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1279 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 41985.9 0 0 0 0 0 0 0 0 0 0 0 3763.5 0 0 0 0 45749.4 0 0 1014421826 1144826884 16 Nurse Practitioners GONZALEZ ASHLEY 999999999 53 Kane 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 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 0 144.83 0 0 0 0 0 0 144.83 0 0 1014421862 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24966.94 0 0 0 0 0 0 0 0 0 0 0 0 0 24966.94 0 0 1014421950 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.5 0 0 0 0 0 0 0 0 0 0 0 0 0 184.5 0 0 1014422036 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 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 0 236.77 236.77 0 0 1014422144 1104265347 10 Physicians SAHAI TANMAY 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2500.17 0 0 0 0 0 0 2500.17 0 0 1014422226 1033655303 61 Independent Laboratories "CLARITY LAB SOLUTIONS, LLC" 999999999 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 24 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 7048.34 0 0 0 0 0 0 0 0 7048.34 0 0 1014422428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23931.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23931.6 0 0 1014422455 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2766.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2766.75 0 0 1014422584 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3635.66 0 0 0 0 0 0 0 0 0 0 0 0 0 3635.66 0 0 1014422681 1154930634 89 Physician Assistant Only(Encounter Only) SHARPE SARAH D 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 0 258.04 0 0 0 0 0 0 258.04 0 0 1014422684 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 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 1014423061 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 883.56 0 0 0 0 0 0 0 0 0 0 0 0 0 883.56 0 0 1014423230 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014423567 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 0 166 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 14135.85 0 0 0 0 0 0 0 0 0 0 0 0 0 14135.85 0 0 1014423597 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5695.38 0 0 0 0 0 0 0 0 0 0 0 0 0 5695.38 0 0 1014423780 1619594835 11 Dentists HAKIMIYAN RIZINA 999999999 200 Cook 0 0 General Dentistry 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23102.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23102.7 0 0 1014423868 1992232193 10 Physicians KOTHARI SHANA 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 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 0 180.68 0 0 0 0 0 0 180.68 0 0 1014424175 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12244.87 0 0 0 0 0 0 0 0 0 0 0 0 0 12244.87 0 0 1014424176 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 78.09 0 0 0 0 0 0 78.09 0 0 1014424180 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23549.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23549.2 0 0 1014424230 1295375806 10 Physicians METWALLY OMAR AZZAM MOHAMED 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 757 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1162 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14405.71 0 24.16 0 0 0 0 0 0 14429.87 0 0 1014424483 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1515.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1515.59 0 0 1014424753 1528095247 87 Psychologist(Encounter Only) JORDAN STEPHEN 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 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 1014424845 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18778.38 0 0 0 0 0 0 0 0 0 0 0 0 0 18778.38 0 0 1014424852 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.95 0 0 0 0 0 0 0 0 0 0 0 0 0 75.95 0 0 1014424869 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7442.47 0 0 0 0 0 0 0 0 0 0 0 0 0 7442.47 0 0 1014424904 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.7 0 0 0 0 0 0 0 0 0 0 0 0 0 180.7 0 0 1014424922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1325.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1325.71 0 0 1014424952 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 31.01 0 0 0 0 0 0 31.01 0 0 1014424986 1740608256 10 Physicians LAMONT SARAH M 999999999 53 Kane 0 0 Orthopedic Surgery 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 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 3470.26 0 0 0 0 0 0 3476.56 0 0 1014425044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17289.36 0 0 0 0 0 0 0 0 0 0 0 0 0 17289.36 0 0 1014425364 1154687549 10 Physicians SULLIVAN THOMAS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 2 1030 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1608 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1608 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.02 19940.39 0 3368.13 0 0 0 0 0 0 23398.54 0 0 1014425672 10 Physicians 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.6 0 0 0 0 0 0 552.6 0 0 1014425939 1528690799 16 Nurse Practitioners PENNELL HOLLY 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 0 115 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 4307.69 0 0 0 0 0 0 4307.69 0 0 1014425997 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13822.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13822.79 0 0 1014426017 1851937643 16 Nurse Practitioners KUPER KATELYN 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 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 0 162.52 0 0 0 0 0 0 162.52 0 0 1014426030 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432.16 0 0 0 0 0 0 432.16 0 0 1014426300 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 0 129 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 12836.44 0 0 0 0 0 0 0 0 0 0 0 0 0 12836.44 0 0 1014426304 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 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 65.8 0 0 0 0 0 0 65.8 0 0 1014426642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1560.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1560.02 0 0 1014426661 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.42 0 0 0 0 0 0 32.42 0 0 1014426682 91 Waiver service provider--Adults (DHS/DDD) 75 Monroe 0 0 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 23977.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23977.36 0 0 1014426720 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 14028.28 0 0 0 0 0 0 0 0 0 0 0 0 0 14028.28 0 0 1014427030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11035.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11035.47 0 0 1014427046 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 1014427104 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 0 362 0 0 0 0 0 0 362 0 0 1014427399 1831538289 10 Physicians JABBAR AHMAD S 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 681.66 0 0 0 0 0 0 681.66 0 0 1014427439 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7228.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7228.74 0 0 1014427466 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26776.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26776.27 0 0 1014427528 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17465.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17465.04 0 0 1014427562 40 Federally Qualified Health Centers 816 Iowa 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 0 496.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496.06 0 0 1014427674 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32322 0 0 0 0 0 0 0 0 0 0 0 0 0 32322 0 0 1014427758 1033107248 33 Nursing Facilities MT VERNON COUNTRYSIDE MANOR 628645072 49 Jefferson 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 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2462 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190520.64 0 0 0 0 0 0 0 190520.64 0 0 1014428081 1194352286 16 Nurse Practitioners ENRIQUEZ DECELLE 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 0 553.64 0 0 0 0 0 0 553.64 0 0 1014428100 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3038 0 0 0 0 0 0 0 0 0 0 0 0 0 3038 0 0 1014428178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26193.9 0 0 0 0 0 0 0 0 0 0 0 0 0 26193.9 0 0 1014428225 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13516.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13516.47 0 0 1014428231 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5860.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5860.08 0 0 1014428378 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8123.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8123.55 0 0 1014428481 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14408.07 0 0 0 0 0 0 0 0 0 0 0 0 0 14408.07 0 0 1014428689 1184041097 10 Physicians HURST IRENE A 999999999 30 DuPage 0 0 Emergency 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 0 662.51 0 0 0 0 0 0 662.51 0 0 1014428717 1417375635 10 Physicians ISAILA BOGDAN V 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 57 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 842.11 0 183.8 0 0 0 0 0 0 1025.91 0 0 1014428742 1154940336 16 Nurse Practitioners KLEIN ANDREA 999999999 19 Champaign 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 0 598.64 0 0 0 0 0 0 598.64 0 0 1014428755 1558707554 10 Physicians AFANA MAJED 999999999 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.8 0 3904.3 0 0 0 0 0 0 3913.1 0 0 1014428991 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8740.07 0 0 0 0 0 0 0 0 0 0 0 0 0 8740.07 0 0 1014429157 10 Physicians 30 DuPage 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 0 197.71 0 0 0 0 0 0 197.71 0 0 1014429575 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41228.06 0 0 0 0 0 0 41228.06 0 0 1014429578 10 Physicians 91 Sangamon 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 5.54 0 0 0 0 0 0 0 0 5.54 0 0 1014429634 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11642.05 0 0 0 0 0 0 0 0 0 0 0 0 0 11642.05 0 0 1014429721 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 26.63 0 0 0 0 0 0 26.63 0 0 1014429839 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6850.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6850.9 0 0 1014430194 1497307383 94 Waiver service provider--Children's support (DHS/DDD) WILSON STEPHANIE 627621000 91 Sangamon 0 0 0 0 0 0 0 7 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 13360.78 0 0 0 0 0 0 0 0 0 0 0 0 0 13360.78 0 0 1014430299 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 732.6 0 0 0 0 0 0 0 0 0 0 0 0 0 732.6 0 0 1014430326 1699386755 12 Optometrists FULLENWIDER ROBERT 999999999 65 Madison 0 0 Diagnostic Pharmaceutical Agents 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 0 175 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 4028.28 0 0 0 0 0 0 4028.28 0 0 1014430588 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14543.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14543.39 0 0 1014430617 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1724.69 0 0 0 0 0 0 0 0 0 0 0 0 0 1724.69 0 0 1014430770 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 7119.17 0 0 0 0 0 0 7119.17 0 0 1014431109 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 0 119.58 0 0 0 0 0 0 119.58 0 0 1014431240 1063925691 16 Nurse Practitioners KWON HAEMIN 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 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 0 554.36 0 0 0 0 0 0 554.36 0 0 1014431267 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 1.64 0 0 0 0 0 0 1.64 0 0 1014431415 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1171.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1171.8 0 0 1014431728 4014431728 90 Waiver service provider--Elderly (DOA) EVERGREEN HOME CARE LTD 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 3287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334941.75 0 0 0 0 0 0 0 0 0 0 0 0 0 334941.75 0 0 1014431736 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 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 44.87 0 0 0 0 0 0 44.87 0 0 1014431798 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5262.51 0 0 0 0 0 0 0 0 0 0 0 0 0 5262.51 0 0 1014431852 25 Audiologists 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 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 22.33 22.33 0 0 1014431938 1912273988 10 Physicians KAO CAROL 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 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 0 183.34 0 0 0 0 0 0 183.34 0 0 1014432057 1275158990 16 Nurse Practitioners PERRY ASHLEY L 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 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 0 731.43 0 0 0 0 0 0 731.43 0 0 1014432217 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 1014432624 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.61 0 0 0 0 0 0 2.61 0 0 1014432625 91 Waiver 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Facilities SERENITY OF LAKE STOREY 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263930.46 0 0 0 0 0 0 0 263930.46 0 0 1014432867 1467747659 10 Physicians MEDINA CARBONELL FERNANDO 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 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 3489.7 0 0 0 0 0 0 3489.7 0 0 1014432905 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 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 1408.68 1408.68 0 0 1014432983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3861.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3861.21 0 0 1014433088 1194354829 11 Dentists VALIKA AQIL 999999999 200 Cook 0 0 0 0 212 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1089 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1089 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 26359.39 0 0 0 0 0 0 0 0 0 0 0 3763.5 0 0 0 0 30122.89 0 0 1014433190 1205210341 10 Physicians AHAMED RIZWAN 999999999 47 Jackson 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 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 0 460.15 0 0 0 0 0 0 460.15 0 0 1014433603 1144871237 89 Physician Assistant Only(Encounter Only) MCCLARD TAYLOR L 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 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 0 142.66 0 0 0 0 0 0 142.66 0 0 1014433675 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92.25 0 0 0 0 0 0 0 0 0 0 0 0 0 92.25 0 0 1014433721 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6379.61 0 0 0 0 0 0 0 0 0 0 0 0 0 6379.61 0 0 1014433892 1851522239 16 Nurse Practitioners AUCK LYNN 999999999 25 Crawford 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014433951 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11284.58 0 0 0 0 0 0 0 0 0 0 0 0 0 11284.58 0 0 1014434134 1760079941 16 Nurse Practitioners MATHEWS TIJU 999999999 200 Cook 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811.63 0 0 0 0 0 0 811.63 0 0 1014434323 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 0 178 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 17251.5 0 0 0 0 0 0 0 0 0 0 0 0 0 17251.5 0 0 1014434633 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 5158.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5158.25 0 0 1014434668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26622.36 0 0 0 0 0 0 0 0 0 0 0 0 0 26622.36 0 0 1014434671 1174165096 16 Nurse Practitioners ALIGNO MICHAEL 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 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 4723.95 0 0 0 0 0 0 4723.95 0 0 1014434726 1710592423 16 Nurse Practitioners NAJRABI KHATERA 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 469.85 0 0 0 0 0 0 469.85 0 0 1014434730 1093260135 11 Dentists RAJPARA SOHAM 999999999 53 Kane 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 391 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 13839.56 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 14968.61 0 0 1014434745 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21488.19 0 0 0 0 0 0 0 0 0 0 0 0 0 21488.19 0 0 1014434767 1679898746 10 Physicians KUSHAL AMRITA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 939 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3022.54 0 0 0 0 0 0 3022.54 0 0 1014434768 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 0 116.19 0 0 0 0 0 0 116.19 0 0 1014434808 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4446.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4446.2 0 0 1014434873 1669083655 33 Nursing Facilities ACCOLADE HEALTHCARE DANVILLE 618323715 100 Vermilion 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305691.26 0 0 0 0 0 0 0 305691.26 0 0 1014434938 1588004329 10 Physicians HEBERER BRIAN J 953586411 200 Cook 0 0 Emergency 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 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 1705.23 0 0 0 0 0 0 1705.23 0 0 1014434990 16 Nurse Practitioners 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 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 0 100.52 0 0 0 0 0 0 100.52 0 0 1014435035 1033400718 10 Physicians SAWYER NIA 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 847 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19367.47 0 663.81 0 0 0 0 0 0 20031.28 0 0 1014435090 55 Early Intervention Services 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 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 0 247.02 0 0 0 0 0 0 247.02 0 0 1014435117 86 Clinical Social Worker(Encounter Only) 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 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 1014435140 1770117335 89 Physician Assistant Only(Encounter Only) CRAWFORD MADELEINE 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 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 0 170.41 0 0 0 0 0 0 170.41 0 0 1014435169 1346395431 11 Dentists TABOR CHRIS J 999999999 200 Cook 0 0 General Dentistry 0 0 27 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 6338.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6338.87 0 0 1014435201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13400.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13400.96 0 0 1014435223 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 0 198 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 16275 0 0 0 0 0 0 0 0 0 0 0 0 0 16275 0 0 1014435289 1740719061 10 Physicians MARBURGER ERICA C 999999999 80 Peoria 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 0 277.27 0 0 0 0 0 0 277.27 0 0 1014435365 60 Pharmacies 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.49 0 0 0 102.49 0 0 1014435726 10 Physicians 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193.26 0 0 0 0 0 0 193.26 0 0 1014435855 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 5 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 2436.47 2436.47 0 0 1014436654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591.32 0 0 0 0 0 0 0 0 0 0 0 0 0 591.32 0 0 1014436736 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19988.59 0 0 0 0 0 0 0 0 0 0 0 0 0 19988.59 0 0 1014436745 1104356955 10 Physicians MEHTA ROHAN 999999999 30 DuPage 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 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 0 695.84 0 0 0 0 0 0 695.84 0 0 1014436853 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12627.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12627.88 0 0 1014436989 1427273598 61 Independent Laboratories CDX DIAGNOSTICS 999999999 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 499.11 0 0 0 0 0 0 0 0 499.11 0 0 1014437018 1669851424 10 Physicians ALTOOS BASEL 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708.5 0 0 0 0 0 0 708.5 0 0 1014437704 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 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 0 109.35 0 0 0 0 0 0 109.35 0 0 1014437850 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.36 0 0 0 0 0 0 190.36 0 0 1014438076 1790166965 10 Physicians WOOSLEY JENNIFER M 999999999 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0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.09 0 0 0 0 0 0 0 0 0 0 0 0 0 141.09 0 0 1014439711 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 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 0 384.08 0 0 0 0 0 0 0 0 0 0 0 0 0 384.08 0 0 1014439889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21699.64 0 0 0 0 0 0 0 0 0 0 0 0 0 21699.64 0 0 1014439962 1760097604 16 Nurse Practitioners LISEK ASHLEY 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 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 82.69 0 0 0 0 0 0 82.69 0 0 1014440052 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 5791.61 0 0 0 0 0 0 0 0 0 0 0 0 0 5791.61 0 0 1014440474 1255394177 10 Physicians SMITH JONATHAN K 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 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 0 976.85 0 0 0 0 0 0 976.85 0 0 1014440486 1730674268 10 Physicians RAMESH-SCHOENROCK ARCHANA 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 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 0 281.28 0 0 0 0 0 0 281.28 0 0 1014440523 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 1014440602 16 Nurse Practitioners 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 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 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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 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 8111.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8111.6 0 0 1014444629 1073137360 11 Dentists SHAREEF AHMED M 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 0 278 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 9884.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9884.54 0 0 1014444639 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21589.88 0 0 0 0 0 0 0 0 0 0 0 0 0 21589.88 0 0 1014444705 1255826814 16 Nurse Practitioners YODER HAYLEY C 999999999 78 Moultrie 0 0 0 0 0 0 0 0 0 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 0 206.35 0 0 0 0 0 0 206.35 0 0 1014444730 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 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 94.81 94.81 0 0 1014444758 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1014444892 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 0 113.26 0 0 0 0 0 0 113.26 0 0 1014444979 1699305136 16 Nurse Practitioners JENAMAN KAILA 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1014445117 1164048195 55 Early Intervention Services PERRIN JAYVA 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 0 100 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 6629.43 0 0 0 0 0 0 6629.43 0 0 1014445572 4014445572 91 Waiver service provider--Adults (DHS/DDD) MAXWELL CASSIDY 999999999 91 Sangamon 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16223.02 0 0 0 0 0 0 0 0 0 0 0 0 0 16223.02 0 0 1014445598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21569.41 0 0 0 0 0 0 0 0 0 0 0 0 0 21569.41 0 0 1014445601 1710470257 10 Physicians AKIRA ALAN 999999999 200 Cook 0 0 Psychiatry 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 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12869.34 0 0 0 0 0 0 12869.34 0 0 1014445665 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 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 2777.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2777.6 0 0 1014445722 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3360.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3360.06 0 0 1014445742 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 5864.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5864.3 0 0 1014445753 1396036406 10 Physicians GULACK BRIAN C 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 0 135 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 16845.87 0 0 0 0 0 0 16845.87 0 0 1014445832 1811417892 10 Physicians DY MARC WRICH G 999999999 53 Kane 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 0 251 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 3667.31 0 0 0 0 0 0 3667.31 0 0 1014445978 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 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 26841.08 0 0 0 0 0 0 0 0 0 0 0 0 0 26841.08 0 0 1014446072 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20927.94 0 0 0 0 0 0 0 0 0 0 0 0 0 20927.94 0 0 1014446176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4277.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4277.34 0 0 1014446285 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 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 2409.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2409.44 0 0 1014446362 10 Physicians 31 Edgar 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 73.4 0 0 0 0 0 0 73.4 0 0 1014446433 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5477.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5477.69 0 0 1014446549 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22199.1 0 0 0 0 0 0 0 0 0 0 0 0 0 22199.1 0 0 1014446662 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23430.99 0 0 0 0 0 0 0 0 0 0 0 0 0 23430.99 0 0 1014446860 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 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 2899.24 2899.24 0 0 1014446913 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21307.41 0 0 0 0 0 0 0 0 0 0 0 0 0 21307.41 0 0 1014446943 1568097244 89 Physician Assistant Only(Encounter Only) DASSOW ELIZABETH D 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 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 0 303.22 0 0 0 0 0 0 303.22 0 0 1014447101 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 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 1435.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1435.4 0 0 1014447201 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2133.23 0 0 0 0 0 0 0 0 0 0 0 0 0 2133.23 0 0 1014447208 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8892.59 0 0 0 0 0 0 0 0 0 0 0 0 0 8892.59 0 0 1014447412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 967.77 0 0 0 0 0 0 0 0 0 0 0 0 0 967.77 0 0 1014447673 10 Physicians 53 Kane 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.62 0 0 0 0 0 0 165.62 0 0 1014447770 10 Physicians 30 DuPage 0 0 0 0 0 0 0 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 0 104.12 0 0 0 0 0 0 0 0 104.12 0 0 1014447790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 575.03 0 0 0 0 0 0 0 0 0 0 0 0 0 575.03 0 0 1014447892 1205290319 10 Physicians ROSALES RODRIGUEZ JERAMIE L 999999999 200 Cook 0 0 Psychiatry 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 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11405.83 0 0 0 0 0 0 11405.83 0 0 1014447935 10 Physicians 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014447949 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4539.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4539.03 0 0 1014447974 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.53 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.53 0 0 1014448059 1689264061 16 Nurse Practitioners SULLIVAN REBECCA 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 41.73 0 0 0 0 0 0 41.73 0 0 1014448100 1699370130 16 Nurse Practitioners SHINK VICTORIA 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 0 817.93 0 0 0 0 0 0 817.93 0 0 1014448194 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3633.83 0 0 0 0 0 0 0 0 0 0 0 0 0 3633.83 0 0 1014448202 1407304728 16 Nurse Practitioners DUNAJCIK MAUREEN JULIA 999999999 50 Jersey 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 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 0 656.66 0 0 0 0 0 0 656.66 0 0 1014448319 1255994075 87 Psychologist(Encounter Only) ARIEL-DONGES AVIVA 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 0 127 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 0 597.96 0 0 0 0 0 0 597.96 0 0 1014448334 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 0 232 0 0 0 0 0 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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 11360.57 0 0 0 0 0 0 0 0 0 0 0 0 0 11360.57 0 0 1014449071 1134769409 16 Nurse Practitioners SOTAK CATHRYN 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 1335.57 0 0 0 0 0 0 1335.57 0 0 1014449238 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 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 0 450.06 0 0 0 0 450.06 0 0 1014449279 1972751451 10 Physicians KULANDHAISAMY SURESH K 999999999 92 Schuyler 0 0 Internal Medicine 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 0 274 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 5633.25 0 0 0 0 0 0 5633.25 0 0 1014449305 1437706314 16 Nurse Practitioners CECCHETTO MICHAEL 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 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 1702.44 0 0 0 0 0 0 1702.44 0 0 1014449623 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 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 0 894.37 0 0 0 0 0 0 894.37 0 0 1014449715 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12289.39 0 0 0 0 0 0 0 0 0 0 0 0 0 12289.39 0 0 1014449716 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21948.91 0 0 0 0 0 0 0 0 0 0 0 0 0 21948.91 0 0 1014449752 1902413537 33 Nursing Facilities "CITADEL OF GLENVIEW, THE" 999999999 200 Cook 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 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 834575.6 0 0 0 0 0 0 0 834575.6 0 0 1014449956 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 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 0 944.24 0 0 0 0 0 0 0 0 0 0 0 0 0 944.24 0 0 1014450013 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11637.77 0 0 0 0 0 0 0 0 0 0 0 0 0 11637.77 0 0 1014450155 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5569.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5569.96 0 0 1014450291 1902339591 10 Physicians BIERDEMAN KELSEY L 999999999 109 Winnebago 0 0 Family Practice 0 0 0 8 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1 0 40 0 0 0 0 0 0 0 0 0 763.86 0 0 0 0 0 0 0 0 1251.37 0 0 0 0 0 0 2015.23 0 0 1014450312 4014450312 71 Medicar Provider NEW ERA TRANSPORTATION INC 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14708.83 0 0 0 0 0 0 14708.83 0 0 1014450349 1639719289 24 Speech Therapists DEENEY ANNA B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37844.18 37844.18 0 0 1014450386 1396375788 89 Physician Assistant Only(Encounter Only) SLOAN EMILY J 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 0 103 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 2031.3 0 0 0 0 0 0 2031.3 0 0 1014450501 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 130.24 0 0 0 0 0 0 0 0 0 0 0 0 0 130.24 0 0 1014450503 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2319.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2319.17 0 0 1014450555 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11614.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11614.31 0 0 1014450606 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336.54 0 0 0 336.54 0 0 1014450607 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14339.33 0 0 0 0 0 0 0 0 0 0 0 0 0 14339.33 0 0 1014450756 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22315.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22315.2 0 0 1014450791 1043730138 10 Physicians RUMBURG AARON 999999999 200 Cook 0 0 Emergency 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 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 1707.8 0 0 0 0 0 0 1707.8 0 0 1014450924 1134770175 16 Nurse Practitioners STICKNEY EMILY J 999999999 47 Jackson 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 0 684.16 0 0 0 0 0 0 684.16 0 0 1014450968 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2919.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2919.14 0 0 1014451196 1942804646 16 Nurse Practitioners PHILIP SARA E 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 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 0 168.94 0 0 0 0 0 0 168.94 0 0 1014451203 1558711101 10 Physicians RUDDOCK-WALKER SARA 999999999 200 Cook 0 0 Pediatrics 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 0 117 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 0 945.42 0 0 0 0 0 0 945.42 0 0 1014451235 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 78.34 0 0 0 0 0 0 78.34 0 0 1014451432 1427554211 10 Physicians GIBBONS RYAN J 999999999 200 Cook 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 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 0 764.67 0 0 0 0 0 0 764.67 0 0 1014451527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4383.23 0 0 0 0 0 0 0 0 0 0 0 0 0 4383.23 0 0 1014451790 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1014451884 1477086080 13 Podiatrists BETRUS CHRISTOPHER 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 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 0 941.23 0 0 0 0 0 0 941.23 0 0 1014452040 1942221726 16 Nurse Practitioners KOSTER STEPHEN 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 0 452.95 0 0 0 0 0 0 452.95 0 0 1014452056 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 66.49 0 0 0 0 0 0 66.49 0 0 1014452122 1578161865 16 Nurse Practitioners HARDESTY ABIGAIL 999999999 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 193.67 0 0 0 0 0 0 0 0 406.51 0 0 0 0 0 0 600.18 0 0 1014452143 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23907.18 0 0 0 0 0 0 0 0 0 0 0 0 0 23907.18 0 0 1014452291 1891840641 10 Physicians ROSS ASHLEY E 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 10 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430.71 0 1513.58 0 0 0 0 0 0 1944.29 0 0 1014452791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9848.62 0 0 0 0 0 0 0 0 0 0 0 0 0 9848.62 0 0 1014452840 1932760964 12 Optometrists TRAN NHUNG T 999999999 200 Cook 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 0 262 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 5738.77 0 0 0 0 0 0 5738.77 0 0 1014452856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3612.28 0 0 0 0 0 0 0 0 0 0 0 0 0 3612.28 0 0 1014452893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34911.58 0 0 0 0 0 0 0 0 0 0 0 0 0 34911.58 0 0 1014452896 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26705.18 0 0 0 0 0 0 0 0 0 0 0 0 0 26705.18 0 0 1014453315 1215478466 10 Physicians JONKHEER IMA 999999999 200 Cook 0 0 Orthopedic 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 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 1.95 0 0 0 0 0 0 1.95 0 0 1014453321 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 0 0 0 0 0 0 0 0 0 0 1014453409 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155.12 0 0 0 0 0 0 155.12 0 0 1014453677 1982015749 10 Physicians JEONG SARAH 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 15 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 0 635 0 0 0 0 0 0 635 0 0 1014453683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16427.65 0 0 0 0 0 0 0 0 0 0 0 0 0 16427.65 0 0 1014453778 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 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 25580.72 0 0 0 0 0 0 0 0 0 0 0 0 0 25580.72 0 0 1014453873 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 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 1014453947 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 6287.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6287.27 0 0 1014454114 1124620893 16 Nurse Practitioners POPLAR MAUREEN A 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 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 0 541.42 0 0 0 0 0 0 541.42 0 0 1014454172 1366079907 87 Psychologist(Encounter Only) WILEY COLBY P 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 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 4558.77 0 0 0 0 0 0 4558.77 0 0 1014454242 1750801619 10 Physicians LANKA HEMATHEJA 999999999 80 Peoria 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 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 3759.07 0 0 0 0 0 0 3759.07 0 0 1014454494 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22967.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22967.28 0 0 1014454541 1881225084 89 Physician Assistant Only(Encounter Only) RIVETT JORDAN 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 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 0 453.95 0 0 0 0 0 0 453.95 0 0 1014454751 1902439193 16 Nurse Practitioners BOSKA IWONA 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 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 0 318.39 0 0 0 0 0 0 318.39 0 0 1014454886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 171.03 0 0 0 0 0 0 0 0 0 0 0 0 0 171.03 0 0 1014454893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5858.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5858.86 0 0 1014454922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.07 0 0 0 0 0 0 0 0 0 0 0 0 0 117.07 0 0 1014454949 1265879209 10 Physicians JAYARAM ASWATHI 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 154 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20009.66 0 10687.24 0 0 0 0 0 0 30696.9 0 0 1014455230 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 467.34 0 0 0 0 0 0 0 0 0 0 0 0 0 467.34 0 0 1014455369 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 0 102.27 0 0 0 0 0 0 102.27 0 0 1014455379 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2497.71 0 0 0 0 0 0 0 0 0 0 0 0 0 2497.71 0 0 1014455829 1265591630 10 Physicians IZAD ALEXANDER 999999999 109 Winnebago 0 0 Ophthalmology 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.31 0 1576.41 0 0 0 0 0 0 1585.72 0 0 1014455996 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 0 188.22 0 0 0 0 0 0 188.22 0 0 1014456188 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3720.97 0 0 0 0 0 0 0 0 0 0 0 0 0 3720.97 0 0 1014456263 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1755.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1755.08 0 0 1014456270 1982650719 10 Physicians MALONE MICHAEL D 999999999 200 Cook 0 0 Vascular Surgery 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 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683.75 0 0 0 0 0 0 683.75 0 0 1014456486 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11960.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11960.52 0 0 1014456614 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21479.54 0 0 0 0 0 0 0 0 0 0 0 0 0 21479.54 0 0 1014456912 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 9120.93 0 0 0 0 0 0 0 0 0 0 0 0 0 9120.93 0 0 1014457135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 641.87 0 0 0 0 0 0 0 0 0 0 0 0 0 641.87 0 0 1014457149 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 1099.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1099.8 0 0 1014457230 10 Physicians 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 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 0 119.03 0 0 0 0 0 0 119.03 0 0 1014457332 1609415454 89 Physician Assistant Only(Encounter Only) MCKEOWN NICHOLAS P 999999999 109 Winnebago 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 0 120 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 0 777.62 0 0 0 0 0 0 777.62 0 0 1014457668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28404.97 0 0 0 0 0 0 0 0 0 0 0 0 0 28404.97 0 0 1014457911 1295276418 10 Physicians AZIM IRUM 999999999 19 Champaign 0 0 Family Practice 0 0 0 0 0 0 0 0 0 1 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.7 0 0 4951.44 0 0 0 0 0 0 5169.14 0 0 1014458105 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 79.72 0 0 0 0 0 0 79.72 0 0 1014458447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11847.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11847.31 0 0 1014458492 1588273916 16 Nurse Practitioners BIERMAN MARY JO 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014458507 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16229.25 0 0 0 0 0 0 0 0 0 0 0 0 0 16229.25 0 0 1014458531 1790943900 10 Physicians MUALA SAMER 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 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 67.55 0 0 0 0 0 0 67.55 0 0 1014458647 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 0 102.27 0 0 0 0 0 0 102.27 0 0 1014458710 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3843.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3843.56 0 0 1014458766 1588170872 55 Early Intervention Services HYDE BRIANNA 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 13615.69 0 0 0 0 0 0 13615.69 0 0 1014458825 92 Waiver service 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2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 409.63 0 0 0 0 0 0 0 0 0 0 0 0 0 409.63 0 0 1014462059 1427545086 16 Nurse Practitioners OLSON ANGELA 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 240 0 0 0 0 0 0 0 0 0 371.9 0 0 0 0 0 0 0 0 4215.49 0 0 0 0 0 0 4587.39 0 0 1014462157 1932190436 10 Physicians KEENAN SEAN 999999999 63 Macon 0 0 0 0 0 0 0 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 0 578.53 0 0 0 0 0 0 0 0 578.53 0 0 1014462520 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17452.87 0 0 0 0 0 0 0 0 0 0 0 0 0 17452.87 0 0 1014462564 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 3842.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3842.08 0 0 1014463595 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1504.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1504.36 0 0 1014463632 1790327682 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE BURBANK 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 0 259 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 41681.12 0 0 0 0 0 0 41681.12 0 0 1014463714 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 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 10902.08 0 0 0 0 0 0 0 0 0 0 0 0 0 10902.08 0 0 1014463819 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 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0 0 0 0 0 108.57 0 0 1014464861 1477887032 16 Nurse Practitioners LEAR SUSAN L 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 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 0 690.63 0 0 0 0 0 0 690.63 0 0 1014464867 1609481332 22 Physical Therapists VANDERLINDEN NATASHA M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 668.5 668.5 0 0 1014464927 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10854.69 0 0 0 0 0 0 0 0 0 0 0 0 0 10854.69 0 0 1014464946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12266.15 0 0 0 0 0 0 0 0 0 0 0 0 0 12266.15 0 0 1014464970 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5139.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5139.47 0 0 1014465097 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 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 76.91 0 0 0 0 0 0 76.91 0 0 1014465114 1710518741 36 Community mental health provider WCYA SATELLITE 999999999 63 Macon 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 236 0 0 1869.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20655.68 0 0 22525.36 0 0 1014465240 1306072855 25 Audiologists WOOD RACHEL 627621000 91 Sangamon 0 0 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 0 276 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 35293.44 35293.44 0 0 1014465518 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3490.98 0 0 0 0 0 0 0 0 0 0 0 0 0 3490.98 0 0 1014465565 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8622.04 0 0 0 0 0 0 0 0 0 0 0 0 0 8622.04 0 0 1014465638 1275990285 89 Physician Assistant Only(Encounter Only) KROYMANN AMANDA M 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 728.67 0 0 0 0 0 0 728.67 0 0 1014465786 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11581.29 0 0 0 0 0 0 0 0 0 0 0 0 0 11581.29 0 0 1014466412 1457999872 16 Nurse Practitioners JUMANAN THERESA T 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 49.22 0 0 0 0 0 0 49.22 0 0 1014466474 1598741951 10 Physicians HASHEM BASSAM 999999999 53 Kane 0 0 Internal Medicine 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 0 289 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 7059.59 0 0 0 0 0 0 7059.59 0 0 1014466485 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7655.93 0 0 0 0 0 0 0 0 0 0 0 0 0 7655.93 0 0 1014466813 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 1099.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1099.22 0 0 1014466860 1942576566 86 Clinical Social Worker(Encounter Only) GALINDO EMILY A 999999999 35 Ford 0 0 0 0 0 0 0 0 0 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 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 1156.84 0 0 0 0 0 0 1156.84 0 0 1014466879 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1014466949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5815.6 0 0 0 0 0 0 0 0 0 0 0 0 0 5815.6 0 0 1014466997 1023371333 10 Physicians ELLIS JABON 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250.96 0 0 0 0 0 0 250.96 0 0 1014467193 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213.44 0 0 0 0 0 0 213.44 0 0 1014467260 1619517505 88 Other behavior health professional MITCHELL AMBER 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 5316.8 0 0 0 0 0 0 5316.8 0 0 1014467576 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 6242.31 0 0 0 0 0 0 0 0 0 0 0 0 0 6242.31 0 0 1014467745 1114564317 16 Nurse Practitioners STEELE SHERI K 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 443.48 0 0 0 0 0 0 443.48 0 0 1014467846 1518973882 10 Physicians GUPTA RICHA 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 2.64 0 0 0 0 0 0 2.64 0 0 1014467875 1396251922 11 Dentists CASTILLO HAIVY L 999999999 30 DuPage 0 0 0 0 100 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 17540.74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17540.74 0 0 1014468087 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 45.82 0 0 0 0 0 0 45.82 0 0 1014468174 1497138838 10 Physicians MOHAN VISHNU 999999999 53 Kane 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 0 106 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 1148.04 0 0 0 0 0 0 1148.04 0 0 1014468219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1156.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1156.01 0 0 1014468228 1649447947 22 Physical Therapists PAVLOVIC ELLEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 667.08 667.08 0 0 1014468230 1669890752 10 Physicians LEHMANN ASHTON E 999999999 47 Jackson 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 203.34 0 0 0 0 0 0 203.34 0 0 1014468266 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23809.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23809.5 0 0 1014468624 1386915700 61 Independent Laboratories LABTECH DIAGNOSTICS LLC 999999999 842 South Carolina 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 0 179 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 9897.43 0 0 0 0 0 0 0 0 9897.43 0 0 1014468795 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20616.9 0 0 0 0 0 0 0 0 0 0 0 0 0 20616.9 0 0 1014468920 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1405.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1405.97 0 0 1014468935 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28496.63 0 0 0 0 0 0 0 0 0 0 0 0 0 28496.63 0 0 1014468967 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 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 0 618.62 0 0 0 0 0 0 0 0 0 0 0 0 0 618.62 0 0 1014469150 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 0 0 0 0 0 0 0 0 0 0 1014469186 1316160922 11 Dentists SUKOVIC MAJA 999999999 200 Cook 0 0 General Dentistry 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 1793.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1793.61 0 0 1014469192 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2908.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2908.62 0 0 1014469235 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22568 0 0 0 0 0 0 0 0 0 0 0 0 0 22568 0 0 1014469262 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26521.05 0 0 0 0 0 0 0 0 0 0 0 0 0 26521.05 0 0 1014469688 1083258008 16 Nurse Practitioners JENKINS DAWYN 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 0 463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4224.93 0 0 0 0 0 0 4224.93 0 0 1014469775 1528626975 11 Dentists GOLK MICHAEL 999999999 200 Cook 0 0 General Dentistry/Anesthesiology 0 0 27 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 4905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4905 0 0 1014469833 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 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 0 881.8 881.8 0 0 1014470025 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 8287.5 0 0 0 0 0 0 0 0 0 0 0 0 0 8287.5 0 0 1014470029 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 0 448.17 0 0 0 0 0 0 448.17 0 0 1014470042 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 581.37 0 0 0 0 0 0 581.37 0 0 1014470183 1194119545 10 Physicians KUO TERESA 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 41.27 0 0 0 0 0 0 41.27 0 0 1014470219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1942.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1942.38 0 0 1014470242 10 Physicians 91 Sangamon 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 1014470249 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11151.17 0 0 0 0 0 0 0 0 0 0 0 0 0 11151.17 0 0 1014470330 87 Psychologist(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014470348 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 7625.39 0 0 0 0 0 0 0 0 0 0 0 0 0 7625.39 0 0 1014470387 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16012.23 0 0 0 0 0 0 0 0 0 0 0 0 0 16012.23 0 0 1014470661 94 Waiver service provider--Children's support (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 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 3468.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3468.6 0 0 1014470751 1083034698 87 Psychologist(Encounter Only) FRANCEN SCHMITT NICOLE L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1706.56 0 0 0 0 0 0 1706.56 0 0 1014470814 1023138443 10 Physicians COUREY ANTHONY 999999999 200 Cook 0 0 Internal Medicine 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7020.57 0 0 0 0 0 0 7020.57 0 0 1014470859 1710397781 10 Physicians LAMIKANRA OLAOLUWATOMI 999999999 91 Sangamon 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 0 175 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 2904.88 0 0 0 0 0 0 2904.88 0 0 1014470984 1679169908 25 Audiologists CANESSA MAZZONI CLEMENTINA 999999999 200 Cook 0 0 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 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130098.43 130098.43 0 0 1014471039 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22953.17 0 0 0 0 0 0 0 0 0 0 0 0 0 22953.17 0 0 1014471289 1063996858 30 General Hospitals NORTHGROVE DIALYSIS 999999999 65 Madison DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014471397 1093121006 11 Dentists PATEL HARSH 999999999 200 Cook 0 0 General Dentistry 0 0 159 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 721 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 721 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 24127.79 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 26762.24 0 0 1014471481 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 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 8668.97 0 0 0 0 0 0 0 0 0 0 0 0 0 8668.97 0 0 1014471730 1417164062 10 Physicians KHAN KHURRAM J 999999999 107 Will 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 16 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5161.89 0 0 0 0 0 0 5161.89 0 0 1014471920 4014471920 71 Medicar Provider COMPASSIONATE MEDICAL TRANSPOR 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 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 1099.55 0 0 0 0 0 0 1099.55 0 0 1014472031 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 6760.29 0 0 0 0 0 0 0 0 0 0 0 0 0 6760.29 0 0 1014472056 1952912941 11 Dentists SADIGHNIA AZIN 999999999 19 Champaign 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 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 0 967.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 967.9 0 0 1014472205 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12378.36 0 0 0 0 0 0 0 0 0 0 0 0 0 12378.36 0 0 1014472242 1740710292 10 Physicians HERRING KYRIE 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 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 0 450.47 0 0 0 0 0 0 450.47 0 0 1014472380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14786.79 0 0 0 0 0 0 0 0 0 0 0 0 0 14786.79 0 0 1014472404 1386287597 16 Nurse Practitioners SAFAEIAN NILA 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 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 0 591.54 0 0 0 0 0 0 591.54 0 0 1014472577 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22792 0 0 0 0 0 0 0 0 0 0 0 0 0 22792 0 0 1014473123 10 Physicians 19 Champaign 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.63 0 0 0 0 0 0 117.63 0 0 1014473249 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5361.85 0 0 0 0 0 0 0 0 0 0 0 0 0 5361.85 0 0 1014473299 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5226.32 0 0 0 0 0 0 0 0 0 0 0 0 0 5226.32 0 0 1014473378 1265896260 10 Physicians LUO LARKIN X 999999999 30 DuPage 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 0 969.23 0 0 0 0 0 0 969.23 0 0 1014473387 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4806.67 0 0 0 0 0 0 0 0 0 0 0 0 0 4806.67 0 0 1014473685 1972998441 10 Physicians CYRIAC GEORGE M 999999999 81 Perry 0 0 0 0 0 0 0 0 0 0 0 0 58 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 625.04 0 44.23 0 0 0 0 0 0 669.27 0 0 1014473765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24306.04 0 0 0 0 0 0 0 0 0 0 0 0 0 24306.04 0 0 1014473948 1083276703 16 Nurse Practitioners PROKOPF RACHEL 999999999 200 Cook 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 37 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 190.61 0 0 0 0 0 0 0 0 378.05 0 0 0 0 0 0 568.66 0 0 1014473970 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 0 268 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 12452.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12452.58 0 0 1014474304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38883.2 0 0 0 0 0 0 0 0 0 0 0 0 0 38883.2 0 0 1014474334 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23719.96 0 0 0 0 0 0 0 0 0 0 0 0 0 23719.96 0 0 1014474394 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 472.37 0 0 0 0 0 0 0 0 0 0 0 0 0 472.37 0 0 1014474633 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 624.01 0 0 0 0 0 0 0 0 0 0 0 0 0 624.01 0 0 1014474713 4014474713 90 Waiver service provider--Elderly (DOA) "NOVACARE SERVICES, INC." 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 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54518.88 0 0 0 0 0 0 0 0 0 0 0 0 0 54518.88 0 0 1014474733 1073135224 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE GLENWOOD 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 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 13902 0 0 0 0 0 0 13902 0 0 1014474777 1871127019 16 Nurse Practitioners HAMM MICAH 999999999 34 Fayette 0 0 0 0 0 1 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 1206.66 0 0 0 0 0 0 1291.28 0 0 1014474876 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22621.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22621.6 0 0 1014475138 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 0 592.64 0 0 0 0 0 0 592.64 0 0 1014475239 1336528827 10 Physicians PASICHOW SCOTT 999999999 34 Fayette 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 2 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6715.79 0 0 0 0 0 0 6715.79 0 0 1014475261 63 Other Providers of Medical Equipment/Supplies (Non-registered) 72 McLean 0 0 0 0 0 0 0 0 0 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 1158.5 0 0 0 0 0 0 1158.5 0 0 1014475321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 900.54 0 0 0 0 0 0 0 0 0 0 0 0 0 900.54 0 0 1014475364 1265524771 10 Physicians HAZLEWOOD DEXTER 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 985.42 0 0 0 0 0 0 987.6 0 0 1014475609 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5370.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5370.74 0 0 1014475688 10 Physicians 31 Edgar 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.21 0 0 0 0 0 0 0 0 98.21 0 0 1014475854 1336283902 10 Physicians RAINES-HEPPLE ROBERT 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 21 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 582.44 0 41.79 0 0 0 0 0 0 624.23 0 0 1014475869 10 Physicians 89 Rock Island 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.99 0 162.19 0 0 0 0 0 0 167.18 0 0 1014476091 1073148375 16 Nurse Practitioners KIRKPATRICK ASHLEY E 999999999 91 Sangamon 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 0 224 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 3400.05 0 0 0 0 0 0 3400.05 0 0 1014476141 1053762807 10 Physicians PAPPAS DANIEL J 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 858.9 0 0 0 0 0 0 858.9 0 0 1014476158 1538797253 89 Physician Assistant Only(Encounter Only) NOTZ ANNE 999999999 91 Sangamon 0 0 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 788.87 0 0 0 0 0 0 866.74 0 0 1014476314 10 Physicians 53 Kane 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 0 0 0 0 0 0 0 0 0 0 0 0 1014476544 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11606.59 0 0 0 0 0 0 0 0 0 0 0 0 0 11606.59 0 0 1014476636 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 458.59 0 0 0 0 0 0 0 0 0 0 0 0 0 458.59 0 0 1014476689 1972506186 10 Physicians HUTSON RODNEY K 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 83 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586.23 0 21.07 0 0 0 0 0 0 607.3 0 0 1014476810 1447645320 10 Physicians SHIN NICOLE 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 991.44 0 0 0 0 0 0 991.44 0 0 1014477007 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 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 0 736.28 0 0 0 0 0 0 736.28 0 0 1014477130 1770005936 10 Physicians RUBIN ELIZABETH 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1353.26 0 0 0 0 0 0 1353.26 0 0 1014477524 1679188114 16 Nurse Practitioners WONG JAMES 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 0 594.21 0 0 0 0 0 0 594.21 0 0 1014477888 1336250596 10 Physicians MOHAPATRA SABYASACHI 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 0 235.11 0 0 0 0 0 0 235.11 0 0 1014478215 1174547467 10 Physicians WEAVER JOHN J 999999999 80 Peoria 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 0 192 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 0 809.19 0 0 0 0 0 0 809.19 0 0 1014478342 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14521.76 0 0 0 0 0 0 0 0 0 0 0 0 0 14521.76 0 0 1014478344 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1315.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1315.21 0 0 1014478376 16 Nurse Practitioners 42 Hancock 0 0 0 0 0 0 0 0 0 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 1014478475 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1872.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1872.2 0 0 1014478811 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2189.66 0 0 0 0 0 0 0 0 0 0 0 0 0 2189.66 0 0 1014478968 1932728201 16 Nurse Practitioners TSE RACHAEL KA WAI 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 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 0 550.45 0 0 0 0 0 0 550.45 0 0 1014479188 4014479188 71 Medicar Provider SUNSHINE TRANSPORT LLC 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 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 775 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9736.98 0 0 0 0 0 0 9736.98 0 0 1014479381 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3300.31 0 0 0 0 0 0 0 0 0 0 0 0 0 3300.31 0 0 1014479516 1336580760 10 Physicians LIN CHRISTINE 999999999 47 Jackson 0 0 Family Practice 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 0 145 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 5564.6 0 0 0 0 0 0 5564.6 0 0 1014479545 1215311683 10 Physicians CHATURVEDULA CHANDRA KANTH 999999999 53 Kane 0 0 Internal Medicine 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 0 325 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 2526.15 0 0 0 0 0 0 2526.15 0 0 1014479546 10 Physicians 87 Randolph 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905.65 0 0 0 0 0 0 905.65 0 0 1014479573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13463.56 0 0 0 0 0 0 0 0 0 0 0 0 0 13463.56 0 0 1014479701 1780177931 86 Clinical Social Worker(Encounter Only) MOON KARA C 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 0 122 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 4797.95 0 0 0 0 0 0 4797.95 0 0 1014479723 10 Physicians 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 1014479729 91 Waiver service provider--Adults (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 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 7730.62 0 0 0 0 0 0 0 0 0 0 0 0 0 7730.62 0 0 1014479850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 0 0 0 0 0 0 0 0 0 0 0 129.18 0 0 1014479867 91 Waiver 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1689067183 16 Nurse Practitioners VIHTELIC COURTENAY A 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 0 135 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 0 422.18 0 0 0 0 0 0 422.18 0 0 1014480526 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 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 4637.39 0 0 0 0 0 0 4637.39 0 0 1014480740 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 32.15 0 0 0 0 0 0 32.15 0 0 1014480918 1225514094 11 Dentists SATAM GAYATRI 999999999 200 Cook 0 0 General Dentistry 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13816.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13816.38 0 0 1014480941 1184644023 30 General Hospitals CARLE EUREKA HOSPITAL 615301246 110 Woodford DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 1 0 0 0 138 0 0 0 0 11 0 0 0 222 0 0 0 0 0 1 0 0 0 196 0 0 0 0 12 0 0 0 429 0 0 0 0 0 1 0 0 0 198 0 0 0 0 41 0 0 0 442 0 0 0 0 0 0 0 0 0 28727.6 0 0 0 0 37.2 0 0 0 44479.87 0 0 0 0 0 73244.67 0 0 1014481004 1679118616 16 Nurse Practitioners PRATER ERICA 999999999 200 Cook 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 0 322 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 2545.69 0 0 0 0 0 0 2545.69 0 0 1014481047 10 Physicians 89 Rock Island 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 297.46 0 0 0 0 0 0 297.46 0 0 1014481204 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20932.01 0 0 0 0 0 0 0 0 0 0 0 0 0 20932.01 0 0 1014481226 1104416163 16 Nurse Practitioners JOHNSON ROCHELLE 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 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 0 160.45 0 0 0 0 0 0 160.45 0 0 1014481383 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 454.55 0 0 0 0 0 0 0 0 0 0 0 0 0 454.55 0 0 1014481472 1659965804 16 Nurse Practitioners BALAZS HOLLIE A 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 120.17 0 0 0 0 0 0 0 0 6783.84 0 0 0 0 0 0 6904.01 0 0 1014481631 1043637325 10 Physicians NELSON MARC H 999999999 57 Lake 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 472 0 0 0 0 0 0 474.18 0 0 1014481777 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 6784.47 0 0 0 0 0 0 0 0 0 0 0 0 0 6784.47 0 0 1014481789 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30858.8 0 0 0 0 0 0 0 0 0 0 0 0 0 30858.8 0 0 1014481880 1043860299 16 Nurse Practitioners DANNER KIMBERLY 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 0 835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9251.56 0 0 0 0 0 0 9251.56 0 0 1014481894 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 23.76 0 0 0 0 0 0 23.76 0 0 1014481914 10 Physicians 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1014481939 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 7977.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7977.36 0 0 1014482142 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7855.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7855.73 0 0 1014482156 1871947630 10 Physicians CHAUDHARY SHWETA 999999999 200 Cook 0 0 Ophthalmology 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 0 845.69 0 0 0 0 0 0 845.69 0 0 1014482218 1124215173 10 Physicians HANNA ELIAS 999999999 53 Kane 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 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 45.93 0 0 0 0 0 0 45.93 0 0 1014482248 1760832562 10 Physicians PELLETIER DANIEL 999999999 30 DuPage 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 0 103 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 0 504.11 0 0 0 0 0 0 0 0 504.11 0 0 1014482257 1205440948 16 Nurse Practitioners LOPEZ JENICE 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 481.77 0 0 0 0 0 0 494.57 0 0 1014482510 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 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 26198.73 0 0 0 0 0 0 0 0 0 0 0 0 0 26198.73 0 0 1014482642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1552.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1552.58 0 0 1014482679 1871109876 16 Nurse Practitioners YOHANNAN JENNY 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 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 2.2 0 0 0 0 0 0 2.2 0 0 1014482701 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1220.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1220.1 0 0 1014482785 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14062 0 0 0 0 0 0 0 0 0 0 0 0 0 14062 0 0 1014482923 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23817.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23817.64 0 0 1014483038 1548741960 91 Waiver service provider--Adults (DHS/DDD) GREENWOOD STEPHANIE 999999999 91 Sangamon 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 1012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60089.63 0 0 0 0 0 0 0 0 0 0 0 0 0 60089.63 0 0 1014483093 1760825236 10 Physicians MUKADAM SHIREEN 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 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 0 358.23 0 0 0 0 0 0 358.23 0 0 1014483263 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 78.09 0 0 0 0 0 0 78.09 0 0 1014483353 25 Audiologists 91 Sangamon 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.04 156.04 0 0 1014483384 1790307387 89 Physician Assistant Only(Encounter Only) DIXON BRETT 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 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 0 299.78 0 0 0 0 0 0 299.78 0 0 1014483404 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.25 0 0 0 0 0 0 0 0 0 0 0 0 0 54.25 0 0 1014483470 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22739.43 0 0 0 0 0 0 0 0 0 0 0 0 0 22739.43 0 0 1014483679 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 743.69 0 0 0 0 0 0 0 0 0 0 0 0 0 743.69 0 0 1014483837 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 0 119 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 14846.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14846.6 0 0 1014483990 1427683903 16 Nurse Practitioners HOFFMAN MADELINE 999999999 91 Sangamon 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 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 1227.78 0 0 0 0 0 0 1227.78 0 0 1014483997 1992304174 16 Nurse Practitioners CURTIN SUZANNE M 999999999 47 Jackson 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 1255.05 0 0 0 0 0 0 1255.05 0 0 1014484029 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 0 206 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 24091.55 0 0 0 0 0 0 0 0 0 0 0 0 0 24091.55 0 0 1014484111 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6211.7 0 0 0 0 0 0 0 0 0 0 0 0 0 6211.7 0 0 1014484145 1457964652 23 Occupational Therapists DELAY ARIANA E 999999999 200 Cook 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 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 1027.08 1027.08 0 0 1014484162 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18070.63 0 0 0 0 0 0 0 0 0 0 0 0 0 18070.63 0 0 1014484191 1649810987 16 Nurse Practitioners WESLEY ALISHA 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 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 3110.08 0 0 0 0 0 0 3110.08 0 0 1014484208 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8205.12 0 0 0 0 0 0 0 0 0 0 0 0 0 8205.12 0 0 1014484459 1912540113 91 Waiver service provider--Adults (DHS/DDD) WEEMS JACQUELINE 999999999 200 Cook 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 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126449.2 0 0 0 0 0 0 0 0 0 0 0 0 0 126449.2 0 0 1014484618 1427409861 10 Physicians YE FENG 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 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 1360.16 0 0 0 0 0 0 1360.16 0 0 1014484788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17208.07 0 0 0 0 0 0 0 0 0 0 0 0 0 17208.07 0 0 1014484903 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19624.81 0 0 0 0 0 0 0 0 0 0 0 0 0 19624.81 0 0 1014484932 1760862932 10 Physicians MER JESSE 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 213 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 305 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3505.22 0 999.97 0 0 0 0 0 0 4505.19 0 0 1014484964 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5461.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5461.5 0 0 1014485111 1477150936 16 Nurse Practitioners PRESTON DEBARA 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 1383.25 0 0 0 0 0 0 1383.25 0 0 1014485115 1881239168 16 Nurse Practitioners BACHMAN AMY 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 0 554.98 0 0 0 0 0 0 554.98 0 0 1014485290 1891308185 16 Nurse Practitioners RINGER WHITNEY C 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 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 3095.71 0 0 0 0 0 0 3095.71 0 0 1014485465 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 19021.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19021.3 0 0 1014485567 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 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 0 533.8 533.8 0 0 1014485569 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 3283.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3283.84 0 0 1014485605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304.06 0 0 0 0 0 0 0 0 0 0 0 0 0 304.06 0 0 1014485636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1253.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1253.56 0 0 1014485681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23627.13 0 0 0 0 0 0 0 0 0 0 0 0 0 23627.13 0 0 1014485791 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 0 280 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 24760.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24760.4 0 0 1014485796 1306456819 16 Nurse Practitioners COLLINS SAMANTHA 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 2655.49 0 0 0 0 0 0 2751.94 0 0 1014486163 1285258855 16 Nurse Practitioners BRICKEY DOUGLAS J 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1521.19 0 0 0 0 0 0 1521.19 0 0 1014486359 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 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 1777.06 0 0 0 0 0 0 0 0 0 0 0 0 0 1777.06 0 0 1014486427 91 Waiver service provider--Adults (DHS/DDD) 78 Moultrie 0 0 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 13323.8 0 0 0 0 0 0 0 0 0 0 0 0 0 13323.8 0 0 1014486594 1851880041 10 Physicians KAUR BALPREET 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 0 134 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 1509.73 0 0 0 0 0 0 1509.73 0 0 1014486721 1730333949 11 Dentists SPECTOR SARA W 999999999 200 Cook 0 0 Orthodontist 0 0 19 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 8139.91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8139.91 0 0 1014486853 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.03 0 0 0 0 0 0 0 0 0 0 0 0 0 56.03 0 0 1014486900 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 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 24876.85 0 0 0 0 0 0 0 0 0 0 0 0 0 24876.85 0 0 1014486960 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10390.72 0 0 0 0 0 0 0 0 0 0 0 0 0 10390.72 0 0 1014487021 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 0 288 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 17137.47 0 0 0 0 0 0 0 0 0 0 0 0 0 17137.47 0 0 1014487136 89 Physician Assistant Only(Encounter Only) 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 1014487154 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 1837.48 0 0 0 0 0 0 1837.48 0 0 1014487174 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3189.46 0 0 0 0 0 0 0 0 0 0 0 0 0 3189.46 0 0 1014487294 1043834435 16 Nurse Practitioners EGGLESTON PHYLLIS L 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 0 117.1 0 0 0 0 0 0 117.1 0 0 1014487305 1508194887 10 Physicians JAMEEL AYISHA 999999999 200 Cook 0 0 Psychiatry 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 0 275 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 4480.36 0 0 0 0 0 0 4480.36 0 0 1014487331 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 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 1424.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1424.5 0 0 1014487351 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17190.47 0 0 0 0 0 0 0 0 0 0 0 0 0 17190.47 0 0 1014487353 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5201.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5201.46 0 0 1014487379 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 0 0 1014487410 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 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 1394.18 0 0 0 0 0 0 1394.18 0 0 1014487428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25534.69 0 0 0 0 0 0 0 0 0 0 0 0 0 25534.69 0 0 1014487548 1760911465 10 Physicians KIRKPATRICK RADMILA A 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 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 10 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 5.17 0 1220.84 0 0 0 0 0 0 1330.97 0 0 1014487589 1821637927 16 Nurse Practitioners RHOADES NICKOLAS A 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 0 204 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 1612.07 0 0 0 0 0 0 1612.07 0 0 1014487678 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 1014487814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7330.12 0 0 0 0 0 0 0 0 0 0 0 0 0 7330.12 0 0 1014487979 1417357054 86 Clinical Social Worker(Encounter Only) JEWELL KERRIE A 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 0 112 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 5034.82 0 0 0 0 0 0 5034.82 0 0 1014488161 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 0 156 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 11134 0 0 0 0 0 0 0 0 0 0 0 0 0 11134 0 0 1014488195 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 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 3998.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3998.19 0 0 1014488345 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15464.88 0 0 0 0 0 0 0 0 0 0 0 0 0 15464.88 0 0 1014488433 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8860.25 0 0 0 0 0 0 0 0 0 0 0 0 0 8860.25 0 0 1014489253 1316300247 10 Physicians AHMAD WAQAS 999999999 53 Kane 0 0 Internal Medicine 0 0 0 1 0 0 0 0 0 0 6 0 56 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 17 0 107 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 17 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182.36 0 1425.95 0 0 0 0 0 0 1608.31 0 0 1014489272 1497872543 40 Federally Qualified Health Centers ANGEL HARVEY FAMILY HEALTH CEN 999999999 200 Cook 0 0 0 848 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3773 0 1086 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3773 0 1086 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292728.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292728.23 0 0 1014489457 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 5657.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5657.75 0 0 1014489526 1730543331 10 Physicians VOHS JACOB 999999999 91 Sangamon 0 0 Anesthesiology 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 2 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4230.35 0 0 0 0 0 0 4230.35 0 0 1014489695 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 1151.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1151.16 0 0 1014489728 1871541714 10 Physicians POPE THOMAS 999999999 63 Macon 0 0 0 0 0 0 0 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 0 333.47 0 0 0 0 0 0 0 0 333.47 0 0 1014489801 1750814869 10 Physicians SMITH ANTONIO 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 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 0 946.92 0 0 0 0 0 0 946.92 0 0 1014489852 1821624768 89 Physician Assistant Only(Encounter Only) ATKINS RYAN 999999999 109 Winnebago 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 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 2030.49 0 0 0 0 0 0 2030.49 0 0 1014489896 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 0.03 0 0 0 0 0 0 0.03 0 0 1014490026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16138.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16138.67 0 0 1014490056 1194088120 10 Physicians KOREPTA LINDSEY 999999999 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 2 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3487.59 0 0 0 0 0 0 3487.59 0 0 1014490457 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24859.56 0 0 0 0 0 0 0 0 0 0 0 0 0 24859.56 0 0 1014490611 1548622806 10 Physicians LOUDON CAITLIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 8 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 2930.26 0 0 0 0 0 0 2942.28 0 0 1014490713 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13616.74 0 0 0 0 0 0 0 0 0 0 0 0 0 13616.74 0 0 1014490728 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3416.23 0 0 0 0 0 0 0 0 0 0 0 0 0 3416.23 0 0 1014490898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1067.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1067.35 0 0 1014490954 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 1014490986 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2291.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.97 0 0 1014491013 10 Physicians 19 Champaign 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 0 185.44 0 0 0 0 0 0 0 0 185.44 0 0 1014491029 91 Waiver service provider--Adults (DHS/DDD) 87 Randolph 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18819.29 0 0 0 0 0 0 0 0 0 0 0 0 0 18819.29 0 0 1014491084 1164802419 10 Physicians MATHEW JENNIFER 999999999 200 Cook 0 0 Pediatrics 0 0 0 27 0 0 0 0 0 0 4 0 24 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 7 0 30 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 7 0 30 0 0 0 0 0 0 0 0 0 1308.32 0 0 0 0 0 0 49.58 0 818.01 0 0 0 0 0 0 2175.91 0 0 1014491187 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 0 126.42 0 0 0 0 0 0 126.42 0 0 1014491358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6269.12 0 0 0 0 0 0 0 0 0 0 0 0 0 6269.12 0 0 1014491459 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 9445.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9445.08 0 0 1014491469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20759.28 0 0 0 0 0 0 0 0 0 0 0 0 0 20759.28 0 0 1014491500 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22596.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22596.64 0 0 1014491541 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25608 0 0 0 0 0 0 0 0 0 0 0 0 0 25608 0 0 1014491598 1285130435 10 Physicians URBANIK JOSEPH 999999999 200 Cook 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 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 32.09 0 0 0 0 0 0 32.09 0 0 1014491635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 602.16 0 0 0 0 0 0 0 0 0 0 0 0 0 602.16 0 0 1014491768 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 258.36 0 0 0 0 0 0 0 0 0 0 0 0 0 258.36 0 0 1014491770 1477180149 16 Nurse Practitioners HAPANOVICH MICHELLE A 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 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 0 766.23 0 0 0 0 0 0 766.23 0 0 1014491813 1760885693 10 Physicians SIRAJ ROOHI 999999999 53 Kane 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 0 125 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 0 387.1 0 0 0 0 0 0 387.1 0 0 1014491872 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014491899 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 73.23 73.23 0 0 1014491901 1801413190 91 Waiver service provider--Adults (DHS/DDD) BOEHMERT RACHEL L 999999999 30 DuPage 0 0 0 0 0 0 0 17 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 69698.8 0 0 0 0 0 0 0 0 0 0 0 0 0 69698.8 0 0 1014491950 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 5308.84 0 0 0 0 0 0 0 0 0 0 0 0 0 5308.84 0 0 1014492064 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 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1950.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1950.88 0 0 1014493317 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24802.94 0 0 0 0 0 0 0 0 0 0 0 0 0 24802.94 0 0 1014493510 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12809.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12809.01 0 0 1014493785 48 Rural Health Clinics 110 Woodford 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 31.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.89 0 0 1014493900 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 35.4 0 0 0 0 0 0 35.4 0 0 1014493927 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24290.09 0 0 0 0 0 0 0 0 0 0 0 0 0 24290.09 0 0 1014493983 1699376202 16 Nurse Practitioners ROTH-PHILLIPS VERONICA L 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 444.11 0 0 0 0 0 0 444.11 0 0 1014494089 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 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 6076 0 0 0 0 0 0 0 0 0 0 0 0 0 6076 0 0 1014494181 10 Physicians 89 Rock Island 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 0 0 0 0 0 0 0 0 0 0 1014494284 1225428980 10 Physicians PIRI NILOOFAR 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.46 0 542.13 0 0 0 0 0 0 571.59 0 0 1014494321 89 Physician Assistant Only(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 71.87 0 0 0 0 0 0 71.87 0 0 1014494360 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 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 58.03 0 0 0 0 0 0 58.03 0 0 1014494423 1013503150 16 Nurse Practitioners PINOL EMILY P 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 166.61 0 0 0 0 0 0 166.61 0 0 1014494626 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 0 0 0 0 0 0 0 0 0 0 1014494666 1457976490 22 Physical Therapists BREWSTER MEGHAN M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 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 1619.62 1619.62 0 0 1014494756 1679193387 16 Nurse Practitioners AUMANN JENNIFER 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 0 856.84 0 0 0 0 0 0 856.84 0 0 1014494961 1023509320 10 Physicians HARPER THEODORE R 999999999 200 Cook 0 0 Emergency 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 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 2931.3 0 0 0 0 0 0 2931.3 0 0 1014494967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32350.01 0 0 0 0 0 0 0 0 0 0 0 0 0 32350.01 0 0 1014495099 86 Clinical Social Worker(Encounter Only) 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.25 0 0 0 0 0 0 320.25 0 0 1014495215 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4086.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4086.11 0 0 1014495239 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 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 0 222.44 0 0 0 0 0 0 222.44 0 0 1014495272 1912091109 10 Physicians BOYKIN MARK 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 791.94 0 0 0 0 0 0 0 0 791.94 0 0 1014495705 1447549571 10 Physicians O HALLORAN EILEEN A 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 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6626.16 0 0 0 0 0 0 6626.16 0 0 1014495816 1134765712 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARLE MEDICAL SUPPLY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349.26 0 148.62 0 0 0 0 497.88 0 0 1014496056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13727.11 0 0 0 0 0 0 0 0 0 0 0 0 0 13727.11 0 0 1014496082 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 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 32660.49 0 0 0 0 0 0 0 0 0 0 0 0 0 32660.49 0 0 1014496293 1215540570 60 Pharmacies SAV-MOR PHARMACY 999999999 29 Douglas 0 0 0 0 0 0 0 0 0 0 0 0 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 2766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 777.95 0 0 0 777.95 0 0 1014496303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11143.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11143.4 0 0 1014496441 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1848.9 0 0 0 0 0 0 1848.9 0 0 1014496554 1720433212 13 Podiatrists IBRAHIM NOOREEN 999999999 71 McHenry 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 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 79.56 0 0 0 0 0 0 79.56 0 0 1014496633 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7693.69 0 0 0 0 0 0 0 0 0 0 0 0 0 7693.69 0 0 1014496850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3205.63 0 0 0 0 0 0 0 0 0 0 0 0 0 3205.63 0 0 1014496996 1639717184 22 Physical Therapists QUAN CHRISTINA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33748.83 33748.83 0 0 1014497112 1255422606 10 Physicians SONG HYUN M 999999999 200 Cook 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 0 391.2 0 0 0 0 0 0 0 0 391.2 0 0 1014497427 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 15564.77 0 0 0 0 0 0 0 0 0 0 0 0 0 15564.77 0 0 1014497714 1841805546 16 Nurse Practitioners LOCASCIO ANAYELI 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 0 505.49 0 0 0 0 0 0 505.49 0 0 1014497905 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19077.52 0 0 0 0 0 0 0 0 0 0 0 0 0 19077.52 0 0 1014498030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 53551.18 0 0 0 0 0 0 0 0 0 0 0 0 0 53551.18 0 0 1014498080 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3493.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3493.7 0 0 1014498183 1497103352 89 Physician Assistant Only(Encounter Only) CORSBIE JENNIFER 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 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 1014498189 1922644285 16 Nurse Practitioners MCCOY HEIDI 999999999 35 Ford 0 0 0 0 0 0 0 0 0 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 0 426.95 0 0 0 0 0 0 426.95 0 0 1014498296 1659790525 10 Physicians BLUHER ANDREW E 999999999 53 Kane 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 20 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 4100.52 0 0 0 0 0 0 4100.52 0 0 1014498349 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18059.68 0 0 0 0 0 0 0 0 0 0 0 0 0 18059.68 0 0 1014498382 1053931196 91 Waiver service provider--Adults (DHS/DDD) SMOCK SAMANTHA 999999999 107 Will 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 0 679 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 72073.04 0 0 0 0 0 0 0 0 0 0 0 0 0 72073.04 0 0 1014498466 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12998.07 0 0 0 0 0 0 0 0 0 0 0 0 0 12998.07 0 0 1014498484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17261.68 0 0 0 0 0 0 0 0 0 0 0 0 0 17261.68 0 0 1014498576 1851918635 16 Nurse Practitioners COVAL MITCHELL A 999999999 10 Adams 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 906.77 0 0 0 0 0 0 906.77 0 0 1014498754 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1237.28 0 0 0 0 0 0 0 0 0 0 0 0 0 1237.28 0 0 1014498836 1235659335 10 Physicians BRIGGS KEMBERLY 999999999 200 Cook 0 0 Family Practice 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 0 175 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 3881.62 0 0 0 0 0 0 3881.62 0 0 1014498921 1447738331 91 Waiver service provider--Adults (DHS/DDD) HODZIC TAJMA 627621000 91 Sangamon 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28121.32 0 0 0 0 0 0 0 0 0 0 0 0 0 28121.32 0 0 1014498964 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18097.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18097.8 0 0 1014499168 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2667.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2667.11 0 0 1014499334 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 8157.34 0 0 0 0 0 0 0 0 0 0 0 0 0 8157.34 0 0 1014499406 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560.42 0 0 0 0 0 0 560.42 0 0 1014499534 1215575402 16 Nurse Practitioners RAKHMAN ELLEN 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 203 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 1140.1 0 0 0 0 0 0 1224.72 0 0 1014499642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 165.02 0 0 0 0 0 0 0 0 0 0 0 0 0 165.02 0 0 1014500283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.19 0 0 0 0 0 0 0 0 0 0 0 0 0 113.19 0 0 1014500337 60 Pharmacies 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 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 0 670.82 0 0 0 0 0 0 670.82 0 0 1014500563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20665.79 0 0 0 0 0 0 0 0 0 0 0 0 0 20665.79 0 0 1014500707 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 0 167 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 17229.8 0 0 0 0 0 0 0 0 0 0 0 0 0 17229.8 0 0 1014500735 1215537790 16 Nurse Practitioners LEOS EMILY 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 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 0 167.89 0 0 0 0 0 0 167.89 0 0 1014500769 1558996090 16 Nurse Practitioners ELLIS LAUREN MICHELLE 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 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 1144.57 0 0 0 0 0 0 1144.57 0 0 1014500804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1542.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1542.08 0 0 1014500871 1174717359 10 Physicians STRACHAN LYJIA 999999999 200 Cook 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 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 2466.67 0 0 0 0 0 0 2466.67 0 0 1014501114 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15226.33 0 0 0 0 0 0 0 0 0 0 0 0 0 15226.33 0 0 1014501175 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22638.51 0 0 0 0 0 0 0 0 0 0 0 0 0 22638.51 0 0 1014501220 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4649.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4649.4 0 0 1014501347 1447592878 10 Physicians REIFF STEFANIE 999999999 200 Cook 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 0 124 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 1349.34 0 0 0 0 0 0 1349.34 0 0 1014501452 1710523576 16 Nurse Practitioners EDDINS DANIEL 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 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 0 625.3 0 0 0 0 0 0 625.3 0 0 1014501550 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 18614.4 0 0 0 0 0 0 0 0 0 0 0 0 0 18614.4 0 0 1014501560 1740376383 10 Physicians KAM ANTHONY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 56 0 1 0 0 0 0 0 0 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 76 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1285.04 0 0 0 0 0 0 0 0 1285.04 0 0 1014501817 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 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 1014501972 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 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 14162.44 0 0 0 0 0 0 0 0 0 0 0 0 0 14162.44 0 0 1014501994 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1705.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1705.33 0 0 1014502089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13636.61 0 0 0 0 0 0 0 0 0 0 0 0 0 13636.61 0 0 1014502131 16 Nurse Practitioners 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 62.02 0 0 0 0 0 0 62.02 0 0 1014502194 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 398.86 0 0 0 0 0 0 0 0 0 0 0 0 0 398.86 0 0 1014502243 10 Physicians 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 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 0 466.96 0 0 0 0 0 0 466.96 0 0 1014502259 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7247.78 0 0 0 0 0 0 0 0 0 0 0 0 0 7247.78 0 0 1014502336 1093159287 10 Physicians BERRY-TONY SAGINE A 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 9 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.7 0 1029.68 0 0 0 0 0 0 1082.38 0 0 1014502389 1215550066 16 Nurse Practitioners NDOYE NDIEME 999999999 89 Rock Island 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 0 136 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 1300.68 0 0 0 0 0 0 1300.68 0 0 1014502447 1801434089 16 Nurse Practitioners BESS EMILY R 999999999 89 Rock Island 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 0 122 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 4630.72 0 0 0 0 0 0 4630.72 0 0 1014502467 1730569211 10 Physicians PANICKER ANISHA 999999999 200 Cook 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 0 135 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 5912.52 0 0 0 0 0 0 5912.52 0 0 1014502484 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12600.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12600.72 0 0 1014502596 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.95 0 0 0 0 0 0 74.95 0 0 1014502763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18575.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18575.2 0 0 1014502835 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 9347.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9347.08 0 0 1014503015 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 1573.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1573.48 0 0 1014503049 1659768836 89 Physician Assistant Only(Encounter Only) HEINEMAN HEATHER N 999999999 65 Madison 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 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 1376.88 0 0 0 0 0 0 1376.88 0 0 1014503211 1811139876 33 Nursing Facilities WESTSIDE REHAB CARE CENTER 628961859 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 2446 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202866.07 0 0 0 0 0 0 0 202866.07 0 0 1014503300 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 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49583.56 0 0 0 0 0 0 0 0 0 0 0 0 0 49583.56 0 0 1014503353 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5113.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5113.46 0 0 1014503382 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.83 0 0 0 0 0 0 76.83 0 0 1014503775 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 45.82 0 0 0 0 0 0 45.82 0 0 1014503790 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 412.24 0 0 0 0 0 0 0 0 0 0 0 0 0 412.24 0 0 1014503833 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11511.79 0 0 0 0 0 0 0 0 0 0 0 0 0 11511.79 0 0 1014503840 16 Nurse Practitioners 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.39 0 0 107.6 0 0 0 0 0 0 135.99 0 0 1014503938 1215324447 10 Physicians GLAZER ALEX 999999999 57 Lake 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 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.42 0 0 0 0 0 0 169.42 0 0 1014504237 1558982033 12 Optometrists ROA MARIA-ALESSANDRA C 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 0 106 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 1864.19 0 0 0 0 0 0 1864.19 0 0 1014504446 1912978172 10 Physicians MOSS ROY 999999999 53 Kane 0 0 0 0 0 0 0 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 0 483.75 0 0 0 0 0 0 0 0 483.75 0 0 1014504556 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5941.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5941.4 0 0 1014504589 1881071579 10 Physicians FISCHER CHARLES H 999999999 30 DuPage 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 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 0 994 0 0 0 0 0 0 994 0 0 1014504601 1891755351 30 General Hospitals METHODIST HOSPITAL OF CHICAGO 999999999 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 1 0 0 0 122 0 0 0 0 346 0 0 0 314 0 0 0 0 0 1 0 0 0 144 0 0 0 0 396 0 0 0 525 0 0 0 0 0 1 0 0 0 144 0 0 0 0 2258 0 0 0 525 0 0 0 0 0 20.39 0 0 0 18817.76 0 0 0 0 645303.72 0 0 0 53742.3 0 0 0 0 0 717884.17 0 0 1014504657 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 1014504723 1720557010 55 Early Intervention Services ALASASLEH ABLA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 4068.24 0 0 0 0 0 0 4068.24 0 0 1014504971 4014504971 90 Waiver service provider--Elderly (DOA) ZIING ELDERLY CARE 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 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 794 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78974.61 0 0 0 0 0 0 0 0 0 0 0 0 0 78974.61 0 0 1014504983 10 Physicians 109 Winnebago 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138.34 0 0 0 0 0 0 138.34 0 0 1014505078 1538423132 10 Physicians ASHKAR MOTAZ H 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 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 1032.46 0 0 0 0 0 0 1032.46 0 0 1014505099 1932592524 10 Physicians GIRO PEDRO 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 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 0 288.54 0 0 0 0 0 0 288.54 0 0 1014505160 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5111.18 0 0 0 0 0 0 0 0 0 0 0 0 0 5111.18 0 0 1014505212 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 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 0 386.93 0 0 0 0 0 0 0 0 0 0 0 0 0 386.93 0 0 1014505344 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2582.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2582.95 0 0 1014505368 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 0 175 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 10817.45 0 0 0 0 0 0 0 0 0 0 0 0 0 10817.45 0 0 1014505434 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 72.99 0 0 0 0 0 0 0 0 0 0 0 0 0 72.99 0 0 1014505573 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014505685 1275141475 55 Early Intervention Services COLE REBECCA 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 0 128 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 7642.94 0 0 0 0 0 0 7642.94 0 0 1014505778 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5784.76 0 0 0 0 0 0 0 0 0 0 0 0 0 5784.76 0 0 1014505816 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 12 0 0 0 0 0 0 12 0 0 1014505946 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29627.55 0 0 0 0 0 0 0 0 0 0 0 0 0 29627.55 0 0 1014506081 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 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 0 222.62 0 0 0 0 0 0 0 0 222.62 0 0 1014506095 100 Family Support Program 46 Iroquois 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 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70760.13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70760.13 0 0 1014506252 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 33.6 0 0 0 0 0 0 33.6 0 0 1014506307 10 Physicians 200 Cook 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 49.22 0 0 0 0 0 0 49.22 0 0 1014506364 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24792.25 0 0 0 0 0 0 0 0 0 0 0 0 0 24792.25 0 0 1014506461 1659804417 10 Physicians NATARAJAN SAMEERA 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 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 0 478.94 0 0 0 0 0 0 478.94 0 0 1014506472 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17909.2 0 0 0 0 0 0 0 0 0 0 0 0 0 17909.2 0 0 1014506502 1710400239 16 Nurse Practitioners HORNE DOMINIQUE B 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1122.96 0 0 0 0 0 0 1122.96 0 0 1014506585 1386191393 16 Nurse Practitioners DANIELS ASHLEY 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 168 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 226 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 5106.43 0 0 0 0 0 0 5184.3 0 0 1014506586 1669746988 10 Physicians MUSLEMANI KINDA 999999999 80 Peoria 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 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 0 878.47 0 0 0 0 0 0 878.47 0 0 1014506721 1588019293 10 Physicians BALUZY MATTHEW 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 0 154 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 5650.07 0 0 0 0 0 0 5650.07 0 0 1014506848 1538520309 16 Nurse Practitioners ABU INSEIR SAGER A 999999999 200 Cook 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 1816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1816 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6887.52 0 0 0 0 0 0 6887.52 0 0 1014506856 1093370108 63 Other Providers of Medical Equipment/Supplies (Non-registered) OSF HOME MEDICAL EQUIPMENT 616033028 80 Peoria 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 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13700.96 0 0 0 0 0 0 13700.96 0 0 1014506910 1053678755 10 Physicians JUNAID NIDA 999999999 47 Jackson 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 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4431.31 0 0 0 0 0 0 4431.31 0 0 1014507186 1720170806 10 Physicians SIDDIQI SIRAJ U 999999999 91 Sangamon 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 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 6994.23 0 0 0 0 0 0 6994.23 0 0 1014507319 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 0 117.47 0 0 0 0 0 0 117.47 0 0 1014507370 16 Nurse Practitioners 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 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 80.62 0 0 0 0 0 0 80.62 0 0 1014507491 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 1350.16 0 0 0 0 0 0 1350.16 0 0 1014507586 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 0 924.45 0 0 0 0 0 0 924.45 0 0 1014507686 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9918.59 0 0 0 0 0 0 0 0 0 0 0 0 0 9918.59 0 0 1014507811 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1114.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1114.49 0 0 1014507821 1235634403 10 Physicians WECKSTEIN ETHAN 999999999 200 Cook 0 0 Psychiatry 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 1706.24 0 0 0 0 0 0 1706.24 0 0 1014508017 1639781792 91 Waiver service provider--Adults (DHS/DDD) DADA OLAYINKA E 999999999 30 DuPage 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 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 111711.27 0 0 0 0 0 0 0 0 0 0 0 0 0 111711.27 0 0 1014508049 1790166916 10 Physicians NORTON ADAM 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 26 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 988.73 0 2615.18 0 0 0 0 0 0 3603.91 0 0 1014508181 1275076499 16 Nurse Practitioners ADENIYI KHADIJAT 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 0 141 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 0 737.56 0 0 0 0 0 0 737.56 0 0 1014508390 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 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 2319.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2319.9 0 0 1014508613 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 12132.43 0 0 0 0 0 0 0 0 0 0 0 0 0 12132.43 0 0 1014508621 1730618927 10 Physicians PARECKI DANIEL 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 16 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 0 899.02 0 0 0 0 0 0 899.02 0 0 1014508973 87 Psychologist(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 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 1014509012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27755.54 0 0 0 0 0 0 0 0 0 0 0 0 0 27755.54 0 0 1014509057 1003346420 10 Physicians WILLIAMS JOY 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 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 0 822.09 0 0 0 0 0 0 822.09 0 0 1014509076 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 13027.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13027.75 0 0 1014509092 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 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 2764.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2764.58 0 0 1014509330 1831611367 10 Physicians KHALID MUHAMMAD T 999999999 200 Cook 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 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 612 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4960 0 0 0 0 0 0 4960 0 0 1014509396 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 0 208 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 19868.16 0 0 0 0 0 0 0 0 0 0 0 0 0 19868.16 0 0 1014509470 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10871.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10871.5 0 0 1014509763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9694.74 0 0 0 0 0 0 0 0 0 0 0 0 0 9694.74 0 0 1014509765 1336407998 10 Physicians AZIZ AMMARA 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.42 0 84.09 0 0 0 0 0 0 100.51 0 0 1014509979 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 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 0 128.93 0 0 0 0 0 0 128.93 0 0 1014510067 1417083494 12 Optometrists WEHRMAN MELANIE B 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 766.48 0 0 0 0 0 0 766.48 0 0 1014510094 1578180105 22 Physical Therapists GIBBONS ANNA R 999999999 109 Winnebago 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 0 207 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 1777.38 1777.38 0 0 1014510238 10 Physicians 80 Peoria 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.88 0 0 0 0 0 0 104.88 0 0 1014510258 1043487796 10 Physicians LINARES GUILLERMO 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2209.91 0 0 0 0 0 0 2209.91 0 0 1014510339 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 76474.19 0 0 0 0 0 0 0 0 0 0 0 0 0 76474.19 0 0 1014510410 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20272.62 0 0 0 0 0 0 0 0 0 0 0 0 0 20272.62 0 0 1014510473 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 1126.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1126.29 0 0 1014510475 1225560733 10 Physicians AHMED TALHA 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 0 190 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 6400.65 0 0 0 0 0 0 6400.65 0 0 1014510542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15945.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15945.8 0 0 1014510677 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6852.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6852.5 0 0 1014510726 1770078743 10 Physicians KRESCA MATTHEW A 999999999 200 Cook 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 0 160.34 0 0 0 0 0 0 160.34 0 0 1014510748 1700254703 16 Nurse Practitioners KAMBA KATHLEEN M 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 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 0 283.96 0 0 0 0 0 0 283.96 0 0 1014510994 1871146761 30 General Hospitals FRESENIUS KIDNEY CARE WEST MET 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 13 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 4686.02 0 0 0 0 0 4686.02 0 0 1014511000 1922492297 10 Physicians CHEN XIUXU 999999999 200 Cook 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 0 290 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 5194.38 0 0 0 0 0 0 0 0 5194.38 0 0 1014511092 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2405.49 0 0 0 0 0 0 0 0 0 0 0 0 0 2405.49 0 0 1014511149 1538477435 10 Physicians KAUR DEEPKAMAL 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 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 0 920.84 0 0 0 0 0 0 920.84 0 0 1014511338 10 Physicians 200 Cook 0 0 Family Practice 0 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0 0 0 0 0 51715.42 0 0 0 0 0 0 0 0 0 0 0 0 0 51715.42 0 0 1014516152 1063039386 60 Pharmacies "GENOA HEALTHCARE, LLC" 999999999 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6856.5 0 0 0 6856.5 0 0 1014516216 71 Medicar Provider 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 24.88 0 0 0 0 0 0 24.88 0 0 1014516257 1982123469 89 Physician Assistant Only(Encounter Only) PARMAR BIJAL 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 0 107 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 0 138.06 0 0 0 0 0 0 138.06 0 0 1014516321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 1687.18 0 0 1014516780 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 73.26 0 0 0 0 0 0 0 0 0 0 0 0 0 73.26 0 0 1014516849 1710418132 10 Physicians EDWARDS CADY B 999999999 0 0 0 0 0 0 0 0 0 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 0 373.09 0 0 0 0 0 0 373.09 0 0 1014517144 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1014517213 1760035505 11 Dentists PATEL TEJAL T 999999999 27 Dekalb 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 5787.63 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 7293.03 0 0 1014517386 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 15491.42 0 0 0 0 0 0 0 0 0 0 0 0 0 15491.42 0 0 1014517684 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 24.16 0 0 0 0 0 0 24.16 0 0 1014517694 1275073355 10 Physicians HUANG HAN SHEN 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 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 13.95 0 0 0 0 0 0 13.95 0 0 1014517857 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 73.4 0 0 0 0 0 0 73.4 0 0 1014517898 1447778642 10 Physicians SHAH ADIT 999999999 19 Champaign 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 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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 1014519204 1235731001 22 Physical Therapists BARNETT KENNETH A 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 0 151 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 1131.26 1131.26 0 0 1014519292 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6346.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6346.53 0 0 1014519305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11043.51 0 0 0 0 0 0 0 0 0 0 0 0 0 11043.51 0 0 1014519358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 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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 1942.49 0 0 0 0 0 0 1942.49 0 0 1014521344 1780207332 16 Nurse Practitioners POORTENGA DIANA 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 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 1225.43 0 0 0 0 0 0 1225.43 0 0 1014521355 1972190767 20 Registered nurse HARAMIJA SHAUNA M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 315.52 0 0 0 0 0 0 315.52 0 0 1014521510 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 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 2594.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2594.47 0 0 1014521585 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1445.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1445.52 0 0 1014521614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7065.25 0 0 0 0 0 0 0 0 0 0 0 0 0 7065.25 0 0 1014521760 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 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 0 193.98 0 0 0 0 0 0 193.98 0 0 1014521818 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 10345.57 0 0 0 0 0 0 0 0 0 0 0 0 0 10345.57 0 0 1014522176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22201.66 0 0 0 0 0 0 0 0 0 0 0 0 0 22201.66 0 0 1014522465 1881958098 10 Physicians COHN TYLER D 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 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 2004.74 0 0 0 0 0 0 2004.74 0 0 1014522495 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16410.24 0 0 0 0 0 0 0 0 0 0 0 0 0 16410.24 0 0 1014522701 1942717418 16 Nurse Practitioners KHAN MADIHA 999999999 200 Cook 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 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3756.8 0 0 0 0 0 0 3756.8 0 0 1014522742 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12668.2 0 0 0 0 0 0 0 0 0 0 0 0 0 12668.2 0 0 1014522813 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 57766.13 0 0 0 0 0 0 0 0 0 0 0 0 0 57766.13 0 0 1014522814 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 4207.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4207.39 0 0 1014522954 1538527882 91 Waiver service provider--Adults (DHS/DDD) HARRIS REGINALD J 999999999 30 DuPage 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 3018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3018 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81706.1 0 0 0 0 0 0 0 0 0 0 0 0 0 81706.1 0 0 1014523026 1376168740 55 Early Intervention Services GOURLEY CHELSEA 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 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 1690.52 0 0 0 0 0 0 1690.52 0 0 1014523090 1366968356 10 Physicians NAIK RUCHI 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 0 683 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4015.54 0 0 0 0 0 0 4015.54 0 0 1014523315 10 Physicians 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 0 126.82 0 0 0 0 0 0 126.82 0 0 1014523464 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28405.41 0 0 0 0 0 0 0 0 0 0 0 0 0 28405.41 0 0 1014523588 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21580.55 0 0 0 0 0 0 0 0 0 0 0 0 0 21580.55 0 0 1014523645 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 49671 0 0 0 0 0 0 0 0 0 0 0 0 0 49671 0 0 1014523680 1609294305 10 Physicians DORNBIER RYAN A 999999999 80 Peoria 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 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 17.56 0 0 0 0 0 0 17.56 0 0 1014523805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2906.87 0 0 0 0 0 0 0 0 0 0 0 0 0 2906.87 0 0 1014523905 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27086.36 0 0 0 0 0 0 0 0 0 0 0 0 0 27086.36 0 0 1014523968 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9461.15 0 0 0 0 0 0 0 0 0 0 0 0 0 9461.15 0 0 1014524019 1316391089 10 Physicians DISALVO DALE 999999999 53 Kane 0 0 Anesthesiology 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 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 0 980.5 0 0 0 0 0 0 980.5 0 0 1014524072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1245.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1245.1 0 0 1014524085 1104388800 12 Optometrists WYSZOMIRSKI TESIA 999999999 80 Peoria 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 0 413 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 8367.17 0 0 0 0 0 0 8367.17 0 0 1014524123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1000.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1000.81 0 0 1014524267 1033728480 23 Occupational Therapists MOCK EMILY G 999999999 91 Sangamon 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25757.27 25757.27 0 0 1014524342 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1693.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1693.2 0 0 1014524420 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15563.68 0 0 0 0 0 0 0 0 0 0 0 0 0 15563.68 0 0 1014524435 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20127.15 0 0 0 0 0 0 0 0 0 0 0 0 0 20127.15 0 0 1014524594 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26362.4 0 0 0 0 0 0 0 0 0 0 0 0 0 26362.4 0 0 1014524788 1144731605 61 Independent Laboratories CURATIVE LABS INC. 999999999 805 California 0 0 0 0 0 0 0 0 0 0 0 0 17 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 1664.28 0 0 0 0 0 0 0 0 1664.28 0 0 1014524880 1033600168 10 Physicians HENDERSON TIMOTHY 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 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 3347.18 0 0 0 0 0 0 3347.18 0 0 1014524898 4014524898 71 Medicar Provider SEABREEZE NEMT 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 0 170 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 1337.06 0 0 0 0 0 0 1337.06 0 0 1014524976 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 25231.95 0 0 0 0 0 0 0 0 0 0 0 0 0 25231.95 0 0 1014525009 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22741.13 0 0 0 0 0 0 0 0 0 0 0 0 0 22741.13 0 0 1014525140 1982014130 10 Physicians TATMAN LAUREN MACCORMICK 999999999 80 Peoria 0 0 Orthopedic 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 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 7935.7 0 0 0 0 0 0 7935.7 0 0 1014525230 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22492.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22492.04 0 0 1014525422 1215467154 10 Physicians TATE MARGARET L 999999999 63 Macon 0 0 Family Practice 0 0 0 9 0 0 0 0 0 0 5 0 52 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 131 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 5 0 131 0 0 0 0 0 0 0 0 0 490.9 0 0 0 0 0 0 1.93 0 3306.37 0 0 0 0 0 0 3799.2 0 0 1014525457 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 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 0 242.9 0 0 0 0 0 0 242.9 0 0 1014525565 1154842029 10 Physicians DURAN ADRIANO M 999999999 200 Cook 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 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 1073.08 0 0 0 0 0 0 1073.08 0 0 1014525593 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 5565.04 0 0 0 0 0 0 0 0 0 0 0 0 0 5565.04 0 0 1014525657 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16870.68 0 0 0 0 0 0 0 0 0 0 0 0 0 16870.68 0 0 1014525845 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3929.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3929.08 0 0 1014526197 1235556192 10 Physicians GHADERSOHI SAIED 999999999 200 Cook 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 0 198 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 14892.07 0 0 0 0 0 0 14892.07 0 0 1014526578 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4270.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4270.56 0 0 1014526627 1750921631 16 Nurse Practitioners REEVAS BRENT 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 191 0 0 0 0 0 0 0 0 0 1 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 5510.23 0 0 0 0 0 0 5510.23 0 0 1014526657 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7898.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7898.8 0 0 1014526729 1679128177 12 Optometrists PODPESKAR NICHOLAS J 999999999 56 Knox 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 144 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5742.19 0 1851.8 0 0 0 0 7593.99 0 0 1014526998 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17229.8 0 0 0 0 0 0 0 0 0 0 0 0 0 17229.8 0 0 1014527201 1104316744 10 Physicians ARRIETA CARLOS 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 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 0 800.66 0 0 0 0 0 0 800.66 0 0 1014527334 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24526.36 0 0 0 0 0 0 0 0 0 0 0 0 0 24526.36 0 0 1014527403 1356988216 16 Nurse Practitioners NELSON LAVERA 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 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 0 897.1 0 0 0 0 0 0 897.1 0 0 1014527476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 658.01 0 0 0 0 0 0 0 0 0 0 0 0 0 658.01 0 0 1014527521 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.44 0 0 0 0 0 0 0 0 0 0 0 0 0 48.44 0 0 1014527698 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3584.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3584.24 0 0 1014527711 1326137159 10 Physicians CHERULLO LISA M 999999999 200 Cook 0 0 0 0 0 18 0 0 0 0 0 0 3 0 8 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 5 0 11 0 0 0 0 0 0 0 0 0 943.6 0 0 0 0 0 0 18.33 0 395.36 0 0 0 0 0 0 1357.29 0 0 1014527834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12806.22 0 0 0 0 0 0 0 0 0 0 0 0 0 12806.22 0 0 1014527871 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5319.43 0 0 0 0 0 0 0 0 0 0 0 0 0 5319.43 0 0 1014527882 16 Nurse Practitioners 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 91.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.9 0 0 1014527984 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 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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 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 1132.99 0 0 0 0 0 0 1132.99 0 0 1014528269 1225419823 10 Physicians GALVEZ LIMA DANIEL 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 64 0 0 0 0 0 0 64 0 0 1014528553 1982935789 33 Nursing Facilities PIPER CITY REHAB LIVING CTR 609597095 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193753.37 0 0 0 0 0 0 0 193753.37 0 0 1014528575 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 3947.17 0 0 0 0 0 0 0 0 0 0 0 0 0 3947.17 0 0 1014528677 93 Waiver service provider--HIV/AIDS (DHS/DRS) 91 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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 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 4885.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4885.08 0 0 1014530407 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 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 1939.14 1939.14 0 0 1014530452 1154731321 10 Physicians MELITAS CONSTANTINE 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 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 5292.04 0 0 0 0 0 0 5292.04 0 0 1014530502 1710304670 10 Physicians MCCORMACK MICHAEL SEAN 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 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 1632.85 0 0 0 0 0 0 1632.85 0 0 1014530690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 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0 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 1046.08 1046.08 0 0 1014531806 1366081341 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) SKOKIE MEADOWS 999999999 200 Cook 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 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2465 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266670.88 0 0 0 0 0 0 0 266670.88 0 0 1014531828 1730790817 33 Nursing Facilities THRIVE OF FOX VALLEY 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19698.78 0 0 0 0 0 0 0 19698.78 0 0 1014531862 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6995.83 0 0 0 0 0 0 0 0 0 0 0 0 0 6995.83 0 0 1014531908 1811521883 16 Nurse Practitioners TESKE SHANA M 999999999 54 Kankakee 0 0 0 0 0 13 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 128 0 0 0 0 0 0 0 0 0 1398.79 0 0 0 0 0 0 0 0 3816.1 0 0 0 0 0 0 5214.89 0 0 1014532026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28129.73 0 0 0 0 0 0 0 0 0 0 0 0 0 28129.73 0 0 1014532191 1356985329 16 Nurse Practitioners WEGLARZ JILLIAN M 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 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 1189.62 0 0 0 0 0 0 1189.62 0 0 1014532409 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23408.82 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.82 0 0 1014532601 16 Nurse Practitioners 42 Hancock 0 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Practice 0 0 0 1 0 0 0 0 0 0 553 0 206 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1048 0 437 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1048 0 437 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 13706.79 0 4956.55 0 0 0 0 0 0 18748.99 0 0 1014533247 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23924.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.25 0 0 1014533370 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.55 0 0 0 0 0 0 176.55 0 0 1014533551 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 43047.95 0 0 0 0 0 0 0 0 0 0 0 0 0 43047.95 0 0 1014533562 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 913.6 0 0 0 0 0 0 0 0 0 0 0 0 0 913.6 0 0 1014533625 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7112.13 0 0 0 0 0 0 0 0 0 0 0 0 0 7112.13 0 0 1014533791 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20123.54 0 0 0 0 0 0 0 0 0 0 0 0 0 20123.54 0 0 1014533809 1134731375 16 Nurse Practitioners WILLIAMS-BRADY OTANTHIA 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 0 139 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 0 277.88 0 0 0 0 0 0 277.88 0 0 1014533894 1326663873 11 Dentists CHEBOLU SRUTHA KEERTHI 999999999 91 Sangamon 0 0 General Dentistry 0 0 53 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 6401.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6401.18 0 0 1014534049 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 13429.83 0 0 0 0 0 0 0 0 0 0 0 0 0 13429.83 0 0 1014534152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.81 0 0 0 0 0 0 0 0 0 0 0 0 0 81.81 0 0 1014534272 1104184944 10 Physicians VIGIOLA CRUZ MARIANA 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 1147.17 0 0 0 0 0 0 1147.17 0 0 1014534332 1902111248 16 Nurse Practitioners CHOI EUNJIN 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 0 179.19 0 0 0 0 0 0 179.19 0 0 1014534412 1669721213 16 Nurse Practitioners HEUERMAN ANGELA 999999999 97 Stephenson 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 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 5667.84 0 0 0 0 0 0 5667.84 0 0 1014534414 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 9589.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9589.2 0 0 1014534523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37187.44 0 0 0 0 0 0 0 0 0 0 0 0 0 37187.44 0 0 1014534554 1972958726 10 Physicians EVANS TIMOTHY R 999999999 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 19 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 1165.33 0 0 0 0 0 0 1165.33 0 0 1014534567 1003393489 87 Psychologist(Encounter Only) CULNAN ELIZABETH J 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 0 276.12 0 0 0 0 0 0 276.12 0 0 1014534625 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15472.83 0 0 0 0 0 0 0 0 0 0 0 0 0 15472.83 0 0 1014534704 91 Waiver service provider--Adults (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 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 547 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138933.33 0 0 0 0 0 0 0 0 0 0 0 0 0 138933.33 0 0 1014534828 1396152005 10 Physicians ABDELBAKI AHMED 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 67 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541.09 0 2319.91 0 0 0 0 0 0 2861 0 0 1014534890 1093345415 16 Nurse Practitioners PRYOR KAYLA 999999999 81 Perry 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 0 180 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 6262.93 0 0 0 0 0 0 6262.93 0 0 1014534997 1043614365 16 Nurse Practitioners ROSENER JENNIFER L 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 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 0 372.85 0 0 0 0 0 0 372.85 0 0 1014535119 10 Physicians 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.4 0 0 0 0 0 0 64.4 0 0 1014535133 91 Waiver 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0 0 0 0 0 0 0 73.97 0 0 0 0 0 0 73.97 0 0 1014547580 1518470509 16 Nurse Practitioners ARANT JACQUELINE P 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 0 180.11 0 0 0 0 0 0 180.11 0 0 1014547586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2457.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2457.1 0 0 1014547660 1114542404 89 Physician Assistant Only(Encounter Only) HOHM MICHAEL J 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 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 1543.84 0 0 0 0 0 0 1543.84 0 0 1014547745 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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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 2193 0 0 0 0 0 0 0 0 0 0 0 0 0 2193 0 0 1014549930 1164696779 10 Physicians HUANG YENHUI 999999999 200 Cook 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 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 0 375.37 0 0 0 0 0 0 375.37 0 0 1014549934 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10031.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10031.7 0 0 1014550232 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014550314 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 1014550500 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1820.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1820.47 0 0 1014550607 1023099256 10 Physicians WOJNICKI JARED A 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 26 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.13 0 0 0 0 0 0 0 0 167.13 0 0 1014550647 1295211548 89 Physician Assistant Only(Encounter Only) HARGRAVE LAUREN J 999999999 80 Peoria 0 0 0 0 0 12 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 1074.75 0 0 0 0 0 0 0 0 3013.54 0 0 0 0 0 0 4088.29 0 0 1014550671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 726.7 0 0 0 0 0 0 0 0 0 0 0 0 0 726.7 0 0 1014550819 1700447174 11 Dentists AMIRAN NADER 999999999 200 Cook 0 0 General Dentistry 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1833 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58445.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58445.19 0 0 1014550909 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17387.04 0 0 0 0 0 0 0 0 0 0 0 0 0 17387.04 0 0 1014550933 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 0 110.28 110.28 0 0 1014551210 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19444.32 0 0 0 0 0 0 0 0 0 0 0 0 0 19444.32 0 0 1014551315 65 Independent Diagnostic Testing Facility (IDTF) 821 Maryland 0 0 0 0 0 0 0 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 92.84 0 0 0 0 0 0 0 0 92.84 0 0 1014551322 86 Clinical Social Worker(Encounter Only) 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 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 72.84 0 0 0 0 0 0 72.84 0 0 1014551458 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2347.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2347.47 0 0 1014551523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.49 0 0 0 0 0 0 0 0 0 0 0 0 0 119.49 0 0 1014551531 10 Physicians 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 0 143.58 0 0 0 0 0 0 0 0 143.58 0 0 1014551591 10 Physicians 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.97 0 0 0 0 0 0 1.97 0 0 1014551865 1760010896 24 Speech Therapists GOSTOMELSKY AMY B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330 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 20482.78 20482.78 0 0 1014552051 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 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 58.26 0 0 0 0 0 0 58.26 0 0 1014552148 1447567011 10 Physicians BARTHELEMY JOSEPH 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 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 0 150.19 0 0 0 0 0 0 150.19 0 0 1014552289 10 Physicians 200 Cook 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 84.28 0 0 0 0 0 0 84.28 0 0 1014552348 1235751488 16 Nurse Practitioners SOLTWEDEL CASSIE 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 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 1806.54 0 0 0 0 0 0 1806.54 0 0 1014552525 1174535249 13 Podiatrists SARANTOPOULOS CHRISTINA 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 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 0 144.24 0 0 0 0 0 0 144.24 0 0 1014552616 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10016.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10016.56 0 0 1014552654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10810.03 0 0 0 0 0 0 0 0 0 0 0 0 0 10810.03 0 0 1014552849 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 4363.74 0 0 0 0 0 0 0 0 0 0 0 0 0 4363.74 0 0 1014552888 10 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 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 0 388.72 0 0 0 0 0 0 388.72 0 0 1014553324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 387.45 0 0 0 0 0 0 0 0 0 0 0 0 0 387.45 0 0 1014553382 1407269111 10 Physicians LUEHMANN NATALIE 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 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 95.24 0 0 0 0 0 0 95.24 0 0 1014553430 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3122.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3122.74 0 0 1014553553 60 Pharmacies 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13139.17 0 0 0 13139.17 0 0 1014553624 1477629574 60 Pharmacies "DANIA DISCOUNT DRUGS, INC." 999999999 810 Florida 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 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 0 440.97 0 0 0 440.97 0 0 1014553631 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 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 1014553805 1255626487 10 Physicians TODD TIMOTHY 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 7 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.88 0 5948.07 0 0 0 0 0 0 6078.95 0 0 1014553861 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10310.69 0 0 0 0 0 0 0 0 0 0 0 0 0 10310.69 0 0 1014553942 1184733008 10 Physicians KAAKAJI WAYEL 999999999 200 Cook 0 0 Neurology 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 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 3723.07 0 0 0 0 0 0 3723.07 0 0 1014554062 1720345929 10 Physicians SIDDIQUI ADEEL 42420 818 Kentucky 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 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 0 288.05 0 0 0 0 0 0 288.05 0 0 1014554102 1407452923 16 Nurse Practitioners AMORAH HUDA 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 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 2528.51 0 0 0 0 0 0 2528.51 0 0 1014554198 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.61 0 0 0 0 0 0 34.61 0 0 1014554299 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0 0 0 0 1216.02 0 0 1014554882 1093915852 10 Physicians SHAH FAISAL M 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 516 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8252.14 0 244.6 0 0 0 0 0 0 8496.74 0 0 1014554979 39 Hospice 200 Cook 0 0 0 0 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8232.07 0 0 0 0 0 0 0 0 0 0 0 8232.07 0 0 1014555136 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8223.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8223.73 0 0 1014555338 1255781365 10 Physicians ALGHALITH YAZAN N 999999999 47 Jackson 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.22 0 0 0 0 0 0 290.22 0 0 1014555354 1568083301 60 Pharmacies OSF PHARMACY - PEORIA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 3739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4677.39 0 0 0 4677.39 0 0 1014555454 1831351303 10 Physicians COX DAVID B 999999999 81 Perry 0 0 0 0 0 0 0 0 0 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 0 461.81 0 0 0 0 0 0 461.81 0 0 1014555626 89 Physician Assistant Only(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014555705 89 Physician Assistant Only(Encounter Only) 90 Saline 0 0 0 0 0 0 0 0 0 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 60.94 0 0 0 0 0 0 60.94 0 0 1014555868 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 0 102 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 7095.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7095.64 0 0 1014556044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25991.02 0 0 0 0 0 0 0 0 0 0 0 0 0 25991.02 0 0 1014556453 89 Physician Assistant Only(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.25 0 0 0 0 0 0 56.25 0 0 1014556497 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13898.34 0 0 0 0 0 0 0 0 0 0 0 0 0 13898.34 0 0 1014556632 1154338184 63 Other Providers of Medical Equipment/Supplies (Non-registered) OSF HOME MEDICAL EQUIPMENT 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1963 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13802 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13802 0 336 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 299994.23 0 17185.73 0 0 0 0 317179.96 0 0 1014556663 1114558632 16 Nurse Practitioners HEILENBACH ALLISON K 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 0 572.39 0 0 0 0 0 0 572.39 0 0 1014556843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6549.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6549.14 0 0 1014556916 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 56071.27 0 0 0 0 0 0 0 0 0 0 0 0 0 56071.27 0 0 1014556983 11 Dentists 30 DuPage 0 0 General Dentistry 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870.8 0 0 1014557250 1043816374 16 Nurse Practitioners GINNY YOUNG 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421.91 0 0 0 0 0 0 421.91 0 0 1014557391 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1014557417 1003452160 89 Physician Assistant Only(Encounter Only) MCDANIEL JOSEPH P 999999999 200 Cook 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 0 638 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 9005.76 0 0 0 0 0 0 9005.76 0 0 1014557505 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4278.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4278.4 0 0 1014557613 1154700961 10 Physicians COLLIER SANDRICKA 999999999 53 Kane 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 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 2623.9 0 0 0 0 0 0 2623.9 0 0 1014557636 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20366.28 0 0 0 0 0 0 0 0 0 0 0 0 0 20366.28 0 0 1014557994 1346583101 10 Physicians SALINAS ABRAHAM F 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 583 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9898.37 0 1.84 0 0 0 0 0 0 9900.21 0 0 1014558023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1687.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1687.43 0 0 1014558084 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.96 0 0 0 0 0 0 0 0 18.96 0 0 1014558177 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 7.34 0 0 0 0 0 0 7.34 0 0 1014558305 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 12.59 0 0 0 0 0 0 12.59 0 0 1014558312 1922541572 33 Nursing Facilities RIVER CROSSING OF MOLINE 999999999 89 Rock Island 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 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668004.41 0 0 0 0 0 0 0 668004.41 0 0 1014558488 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.89 0 0 0 0 0 0 0 0 0 0 0 0 0 50.89 0 0 1014558701 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5419.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5419.94 0 0 1014558793 1518593342 89 Physician Assistant Only(Encounter Only) SIMPSON LEAH 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 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 0 803.53 0 0 0 0 0 0 803.53 0 0 1014558835 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 20748.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20748.66 0 0 1014559068 1104460062 89 Physician Assistant Only(Encounter Only) MCGOWAN MATTHEW G 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 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 0 513.36 0 0 0 0 0 0 513.36 0 0 1014559179 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5307.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5307.69 0 0 1014559378 1033745971 89 Physician Assistant Only(Encounter Only) FLETCHER ALYSSA 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 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 0 259.87 0 0 0 0 0 0 259.87 0 0 1014559459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6526.59 0 0 0 0 0 0 0 0 0 0 0 0 0 6526.59 0 0 1014559471 1952600058 13 Podiatrists LAFONTANT MAGDALA 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 0 584 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 2794.88 0 0 0 0 0 0 2794.88 0 0 1014559473 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8817.54 0 0 0 0 0 0 0 0 0 0 0 0 0 8817.54 0 0 1014559499 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11643.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11643.31 0 0 1014559532 1710598271 11 Dentists BRAR AMANDEEP K 999999999 200 Cook 0 0 General Dentistry 0 0 5 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1655.85 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 2408.55 0 0 1014559557 1528657582 16 Nurse Practitioners SHASTEEN HOLLY 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 0 164.3 0 0 0 0 0 0 164.3 0 0 1014559685 1700329240 33 Nursing Facilities RIVER CROSSING OF ROCKFORD 999999999 109 Winnebago 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 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 507486.31 0 0 0 0 0 0 0 507486.31 0 0 1014559686 1770191017 87 Psychologist(Encounter Only) SKEDGELL KYLEIGH 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 0 731.06 0 0 0 0 0 0 731.06 0 0 1014559757 1285977678 10 Physicians KOLETTIS DIANA 999999999 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 69 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5871.94 0 3742.67 0 0 0 0 0 0 9614.61 0 0 1014559822 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 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 2922.26 0 0 0 0 0 0 0 0 0 0 0 0 0 2922.26 0 0 1014559837 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7199.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7199.51 0 0 1014559875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24219.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24219.75 0 0 1014559966 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 0 0 0 0 0 0 0 0 0 0 0 850 0 0 1014560046 1285112854 10 Physicians BATOOL SABA 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 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 0 181.97 0 0 0 0 0 0 181.97 0 0 1014560100 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22282.64 0 0 0 0 0 0 0 0 0 0 0 0 0 22282.64 0 0 1014560150 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 1014560187 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1803.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1803.84 0 0 1014560282 1760082754 16 Nurse Practitioners FRAHM CRYSTAL 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 0 510.74 0 0 0 0 0 0 510.74 0 0 1014560400 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6642.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6642.24 0 0 1014560574 10 Physicians 25 Crawford 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 0 109.35 0 0 0 0 0 0 109.35 0 0 1014560801 1396234571 10 Physicians HAMMOUR RASHAD 999999999 30 DuPage 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 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 0 199.11 0 0 0 0 0 0 199.11 0 0 1014560830 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 0 243.86 0 0 0 0 0 0 243.86 0 0 1014561151 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 22223.02 0 0 0 0 0 0 0 0 0 0 0 0 0 22223.02 0 0 1014561294 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 0 0 0 0 0 0 0 0 0 0 1014561694 1790385987 16 Nurse Practitioners OYEBAMIJI ADEBOWALE 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 1204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7996.58 0 0 0 0 0 0 7996.58 0 0 1014561699 1174155337 16 Nurse Practitioners LUTZ LAUREN 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 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 0 258.1 0 0 0 0 0 0 258.1 0 0 1014561833 1881207298 16 Nurse Practitioners BAKER CLAIRE M 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 9 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 12.88 0 0 0 0 0 0 0 0 149.1 0 0 0 0 0 0 161.98 0 0 1014561988 1992330583 16 Nurse Practitioners PIERCE HEATHER R 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 0 130 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 3507.25 0 0 0 0 0 0 3507.25 0 0 1014562042 10 Physicians 47 Jackson 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 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 1144.9 0 0 0 0 0 0 1144.9 0 0 1014562107 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13794.65 0 0 0 0 0 0 0 0 0 0 0 0 0 13794.65 0 0 1014562150 1952669178 10 Physicians CHOI HEEJUNG 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2569.34 0 0 0 0 0 0 2569.34 0 0 1014562159 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3992.18 0 0 0 0 0 0 0 0 0 0 0 0 0 3992.18 0 0 1014562333 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 459.68 0 0 0 0 0 0 0 0 0 0 0 0 0 459.68 0 0 1014562467 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23023.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23023.7 0 0 1014562873 1750926077 16 Nurse Practitioners MCDANNALD AMANDA 999999999 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 0 381 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 5843.97 0 0 0 0 0 0 5843.97 0 0 1014563069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5981.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5981.94 0 0 1014563117 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6771.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6771.34 0 0 1014563173 1972965689 10 Physicians ODOM BRITTANY K 999999999 24 Coles 0 0 0 0 0 68 0 0 0 0 0 0 15 0 65 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 18 0 116 0 0 0 0 0 0 0 0 0 210 0 0 0 0 0 0 18 0 116 0 0 0 0 0 0 0 0 0 7310.24 0 0 0 0 0 0 317.19 0 4391.35 0 0 0 0 0 0 12018.78 0 0 1014563180 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2843.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2843.91 0 0 1014563409 1871022095 10 Physicians SAHADEVAN MATHAVI 999999999 109 Winnebago 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 0 293 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 1822.7 0 0 0 0 0 0 1822.7 0 0 1014563635 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 1014563696 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1000.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1000.44 0 0 1014563759 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 43.54 0 0 0 0 0 0 43.54 0 0 1014563797 1619353760 10 Physicians SANDEEP RAM BHUVANESWARI 999999999 30 DuPage 0 0 Anesthesiology 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 0 117 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 9706.99 0 0 0 0 0 0 9706.99 0 0 1014563890 1457376659 10 Physicians MILLER SUE 999999999 36 Franklin 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 0 164 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 1513.95 0 0 0 0 0 0 1513.95 0 0 1014563956 1568859007 10 Physicians BHALLA VARUN 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 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 1595.75 0 0 0 0 0 0 1595.75 0 0 1014563961 1588288906 11 Dentists KHAN USAMAH M 999999999 200 Cook 0 0 General Dentistry 0 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25418.47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25418.47 0 0 1014564067 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10364.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10364.36 0 0 1014564201 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2651.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2651.77 0 0 1014564261 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90.4 0 0 0 0 0 0 0 0 90.4 0 0 1014564343 1356987317 22 Physical Therapists LAKAG PAUNILIAN MARY B 999999999 200 Cook 0 0 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 5654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5654 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28103.22 28103.22 0 0 1014564439 97 Waiver service provider--Children's residential (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 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 0 270.6 0 0 0 0 0 0 0 0 0 0 0 0 0 270.6 0 0 1014564496 16 Nurse Practitioners 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014564544 1417306838 16 Nurse Practitioners KELLEY BETHANY A 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 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 0 588.21 0 0 0 0 0 0 588.21 0 0 1014564676 1841587540 89 Physician Assistant Only(Encounter Only) MAZALEWSKI ROBERT 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366.97 0 0 0 0 0 0 366.97 0 0 1014564933 16 Nurse Practitioners 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 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 0 298.9 0 0 0 0 0 0 298.9 0 0 1014565397 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1647.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1647.72 0 0 1014565454 1023549821 10 Physicians HINES PATRICK 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 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 0 197.87 0 0 0 0 0 0 197.87 0 0 1014565473 1235677352 16 Nurse Practitioners BELVILLE MOLLY 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 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 0 492.07 0 0 0 0 0 0 492.07 0 0 1014565624 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 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 81.81 0 0 0 0 0 0 81.81 0 0 1014565674 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11907.17 0 0 0 0 0 0 0 0 0 0 0 0 0 11907.17 0 0 1014565744 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 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 0 520.42 520.42 0 0 1014565794 1700400074 11 Dentists NAJJAR ISMAEIL 999999999 200 Cook 0 0 General Dentistry 0 0 280 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1493 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1493 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 58277.97 0 0 0 0 0 0 0 0 0 0 0 3387.15 0 0 0 0 61665.12 0 0 1014565796 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 588.03 0 0 0 0 0 0 0 0 0 0 0 0 0 588.03 0 0 1014565902 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1165.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1165.24 0 0 1014566088 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1325.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1325.86 0 0 1014566104 10 Physicians 65 Madison 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 0 743.5 0 0 0 0 0 0 743.5 0 0 1014566213 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 44190.14 0 0 0 0 0 0 0 0 0 0 0 0 0 44190.14 0 0 1014566216 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5996.54 0 0 0 0 0 0 0 0 0 0 0 0 0 5996.54 0 0 1014566271 1053798264 10 Physicians KIM JENNIFER 999999999 80 Peoria 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 0 118 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 5674.85 0 0 0 0 0 0 5674.85 0 0 1014566524 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 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 3921.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3921.84 0 0 1014566535 1881056265 10 Physicians WINSTON JARED TODD 999999999 91 Sangamon 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 0 193 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 2367.06 0 0 0 0 0 0 2367.06 0 0 1014566916 1871580019 10 Physicians RAMIREZ PETER 999999999 19 Champaign 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1641.62 0 0 0 0 0 0 1641.62 0 0 1014566917 1861442840 10 Physicians DEVABHAKTUNI YASODA 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 0 196.48 0 0 0 0 0 0 196.48 0 0 1014566939 10 Physicians 818 Kentucky 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1014566989 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1869.28 0 0 0 0 0 0 0 0 0 0 0 0 0 1869.28 0 0 1014567003 1114422961 10 Physicians ALLALI-BIERMAN TAVOR 999999999 200 Cook 0 0 0 0 0 10 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 368.25 0 0 0 0 0 0 0 0 253.74 0 0 0 0 0 0 621.99 0 0 1014567056 1013530815 16 Nurse Practitioners RODRIGUEZ JESSICA 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 0 570.93 0 0 0 0 0 0 570.93 0 0 1014567093 89 Physician Assistant Only(Encounter Only) 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.08 0 0 0 0 0 0 87.08 0 0 1014567103 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 35.4 0 0 0 0 0 0 35.4 0 0 1014567217 1033536412 10 Physicians JOHNSON VERONICA R 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 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 0 547.58 0 0 0 0 0 0 547.58 0 0 1014567552 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18231.71 0 0 0 0 0 0 0 0 0 0 0 0 0 18231.71 0 0 1014567562 10 Physicians 57 Lake 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 5.67 0 0 0 0 0 0 5.67 0 0 1014567572 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.85 0 0 0 0 0 0 0 0 0 0 0 0 0 522.85 0 0 1014567609 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014567725 88 Other behavior health professional 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 20.2 0 0 0 0 0 0 20.2 0 0 1014567763 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15044 0 0 0 0 0 0 0 0 0 0 0 0 0 15044 0 0 1014567878 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 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 71.13 0 0 0 0 0 0 71.13 0 0 1014567959 1033717319 16 Nurse Practitioners SIMANDL THERESA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 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 2896.18 0 0 0 0 0 0 2896.18 0 0 1014568014 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7225.79 0 0 0 0 0 0 0 0 0 0 0 0 0 7225.79 0 0 1014568064 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 248.02 0 0 0 0 0 0 0 0 0 0 0 0 0 248.02 0 0 1014568351 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6010.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6010.9 0 0 1014568381 10 Physicians 53 Kane 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 0 302.34 0 0 0 0 0 0 302.34 0 0 1014568569 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10008.73 0 0 0 0 0 0 0 0 0 0 0 0 0 10008.73 0 0 1014568985 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 11780.01 0 0 0 0 0 0 0 0 0 0 0 0 0 11780.01 0 0 1014569139 1073970901 23 Occupational Therapists TRENKLE KRISTIE L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165 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 1448.58 1448.58 0 0 1014569156 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17622.86 0 0 0 0 0 0 0 0 0 0 0 0 0 17622.86 0 0 1014569184 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.39 0 0 0 0 0 0 3.39 0 0 1014569589 1114549219 16 Nurse Practitioners POWERS KANDACE 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 0 310.37 0 0 0 0 0 0 310.37 0 0 1014569614 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 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 1027.4 1027.4 0 0 1014569650 1083142699 10 Physicians VAN OYEN ALEXANDRA E 999999999 200 Cook 0 0 Pediatrics 0 0 0 21 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1061.48 0 0 0 0 0 0 0 0 1172.08 0 0 0 0 0 0 2233.56 0 0 1014569683 60 Pharmacies 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2.72 0 0 0 2.72 0 0 1014569748 1962897504 10 Physicians DIAL BRIAN LEE 999999999 30 DuPage 0 0 Orthopedic 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 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 2454.94 0 0 0 0 0 0 2454.94 0 0 1014569870 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30914.67 0 0 0 0 0 0 0 0 0 0 0 0 0 30914.67 0 0 1014570106 94 Waiver service provider--Children's support (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 5 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 28363.8 0 0 0 0 0 0 0 0 0 0 0 0 0 28363.8 0 0 1014570152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13895.12 0 0 0 0 0 0 0 0 0 0 0 0 0 13895.12 0 0 1014570168 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1365.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1365.6 0 0 1014570203 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 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 14510.98 0 0 0 0 0 0 0 0 0 0 0 0 0 14510.98 0 0 1014570235 1760004071 12 Optometrists MARTIN KYLE 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 321.36 0 0 0 0 0 0 321.36 0 0 1014570236 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25353.35 0 0 0 0 0 0 0 0 0 0 0 0 0 25353.35 0 0 1014570430 1134582521 10 Physicians MIHELCIC JOHN A 999999999 76 Montgomery 0 0 General 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 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 1074.11 0 0 0 0 0 0 1074.11 0 0 1014570468 1700205630 10 Physicians FARRELL NYSSA F 999999999 106 Whiteside 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 271 0 0 0 0 0 0 271 0 0 1014570506 1366079667 16 Nurse Practitioners THELEN JENNIFER 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 0 162 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 1771.08 0 0 0 0 0 0 1771.08 0 0 1014570552 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 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 11538.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11538.45 0 0 1014570594 1073809398 10 Physicians MODI PARTH K 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 5 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.54 0 5023.2 0 0 0 0 0 0 5030.74 0 0 1014570639 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246.91 0 0 0 0 0 0 246.91 0 0 1014570759 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 0 126.42 0 0 0 0 0 0 126.42 0 0 1014570865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 87.25 0 0 0 0 0 0 0 0 0 0 0 0 0 87.25 0 0 1014570906 1528681145 16 Nurse Practitioners SUMPTER STEVEN 999999999 54 Kankakee 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 0 754.95 0 0 0 0 0 0 754.95 0 0 1014570951 1720225436 10 Physicians YERKES NICHOLAS 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655.93 0 0 0 0 0 0 655.93 0 0 1014571211 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6629.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6629.14 0 0 1014571614 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 0 211 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 16744.45 0 0 0 0 0 0 0 0 0 0 0 0 0 16744.45 0 0 1014571761 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8826.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8826.38 0 0 1014571775 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 402.96 0 0 0 0 0 0 0 0 0 0 0 0 0 402.96 0 0 1014571788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1019.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1019.19 0 0 1014571808 1073825717 10 Physicians SESKE LAURA M 999999999 200 Cook 0 0 Pediatrics 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 0 185 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 28191.82 0 0 0 0 0 0 28191.82 0 0 1014571814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8003.8 0 0 0 0 0 0 0 0 0 0 0 0 0 8003.8 0 0 1014571916 1548706708 16 Nurse Practitioners MATTICKS VERONICA 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 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 0 170.44 0 0 0 0 0 0 170.44 0 0 1014571997 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17520.69 0 0 0 0 0 0 0 0 0 0 0 0 0 17520.69 0 0 1014572001 1366930091 10 Physicians BARNETT SAMUEL 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 71 0 0 0 0 0 0 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 29.48 0 2483.41 0 0 0 0 0 0 2512.89 0 0 1014572225 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2710.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.05 0 0 1014572267 1356760995 10 Physicians AKHTER TALAL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 280 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 326 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 326 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.49 1280.23 0 1826.06 0 0 0 0 0 0 3119.78 0 0 1014572433 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6805.95 0 0 0 0 0 0 0 0 0 0 0 0 0 6805.95 0 0 1014572438 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11514.85 0 0 0 0 0 0 0 0 0 0 0 0 0 11514.85 0 0 1014572512 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22121.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22121.63 0 0 1014572523 1700181278 89 Physician Assistant Only(Encounter Only) IWUAGWU OBIOMA 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 0 256 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 3502.58 0 0 0 0 0 0 3502.58 0 0 1014572540 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 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 4468.86 0 0 0 0 0 0 0 0 0 0 0 0 0 4468.86 0 0 1014572677 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13421.36 0 0 0 0 0 0 0 0 0 0 0 0 0 13421.36 0 0 1014572777 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22226.16 0 0 0 0 0 0 0 0 0 0 0 0 0 22226.16 0 0 1014572833 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10931.07 0 0 0 0 0 0 0 0 0 0 0 0 0 10931.07 0 0 1014572889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.3 0 0 0 0 0 0 0 0 0 0 0 0 0 405.3 0 0 1014572973 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18536.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18536.82 0 0 1014573050 1255961470 16 Nurse Practitioners KAPPES KYLE 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 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 0 662.35 0 0 0 0 0 0 662.35 0 0 1014573071 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23889.51 0 0 0 0 0 0 0 0 0 0 0 0 0 23889.51 0 0 1014573226 1467930883 89 Physician Assistant Only(Encounter Only) TILLER KIMBERLY L 999999999 30 DuPage 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 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 1716.1 0 0 0 0 0 0 1716.1 0 0 1014573375 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18048.3 0 0 0 0 0 0 0 0 0 0 0 0 0 18048.3 0 0 1014573474 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.63 0 0 0 0 0 0 0 0 0 0 0 0 0 125.63 0 0 1014573545 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 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 6899.73 0 0 0 0 0 0 0 0 0 0 0 0 0 6899.73 0 0 1014573801 1619338498 23 Occupational Therapists EVERETTE SAMANTHA 999999999 91 Sangamon 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 0 178 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 13305.04 13305.04 0 0 1014573904 4014573904 72 Taxicabs and Livery Companies ON TIME 4 U TRANSPORTATION 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 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8133.83 0 0 0 0 0 0 8133.83 0 0 1014574066 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34823.16 0 0 0 0 0 0 0 0 0 0 0 0 0 34823.16 0 0 1014574177 1013533819 16 Nurse Practitioners VOUDRIE MICHELLE D 999999999 63 Macon 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 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 2134.66 0 0 0 0 0 0 2134.66 0 0 1014574415 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3988.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3988.06 0 0 1014574523 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13692.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13692.7 0 0 1014574538 1508491663 16 Nurse Practitioners OLSEN SUSAN J 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 0 119.58 0 0 0 0 0 0 119.58 0 0 1014574650 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14926.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14926.12 0 0 1014574653 1013575356 11 Dentists THOMAS LEAH 999999999 200 Cook 0 0 General Dentistry 0 0 276 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1322 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 1322 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 49250.76 0 0 0 0 0 0 0 0 0 0 0 4892.55 0 0 0 0 54143.31 0 0 1014574689 10 Physicians 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.96 0 0 0 0 0 0 126.96 0 0 1014574761 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 546.85 0 0 0 0 0 0 0 0 0 0 0 0 0 546.85 0 0 1014574864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15943.97 0 0 0 0 0 0 0 0 0 0 0 0 0 15943.97 0 0 1014574946 1255567947 10 Physicians WOOD JONATHAN R 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 82 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1605.63 0 223.88 0 0 0 0 0 0 1829.51 0 0 1014575176 1861964959 75 Department of Alcohol and Substance Abuse Provider THE TURNING POINT CENTER 999999999 200 Cook 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 0 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38702.09 0 0 38702.09 0 0 1014575228 1912544792 16 Nurse Practitioners RAY NOELLE 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 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 0 488.72 0 0 0 0 0 0 488.72 0 0 1014575400 1699319723 16 Nurse Practitioners LUDWIKOWSKA PATRICIA 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 102.85 0 0 0 0 0 0 0 0 7810.35 0 0 0 0 0 0 7913.2 0 0 1014575721 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6826.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6826.98 0 0 1014576037 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3207.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3207.7 0 0 1014576119 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 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 0 221.39 0 0 0 0 0 0 0 0 221.39 0 0 1014576590 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20144.63 0 0 0 0 0 0 0 0 0 0 0 0 0 20144.63 0 0 1014576696 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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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 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 23131.42 0 0 0 0 0 0 0 0 0 0 0 0 0 23131.42 0 0 1014577033 1356869325 16 Nurse Practitioners MEDINA JESSE 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223.42 0 0 0 0 0 0 223.42 0 0 1014577090 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 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 21813.89 0 0 0 0 0 0 0 0 0 0 0 0 0 21813.89 0 0 1014577197 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 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 5365 5365 0 0 1014577242 1376198168 55 Early Intervention Services JAJKOWSKI JENNI M 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 0 108 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 5844.14 0 0 0 0 0 0 5844.14 0 0 1014577251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27447.81 0 0 0 0 0 0 0 0 0 0 0 0 0 27447.81 0 0 1014577393 10 Physicians 200 Cook 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 0 297.08 0 0 0 0 0 0 297.08 0 0 1014577427 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 84.28 0 0 0 0 0 0 84.28 0 0 1014577734 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2253.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2253.91 0 0 1014577847 1215095567 86 Clinical Social Worker(Encounter Only) EARLEY CHARLENE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 298.13 0 0 0 0 0 0 298.13 0 0 1014577932 10 Physicians 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 433.64 0 0 0 0 0 0 433.64 0 0 1014577967 1285258129 11 Dentists TIPTON DALLIN JAY 999999999 200 Cook 0 0 General Dentistry 0 0 32 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 2876.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2876.51 0 0 1014578029 1316406440 16 Nurse Practitioners WEHBE LISA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.66 0 0 0 0 0 0 161.66 0 0 1014578051 1295197754 10 Physicians CORDERO JULIO 999999999 200 Cook 0 0 Nuclear Medicine 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 0 206 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 3202.59 0 0 0 0 0 0 3202.59 0 0 1014578697 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8767.61 0 0 0 0 0 0 0 0 0 0 0 0 0 8767.61 0 0 1014578858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23322.71 0 0 0 0 0 0 0 0 0 0 0 0 0 23322.71 0 0 1014578871 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 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 8274.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8274.6 0 0 1014578918 1871103291 16 Nurse Practitioners DRISCOLL MARY 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 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 1410.57 0 0 0 0 0 0 1410.57 0 0 1014578936 1700012689 10 Physicians ZHAO LARRY 999999999 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 224 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4433.84 0 12.3 0 0 0 0 0 0 4446.14 0 0 1014579143 1548808959 16 Nurse Practitioners DINELLO HOLLY K 999999999 54 Kankakee 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 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 1312.95 0 0 0 0 0 0 1312.95 0 0 1014579246 1538689062 48 Rural Health Clinics SIH MEDICAL GROUP ANNA PRIMARY 999999999 99 Union 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12404.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12404.07 0 0 1014579288 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 0 0 0 0 0 0 0 0 0 0 1014579521 1760878748 10 Physicians HARVEY MICHAEL J 999999999 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.84 0 421.27 0 0 0 0 0 0 471.11 0 0 1014579541 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 1014579610 22 Physical Therapists 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.41 96.41 0 0 1014579669 1760099576 89 Physician Assistant Only(Encounter Only) CRAWFORD PERRY W 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 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 34.78 0 0 0 0 0 0 34.78 0 0 1014579817 1194105056 10 Physicians URDAY SEBASTIAN 999999999 200 Cook 0 0 Neurology 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 0 149 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 4202.45 0 0 0 0 0 0 4202.45 0 0 1014579958 1578178679 89 Physician Assistant Only(Encounter Only) STIGALL AMELIA 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 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 0 357.84 0 0 0 0 0 0 357.84 0 0 1014579961 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27500.32 0 0 0 0 0 0 0 0 0 0 0 0 0 27500.32 0 0 1014580170 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 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 75.98 0 0 0 0 0 0 75.98 0 0 1014580364 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14513.62 0 0 0 0 0 0 0 0 0 0 0 0 0 14513.62 0 0 1014580402 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1635.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1635.54 0 0 1014580510 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561.45 0 0 0 0 0 0 0 0 0 0 0 0 0 561.45 0 0 1014580631 1992316376 16 Nurse Practitioners REYNOLDS TATUM J 999999999 91 Sangamon 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 0 115 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 3038.17 0 0 0 0 0 0 3038.17 0 0 1014580751 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 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 1569.51 1569.51 0 0 1014581041 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1092.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1092.39 0 0 1014581232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2197.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2197.35 0 0 1014581282 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12991.74 0 0 0 0 0 0 0 0 0 0 0 0 0 12991.74 0 0 1014581324 10 Physicians 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 1267.81 0 0 0 0 0 0 1267.81 0 0 1014581519 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 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 1778.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1778.4 0 0 1014581634 1801913769 89 Physician Assistant Only(Encounter Only) LINDLEY MEGAN 999999999 200 Cook 0 0 0 0 0 0 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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 21684.96 0 0 0 0 0 0 0 0 0 0 0 0 0 21684.96 0 0 1014583572 1427601855 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 109 Winnebago 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 0 226 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 0 885.27 0 0 0 0 0 0 0 0 885.27 0 0 1014583583 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 1700.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1700.48 0 0 1014584250 1992805147 33 Nursing Facilities TWIN LAKES REHAB HEALTH CARE 619441938 31 Edgar 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 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2262 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286114.3 0 0 0 0 0 0 0 286114.3 0 0 1014584342 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 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 7477.88 0 0 0 0 0 0 0 0 0 0 0 0 0 7477.88 0 0 1014585133 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.84 0 0 0 0 0 0 0 0 0 0 0 0 0 222.84 0 0 1014585162 1093109803 89 Physician Assistant Only(Encounter Only) BUCKINGHAM LAUREN 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 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 15.99 0 0 0 0 0 0 15.99 0 0 1014585168 89 Physician Assistant Only(Encounter Only) 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 49.22 0 0 0 0 0 0 49.22 0 0 1014585216 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5114.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5114.08 0 0 1014585528 22 Physical Therapists 109 Winnebago 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 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 0 926.9 926.9 0 0 1014585643 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 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 2047.64 2047.64 0 0 1014585685 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7054.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7054.09 0 0 1014585807 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8477.9 0 0 0 0 0 0 0 0 0 0 0 0 0 8477.9 0 0 1014585821 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11910.82 0 0 0 0 0 0 0 0 0 0 0 0 0 11910.82 0 0 1014585968 89 Physician Assistant Only(Encounter Only) 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 1014586022 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 0 0 0 0 0 0 0 0 0 0 1014586123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18899.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18899.5 0 0 1014586178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1784.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1784.19 0 0 1014586296 1194364596 22 Physical Therapists TERVEER LUCAS 999999999 89 Rock Island 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 0 136 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 1752.78 1752.78 0 0 1014586315 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 0 114.7 0 0 0 0 0 0 114.7 0 0 1014586442 1558867010 10 Physicians FORTE SEAN 999999999 53 Kane 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 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 0 503.26 0 0 0 0 0 0 503.26 0 0 1014586460 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7928.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7928.91 0 0 1014586496 16 Nurse Practitioners 98 Tazewell 0 0 0 0 0 0 0 0 0 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 1014586650 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21450.11 0 0 0 0 0 0 0 0 0 0 0 0 0 21450.11 0 0 1014586769 1649760984 10 Physicians CHOW KENNETH C 999999999 200 Cook 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 252.9 0 0 0 0 0 0 31.3 0 1948.9 0 0 0 0 0 0 2233.1 0 0 1014586889 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 0 716.47 0 0 0 0 0 0 0 0 0 0 0 0 0 716.47 0 0 1014586926 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2095.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2095.72 0 0 1014586946 1467972497 13 Podiatrists WILSON JOSEPH G 999999999 71 McHenry 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 0 259 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 10636.2 0 0 0 0 0 0 10636.2 0 0 1014587105 1952518235 10 Physicians BARCHIE MATTHEW 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1466.22 0 0 0 0 0 0 0 0 1466.22 0 0 1014587154 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18388.86 0 0 0 0 0 0 0 0 0 0 0 0 0 18388.86 0 0 1014587282 10 Physicians 63 Macon 0 0 0 0 0 0 0 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 0 145.2 0 0 0 0 0 0 0 0 145.2 0 0 1014587329 1952837601 10 Physicians SETTIPALLE BHANU 999999999 200 Cook 0 0 Internal Medicine 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 0 117 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 0 0 5057.16 0 0 0 0 0 0 5076.74 0 0 1014587393 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17988.22 0 0 0 0 0 0 0 0 0 0 0 0 0 17988.22 0 0 1014587485 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12683.64 0 0 0 0 0 0 0 0 0 0 0 0 0 12683.64 0 0 1014587606 1487207080 91 Waiver service provider--Adults (DHS/DDD) POWELL JASMINE C 999999999 91 Sangamon 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 2278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99386.17 0 0 0 0 0 0 0 0 0 0 0 0 0 99386.17 0 0 1014587637 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29847.15 0 0 0 0 0 0 0 0 0 0 0 0 0 29847.15 0 0 1014587646 1518386614 10 Physicians LEVIN JARED R 999999999 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 113 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 0 113 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 14.16 0 5805.55 0 0 0 0 0 0 5839.29 0 0 1014587667 22 Physical Therapists 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1419.68 1419.68 0 0 1014587732 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 983.08 0 0 0 0 0 0 0 0 0 0 0 0 0 983.08 0 0 1014587773 1639798366 16 Nurse Practitioners ERICA MCNEALEY 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 1998.91 0 0 0 0 0 0 1998.91 0 0 1014587794 1356961015 89 Physician Assistant Only(Encounter Only) BLANK ALEXANDER 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 0 100 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 0 501.34 0 0 0 0 0 0 501.34 0 0 1014587859 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47125.94 0 0 0 0 0 0 0 0 0 0 0 0 0 47125.94 0 0 1014587869 1154924827 16 Nurse Practitioners BROWN NICOLE 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 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 1588.42 0 0 0 0 0 0 1588.42 0 0 1014588229 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7374.84 0 0 0 0 0 0 0 0 0 0 0 0 0 7374.84 0 0 1014588299 1386265551 16 Nurse Practitioners SCHANTZ ALEXIS 999999999 10 Adams 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 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 0 746.99 0 0 0 0 0 0 746.99 0 0 1014588344 1912240805 10 Physicians GUNTURI NIVEDITA 999999999 200 Cook 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 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1316.21 0 0 0 0 0 0 1316.21 0 0 1014588395 10 Physicians 109 Winnebago 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 1014588452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15710.38 0 0 0 0 0 0 0 0 0 0 0 0 0 15710.38 0 0 1014588537 1740806066 11 Dentists AHMAD HUSSIEN 999999999 200 Cook 0 0 0 0 19 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 3740.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3740.9 0 0 1014588701 1235190786 10 Physicians VANDERSTEEN DAVID R 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 5 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.72 0 2484.95 0 0 0 0 0 0 2493.67 0 0 1014588756 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5809.53 0 0 0 0 0 0 0 0 0 0 0 0 0 5809.53 0 0 1014588914 1235171463 10 Physicians HARRISON MATTHEW B 999999999 42 Hancock 0 0 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 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.29 0 378.35 0 0 0 0 0 0 408.64 0 0 1014588917 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1123.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1123.47 0 0 1014588920 1679550644 33 Nursing Facilities LEBANON CARE CENTER 622541103 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1744 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191307.96 0 0 0 0 0 0 0 191307.96 0 0 1014588999 10 Physicians 30 DuPage 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 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 1332.52 0 0 0 0 0 0 1332.52 0 0 1014589097 1285995266 10 Physicians DUVALL ADAM S 999999999 30 DuPage 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 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 3860.27 0 0 0 0 0 0 3860.27 0 0 1014589296 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35157.37 0 0 0 0 0 0 0 0 0 0 0 0 0 35157.37 0 0 1014589304 1285016014 10 Physicians KULT JAMES 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 10 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 3341.68 0 0 0 0 0 0 3341.68 0 0 1014589324 1558657346 10 Physicians PATEL SHEEL A 999999999 57 Lake 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 0 153 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 0 912.88 0 0 0 0 0 0 912.88 0 0 1014589329 1285273805 91 Waiver service provider--Adults (DHS/DDD) WEYMAN SAMANTHA A 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 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 3548.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3548.06 0 0 1014589661 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23985.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23985.9 0 0 1014589825 60 Pharmacies 836 Ohio 0 0 0 0 0 0 0 0 0 0 0 0 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 0 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2546.95 0 0 0 2546.95 0 0 1014589854 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 341.68 0 0 0 0 0 0 0 0 0 0 0 0 0 341.68 0 0 1014590073 1073144457 16 Nurse Practitioners WILLIAMS HEATHER J 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.92 0 0 0 0 0 0 598.92 0 0 1014590099 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1509.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.6 0 0 1014590206 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 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 1966.87 0 0 0 0 0 0 0 0 0 0 0 0 0 1966.87 0 0 1014590344 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12018.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12018.5 0 0 1014590374 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 31.01 0 0 0 0 0 0 31.01 0 0 1014590614 1689263667 16 Nurse Practitioners LABERTA AMANDA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.11 0 0 0 0 0 0 526.11 0 0 1014590615 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13083.28 0 0 0 0 0 0 0 0 0 0 0 0 0 13083.28 0 0 1014590754 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5190.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5190.64 0 0 1014590795 1558778621 11 Dentists GANDHI AKSHI 999999999 53 Kane 0 0 General Dentistry 0 0 314 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1454 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 49126.22 0 0 0 0 0 0 0 0 0 0 0 4516.2 0 0 0 0 53642.42 0 0 1014590979 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 6153.84 0 0 0 0 0 0 0 0 0 0 0 0 0 6153.84 0 0 1014591088 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 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 0 354.09 0 0 0 0 0 0 0 0 0 0 0 0 0 354.09 0 0 1014591103 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 9426.12 0 0 0 0 0 0 0 0 0 0 0 0 0 9426.12 0 0 1014591298 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 16505.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16505.56 0 0 1014591356 1295223063 16 Nurse Practitioners ZUBRICKAITE ALINA 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 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 0 134.46 0 0 0 0 0 0 134.46 0 0 1014591472 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 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 0 124.66 0 0 0 0 0 0 124.66 0 0 1014591477 1316592256 16 Nurse Practitioners JUNG KELLY M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 134.54 0 0 0 0 0 0 134.54 0 0 1014591585 16 Nurse Practitioners 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 0 0 0 0 0 0 0 0 0 0 1014591594 1952832735 10 Physicians MILLER DANIELLE J 999999999 200 Cook 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 0 196 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 6750.59 0 0 0 0 0 0 6750.59 0 0 1014591628 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8439.25 0 0 0 0 0 0 0 0 0 0 0 0 0 8439.25 0 0 1014591700 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23984.82 0 0 0 0 0 0 0 0 0 0 0 0 0 23984.82 0 0 1014591788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23481.57 0 0 0 0 0 0 0 0 0 0 0 0 0 23481.57 0 0 1014591827 1861656977 10 Physicians KEEGAN CATHERINE 999999999 63 Macon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 51 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.77 0 61.89 0 0 0 0 0 0 1357.66 0 0 1014591859 1912392564 10 Physicians HERMANN GREG M 999999999 72 McLean 0 0 Radiation Oncology 0 0 0 0 0 0 0 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 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 3103.39 0 0 0 0 0 0 3103.39 0 0 1014591871 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325.21 0 0 0 0 0 0 0 0 0 0 0 0 0 325.21 0 0 1014591928 21 Licensed Practical Nurses 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014591977 1356395800 10 Physicians DHILLON TEJWANT S 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 1152.04 0 0 0 0 0 0 1152.04 0 0 1014592068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5075.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5075.29 0 0 1014592190 1154969418 16 Nurse Practitioners TRAN DIEP 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 0 244 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 1547.85 0 0 0 0 0 0 1547.85 0 0 1014592310 1083021976 10 Physicians SYNGAL PRACHI 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 0 209 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 53600.53 0 0 0 0 0 0 53600.53 0 0 1014592453 1396150553 10 Physicians SAVANI GHANSHYAMBHAI 999999999 91 Sangamon 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 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2186.48 0 0 0 0 0 0 2186.48 0 0 1014592516 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 84.7 0 0 0 0 0 0 84.7 0 0 1014592855 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014592910 1386267094 11 Dentists MALIK FAISAL 999999999 30 DuPage 0 0 General Dentistry 0 0 99 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 14051.98 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 14804.68 0 0 1014592918 1528234143 10 Physicians POLLACK SETH M 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 0 194 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 20255.74 0 0 0 0 0 0 20255.74 0 0 1014593135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4436.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4436.4 0 0 1014593136 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 39.86 0 0 0 0 0 0 39.86 0 0 1014593401 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 898.13 0 0 0 0 0 0 0 0 0 0 0 0 0 898.13 0 0 1014593433 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12582.34 0 0 0 0 0 0 0 0 0 0 0 0 0 12582.34 0 0 1014593461 86 Clinical Social Worker(Encounter Only) 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014593492 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 1014593608 1205474483 16 Nurse Practitioners LANTZ KATIE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 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 1398.21 0 0 0 0 0 0 1398.21 0 0 1014593674 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 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 24621.92 0 0 0 0 0 0 0 0 0 0 0 0 0 24621.92 0 0 1014593738 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 11559.66 0 0 0 0 0 0 0 0 0 0 0 0 0 11559.66 0 0 1014593786 1629365275 10 Physicians GANDHI KABIR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 326 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3470.41 0 140.86 0 0 0 0 0 0 3611.27 0 0 1014593860 1669716858 10 Physicians ALMANASIF MOHAMMED 999999999 30 DuPage 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 0 196 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 4077.2 0 0 0 0 0 0 4077.2 0 0 1014593881 1497283774 10 Physicians CIATLOS-DEAK LARISA 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 5 0 0 0 0 0 0 3 0 75 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 3 0 75 0 0 0 0 0 0 0 0 0 83.5 0 0 0 0 0 0 21.69 0 660.16 0 0 0 0 0 0 765.35 0 0 1014593882 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 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16424.64 0 0 0 0 0 0 0 0 0 0 0 0 0 16424.64 0 0 1014601198 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 39.57 0 0 0 0 0 0 39.57 0 0 1014601242 1356762702 16 Nurse Practitioners KRUMWIEDE MELANIE J 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 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 0 136.78 0 0 0 0 0 0 136.78 0 0 1014601396 24 Speech Therapists 98 Tazewell 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 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 1132.32 1132.32 0 0 1014601545 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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Diagnosis 0 0 0 0 0 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 0 330.65 0 0 0 0 0 0 0 0 330.65 0 0 1014601779 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10142.44 0 0 0 0 0 0 0 0 0 0 0 0 0 10142.44 0 0 1014601882 1295359586 11 Dentists YOUSEF PALDIN 999999999 200 Cook 0 0 General Dentistry 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 852 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27344.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27344.82 0 0 1014601945 1114582913 48 Rural Health Clinics HAMMOND HENRY HOSPITAL 999999999 45 Henry 0 0 0 34 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 2673.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2673.64 0 0 1014601957 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 494.99 0 0 0 0 0 0 0 0 0 0 0 0 0 494.99 0 0 1014602061 24 Speech Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.76 119.76 0 0 1014602074 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14086.89 0 0 0 0 0 0 0 0 0 0 0 0 0 14086.89 0 0 1014602089 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 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 0 747.25 0 0 0 0 0 0 747.25 0 0 1014602130 86 Clinical Social Worker(Encounter Only) 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 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 0 291.85 0 0 0 0 0 0 291.85 0 0 1014602413 1356988273 89 Physician Assistant Only(Encounter Only) VISCONTI CLAIR L 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 0 420.68 0 0 0 0 0 0 420.68 0 0 1014602671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2563.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2563.6 0 0 1014602681 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 45.37 0 0 0 0 0 0 0 0 45.37 0 0 1014602842 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 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 5264.22 0 0 0 0 0 0 0 0 0 0 0 0 0 5264.22 0 0 1014602862 1851722250 10 Physicians JOSHI NIKHIL 999999999 200 Cook 0 0 Radiation Oncology 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3678.78 0 0 0 0 0 0 3678.78 0 0 1014602983 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 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 0 0 0 0 1014603034 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19874.93 0 0 0 0 0 0 0 0 0 0 0 0 0 19874.93 0 0 1014603051 1720433220 10 Physicians NUSRAT OSAMA 999999999 80 Peoria 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 0 288 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 2337.56 0 0 0 0 0 0 2337.56 0 0 1014603081 1710127956 10 Physicians HOBEIKA PETER 999999999 36 Franklin 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 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 0 429.48 0 0 0 0 0 0 0 0 429.48 0 0 1014603110 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 0 135 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 8791.2 0 0 0 0 0 0 0 0 0 0 0 0 0 8791.2 0 0 1014603116 1124446687 10 Physicians KELLY DAVID C 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 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 2440.2 0 0 0 0 0 0 2440.2 0 0 1014603211 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1154.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1154.49 0 0 1014603509 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 0 226 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 14523.17 0 0 0 0 0 0 0 0 0 0 0 0 0 14523.17 0 0 1014603681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2860.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2860.05 0 0 1014603690 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 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 22682.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22682.76 0 0 1014603750 1881896637 10 Physicians KASE BENJAMIN 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 50 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3194.35 0 3078.06 0 0 0 0 0 0 6272.41 0 0 1014603790 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12900.65 0 0 0 0 0 0 0 0 0 0 0 0 0 12900.65 0 0 1014603800 1225174659 10 Physicians SMITH CHRISTOPHER 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 85 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2072.22 0 13.49 0 0 0 0 0 0 2085.71 0 0 1014603816 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21963.28 0 0 0 0 0 0 0 0 0 0 0 0 0 21963.28 0 0 1014604139 1215468301 10 Physicians ZAIA RACHIL Y 999999999 200 Cook 0 0 Family Practice 0 0 0 13 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 425.25 0 0 0 0 0 0 2.18 0 1053.76 0 0 0 0 0 0 1481.19 0 0 1014604237 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 1014604400 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 46773.93 0 0 0 0 0 0 0 0 0 0 0 0 0 46773.93 0 0 1014604445 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 33432.22 0 0 0 0 0 0 0 0 0 0 0 0 0 33432.22 0 0 1014604447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35.69 0 0 0 0 0 0 0 0 0 0 0 0 0 35.69 0 0 1014604657 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6927.14 0 0 0 0 0 0 0 0 0 0 0 0 0 6927.14 0 0 1014604729 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 28.9 0 0 0 0 0 0 28.9 0 0 1014604782 1891394417 16 Nurse Practitioners BURTON OLIVIA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 725.67 0 0 0 0 0 0 725.67 0 0 1014604925 1043842172 11 Dentists SENTHILATHIBAN VIDHYA 999999999 200 Cook 0 0 General Dentistry 0 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38497.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38497.5 0 0 1014605027 1609482769 89 Physician Assistant Only(Encounter Only) MCDONALD JOHN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1660.51 0 0 0 0 0 0 1660.51 0 0 1014605030 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20655.42 0 0 0 0 0 0 0 0 0 0 0 0 0 20655.42 0 0 1014605035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27309.21 0 0 0 0 0 0 0 0 0 0 0 0 0 27309.21 0 0 1014605040 1780889063 10 Physicians PAIK HAINES 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 54 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 964.81 0 8362.21 0 0 0 0 0 0 9327.02 0 0 1014605077 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 0 399 0 0 0 0 0 0 399 0 0 1014605110 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18505.35 0 0 0 0 0 0 0 0 0 0 0 0 0 18505.35 0 0 1014605117 1326688714 16 Nurse Practitioners WILLIAMS DANIELLE R 999999999 200 Cook 0 0 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 21 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 38.64 0 0 0 0 0 0 0 0 876.83 0 0 0 0 0 0 915.47 0 0 1014605171 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 0 308 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 44215.88 0 0 0 0 0 0 0 0 0 0 0 0 0 44215.88 0 0 1014605361 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.06 0 0 0 0 0 0 80.06 0 0 1014605465 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 23935.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23935.1 0 0 1014605633 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37625.91 0 0 0 0 0 0 0 0 0 0 0 0 0 37625.91 0 0 1014605665 1316165475 10 Physicians BILLINGSLEY JOSHUA 999999999 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 7 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64.05 0 6622.96 0 0 0 0 0 0 6687.01 0 0 1014605696 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28130.53 0 0 0 0 0 0 0 0 0 0 0 0 0 28130.53 0 0 1014605832 1528589405 10 Physicians HASHM HASSAN 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 0 248.74 0 0 0 0 0 0 248.74 0 0 1014605883 63 Other Providers of Medical Equipment/Supplies (Non-registered) 67 Marshall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 6951 0 0 0 0 0 0 6951 0 0 1014605964 1629683289 16 Nurse Practitioners GILBERT ALLISON 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 0 149.1 0 0 0 0 0 0 149.1 0 0 1014605984 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 0 0 0 0 0 0 0 0 0 0 1014606340 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6952.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6952.11 0 0 1014606406 1912544180 16 Nurse Practitioners KANDA JYOTI 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 0 155 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 46.24 0 0 0 0 0 0 46.24 0 0 1014606417 1902291834 10 Physicians ALIKHAN WASFIA A 999999999 71 McHenry 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.91 0 0 0 0 0 0 143.91 0 0 1014606421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2319.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2319.08 0 0 1014606582 1528603057 16 Nurse Practitioners VIPOND TAYLOR A 999999999 15 Bureau 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 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 0 664.81 0 0 0 0 0 0 664.81 0 0 1014606599 10 Physicians 30 DuPage 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 0 113.26 0 0 0 0 0 0 113.26 0 0 1014606641 1619237708 11 Dentists PATEL SHAIVALKUMAR 999999999 200 Cook 0 0 General Dentistry 0 0 47 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 10572.33 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 11325.03 0 0 1014606790 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28562.18 0 0 0 0 0 0 0 0 0 0 0 0 0 28562.18 0 0 1014606795 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 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 0 354.92 354.92 0 0 1014606960 1821264342 16 Nurse Practitioners LAMBERMONT NADIA 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 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 0 129.14 0 0 0 0 0 0 129.14 0 0 1014607212 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3982.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3982.71 0 0 1014607232 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2092.32 0 0 0 0 0 0 0 0 0 0 0 0 0 2092.32 0 0 1014607363 10 Physicians 200 Cook 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 1014607468 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7233.38 0 0 0 0 0 0 0 0 0 0 0 0 0 7233.38 0 0 1014607496 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24000.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24000.2 0 0 1014607498 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1407.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1407.44 0 0 1014607698 1366946592 10 Physicians CABRERA RANDALL F 999999999 53 Kane 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 0 129 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 1863.22 0 0 0 0 0 0 1863.22 0 0 1014607736 1760012165 89 Physician Assistant Only(Encounter Only) STERLING JULIA K 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 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 29.86 0 0 0 0 0 0 29.86 0 0 1014607786 1982846077 10 Physicians PRIDDY NATHAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 148 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1284.81 0 18.18 0 0 0 0 0 0 1302.99 0 0 1014607819 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20859.38 0 0 0 0 0 0 0 0 0 0 0 0 0 20859.38 0 0 1014607993 1417599317 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE OAK LAWN 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 0 141 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 23335.5 0 0 0 0 0 0 23335.5 0 0 1014608010 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31669.07 0 0 0 0 0 0 0 0 0 0 0 0 0 31669.07 0 0 1014608029 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1529.65 0 0 0 0 0 0 0 0 0 0 0 0 0 1529.65 0 0 1014608118 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.69 0 0 0 0 0 0 52.69 0 0 1014608289 10 Physicians 91 Sangamon 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 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 1014608349 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25832.37 0 0 0 0 0 0 0 0 0 0 0 0 0 25832.37 0 0 1014608748 1992302954 55 Early Intervention Services THOMPSON VANNETTA 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 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 4349.31 0 0 0 0 0 0 4349.31 0 0 1014608766 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 768.96 0 0 0 0 0 0 0 0 0 0 0 0 0 768.96 0 0 1014608768 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13787.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13787.93 0 0 1014609291 1417440256 10 Physicians MISBAH SAMAN 999999999 19 Champaign 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 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 0 514.7 0 0 0 0 0 0 514.7 0 0 1014609346 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26617.42 0 0 0 0 0 0 0 0 0 0 0 0 0 26617.42 0 0 1014609426 1245694090 10 Physicians ALLAWIRDI GRACE 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 3175.51 0 0 0 0 0 0 3196.83 0 0 1014609569 1063067478 63 Other Providers of Medical Equipment/Supplies (Non-registered) CASTOR MEDICAL SUPPLIES 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 4869.48 0 0 0 0 0 0 4869.48 0 0 1014609668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39325.65 0 0 0 0 0 0 0 0 0 0 0 0 0 39325.65 0 0 1014609753 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6698.15 0 0 0 0 0 0 0 0 0 0 0 0 0 6698.15 0 0 1014609814 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 0 233 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 16386.7 0 0 0 0 0 0 0 0 0 0 0 0 0 16386.7 0 0 1014609881 1831479005 10 Physicians KHALID MARIAM 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 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 0 775.03 0 0 0 0 0 0 775.03 0 0 1014609982 1881049583 10 Physicians GALLAGHER KRISTEN 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 14 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.9 0 4367.39 0 0 0 0 0 0 4774.29 0 0 1014610192 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 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 0 184.71 0 0 0 0 0 0 184.71 0 0 1014610572 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014610666 1891329280 16 Nurse Practitioners EMBERTON KIERSTEN M 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1254.69 0 0 0 0 0 0 1254.69 0 0 1014610761 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 79.72 0 0 0 0 0 0 79.72 0 0 1014610782 1932321395 10 Physicians LEVY MIA A 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 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 0 869.92 0 0 0 0 0 0 869.92 0 0 1014611009 1881864213 16 Nurse Practitioners COYLE LAURA 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 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 0 111.12 0 0 0 0 0 0 111.12 0 0 1014611105 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23754.01 0 0 0 0 0 0 0 0 0 0 0 0 0 23754.01 0 0 1014611138 1922329986 10 Physicians DECUYPERE MICHAEL 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 4486.78 0 0 0 0 0 0 4486.78 0 0 1014611372 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23956.02 0 0 0 0 0 0 0 0 0 0 0 0 0 23956.02 0 0 1014611475 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22921.76 0 0 0 0 0 0 0 0 0 0 0 0 0 22921.76 0 0 1014611499 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 0 181 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 15929.98 0 0 0 0 0 0 0 0 0 0 0 0 0 15929.98 0 0 1014611573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11804.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11804.8 0 0 1014611705 1558676221 16 Nurse Practitioners HALLIWELL BOSEUNG 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 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 1086.67 0 0 0 0 0 0 1086.67 0 0 1014611787 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11134 0 0 0 0 0 0 0 0 0 0 0 0 0 11134 0 0 1014611805 10 Physicians 47 Jackson 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 0 0 0 0 0 0 0 0 0 0 1014611969 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 4140.83 0 0 0 0 0 0 0 0 0 0 0 0 0 4140.83 0 0 1014612032 1851936132 60 Pharmacies COMPASSIONATE CARE PHARMACY 999999999 200 Cook 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 0 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10327 0 0 0 0 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0 0 0 1085 0 0 1014612742 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 6931.21 0 0 0 0 0 0 0 0 0 0 0 0 0 6931.21 0 0 1014612826 1083253413 16 Nurse Practitioners JAMES LISA K 999999999 109 Winnebago 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 0 108 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 0 828.95 0 0 0 0 0 0 828.95 0 0 1014612852 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23917.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23917.8 0 0 1014613067 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 0 188 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 18384.19 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 15700.32 0 0 1014615835 1093127557 10 Physicians BROWN LESLIE 999999999 30 DuPage 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 24 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 15 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 1014615988 1669905097 10 Physicians REICHERT HEATHER K 999999999 109 Winnebago 0 0 Pediatrics 0 0 0 14 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 1755.59 0 0 0 0 0 0 16.51 0 768.11 0 0 0 0 0 0 2540.21 0 0 1014616129 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 0 491.21 0 0 0 0 0 0 0 0 0 0 0 0 0 491.21 0 0 1014616158 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 0 166.53 0 0 0 0 0 0 166.53 0 0 1014616198 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3595.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3595.51 0 0 1014616244 1508109505 10 Physicians BURKE ELIZABETH ANNE 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 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 0 286.96 0 0 0 0 0 0 286.96 0 0 1014616428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 761.94 0 0 0 0 0 0 0 0 0 0 0 0 0 761.94 0 0 1014616727 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12964.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12964.82 0 0 1014616745 1336707611 16 Nurse Practitioners ANKENEY LEIGH A 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 0 154 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 0 690.38 0 0 0 0 0 0 690.38 0 0 1014616787 1871113381 16 Nurse Practitioners HEIDEMAN KATHERINE 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 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 0 268.34 0 0 0 0 0 0 268.34 0 0 1014616807 1902033210 10 Physicians GLENN ROBERT C 999999999 30 DuPage 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 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 1956.89 0 0 0 0 0 0 1956.89 0 0 1014616980 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 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 2476.6 0 0 0 0 0 0 0 0 0 0 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Provider 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 0 183 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 1373.73 0 0 0 0 0 0 1373.73 0 0 1014618291 1629304191 12 Optometrists ALDRICH MARISSA 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 632 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9314.68 0 2518.08 0 0 0 0 11832.76 0 0 1014618341 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3697.13 0 0 0 0 0 0 0 0 0 0 0 0 0 3697.13 0 0 1014618495 1700448917 89 Physician Assistant Only(Encounter Only) NGUYEN NGOC N 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 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 0 218.6 0 0 0 0 0 0 218.6 0 0 1014618597 1649708942 10 Physicians KOLLU RAMYA 999999999 47 Jackson 0 0 Emergency 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 0 160 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 5765.28 0 0 0 0 0 0 5765.28 0 0 1014618641 1720492572 10 Physicians MEDINA VICTOR M 999999999 200 Cook 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 0 151 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 1915.33 0 0 0 0 0 0 1915.33 0 0 1014618894 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1855.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.96 0 0 1014618940 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 0 684.97 0 0 0 0 0 0 0 0 0 0 0 0 0 684.97 0 0 1014618962 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 48.84 0 0 0 0 0 0 0 0 0 0 0 0 0 48.84 0 0 1014619269 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 1014619281 1366084279 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE MARSEILLES 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 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 15173.98 0 0 0 0 0 0 15173.98 0 0 1014619369 1063024388 89 Physician Assistant Only(Encounter Only) DYCK ALYSON R 999999999 19 Champaign 0 0 0 0 0 4 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 307.21 0 0 0 0 0 0 0 0 906.63 0 0 0 0 0 0 1213.84 0 0 1014619385 1457335838 39 Hospice MIDWEST PALLIATIVE HOSPICE CTR 600153900 57 Lake 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 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4424 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 978775.49 0 0 0 0 0 0 0 0 0 0 0 978775.49 0 0 1014619507 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17256.8 0 0 0 0 0 0 0 0 0 0 0 0 0 17256.8 0 0 1014619623 1588268957 16 Nurse Practitioners BACHMANN JESSICA A 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 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 2025 0 0 0 0 0 0 2025 0 0 1014619717 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 214.83 0 0 0 0 0 0 0 0 0 0 0 0 0 214.83 0 0 1014619765 1578957676 10 Physicians VERNON LAURA ENGEL 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 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 0 677.36 0 0 0 0 0 0 677.36 0 0 1014619876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15576.45 0 0 0 0 0 0 0 0 0 0 0 0 0 15576.45 0 0 1014619898 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.78 0 0 0 0 0 0 55.78 0 0 1014620120 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7514.55 0 0 0 0 0 0 0 0 0 0 0 0 0 7514.55 0 0 1014620585 1811199953 10 Physicians BOHNSACK BRENDA 999999999 200 Cook 0 0 Ophthalmology 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 2 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32.67 0 10008.05 0 0 0 0 0 0 10040.72 0 0 1014620654 11 Dentists 200 Cook 0 0 General Dentistry 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 0 316.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 316.9 0 0 1014620668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22816.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22816.42 0 0 1014620734 1538757695 16 Nurse Practitioners CORDERO RICHARD 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 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 1188.11 0 0 0 0 0 0 1188.11 0 0 1014620819 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 0 293 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 28055.91 0 0 0 0 0 0 0 0 0 0 0 0 0 28055.91 0 0 1014620872 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 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 0 889.23 0 0 0 0 0 0 889.23 0 0 1014620936 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 11906.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11906.23 0 0 1014621013 1689298036 16 Nurse Practitioners SHICK CLAYTON 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 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 0 610.04 0 0 0 0 0 0 610.04 0 0 1014621027 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 0 199.55 0 0 0 0 0 0 199.55 0 0 1014621150 1013118702 10 Physicians BAZZANI MICHAEL D 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 195 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 344 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6465.45 0 148.29 0 0 0 0 0 0 6613.74 0 0 1014621232 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1014621492 1588059570 10 Physicians CHERAYIL NEENA 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 0 120 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 1496.99 0 0 0 0 0 0 1496.99 0 0 1014621518 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19677.09 0 0 0 0 0 0 0 0 0 0 0 0 0 19677.09 0 0 1014621774 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 820.74 0 0 0 0 0 0 0 0 0 0 0 0 0 820.74 0 0 1014622162 1255743258 10 Physicians CHECOVICH ALLYN 999999999 19 Champaign 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 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 4217.68 0 0 0 0 0 0 4217.68 0 0 1014622258 1558717140 25 Audiologists WALSER MARIE N 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014.21 1014.21 0 0 1014622260 1831662790 22 Physical Therapists PATEL NEIL 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 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 0 283.52 283.52 0 0 1014622265 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23021.08 0 0 0 0 0 0 0 0 0 0 0 0 0 23021.08 0 0 1014622294 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1658.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1658.11 0 0 1014622342 1902398019 10 Physicians AHMAD UZMA F 999999999 200 Cook 0 0 Emergency Medicine 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 1258.96 0 0 0 0 0 0 1258.96 0 0 1014622430 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1432.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1432.6 0 0 1014622728 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8448.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8448.55 0 0 1014622790 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6182.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6182.55 0 0 1014622843 1225391592 10 Physicians MALIK ALI A 999999999 91 Sangamon 0 0 Radiation Oncology 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.35 0 1859.21 0 0 0 0 0 0 1894.56 0 0 1014623105 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9752.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9752.78 0 0 1014623235 1164044079 16 Nurse Practitioners MARCINKOWSKI NATALIA E 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 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 0 149.66 0 0 0 0 0 0 149.66 0 0 1014623252 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5668.5 5668.5 0 0 1014623322 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13933.66 0 0 0 0 0 0 0 0 0 0 0 0 0 13933.66 0 0 1014623398 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 47.71 0 0 0 0 0 0 47.71 0 0 1014623471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7372.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7372.63 0 0 1014623473 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4875.86 0 0 0 0 0 0 0 0 0 0 0 0 0 4875.86 0 0 1014623569 1043750144 10 Physicians SALIK FAARIA 999999999 19 Champaign 0 0 Family Practice 0 0 0 6 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 662.74 0 0 0 0 0 0 0 0 1554.63 0 0 0 0 0 0 2217.37 0 0 1014623765 1174137400 86 Clinical Social Worker(Encounter Only) MENDEZ CHRISTINA 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 0 106 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 0 0 0 0 0 0 0 0 0 0 1014623970 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 689.29 0 0 0 0 0 0 0 0 0 0 0 0 0 689.29 0 0 1014624159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13035.14 0 0 0 0 0 0 0 0 0 0 0 0 0 13035.14 0 0 1014624360 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9114 0 0 0 0 0 0 0 0 0 0 0 0 0 9114 0 0 1014624363 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31094.57 0 0 0 0 0 0 0 0 0 0 0 0 0 31094.57 0 0 1014624493 1770965394 10 Physicians LUU BRIAN 999999999 200 Cook 0 0 Anesthesiology 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 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 3806.75 0 0 0 0 0 0 3806.75 0 0 1014624764 1245866805 16 Nurse Practitioners CHERIAN SELBY 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 0 0 0 0 0 0 0 0 0 0 1014624916 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19100.83 0 0 0 0 0 0 0 0 0 0 0 0 0 19100.83 0 0 1014624933 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24082.16 0 0 0 0 0 0 0 0 0 0 0 0 0 24082.16 0 0 1014625286 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 2.7 0 0 0 0 0 0 2.7 0 0 1014625544 1588980189 10 Physicians PATEL RAJAL 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 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 0 530.83 0 0 0 0 0 0 530.83 0 0 1014625621 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7035.74 0 0 0 0 0 0 0 0 0 0 0 0 0 7035.74 0 0 1014625659 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 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 12464.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12464.97 0 0 1014625697 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 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 27310.57 0 0 0 0 0 0 0 0 0 0 0 0 0 27310.57 0 0 1014625742 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22655.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22655.9 0 0 1014625803 1821272006 10 Physicians OLWENY EPHREM O 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 12 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.04 0 7799.98 0 0 0 0 0 0 7880.02 0 0 1014626189 1689293987 16 Nurse Practitioners GRANBERRY RICKEDA D 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 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 1810.9 0 0 0 0 0 0 1810.9 0 0 1014626301 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 0 0 0 0 0 0 0 0 0 0 1014626352 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 20674.57 0 0 0 0 0 0 0 0 0 0 0 0 0 20674.57 0 0 1014626359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18924.28 0 0 0 0 0 0 0 0 0 0 0 0 0 18924.28 0 0 1014626580 1093354078 33 Nursing Facilities "CITADEL OF SKOKIE, THE" 999999999 200 Cook 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 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719563.93 0 0 0 0 0 0 0 719563.93 0 0 1014626623 1114560190 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNITYPOINT AT HOME 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1709 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1709 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25079.25 0 17.97 0 0 0 0 25097.22 0 0 1014626682 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13015.86 0 0 0 0 0 0 0 0 0 0 0 0 0 13015.86 0 0 1014626847 1902425937 16 Nurse Practitioners DOORNBOSCH SARA K 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 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 0 786.15 0 0 0 0 0 0 786.15 0 0 1014626866 1780145151 16 Nurse Practitioners BOHLAND AMY 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 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9457.15 0 0 0 0 0 0 9457.15 0 0 1014626904 1205369410 13 Podiatrists GRIGOROPOULOS KATERINA 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 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 0 130.39 0 0 0 0 0 0 130.39 0 0 1014626945 1336759935 33 Nursing Facilities ALHAMBRA REHAB AND HEALTHCARE 999999999 65 Madison 0 0 0 0 0 0 0 0 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 1619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96962.51 0 0 0 0 0 0 0 96962.51 0 0 1014627177 1134750342 16 Nurse Practitioners WELCH HEATHER 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 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 0 625 0 0 0 0 0 0 625 0 0 1014627196 1730792359 11 Dentists ABRAHAM JASON 999999999 200 Cook 0 0 General Dentistry 0 0 220 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1130 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 33284.64 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 34790.04 0 0 1014627396 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1799.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1799.48 0 0 1014627397 1447702089 10 Physicians TRIPATHEE NIROJ 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 312 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 462 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5378.46 0 124.22 0 0 0 0 0 0 5502.68 0 0 1014627429 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9052.15 0 0 0 0 0 0 0 0 0 0 0 0 0 9052.15 0 0 1014627446 1689869588 89 Physician Assistant Only(Encounter Only) STULTS VANESSA M 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 325.65 0 0 0 0 0 0 325.65 0 0 1014627570 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 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 1681.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1681.75 0 0 1014627847 1083238299 16 Nurse Practitioners WOLF ANJA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 987.43 0 0 0 0 0 0 987.43 0 0 1014627880 1639648652 16 Nurse Practitioners SCAMMAN AMY 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1014628343 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5412.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5412.15 0 0 1014628348 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 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 0 998.04 0 0 0 0 0 0 998.04 0 0 1014628436 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27849.24 0 0 0 0 0 0 0 0 0 0 0 0 0 27849.24 0 0 1014628455 10 Physicians 60 Lee 0 0 0 0 0 0 0 0 0 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1014628592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8366.15 0 0 0 0 0 0 0 0 0 0 0 0 0 8366.15 0 0 1014628619 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 0 430.49 0 0 0 0 0 0 0 0 0 0 0 0 0 430.49 0 0 1014628620 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2946.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2946.91 0 0 1014628623 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12460.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12460.5 0 0 1014628734 1407444508 10 Physicians AFAQ ASIM 999999999 19 Champaign 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 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254.19 0 17.49 0 0 0 0 0 0 271.68 0 0 1014628843 1740895218 16 Nurse Practitioners TWILLEY RYAN 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 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 0 359.88 0 0 0 0 0 0 359.88 0 0 1014628997 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7945.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7945.63 0 0 1014629008 1265665707 10 Physicians WALLENTIN CYNTHIA 999999999 200 Cook 0 0 Radiology Diagnosis 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 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 0 765.22 0 0 0 0 0 0 0 0 765.22 0 0 1014629037 1912122649 22 Physical Therapists PIOTROWICZ ANNA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 471.91 471.91 0 0 1014629225 1902917891 10 Physicians VERGHESE PRIYA 999999999 200 Cook 0 0 Pediatrics 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 0 135 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 7227.33 0 0 0 0 0 0 7233.73 0 0 1014629276 10 Physicians 36 Franklin 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 0 376.44 0 0 0 0 0 0 376.44 0 0 1014629337 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 0 112 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 10765.14 0 0 0 0 0 0 0 0 0 0 0 0 0 10765.14 0 0 1014629343 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 0 219 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 10527.98 0 0 0 0 0 0 0 0 0 0 0 0 0 10527.98 0 0 1014629370 1861466096 10 Physicians DINNEEN LAURA N 999999999 200 Cook 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 7 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394.89 0 17.62 0 0 0 0 0 0 412.51 0 0 1014629449 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29663.37 0 0 0 0 0 0 0 0 0 0 0 0 0 29663.37 0 0 1014629569 90 Waiver service provider--Elderly (DOA) 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 0 247 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 21873.15 0 0 0 0 0 0 0 0 0 0 0 0 0 21873.15 0 0 1014629578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2680.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2680.24 0 0 1014629637 1962792473 10 Physicians BEHR CHRISTOPHER 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 0 108 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 12702.58 0 0 0 0 0 0 12702.58 0 0 1014629741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4587.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4587.85 0 0 1014629758 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17932.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17932.42 0 0 1014629872 1487174900 86 Clinical Social Worker(Encounter Only) ROLFS ANDREA 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 0 172 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 2126.91 0 0 0 0 0 0 2126.91 0 0 1014630071 1992344451 16 Nurse Practitioners SCHUSTER JESSICA L 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 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 0 820.01 0 0 0 0 0 0 820.01 0 0 1014630316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2230.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2230.55 0 0 1014630498 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20370.35 0 0 0 0 0 0 0 0 0 0 0 0 0 20370.35 0 0 1014630518 1942827316 33 Nursing Facilities ELEVATE CARE NORTH BRANCH 999999999 200 Cook 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 0 429 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10277 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1595507.47 0 0 0 0 0 0 0 1595507.47 0 0 1014630582 98 Waiver service provider--TBI (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 6565.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6565.08 0 0 1014630608 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 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 16193.44 0 0 0 0 0 0 0 0 0 0 0 0 0 16193.44 0 0 1014630776 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014631129 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3676.94 0 0 0 0 0 0 0 0 0 0 0 0 0 3676.94 0 0 1014631151 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6408.26 0 0 0 0 0 0 0 0 0 0 0 0 0 6408.26 0 0 1014631293 1164876553 10 Physicians BULWA ZACHARY B 999999999 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 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 0 846.46 0 0 0 0 0 0 846.46 0 0 1014631295 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 18.17 0 0 0 0 0 0 18.17 0 0 1014631501 1700872611 10 Physicians LIDDELL JERRY 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 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 1324.91 0 0 0 0 0 0 1324.91 0 0 1014631559 1427497726 10 Physicians MOMIN SAJEDABANU 999999999 91 Sangamon 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 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1501.88 0 0 0 0 0 0 1501.88 0 0 1014631740 11 Dentists 200 Cook 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014631839 1548290836 10 Physicians JANDURA-CESSNA HALINA 999999999 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 0 196 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 4999.65 0 0 0 0 0 0 4999.65 0 0 1014631863 1538774898 16 Nurse Practitioners ARENDT RUSSELL C 999999999 54 Kankakee 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 1820.47 0 0 0 0 0 0 1820.47 0 0 1014631889 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12751.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12751.1 0 0 1014631896 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 0 156 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 18515.72 0 0 0 0 0 0 0 0 0 0 0 0 0 18515.72 0 0 1014631966 1013523711 16 Nurse Practitioners ROBINSON TIFFANY 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 0 147 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 0 933.32 0 0 0 0 0 0 933.32 0 0 1014632138 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23247.84 0 0 0 0 0 0 0 0 0 0 0 0 0 23247.84 0 0 1014632320 1396109153 10 Physicians BONZELAAR LAUREN 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 35 0 0 0 0 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 0 0 1728.21 0 0 0 0 0 0 1728.21 0 0 1014632425 10 Physicians 30 DuPage 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 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 0 250.75 0 0 0 0 0 0 250.75 0 0 1014632466 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 0 258 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 20420.34 0 0 0 0 0 0 0 0 0 0 0 0 0 20420.34 0 0 1014632531 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 52.91 0 0 0 0 0 0 0 0 0 0 0 0 0 52.91 0 0 1014632603 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 1014632653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10573.86 0 0 0 0 0 0 0 0 0 0 0 0 0 10573.86 0 0 1014632709 1275052318 10 Physicians SATURNO ARIAS DANY 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 0 250 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 2327.27 0 0 0 0 0 0 2327.27 0 0 1014632747 98 Waiver service 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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 0 229 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 7420.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7420.91 0 0 1014633190 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21849.77 0 0 0 0 0 0 0 0 0 0 0 0 0 21849.77 0 0 1014633224 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 2.16 0 0 0 0 0 0 2.16 0 0 1014633321 10 Physicians 19 Champaign 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.97 0 0 0 0 0 0 121.97 0 0 1014633340 30 General Hospitals 836 Ohio 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 0 337.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337.61 0 0 1014633390 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 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 1395.26 0 0 0 0 0 0 1395.26 0 0 1014633523 1821026147 10 Physicians O'SABEN JOE 999999999 109 Winnebago 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 9 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261.49 0 3722.31 0 0 0 0 0 0 3983.8 0 0 1014633527 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1740.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1740.01 0 0 1014633534 1407383714 10 Physicians ANTCZAK JUSTYNA 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 604.34 0 0 0 0 0 0 1.91 0 435.51 0 0 0 0 0 0 1041.76 0 0 1014633560 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 908.12 0 0 0 0 0 0 0 0 0 0 0 0 0 908.12 0 0 1014633635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 423.28 0 0 0 0 0 0 0 0 0 0 0 0 0 423.28 0 0 1014633646 1245610500 10 Physicians ROBINSON LAUREN K 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 0 228 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 2880.89 0 0 0 0 0 0 2880.89 0 0 1014633693 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 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0 0 0 0 0 0 0 0 0 0 24526.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24526.37 0 0 1014634197 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11513.31 0 0 0 0 0 0 0 0 0 0 0 0 0 11513.31 0 0 1014634454 1003300625 12 Optometrists PARASHER NAGEENA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 0 112.44 0 58.56 0 0 0 0 171 0 0 1014634512 1841815784 16 Nurse Practitioners TISZA KAYLA M 999999999 63 Macon 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 1630.45 0 0 0 0 0 0 1630.45 0 0 1014634521 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17522.71 0 0 0 0 0 0 0 0 0 0 0 0 0 17522.71 0 0 1014634523 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23923.46 0 0 0 0 0 0 0 0 0 0 0 0 0 23923.46 0 0 1014634616 1417556812 16 Nurse Practitioners FIGUEROA MONICA 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 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 0 0 0 0 0 0 0 0 0 0 1014634733 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25113.35 0 0 0 0 0 0 0 0 0 0 0 0 0 25113.35 0 0 1014634822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28923.98 0 0 0 0 0 0 0 0 0 0 0 0 0 28923.98 0 0 1014634867 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8412.96 0 0 0 0 0 0 0 0 0 0 0 0 0 8412.96 0 0 1014635225 1427589738 89 Physician Assistant Only(Encounter Only) PATEL SACHI 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 0 0 0 0 0 0 0 0 0 0 1014635401 1811527120 16 Nurse Practitioners RADOSEVICH CHRISTINA 999999999 57 Lake 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 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11415.38 0 0 0 0 0 0 11415.38 0 0 1014635442 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3975.54 0 0 0 0 0 0 0 0 0 0 0 0 0 3975.54 0 0 1014635691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6152.7 0 0 0 0 0 0 0 0 0 0 0 0 0 6152.7 0 0 1014635709 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 0 102.57 0 0 0 0 0 0 102.57 0 0 1014635800 1720618457 16 Nurse Practitioners STARMAN LAURA 999999999 10 Adams 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 0 231 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 1353.47 0 0 0 0 0 0 1353.47 0 0 1014635835 1700232634 10 Physicians MOLINA ALBA C 999999999 200 Cook 0 0 Family Practice 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 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 0 810.42 0 0 0 0 0 0 810.42 0 0 1014636015 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 1014636210 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1890.32 0 0 0 0 0 0 0 0 0 0 0 0 0 1890.32 0 0 1014636375 1144751967 10 Physicians ORDING JEFFREY C 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 0 296 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 4717.44 0 0 0 0 0 0 4717.44 0 0 1014636511 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24467.3 0 0 0 0 0 0 0 0 0 0 0 0 0 24467.3 0 0 1014636580 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14068.32 0 0 0 0 0 0 0 0 0 0 0 0 0 14068.32 0 0 1014636669 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1626.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1626.03 0 0 1014636696 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 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 2937.12 2937.12 0 0 1014636900 1073046819 10 Physicians HUSSAIN HASHIM 999999999 24 Coles 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 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 67.29 0 0 0 0 0 0 67.29 0 0 1014637005 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 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 0 533.81 0 0 0 0 0 0 533.81 0 0 1014637007 1164829735 10 Physicians MAHVISH FARHA 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 0 243.94 0 0 0 0 0 0 243.94 0 0 1014637083 1831793850 16 Nurse Practitioners WEYBRIGHT LISA 999999999 80 Peoria 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 61 0 0 0 0 0 0 0 0 0 1 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 1051.07 0 0 0 0 0 0 1051.07 0 0 1014637224 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 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 3557.27 0 0 0 0 0 0 0 0 0 0 0 0 0 3557.27 0 0 1014637225 1558973461 22 Physical Therapists YOGGERST CHARITY E 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 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 0 626.66 626.66 0 0 1014637305 1346888500 36 Community mental health provider ECKER CENTER FOR BEHAVIORAL HE 999999999 53 Kane 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 179.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.62 0 0 349.46 0 0 1014637375 1184258873 11 Dentists PATEL DEWANSI H 999999999 200 Cook 0 0 General Dentistry 0 0 61 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 7671.79 0 0 0 0 0 0 0 0 0 0 0 3010.8 0 0 0 0 10682.59 0 0 1014637395 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 0 0 0 0 0 0 0 0 0 0 1014637413 1144630062 10 Physicians SHEW MATTHEW 999999999 91 Sangamon 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 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 0 247.69 0 0 0 0 0 0 247.69 0 0 1014637646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47100.2 0 0 0 0 0 0 0 0 0 0 0 0 0 47100.2 0 0 1014637703 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 1549.8 0 0 0 0 0 0 0 0 0 0 0 1549.8 0 0 0 0 0 0 3099.6 0 0 1014637715 1770012270 10 Physicians KOROVAICHUK SOPHIA 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 0 225 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 1942.01 0 0 0 0 0 0 1942.01 0 0 1014637813 1164047858 11 Dentists LEE ALEX 999999999 53 Kane 0 0 General Dentistry 0 0 177 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 989 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 989 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 27379.11 0 0 0 0 0 0 0 0 0 0 0 4516.2 0 0 0 0 31895.31 0 0 1014638159 1639786288 16 Nurse Practitioners BERLIN STEPHANIE M 999999999 60 Lee 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 0 150 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 3957.18 0 0 0 0 0 0 3957.18 0 0 1014638241 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7710.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7710.4 0 0 1014638275 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 1014638580 1265060925 16 Nurse Practitioners VEEDER AMANDA 999999999 97 Stephenson 0 0 0 0 0 7 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 453.26 0 0 0 0 0 0 0 0 1420.66 0 0 0 0 0 0 1873.92 0 0 1014638668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4101.68 0 0 0 0 0 0 0 0 0 0 0 0 0 4101.68 0 0 1014638738 1477052751 10 Physicians KWARCIAK MARK 999999999 57 Lake 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4883.95 0 0 0 0 0 0 4883.95 0 0 1014639063 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 0 0 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 19643.17 0 0 0 0 0 0 0 0 0 0 0 0 0 19643.17 0 0 1014639346 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 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 39.19 39.19 0 0 1014639418 1861030215 16 Nurse Practitioners BOUTON AMBER 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 722.99 0 0 0 0 0 0 722.99 0 0 1014639422 1578958096 10 Physicians LAWRENCE AN L 999999999 10 Adams 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 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 0 0 70.55 0 0 0 0 0 0 70.55 0 0 1014639513 1275594954 11 Dentists HUSAIN MEHTAB 999999999 200 Cook 0 0 General Dentistry 0 0 25 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5096.02 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 5848.72 0 0 1014639586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27727.5 0 0 0 0 0 0 0 0 0 0 0 0 0 27727.5 0 0 1014639632 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 0 114.63 0 0 0 0 0 0 114.63 0 0 1014639686 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3312.98 0 0 0 0 0 0 0 0 0 0 0 0 0 3312.98 0 0 1014639777 1639698244 16 Nurse Practitioners BISHOP STEWART 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 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6492.9 0 0 0 0 0 0 6492.9 0 0 1014640130 1770874893 10 Physicians FOX JEREMY L 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 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 8760.85 0 0 0 0 0 0 8760.85 0 0 1014640256 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 0 0 0 0 0 0 0 0 0 0 1014640364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 295.67 0 0 0 0 0 0 0 0 0 0 0 0 0 295.67 0 0 1014640388 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30909.44 0 0 0 0 0 0 0 0 0 0 0 0 0 30909.44 0 0 1014640714 1255938726 16 Nurse Practitioners PRESTIDGE LAURA J 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 12.3 0 0 0 0 0 0 0 0 303.28 0 0 0 0 0 0 315.58 0 0 1014640770 1043208515 89 Physician Assistant Only(Encounter Only) SHELDON MIKAN E 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 0 239.45 0 0 0 0 0 0 239.45 0 0 1014640867 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014641014 16 Nurse Practitioners 81 Perry 0 0 0 0 0 0 0 0 0 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 1014641039 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 0 293 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 19706.94 0 0 0 0 0 0 0 0 0 0 0 0 0 19706.94 0 0 1014641167 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13960.3 0 0 0 0 0 0 0 0 0 0 0 0 0 13960.3 0 0 1014641206 1922342427 16 Nurse Practitioners BUTLER BETHANY A 999999999 47 Jackson 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 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 0 912.16 0 0 0 0 0 0 912.16 0 0 1014641420 1790891711 10 Physicians PREMPEH AVRIL LINDA 60613 200 Cook 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 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 0 0 0 0 0 0 0 0 0 0 1014641537 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 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 0 488.4 0 0 0 0 0 0 0 0 0 0 0 0 0 488.4 0 0 1014641797 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3473.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3473.3 0 0 1014641803 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17178.07 0 0 0 0 0 0 0 0 0 0 0 0 0 17178.07 0 0 1014641841 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23019.92 0 0 0 0 0 0 0 0 0 0 0 0 0 23019.92 0 0 1014641925 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 389.81 0 0 0 0 0 0 0 0 0 0 0 0 0 389.81 0 0 1014641957 1730631029 16 Nurse Practitioners DILLARD KELLY 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 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 0 493.2 0 0 0 0 0 0 493.2 0 0 1014642139 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40984.27 0 0 0 0 0 0 0 0 0 0 0 0 0 40984.27 0 0 1014642157 1538697248 10 Physicians KHAN MIRZA 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 3 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.82 0 2866.08 0 0 0 0 0 0 2873.9 0 0 1014642177 10 Physicians 91 Sangamon 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 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 32.61 0 0 0 0 0 0 32.61 0 0 1014642731 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 64.08 0 0 0 0 0 0 64.08 0 0 1014642824 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4842.19 0 0 0 0 0 0 0 0 0 0 0 0 0 4842.19 0 0 1014642827 1467682690 10 Physicians ROQUE DARIO R 999999999 200 Cook 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 2 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.2 0 39864.08 0 0 0 0 0 0 39869.28 0 0 1014642879 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 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 11.05 0 0 0 0 0 0 11.05 0 0 1014643053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5787.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5787.52 0 0 1014643156 1669026944 89 Physician Assistant Only(Encounter Only) WILCOX AMBER 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 0 102.88 0 0 0 0 0 0 102.88 0 0 1014643253 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16570.93 0 0 0 0 0 0 0 0 0 0 0 0 0 16570.93 0 0 1014643312 1902801871 10 Physicians WALDMAN DOUGLAS 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 466.88 0 0 0 0 0 0 486.88 0 0 1014643390 1972141497 16 Nurse Practitioners TRNKA COLLEEN P 999999999 200 Cook 0 0 0 0 0 18 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1199.48 0 0 0 0 0 0 0 0 938.79 0 0 0 0 0 0 2138.27 0 0 1014643451 1134766132 16 Nurse Practitioners HAWKINS CLARESSA 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 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 1089.07 0 0 0 0 0 0 1089.07 0 0 1014643620 1740660554 10 Physicians LEI DAWN K 999999999 30 DuPage 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.09 0 0 0 0 0 0 129.09 0 0 1014643646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25692.42 0 0 0 0 0 0 0 0 0 0 0 0 0 25692.42 0 0 1014643731 1790238160 16 Nurse Practitioners MOE KALI J 999999999 108 Williamson 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 0 122 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 2869.54 0 0 0 0 0 0 2869.54 0 0 1014643767 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1139.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1139.6 0 0 1014644021 1194360164 27 Behavioral Health Clinic "THE TABOR THERAPY GROUP, INC." 999999999 71 McHenry 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 512 0 0 143.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37805.2 0 0 37948.88 0 0 1014644089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10267.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10267.6 0 0 1014644098 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 0 231 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 23752.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23752.52 0 0 1014644395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 766.7 0 0 0 0 0 0 0 0 0 0 0 0 0 766.7 0 0 1014644469 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.57 0 0 0 0 0 0 0 0 0 0 0 0 0 211.57 0 0 1014644550 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 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 0 783.57 0 0 0 0 0 0 0 0 0 0 0 0 0 783.57 0 0 1014644556 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2560.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2560.55 0 0 1014644605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2444.41 0 0 0 0 0 0 0 0 0 0 0 0 0 2444.41 0 0 1014644718 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2965.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2965.46 0 0 1014645070 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1883.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1883.12 0 0 1014645204 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2197.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2197.19 0 0 1014645271 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4612.1 0 0 0 0 0 0 0 0 0 0 0 0 0 4612.1 0 0 1014645299 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15005.42 0 0 0 0 0 0 0 0 0 0 0 0 0 15005.42 0 0 1014645782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6280.33 0 0 0 0 0 0 0 0 0 0 0 0 0 6280.33 0 0 1014645829 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12369.53 0 0 0 0 0 0 0 0 0 0 0 0 0 12369.53 0 0 1014645941 1528608577 16 Nurse Practitioners TYMANN NICOLE A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4223.36 0 0 0 0 0 0 4223.36 0 0 1014645959 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30841.5 0 0 0 0 0 0 0 0 0 0 0 0 0 30841.5 0 0 1014646008 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3529.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3529.22 0 0 1014646205 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 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 2873.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2873.42 0 0 1014646349 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 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 6886.44 0 0 0 0 0 0 0 0 0 0 0 0 0 6886.44 0 0 1014646376 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 5 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 0 561.92 561.92 0 0 1014646441 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1418.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1418.88 0 0 1014646696 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 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 0 499.1 0 0 0 0 0 0 0 0 0 0 0 0 0 499.1 0 0 1014646897 60 Pharmacies 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201031.19 0 0 0 201031.19 0 0 1014647090 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 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 5249.6 5249.6 0 0 1014647115 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1014647409 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 0 168 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 15276.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15276.8 0 0 1014647600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9592 0 0 0 0 0 0 0 0 0 0 0 0 0 9592 0 0 1014647645 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230.38 0 0 0 0 0 0 230.38 0 0 1014647998 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 84.28 0 0 0 0 0 0 84.28 0 0 1014648013 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 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44916.52 0 0 0 0 0 0 0 0 0 0 0 0 0 44916.52 0 0 1014648061 1700847191 10 Physicians DAVIS DEAN 627025131 91 Sangamon 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 425.17 0 0 0 0 0 0 0 0 634.32 0 0 0 0 0 0 1059.49 0 0 1014648063 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.38 0 0 0 0 0 0 0 0 0 0 0 0 0 98.38 0 0 1014648114 1891327144 75 Department of Alcohol and Substance Abuse Provider NORTH CENTRAL BEHAVIORAL HEALT 999999999 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5857.61 0 0 5857.61 0 0 1014648144 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 640.25 0 0 0 0 0 0 0 0 0 0 0 0 0 640.25 0 0 1014648152 1356897979 55 Early Intervention Services STOITCHKOV ANNA 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 11048.43 0 0 0 0 0 0 11048.43 0 0 1014648155 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3585.43 0 0 0 0 0 0 0 0 0 0 0 0 0 3585.43 0 0 1014648213 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34800.97 0 0 0 0 0 0 0 0 0 0 0 0 0 34800.97 0 0 1014648229 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1031.98 0 0 1014648605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17717.89 0 0 0 0 0 0 0 0 0 0 0 0 0 17717.89 0 0 1014648752 1710596804 86 Clinical Social Worker(Encounter Only) MILES SHANIQUA C 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 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 1014648994 1164019972 16 Nurse Practitioners GRIESBAUM ANDREW R 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 720.42 0 0 0 0 0 0 720.42 0 0 1014649041 1992345342 16 Nurse Practitioners MCLAUGHLIN JENNIFER N 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 287.39 0 0 0 0 0 0 287.39 0 0 1014649069 1801398326 16 Nurse Practitioners MURPHY ANTOINETTE M 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 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 0 869.07 0 0 0 0 0 0 869.07 0 0 1014649078 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 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 0 612.73 612.73 0 0 1014649082 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 731.34 0 0 0 0 0 0 0 0 0 0 0 0 0 731.34 0 0 1014649104 1861918666 86 Clinical Social Worker(Encounter Only) SEUFFERHELD GABRIELA 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 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 1740.42 0 0 0 0 0 0 1740.42 0 0 1014649187 1164053484 16 Nurse Practitioners JOHNSON AMBER 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 0 712.8 0 0 0 0 0 0 712.8 0 0 1014649201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1293.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1293.11 0 0 1014649274 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28848.08 0 0 0 0 0 0 0 0 0 0 0 0 0 28848.08 0 0 1014649322 1497370852 16 Nurse Practitioners BALTUSEVICH ALYSSA R 999999999 91 Sangamon 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 0 685 0 0 0 0 0 0 685 0 0 1014649416 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24086.26 0 0 0 0 0 0 0 0 0 0 0 0 0 24086.26 0 0 1014649498 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16459.08 0 0 0 0 0 0 0 0 0 0 0 0 0 16459.08 0 0 1014649587 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 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 18954 0 0 0 0 0 0 0 0 0 0 0 0 0 18954 0 0 1014649620 1245490382 10 Physicians HAILU TESFU L 999999999 80 Peoria 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 0 183 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 1224.75 0 0 0 0 0 0 0 0 1224.75 0 0 1014649664 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 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 9400.22 0 0 0 0 0 0 0 0 0 0 0 0 0 9400.22 0 0 1014649675 13 Podiatrists 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 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 0 552.34 0 0 0 0 0 0 552.34 0 0 1014649779 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12464.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12464.5 0 0 1014649828 1043820517 16 Nurse Practitioners BABAWALE TAWAKALITU 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 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 0 206.35 0 0 0 0 0 0 206.35 0 0 1014649933 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 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 0 224.17 0 0 0 0 0 0 0 0 0 0 0 0 0 224.17 0 0 1014649953 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16660.22 0 0 0 0 0 0 0 0 0 0 0 0 0 16660.22 0 0 1014649975 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9981.44 0 0 0 0 0 0 0 0 0 0 0 0 0 9981.44 0 0 1014649998 1740817436 89 Physician Assistant Only(Encounter Only) JACOBS EMILY E 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 0 912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 912 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3542.47 0 0 0 0 0 0 3542.47 0 0 1014650091 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 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 1014650198 1962022384 12 Optometrists PATEL KAVITA K 999999999 80 Peoria 0 0 Diagnostic Pharmaceutical Agents 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 0 256 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 6248.04 0 0 0 0 0 0 6248.04 0 0 1014650202 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 505.22 0 0 0 0 0 0 505.22 0 0 1014650248 1073958740 10 Physicians LIU JAMES 999999999 19 Champaign 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 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 3441.22 0 0 0 0 0 0 3441.22 0 0 1014650279 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16172.28 0 0 0 0 0 0 0 0 0 0 0 0 0 16172.28 0 0 1014650286 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 0 163 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 14010.75 0 0 0 0 0 0 0 0 0 0 0 0 0 14010.75 0 0 1014650329 89 Physician Assistant Only(Encounter Only) 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 1014650407 13 Podiatrists 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 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 0 172.71 0 0 0 0 0 0 172.71 0 0 1014650606 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3691.49 0 0 0 0 0 0 0 0 0 0 0 0 0 3691.49 0 0 1014650628 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7906.03 0 0 0 0 0 0 0 0 0 0 0 0 0 7906.03 0 0 1014650660 1912325507 10 Physicians HARANGODY SARAH N 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 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 658.99 0 0 0 0 0 0 658.99 0 0 1014650807 1114541075 89 Physician Assistant Only(Encounter Only) KNAPP KRISTOFFER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.01 0 0 0 0 0 0 0 0 0 0 0 0 0 59.01 0 0 1014651665 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1441.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1441.49 0 0 1014651679 1225644909 16 Nurse Practitioners MODI ROMY 999999999 36 Franklin 0 0 0 0 0 0 0 0 0 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 0 181.7 0 0 0 0 0 0 181.7 0 0 1014651843 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 10020.79 0 0 0 0 0 0 0 0 0 0 0 0 0 10020.79 0 0 1014651939 1215415799 16 Nurse Practitioners SCHMULBACH BREE 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 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 0 245.11 0 0 0 0 0 0 245.11 0 0 1014652003 11 Dentists 91 Sangamon 0 0 General Dentistry 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 0 116.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116.2 0 0 1014652104 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1628 0 0 0 0 0 0 0 0 0 0 0 0 0 1628 0 0 1014652292 1770103681 89 Physician Assistant Only(Encounter Only) BACHMAN JESSICA 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 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 0 394.88 0 0 0 0 0 0 394.88 0 0 1014652318 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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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 1173.52 0 0 0 0 0 0 1173.52 0 0 1014652608 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1014652779 1427648807 16 Nurse Practitioners SINN BRIANNA M 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 0 138 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 2837.4 0 0 0 0 0 0 2837.4 0 0 1014652793 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 1233.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1233.21 0 0 1014652894 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 6695.52 0 0 0 0 0 0 0 0 0 0 0 0 0 6695.52 0 0 1014652949 1710477831 91 Waiver service provider--Adults (DHS/DDD) LEE SENG 999999999 91 Sangamon 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29750.16 0 0 0 0 0 0 0 0 0 0 0 0 0 29750.16 0 0 1014653072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 134.84 0 0 0 0 0 0 0 0 0 0 0 0 0 134.84 0 0 1014653231 1336768662 16 Nurse Practitioners WEILAND JESSICA 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 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 0 405.74 0 0 0 0 0 0 405.74 0 0 1014653326 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19616.8 0 0 0 0 0 0 0 0 0 0 0 0 0 19616.8 0 0 1014653334 55 Early Intervention Services 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 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 0 553.03 0 0 0 0 0 0 553.03 0 0 1014653536 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13962.98 0 0 0 0 0 0 0 0 0 0 0 0 0 13962.98 0 0 1014653540 10 Physicians 24 Coles 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 0 106.95 0 0 0 0 0 0 106.95 0 0 1014653736 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 20235.75 0 0 0 0 0 0 0 0 0 0 0 0 0 20235.75 0 0 1014653754 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 2934.13 0 0 0 0 0 0 0 0 0 0 0 0 0 2934.13 0 0 1014653784 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 0 216 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 14533.55 0 0 0 0 0 0 0 0 0 0 0 0 0 14533.55 0 0 1014653805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9110.11 0 0 0 0 0 0 0 0 0 0 0 0 0 9110.11 0 0 1014653948 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23958.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23958.9 0 0 1014653964 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 0 119 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 9654.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9654.04 0 0 1014654022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18559.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18559.2 0 0 1014654066 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3689.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3689.36 0 0 1014654391 1033695820 10 Physicians PRIMUS JOEL 999999999 10 Adams 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 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 1228.63 0 0 0 0 0 0 1228.63 0 0 1014654413 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22397.67 0 0 0 0 0 0 0 0 0 0 0 0 0 22397.67 0 0 1014654423 16 Nurse Practitioners 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 0 317.72 0 0 0 0 0 0 317.72 0 0 1014654437 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 992.43 0 0 0 0 0 0 0 0 0 0 0 0 0 992.43 0 0 1014654850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27563.84 0 0 0 0 0 0 0 0 0 0 0 0 0 27563.84 0 0 1014654884 1073006805 10 Physicians AHMED MUZAMMAL 999999999 19 Champaign 0 0 Family Practice 0 0 0 3 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 307.21 0 0 0 0 0 0 0 0 820.06 0 0 0 0 0 0 1127.27 0 0 1014654894 1194116319 10 Physicians BANDI RACHEL HECHT 999999999 200 Cook 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 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 1467.01 0 0 0 0 0 0 1467.01 0 0 1014655030 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 0 423.39 0 0 0 0 0 0 0 0 0 0 0 0 0 423.39 0 0 1014655065 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12919.09 0 0 0 0 0 0 0 0 0 0 0 0 0 12919.09 0 0 1014655126 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2467.31 0 0 0 0 0 0 0 0 0 0 0 0 0 2467.31 0 0 1014655309 1144855990 16 Nurse Practitioners ROSALES ALLISON 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 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 0 435.74 0 0 0 0 0 0 435.74 0 0 1014655431 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12678.18 0 0 0 0 0 0 0 0 0 0 0 0 0 12678.18 0 0 1014655450 1588105845 10 Physicians DO JENNIFER L 999999999 200 Cook 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 0 243 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 6805.23 0 0 0 0 0 0 6805.23 0 0 1014655712 1902416134 16 Nurse Practitioners MCKENNA KATHRYN 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 0 186.56 0 0 0 0 0 0 186.56 0 0 1014655807 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1339.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1339.22 0 0 1014655857 4014655857 71 Medicar Provider GOD LOVES ALL TRANSPORTATION 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 12073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12073 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97090.62 0 0 0 0 0 0 97090.62 0 0 1014655926 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 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 73.48 73.48 0 0 1014656258 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 1014656282 10 Physicians 200 Cook 0 0 Neurology 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 48.5 0 0 0 0 0 0 48.5 0 0 1014656329 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10824.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10824.92 0 0 1014656353 1790313674 16 Nurse Practitioners MANUYAG JOLENE K 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 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 0 209.1 0 0 0 0 0 0 209.1 0 0 1014656442 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 4957.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4957.26 0 0 1014656540 1346865805 11 Dentists IBNE-RASA NEHA NOOR 999999999 200 Cook 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 737 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 30413.27 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 33047.72 0 0 1014656577 1700408259 12 Optometrists SOHBATI NEGAR 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 0 104 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 0 973.13 0 0 0 0 0 0 973.13 0 0 1014656612 1689012932 10 Physicians PATEL PRATIK 999999999 80 Peoria 0 0 Emergency 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 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 0 484.55 0 0 0 0 0 0 484.55 0 0 1014656666 1053962340 16 Nurse Practitioners NAVA-LOPEZ FABIOLA 999999999 53 Kane 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 0 467.49 0 0 0 0 0 0 467.49 0 0 1014656774 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 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 0 191.8 0 0 0 0 0 0 0 0 191.8 0 0 1014656818 10 Physicians 91 Sangamon 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 0 213.51 0 0 0 0 0 0 213.51 0 0 1014656838 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 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 1758.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1758.24 0 0 1014656987 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 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 24186.64 0 0 0 0 0 0 0 0 0 0 0 0 0 24186.64 0 0 1014656991 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 0 168 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 9027.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9027.2 0 0 1014657025 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21804.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21804.09 0 0 1014657166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27200.42 0 0 0 0 0 0 0 0 0 0 0 0 0 27200.42 0 0 1014657414 1710329776 10 Physicians KANNAMPUZHA JOVIL 999999999 107 Will 0 0 0 0 0 0 0 0 0 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 42.34 0 0 0 0 0 0 42.34 0 0 1014657426 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22275.43 0 0 0 0 0 0 0 0 0 0 0 0 0 22275.43 0 0 1014657798 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 7310.56 0 0 0 0 0 0 0 0 0 0 0 0 0 7310.56 0 0 1014658158 10 Physicians 200 Cook 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.89 0 0 0 0 0 0 297.89 0 0 1014658244 1184011405 10 Physicians MORALES 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1014659615 1164033494 22 Physical Therapists RICHARDSON STEPHANIE E 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440 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 28740.94 28740.94 0 0 1014659686 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8071.59 0 0 0 0 0 0 0 0 0 0 0 0 0 8071.59 0 0 1014659951 1326099656 10 Physicians LOU LILY 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 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 33618.14 0 0 0 0 0 0 33618.14 0 0 1014660023 1033640206 10 Physicians KELLY MARYANN L 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 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 1004.48 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0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10904.4 0 0 0 0 0 0 0 0 0 0 0 0 0 10904.4 0 0 1014660663 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 0 117 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 9580.69 0 0 0 0 0 0 0 0 0 0 0 0 0 9580.69 0 0 1014660705 1417567546 16 Nurse Practitioners RUSNAK CYNTHIA 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 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 0 169.76 0 0 0 0 0 0 169.76 0 0 1014660757 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 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 0 782.3 0 0 0 0 0 0 782.3 0 0 1014660792 1053739888 10 Physicians DRAGISIC NIKOLA 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 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 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0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.85 0 0 1014663744 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19511.45 0 0 0 0 0 0 0 0 0 0 0 0 0 19511.45 0 0 1014663750 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3051.61 0 0 0 0 0 0 0 0 0 0 0 0 0 3051.61 0 0 1014663830 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 13.63 0 0 0 0 0 0 13.63 0 0 1014663872 1831623636 16 Nurse Practitioners MOONAN SHERI K 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 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 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0 0 0 18018.39 0 0 0 0 0 0 0 0 0 0 0 0 0 18018.39 0 0 1014664531 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10598.28 0 0 0 0 0 0 0 0 0 0 0 0 0 10598.28 0 0 1014664535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 308.9 0 0 0 0 0 0 0 0 0 0 0 0 0 308.9 0 0 1014664594 1235364761 10 Physicians ALDE JONATHAN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 8 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128.16 0 99.2 0 0 0 0 0 0 227.36 0 0 1014664748 1598168676 89 Physician Assistant Only(Encounter Only) CLEVELAND CATHERINE 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 0 193.59 0 0 0 0 0 0 193.59 0 0 1014664840 1164060117 16 Nurse Practitioners TRABA MARIOLA 999999999 200 Cook 0 0 0 0 0 43 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 101 0 0 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 3562.85 0 0 0 0 0 0 0 0 7972.77 0 0 0 0 0 0 11535.62 0 0 1014665008 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 21801.46 0 0 0 0 0 0 0 0 0 0 0 0 0 21801.46 0 0 1014665140 1760892343 10 Physicians NEGEM MATTHEW 999999999 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 57 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1109.86 0 21737.51 0 0 0 0 0 0 22847.37 0 0 1014665200 1831622141 10 Physicians WADUD MOHAMMAD 999999999 200 Cook 0 0 Family Practice 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11269.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11269.78 0 0 1014666240 10 Physicians 109 Winnebago 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 69.17 0 0 0 0 0 0 69.17 0 0 1014666251 1316289077 10 Physicians JAIN TARUN 999999999 54 Kankakee 0 0 Internal Medicine 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 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4453.75 0 0 0 0 0 0 4453.75 0 0 1014666341 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12392.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12392.9 0 0 1014666409 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1782.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1782.2 0 0 1014666444 1487288171 16 Nurse Practitioners LOMELI PAMELA 999999999 91 Sangamon 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 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 0 505.26 0 0 0 0 0 0 505.26 0 0 1014666457 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 4 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 3567.88 3567.88 0 0 1014666469 1780217083 24 Speech Therapists O''BRIEN MAEGAN A 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 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 4109.73 4109.73 0 0 1014666486 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2226.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2226.29 0 0 1014666505 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24466.75 0 0 0 0 0 0 0 0 0 0 0 0 0 24466.75 0 0 1014666593 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 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 1019.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1019.88 0 0 1014666851 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8608.05 0 0 0 0 0 0 0 0 0 0 0 0 0 8608.05 0 0 1014666878 12 Optometrists 200 Cook 0 0 Diagnostic 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.41 0 0 0 0 0 0 62.41 0 0 1014666949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4226.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4226.28 0 0 1014666975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2390.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2390.84 0 0 1014667064 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 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 16042.27 0 0 0 0 0 0 0 0 0 0 0 0 0 16042.27 0 0 1014667235 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 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 3549.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3549.04 0 0 1014667249 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2841.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2841.17 0 0 1014667264 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 5262.17 0 0 0 0 0 0 0 0 0 0 0 0 0 5262.17 0 0 1014667334 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 0 189 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 21542.66 0 0 0 0 0 0 0 0 0 0 0 0 0 21542.66 0 0 1014667418 57 Home Nursing Agency 200 Cook 0 0 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 11116.88 0 0 0 0 0 0 0 0 0 0 0 0 0 11116.88 0 0 1014667697 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7132.28 0 0 0 0 0 0 0 0 0 0 0 0 0 7132.28 0 0 1014668280 1639778160 16 Nurse Practitioners GUNNELS ROXANNA L 999999999 96 St Clair 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 0 248 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 1288.96 0 0 0 0 0 0 1288.96 0 0 1014668449 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29943.8 0 0 0 0 0 0 0 0 0 0 0 0 0 29943.8 0 0 1014668503 1164786497 10 Physicians PATEL VAISHALI 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 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 0 683.44 0 0 0 0 0 0 683.44 0 0 1014668532 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 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 11171.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11171.12 0 0 1014668611 1407444862 22 Physical Therapists STELZER KELLY 999999999 19 Champaign 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 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 0 359.5 359.5 0 0 1014668649 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1445.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1445.12 0 0 1014668729 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11166.68 0 0 0 0 0 0 0 0 0 0 0 0 0 11166.68 0 0 1014668795 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8521.59 0 0 0 0 0 0 0 0 0 0 0 0 0 8521.59 0 0 1014668864 1336167956 10 Physicians WU ALLAN D 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 21 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 0 690.74 0 0 0 0 0 0 690.74 0 0 1014668895 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.59 0 0 0 0 0 0 0 0 0 0 0 0 0 82.59 0 0 1014668939 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325.5 0 0 0 0 0 0 0 0 0 0 0 0 0 325.5 0 0 1014669008 1952367641 10 Physicians GAMBLA MICHAEL T 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 18 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.94 0 4631.34 0 0 0 0 0 0 4651.28 0 0 1014669043 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.16 224.16 0 0 1014669180 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1979.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1979.04 0 0 1014669269 1114331451 10 Physicians SON DANIEL 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 24 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519.98 0 443.36 0 0 0 0 0 0 963.34 0 0 1014669299 1487070538 25 Audiologists PARMLEY COURTNEY 999999999 19 Champaign 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 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 1157.19 1157.19 0 0 1014669426 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1178.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1178.18 0 0 1014669436 1871029280 10 Physicians PANDEY PRATIVA 999999999 47 Jackson 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 0 123 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 0 565.65 0 0 0 0 0 0 565.65 0 0 1014669644 1518981661 10 Physicians GORSUCH-RAFFERTY HEIDI 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 2287.67 0 0 0 0 0 0 2287.67 0 0 1014669729 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1014669739 1427696855 16 Nurse Practitioners DIDIER ANNE 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 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 7079.81 0 0 0 0 0 0 7079.81 0 0 1014669794 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5113.55 0 0 0 0 0 0 0 0 0 0 0 0 0 5113.55 0 0 1014669806 1861048605 16 Nurse Practitioners MEHOCHKO ASHLEY N 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 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 0 114.02 0 0 0 0 0 0 114.02 0 0 1014669827 1992902589 10 Physicians ARSHAD HASSAN 999999999 200 Cook 0 0 Otolaryngology 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 0 112 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 3037.83 0 0 0 0 0 0 3037.83 0 0 1014670068 1760454003 10 Physicians MORGAN ADAM 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 114 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1915.53 0 44.56 0 0 0 0 0 0 1960.09 0 0 1014670086 1336535657 10 Physicians BOLDUAN ALYSSA 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 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 0 777.16 0 0 0 0 0 0 777.16 0 0 1014670157 1639458763 10 Physicians PATEL VATSAL K 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 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 0 766.33 0 0 0 0 0 0 766.33 0 0 1014670188 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3349.17 0 0 0 0 0 0 0 0 0 0 0 0 0 3349.17 0 0 1014670373 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 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 0 233.82 233.82 0 0 1014670422 1932726569 16 Nurse Practitioners MCCOURT KRISTEN 999999999 200 Cook 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 0 242 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 3189.84 0 0 0 0 0 0 3189.84 0 0 1014670476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4768.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4768.03 0 0 1014670517 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1709.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1709.86 0 0 1014670546 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 0 151.88 0 0 0 0 0 0 151.88 0 0 1014670595 1841729852 10 Physicians MINER BRIANNA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 4786.38 0 0 0 0 0 0 4859.78 0 0 1014670605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20836.34 0 0 0 0 0 0 0 0 0 0 0 0 0 20836.34 0 0 1014670628 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14248.86 0 0 0 0 0 0 0 0 0 0 0 0 0 14248.86 0 0 1014670995 1184249179 75 Department of Alcohol and Substance Abuse Provider ECKER CENTER FOR BEHAVIORAL HE 999999999 200 Cook 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 0 412 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 26887.92 0 0 26887.92 0 0 1014671092 89 Physician Assistant Only(Encounter Only) 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 47.62 0 0 0 0 0 0 47.62 0 0 1014671136 87 Psychologist(Encounter Only) 90 Saline 0 0 0 0 0 0 0 0 0 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 0 335.45 0 0 0 0 0 0 335.45 0 0 1014671206 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19509.66 0 0 0 0 0 0 0 0 0 0 0 0 0 19509.66 0 0 1014671319 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 1014671420 1700299815 10 Physicians KYESO YOUSUF 999999999 30 DuPage 0 0 Internal Medicine 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 0 226 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 0 823.82 0 0 0 0 0 0 823.82 0 0 1014671451 1669093225 12 Optometrists BYER MEGAN 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 1061.91 0 0 0 0 0 0 1061.91 0 0 1014671540 10 Physicians 200 Cook 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 1014671546 1508386533 10 Physicians HAQUE SABRINA 999999999 81 Perry 0 0 Family Practice 0 0 0 0 0 0 0 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 0 462.31 0 0 0 0 0 0 462.31 0 0 1014671556 1003426149 16 Nurse Practitioners MCCORMACK JOSEPHINE 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 0 109 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 1053.92 0 0 0 0 0 0 1053.92 0 0 1014671782 1922003193 10 Physicians SANDHU AQEEL 999999999 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 23 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 6251.06 0 0 0 0 0 0 6251.06 0 0 1014671996 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9691.22 0 0 0 0 0 0 0 0 0 0 0 0 0 9691.22 0 0 1014672017 10 Physicians 70 McDonough 0 0 Nuclear 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 0 0 0 0 0 0 0 0 0 0 1014672094 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 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 9328.44 0 0 0 0 0 0 0 0 0 0 0 0 0 9328.44 0 0 1014672116 1194378984 16 Nurse Practitioners MURPHY CARA 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 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 0 538.25 0 0 0 0 0 0 538.25 0 0 1014672544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23924.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23924.25 0 0 1014672549 1104177724 16 Nurse Practitioners CRIPPS 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 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 1088.12 0 0 0 0 0 0 1088.12 0 0 1014672698 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 0 115.83 0 0 0 0 0 0 115.83 0 0 1014672750 1407288244 22 Physical Therapists WALDECKER JESSICA ANNE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 221 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 15991.9 15991.9 0 0 1014672760 1134737026 11 Dentists CALVO HERNANDEZ GELSY 999999999 200 Cook 0 0 General Dentistry 0 0 11 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 2518.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2518.44 0 0 1014672772 1912369257 10 Physicians RIZVI JASON 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3491.41 0 0 0 0 0 0 3491.41 0 0 1014672794 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.45 0 0 0 0 0 0 0 0 0 0 0 0 0 115.45 0 0 1014673050 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.18 0 0 0 0 0 0 0 0 0 0 0 0 0 117.18 0 0 1014673208 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 38 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 4264.14 0 0 0 0 0 4264.14 0 0 1014673342 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.71 0 0 0 0 0 0 0 0 0 0 0 0 0 169.71 0 0 1014673373 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37375.22 0 0 0 0 0 0 0 0 0 0 0 0 0 37375.22 0 0 1014673425 100 Family Support Program 815 Indiana 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7260.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7260.02 0 0 1014673520 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17869.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17869.57 0 0 1014673614 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 0 638 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 48798.9 0 0 0 0 0 0 0 0 0 0 0 0 0 48798.9 0 0 1014673749 1285077966 10 Physicians DROZ NICOLE C 999999999 53 Kane 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 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 0 268.51 0 0 0 0 0 0 268.51 0 0 1014673755 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9741.53 0 0 0 0 0 0 0 0 0 0 0 0 0 9741.53 0 0 1014673972 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 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 0 334.2 0 0 0 0 0 0 334.2 0 0 1014674022 86 Clinical Social Worker(Encounter Only) 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.25 0 0 0 0 0 0 320.25 0 0 1014674182 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1982.43 0 0 1014674209 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14683.95 0 0 0 0 0 0 0 0 0 0 0 0 0 14683.95 0 0 1014674357 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6466.65 0 0 0 0 0 0 0 0 0 0 0 0 0 6466.65 0 0 1014674453 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2740.09 0 0 0 0 0 0 0 0 0 0 0 0 0 2740.09 0 0 1014674492 1407478969 12 Optometrists NGUYEN CHRISTINA K 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 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 1344.46 0 0 0 0 0 0 1344.46 0 0 1014674630 10 Physicians 30 DuPage 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 732.33 0 0 0 0 0 0 732.33 0 0 1014674683 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11916.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11916.96 0 0 1014674704 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20258.64 0 0 0 0 0 0 0 0 0 0 0 0 0 20258.64 0 0 1014674765 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926.54 0 0 0 0 0 0 0 0 0 0 0 0 0 926.54 0 0 1014674784 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20095 0 0 0 0 0 0 0 0 0 0 0 0 0 20095 0 0 1014675067 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23977.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23977.36 0 0 1014675225 1275949489 10 Physicians RAKOCEVIC DANIELA B 999999999 200 Cook 0 0 Psychiatry 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 0 170 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 4154.49 0 0 0 0 0 0 4154.49 0 0 1014675298 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 0 901.2 0 0 0 0 0 0 0 0 0 0 0 0 0 901.2 0 0 1014675335 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7752.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7752.73 0 0 1014675481 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 0 677.87 0 0 0 0 0 0 0 0 0 0 0 0 0 677.87 0 0 1014675513 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2302.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2302.3 0 0 1014675772 1225679699 89 Physician Assistant Only(Encounter Only) COTTON NATALIA 999999999 30 DuPage 0 0 0 0 0 48 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 2847.69 0 0 0 0 0 0 0 0 1464.58 0 0 0 0 0 0 4312.27 0 0 1014675995 1790045417 10 Physicians TESCHKE PATRICIA 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 0 119 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 3085.43 0 0 0 0 0 0 3085.43 0 0 1014676144 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2339.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2339.83 0 0 1014676152 1114563640 16 Nurse Practitioners KIESEWETTER MARY 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 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 1652.22 0 0 0 0 0 0 1652.22 0 0 1014676185 1518377233 10 Physicians MONN MARIA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 16 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 248 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79.3 0 31373.28 0 0 0 0 0 0 31452.58 0 0 1014676404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4896.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4896.39 0 0 1014676691 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.55 0 0 0 0 0 0 0 0 0 0 0 0 0 29.55 0 0 1014676851 1417578980 16 Nurse Practitioners HEISE RACHEL N 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 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 2660.12 0 0 0 0 0 0 2660.12 0 0 1014677135 55 Early Intervention Services 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 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 0 471.68 0 0 0 0 0 0 471.68 0 0 1014677223 1982201638 89 Physician Assistant Only(Encounter Only) BEDOLLA LAURA 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 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 0 337.12 0 0 0 0 0 0 337.12 0 0 1014677305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 617.87 0 0 0 0 0 0 0 0 0 0 0 0 0 617.87 0 0 1014677340 1982003109 16 Nurse Practitioners BRENNAN SHARON 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 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 1014677474 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 493.2 0 0 0 0 0 0 0 0 0 0 0 0 0 493.2 0 0 1014677477 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549.34 0 0 0 0 0 0 0 0 0 0 0 0 0 549.34 0 0 1014677652 1932631041 89 Physician Assistant Only(Encounter Only) SANCHEZ RICHARD G 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 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 25.24 0 0 0 0 0 0 25.24 0 0 1014677660 1609334242 16 Nurse Practitioners MERLO JULIA 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 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 0 810.59 0 0 0 0 0 0 810.59 0 0 1014677799 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2385.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2385.02 0 0 1014677935 1205196961 10 Physicians BURCHHARDT DANIELA 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 2041.79 0 0 0 0 0 0 2041.79 0 0 1014677940 92 Waiver 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Physicians HO DUC 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 0 159 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 2880.44 0 0 0 0 0 0 2880.44 0 0 1014678536 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 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 0 230.6 0 0 0 0 0 0 230.6 0 0 1014678612 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15959.43 0 0 0 0 0 0 0 0 0 0 0 0 0 15959.43 0 0 1014678677 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 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 1980.34 1980.34 0 0 1014678841 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19520.07 0 0 0 0 0 0 0 0 0 0 0 0 0 19520.07 0 0 1014678889 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 3 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 2391.3 2391.3 0 0 1014678897 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 42.14 0 0 0 0 0 0 42.14 0 0 1014678931 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23011.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23011.78 0 0 1014679072 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18601.15 0 0 0 0 0 0 0 0 0 0 0 0 0 18601.15 0 0 1014679149 1710515713 23 Occupational Therapists LEVAN JENIFFER 999999999 200 Cook 0 0 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 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46767.26 46767.26 0 0 1014679281 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12299.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12299.56 0 0 1014679369 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 105.56 0 0 0 0 0 0 105.56 0 0 1014679539 1295197481 10 Physicians TIWARI KANCHAN 999999999 40 Grundy 0 0 Internal Medicine 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 0 322 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 4104.68 0 0 0 0 0 0 4104.68 0 0 1014679739 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.17 0 0 0 0 0 0 165.17 0 0 1014679781 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6506.74 0 0 0 0 0 0 0 0 0 0 0 0 0 6506.74 0 0 1014679808 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15179.1 0 0 0 0 0 0 0 0 0 0 0 0 0 15179.1 0 0 1014679856 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 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 5473.97 0 0 0 0 0 0 0 0 0 0 0 0 0 5473.97 0 0 1014679872 1487194205 16 Nurse Practitioners MARSHALL MICHAEL A 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 200.77 0 0 0 0 0 0 200.77 0 0 1014679932 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3000.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3000.69 0 0 1014680231 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7894.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7894.2 0 0 1014680484 1326638925 16 Nurse Practitioners PATEL BINAKI B 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 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 0 106.16 0 0 0 0 0 0 106.16 0 0 1014680492 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 0 105 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 12122.92 0 0 0 0 0 0 0 0 0 0 0 0 0 12122.92 0 0 1014680598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7434.81 0 0 0 0 0 0 0 0 0 0 0 0 0 7434.81 0 0 1014680613 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 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 4220.48 0 0 0 0 0 0 4220.48 0 0 1014680783 1477180537 91 Waiver service provider--Adults (DHS/DDD) HALILI KIMVERLI ASHLY ADAMOS 999999999 91 Sangamon 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 1151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49035.7 0 0 0 0 0 0 0 0 0 0 0 0 0 49035.7 0 0 1014681043 1144834656 16 Nurse Practitioners TELFER ALANA 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 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 0 426.12 0 0 0 0 0 0 426.12 0 0 1014681513 1265053433 16 Nurse Practitioners NATIONS ADRIENNE M 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 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 0 246.78 0 0 0 0 0 0 246.78 0 0 1014681621 1215477344 10 Physicians SAMI SAJID 999999999 200 Cook 0 0 Family Practice 0 0 0 7 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 142 0 0 0 0 0 0 0 0 0 493.7 0 0 0 0 0 0 0 0 3977.95 0 0 0 0 0 0 4471.65 0 0 1014681675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1167.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1167.46 0 0 1014681687 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 52416.92 0 0 0 0 0 0 0 0 0 0 0 0 0 52416.92 0 0 1014681726 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014681869 1225094683 10 Physicians MANJIKIAN VIKEN 999999999 200 Cook 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 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 0 223.22 0 0 0 0 0 0 0 0 223.22 0 0 1014681914 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14477.96 0 0 0 0 0 0 0 0 0 0 0 0 0 14477.96 0 0 1014682053 1427650464 16 Nurse Practitioners REIDER CRISTAL 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 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 0 449.47 0 0 0 0 0 0 449.47 0 0 1014682362 1235286816 22 Physical Therapists CRANNY CHARLES J 999999999 200 Cook 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 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 0 818.52 818.52 0 0 1014682392 23 Occupational Therapists 65 Madison 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 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 0 575.5 575.5 0 0 1014682410 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14739.48 0 0 0 0 0 0 0 0 0 0 0 0 0 14739.48 0 0 1014682513 1942573803 89 Physician Assistant Only(Encounter Only) PRESSLEY ERIN C 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 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 0 364.95 0 0 0 0 0 0 364.95 0 0 1014682611 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21426.63 0 0 0 0 0 0 0 0 0 0 0 0 0 21426.63 0 0 1014682621 1861097255 16 Nurse Practitioners PIRTLE CORRIE M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 124.61 0 0 0 0 0 0 124.61 0 0 1014682625 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 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0 0 0 0 3988.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3988.1 0 0 1014696004 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5682.44 0 0 0 0 0 0 0 0 0 0 0 0 0 5682.44 0 0 1014696194 1447876503 16 Nurse Practitioners MORRISON JORDAN 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 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.4 0 0 0 0 0 0 81.4 0 0 1014696196 86 Clinical Social Worker(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 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 3164.79 0 0 0 0 0 0 3164.79 0 0 1014696222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37548.9 0 0 0 0 0 0 0 0 0 0 0 0 0 37548.9 0 0 1014696575 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7329.95 0 0 0 0 0 0 0 0 0 0 0 0 0 7329.95 0 0 1014696605 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 15685.61 0 0 0 0 0 0 0 0 0 0 0 0 0 15685.61 0 0 1014696860 1114461282 91 Waiver service provider--Adults (DHS/DDD) TRASATTI CASEY K 627621000 91 Sangamon 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39653.4 0 0 0 0 0 0 0 0 0 0 0 0 0 39653.4 0 0 1014696882 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 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 2292.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2292.52 0 0 1014696944 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 800.75 0 0 0 0 0 0 0 0 0 0 0 0 0 800.75 0 0 1014696955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19675.86 0 0 0 0 0 0 0 0 0 0 0 0 0 19675.86 0 0 1014697125 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18414.36 0 0 0 0 0 0 0 0 0 0 0 0 0 18414.36 0 0 1014697127 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 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 0 128.44 128.44 0 0 1014697197 1265049506 89 Physician Assistant Only(Encounter Only) KAISER MARGARET FRANCES 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 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 0 480.19 0 0 0 0 0 0 480.19 0 0 1014697223 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24607.22 0 0 0 0 0 0 0 0 0 0 0 0 0 24607.22 0 0 1014697234 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 0 0 0 0 0 0 0 0 0 0 1014697240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31759 0 0 0 0 0 0 0 0 0 0 0 0 0 31759 0 0 1014697364 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8289.11 0 0 0 0 0 0 0 0 0 0 0 0 0 8289.11 0 0 1014697408 86 Clinical Social Worker(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 372.04 0 0 0 0 0 0 372.04 0 0 1014697493 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 519.94 0 0 0 0 0 0 0 0 0 0 0 0 0 519.94 0 0 1014697515 14 Chiropractors 89 Rock Island 0 0 0 0 0 0 0 0 0 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 10.39 0 0 0 0 0 0 10.39 0 0 1014697613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20527.91 0 0 0 0 0 0 0 0 0 0 0 0 0 20527.91 0 0 1014697674 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15453.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15453.18 0 0 1014697752 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.54 0 0 0 0 0 0 124.54 0 0 1014697860 1679005730 10 Physicians NIAZI ANUM 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 0 327 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 4687.81 0 0 0 0 0 0 4687.81 0 0 1014698023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2228.07 0 0 0 0 0 0 0 0 0 0 0 0 0 2228.07 0 0 1014698180 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 4 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 4648 4648 0 0 1014698189 1033745427 16 Nurse Practitioners TRNINIC SYLWIA K 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 0 116.71 0 0 0 0 0 0 116.71 0 0 1014698246 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5648.07 0 0 0 0 0 0 0 0 0 0 0 0 0 5648.07 0 0 1014698325 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3539.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3539.5 0 0 1014698495 1275172355 16 Nurse Practitioners WALKER ANNIE 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 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 0 641.9 0 0 0 0 0 0 641.9 0 0 1014698499 1285273144 16 Nurse Practitioners KNOX DANA 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 0 177 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 7477.01 0 0 0 0 0 0 7477.01 0 0 1014698537 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3008.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3008.33 0 0 1014698798 1033645189 10 Physicians SOLEIMANI MINA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 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 0 328.51 0 0 0 0 0 0 328.51 0 0 1014698824 1710194626 10 Physicians VEGA ARTURO 999999999 80 Peoria 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 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 0 872.02 0 0 0 0 0 0 872.02 0 0 1014698966 1144882960 10 Physicians AWAD MICHAEL 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 838.76 0 0 0 0 0 0 838.76 0 0 1014698967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1186.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1186.68 0 0 1014699007 1760827273 10 Physicians PERKINS BLAKE W 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 2 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 0 0 1836.5 0 0 0 0 0 0 1836.5 0 0 1014699194 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 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 6083.13 0 0 0 0 0 0 0 0 0 0 0 0 0 6083.13 0 0 1014699240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4269.38 0 0 0 0 0 0 0 0 0 0 0 0 0 4269.38 0 0 1014699258 1386937944 10 Physicians QUADE ROBERT 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 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 48.4 0 0 0 0 0 0 48.4 0 0 1014699298 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22891.75 0 0 0 0 0 0 0 0 0 0 0 0 0 22891.75 0 0 1014699345 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1164 0 0 0 0 0 0 0 0 0 0 0 0 0 1164 0 0 1014699582 1922699008 11 Dentists BOURAKI KYRIAKI 999999999 200 Cook 0 0 General Dentistry 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8144.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8144.73 0 0 1014699586 1285165795 10 Physicians MARCUS JILL K 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 1073.12 0 0 0 0 0 0 1137.42 0 0 1014699701 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014699768 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8561.29 0 0 0 0 0 0 0 0 0 0 0 0 0 8561.29 0 0 1014699798 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24379.95 0 0 0 0 0 0 0 0 0 0 0 0 0 24379.95 0 0 1014699816 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 26963.42 0 0 0 0 0 0 0 0 0 0 0 0 0 26963.42 0 0 1014700018 11 Dentists 200 Cook 0 0 General Dentistry 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 82.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.5 0 0 1014700171 1043828544 16 Nurse Practitioners JIMENEZ MONA L 999999999 54 Kankakee 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 0 179 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 5915.44 0 0 0 0 0 0 5915.44 0 0 1014700187 1982138988 10 Physicians SRIVANGIPURAM SUDARSANA 999999999 200 Cook 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 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 0 465.31 0 0 0 0 0 0 465.31 0 0 1014700393 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2217.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2217.38 0 0 1014700511 1548899834 16 Nurse Practitioners STEWART KARI A 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 0 357 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 52029.26 0 0 0 0 0 0 52029.26 0 0 1014700539 1689216582 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE DOLTON 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 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 5477.5 0 0 0 0 0 0 5477.5 0 0 1014700896 1104106608 10 Physicians SARANGI SIDDHARTH 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 2996.75 0 0 0 0 0 0 2996.75 0 0 1014701534 1467040311 16 Nurse Practitioners ROBINSON CHEROKEE N 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 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 0 586.28 0 0 0 0 0 0 586.28 0 0 1014701588 1194145433 10 Physicians TU LEIGH-ANNE 999999999 200 Cook 0 0 Orthopedic 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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 1619.39 0 0 0 0 0 0 1619.39 0 0 1014709083 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 0 330 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 27401.6 0 0 0 0 0 0 0 0 0 0 0 0 0 27401.6 0 0 1014709091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1337.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1337.18 0 0 1014709241 1831730092 27 Behavioral Health Clinic MARCFIRST 999999999 72 McLean 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 734 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 734 0 0 589.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53736.11 0 0 54325.23 0 0 1014709361 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4505.73 0 0 0 0 0 0 0 0 0 0 0 0 0 4505.73 0 0 1014709393 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14037.16 0 0 0 0 0 0 0 0 0 0 0 0 0 14037.16 0 0 1014709504 1235763863 16 Nurse Practitioners OGBEIDE ERNEST 999999999 109 Winnebago 0 0 Child/Adolescent Psychiatry Residency 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 0 408 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 2877.9 0 0 0 0 0 0 2877.9 0 0 1014709521 1285928416 10 Physicians AKHTAR 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 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 2292.36 0 0 0 0 0 0 2292.36 0 0 1014709542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8791.81 0 0 0 0 0 0 0 0 0 0 0 0 0 8791.81 0 0 1014709550 1487294468 22 Physical Therapists GARNER MARY E 999999999 49 Jefferson 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 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 0 363.58 363.58 0 0 1014709697 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17900.72 0 0 0 0 0 0 0 0 0 0 0 0 0 17900.72 0 0 1014710089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1369.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1369.63 0 0 1014710162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8162.48 0 0 0 0 0 0 0 0 0 0 0 0 0 8162.48 0 0 1014710266 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33612.97 0 0 0 0 0 0 0 0 0 0 0 0 0 33612.97 0 0 1014710291 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1011.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1011.61 0 0 1014710451 1831392570 86 Clinical Social Worker(Encounter Only) STACHYRA MARANDA A 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 1682.44 0 0 0 0 0 0 1682.44 0 0 1014710465 1962019687 16 Nurse Practitioners RAYBURN HELEN 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 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 1314.47 0 0 0 0 0 0 1314.47 0 0 1014710658 1366806119 10 Physicians CYR ANDREA 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 1197.2 0 0 0 0 0 0 1197.2 0 0 1014710871 1285892950 10 Physicians RAPP CATHERINE M 999999999 200 Cook 0 0 Orthopedic Surgery 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 11 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.02 0 1280.09 0 0 0 0 0 0 1346.11 0 0 1014710875 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 19.56 0 0 0 0 0 0 19.56 0 0 1014711010 1780186148 16 Nurse Practitioners VACCARO ELIZABETH C 999999999 200 Cook 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 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3064.61 0 0 0 0 0 0 3064.61 0 0 1014711112 1780970418 10 Physicians COLEMAN ELISHEVA 999999999 200 Cook 0 0 Neurology 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 0 116 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 1903.11 0 0 0 0 0 0 1903.11 0 0 1014711163 1295230787 10 Physicians BIRKS BRIAN 999999999 53 Kane 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 1958.27 0 0 0 0 0 0 1958.27 0 0 1014711217 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 0 0 0 0 0 0 0 0 0 0 1014711259 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 0 217 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 17956.84 0 0 0 0 0 0 0 0 0 0 0 0 0 17956.84 0 0 1014711616 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13368.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13368.96 0 0 1014711715 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.47 0 0 0 0 0 0 0 0 0 0 0 0 0 552.47 0 0 1014711746 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 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 4540.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4540.59 0 0 1014711814 4014711814 72 Taxicabs and Livery Companies INGODHANDSTRANSPORTATION 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 10952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10952 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63841.5 0 0 0 0 0 0 63841.5 0 0 1014711938 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23354.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23354.6 0 0 1014712160 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 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 39373.89 0 0 0 0 0 0 0 0 0 0 0 0 0 39373.89 0 0 1014712322 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21277.96 0 0 0 0 0 0 0 0 0 0 0 0 0 21277.96 0 0 1014712437 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 112.8 0 0 0 0 0 0 0 0 0 0 0 0 0 112.8 0 0 1014712566 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 1695.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1695.01 0 0 1014712620 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11119.08 0 0 0 0 0 0 0 0 0 0 0 0 0 11119.08 0 0 1014712909 1396761318 10 Physicians PIMLOTT BRYAN 999999999 10 Adams 0 0 Orthopedic Surgery 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 2927.36 0 0 0 0 0 0 2927.36 0 0 1014712940 1366571713 11 Dentists CURRY DAVID E 999999999 28 De Witt 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 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 2884.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2884.73 0 0 1014713025 1619339173 10 Physicians MOHAMMAD TASNIM 999999999 57 Lake 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 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 0 646.51 0 0 0 0 0 0 646.51 0 0 1014713066 1851762397 16 Nurse Practitioners GIBSON AMANDA 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 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 0 650.67 0 0 0 0 0 0 650.67 0 0 1014713300 1659910438 89 Physician Assistant Only(Encounter Only) MCKILLIP ADAM J 999999999 19 Champaign 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 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 2250.2 0 0 0 0 0 0 2250.2 0 0 1014713361 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6145.7 0 0 0 0 0 0 0 0 0 0 0 0 0 6145.7 0 0 1014713579 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 605.03 0 0 0 0 0 0 0 0 0 0 0 0 0 605.03 0 0 1014713636 1679503528 10 Physicians NORTH KAY L 999999999 30 DuPage 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 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 0 427.5 0 0 0 0 0 0 0 0 427.5 0 0 1014713637 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22245.54 0 0 0 0 0 0 0 0 0 0 0 0 0 22245.54 0 0 1014713878 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 0 231.76 0 0 0 0 0 0 231.76 0 0 1014713950 10 Physicians 10 Adams 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 0 117.63 0 0 0 0 0 0 117.63 0 0 1014713992 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20935.82 0 0 0 0 0 0 0 0 0 0 0 0 0 20935.82 0 0 1014714202 1609052240 10 Physicians WINGER DAVID 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 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 1513.3 0 0 0 0 0 0 0 0 1513.3 0 0 1014714254 1548249931 10 Physicians IQBAL MUHAMMAD S 999999999 47 Jackson 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 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 1089.79 0 0 0 0 0 0 1089.79 0 0 1014714403 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9154.13 0 0 0 0 0 0 0 0 0 0 0 0 0 9154.13 0 0 1014714404 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 95.24 0 0 0 0 0 0 95.24 0 0 1014714440 1235379256 10 Physicians KUBAT WADE D 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 1787.35 0 0 0 0 0 0 1787.35 0 0 1014714832 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 0 170 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 12945.92 0 0 0 0 0 0 0 0 0 0 0 0 0 12945.92 0 0 1014714868 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 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 2540.48 2540.48 0 0 1014714894 1184074148 10 Physicians YU ALLISON 999999999 200 Cook 0 0 Anesthesiology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1220 0 0 0 0 0 0 1220 0 0 1014714911 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 109.81 0 0 0 0 0 0 0 0 0 0 0 0 0 109.81 0 0 1014715013 1396132403 10 Physicians CHAN NICHOLAS KARJUN 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 32 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 65.35 0 3976.13 0 0 0 0 0 0 4041.48 0 0 1014715041 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10497.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10497.36 0 0 1014715042 1881129286 10 Physicians PHELPS JOEL M 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014715069 1376065730 10 Physicians KHAN FAREEHA 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 0 206 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 2665.93 0 0 0 0 0 0 2665.93 0 0 1014715116 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 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 2955.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2955.54 0 0 1014715195 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 1014715338 1508482563 16 Nurse Practitioners LEWIS EULA C 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 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 0 317.4 0 0 0 0 0 0 317.4 0 0 1014715339 1457301822 10 Physicians WEINBERG GREGG 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 101 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1419.79 0 21.07 0 0 0 0 0 0 1440.86 0 0 1014715558 89 Physician Assistant Only(Encounter Only) 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589.92 0 0 1014717415 1992920516 16 Nurse Practitioners GROMLEY DEBRA 999999999 72 McLean 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 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 14.6 0 0 0 0 0 0 0 0 765.76 0 0 0 0 0 0 780.36 0 0 1014717526 1730318742 10 Physicians CARANI JESSICA 999999999 19 Champaign 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6275.13 0 0 0 0 0 0 6275.13 0 0 1014717535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4734.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4734.61 0 0 1014717662 1649421371 10 Physicians VAZQUEZ-SANABRIA IRMA L 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 8166.84 0 0 0 0 0 0 8166.84 0 0 1014717682 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20546.03 0 0 0 0 0 0 0 0 0 0 0 0 0 20546.03 0 0 1014717733 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 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 6374.92 0 0 0 0 0 0 0 0 0 0 0 0 0 6374.92 0 0 1014717751 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 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 1014717844 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16355.98 0 0 0 0 0 0 0 0 0 0 0 0 0 16355.98 0 0 1014717903 1306396486 89 Physician Assistant Only(Encounter Only) DAMRON JUSTIN 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 0 341.15 0 0 0 0 0 0 341.15 0 0 1014718007 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16808.18 0 0 0 0 0 0 0 0 0 0 0 0 0 16808.18 0 0 1014718091 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.04 0 0 0 0 0 0 51.04 0 0 1014718158 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1113.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1113.01 0 0 1014718221 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1223.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1223.88 0 0 1014718400 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26175.57 0 0 0 0 0 0 0 0 0 0 0 0 0 26175.57 0 0 1014718446 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 43.54 0 0 0 0 0 0 43.54 0 0 1014718617 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320.15 320.15 0 0 1014718681 92 Waiver service provider--Disability 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0 0 0 0 0 0 1168.66 0 0 1014720331 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 25989.08 0 0 0 0 0 0 0 0 0 0 0 0 0 25989.08 0 0 1014720358 1013263219 10 Physicians MARKOVIC JELENA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 785 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.05 0 13009.78 0 0 0 0 0 0 13152.83 0 0 1014720391 1629567185 87 Psychologist(Encounter Only) LEM STEFANIE A 999999999 54 Kankakee 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 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 1092.41 0 0 0 0 0 0 1092.41 0 0 1014720615 1104076330 10 Physicians KOTINSLEY BENJAMIN 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 317 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 411 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2891.24 0 37.72 0 0 0 0 0 0 2928.96 0 0 1014720662 10 Physicians 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 0 184.2 0 0 0 0 0 0 184.2 0 0 1014720665 1578539367 89 Physician Assistant Only(Encounter Only) LOHMEYER KEVIN J 999999999 81 Perry 0 0 0 0 0 0 0 0 0 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 55.28 0 0 0 0 0 0 55.28 0 0 1014720724 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 46.45 0 0 0 0 0 0 46.45 0 0 1014720933 1396363776 22 Physical Therapists NAUMAN REBECCA 999999999 109 Winnebago 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 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 0 619.76 619.76 0 0 1014721022 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20.86 0 0 1014721056 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15958.47 0 0 0 0 0 0 0 0 0 0 0 0 0 15958.47 0 0 1014721153 1437759545 16 Nurse Practitioners RUTTER MICHELLE 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 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 1222.16 0 0 0 0 0 0 1222.16 0 0 1014721210 1790072130 10 Physicians NGUYEN DENNIS 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 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 2365.4 0 0 0 0 0 0 2365.4 0 0 1014721294 1912058561 10 Physicians PATEL VIMAL 999999999 63 Macon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 18 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379.04 0 94.19 0 0 0 0 0 0 473.23 0 0 1014721571 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 31.01 0 0 0 0 0 0 31.01 0 0 1014721633 1861945057 16 Nurse Practitioners NGOBI SUSAN 999999999 30 DuPage 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 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 424.88 0 0 0 0 0 0 431.28 0 0 1014721661 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5689.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5689.25 0 0 1014721969 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 582.53 0 0 0 0 0 0 0 0 0 0 0 0 0 582.53 0 0 1014722533 1750822250 10 Physicians KADAKIA SUHAGI 999999999 200 Cook 0 0 Pediatrics 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 0 211 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 35866.2 0 0 0 0 0 0 35866.2 0 0 1014722560 1316550171 16 Nurse Practitioners SODERSTRUM MADISON 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 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 2577.3 0 0 0 0 0 0 2577.3 0 0 1014722578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2874.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2874.95 0 0 1014722853 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 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 1014722877 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25152.87 0 0 0 0 0 0 0 0 0 0 0 0 0 25152.87 0 0 1014723015 1801438700 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE SPRING VALLEY 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 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 3641 0 0 0 0 0 0 3641 0 0 1014723172 1417328584 89 Physician Assistant Only(Encounter Only) SHAFRAN ALLISON 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 27.96 0 0 0 0 0 0 27.96 0 0 1014723242 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 67.04 0 0 0 0 0 0 67.04 0 0 1014723478 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 11924.02 0 0 0 0 0 0 0 0 0 0 0 0 0 11924.02 0 0 1014723551 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 20466.57 0 0 0 0 0 0 0 0 0 0 0 0 0 20466.57 0 0 1014723555 1851316954 10 Physicians MAUNG TONY 999999999 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 87 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 25078.28 0 0 0 0 0 0 0 0 0 0 0 0 0 25078.28 0 0 1014723873 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 553.52 0 0 0 0 0 0 0 0 0 0 0 0 0 553.52 0 0 1014723890 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.51 0 0 0 0 0 0 0 0 0 0 0 0 0 134.51 0 0 1014723901 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 0 170.31 0 0 0 0 0 0 170.31 0 0 1014724160 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 0 0 0 0 0 0 0 0 0 0 1014724396 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17993.38 0 0 0 0 0 0 0 0 0 0 0 0 0 17993.38 0 0 1014724486 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 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 498 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28644 0 0 0 0 0 0 0 0 0 0 0 0 0 28644 0 0 1014724663 1699193268 10 Physicians ETHEZAZ MAHVEEN 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 0 441 0 0 0 0 0 0 441 0 0 1014724792 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014724855 1265026538 16 Nurse Practitioners WEBER EMILY L 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 2301.17 0 0 0 0 0 0 2301.17 0 0 1014724856 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 3577.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3577.47 0 0 1014724929 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 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 5.93 0 0 0 0 0 0 5.93 0 0 1014724997 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 0 0 0 0 0 0 0 0 0 0 0 23410.64 0 0 1014725111 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18794.95 0 0 0 0 0 0 0 0 0 0 0 0 0 18794.95 0 0 1014725671 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 1014725873 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 0 126 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 25020.1 0 0 0 0 0 0 0 0 0 0 0 0 0 25020.1 0 0 1014726003 1467064154 16 Nurse Practitioners OYESIKU IMUENTIYAN 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 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 0 263.47 0 0 0 0 0 0 263.47 0 0 1014726009 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3766.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3766.07 0 0 1014726564 1225674914 16 Nurse Practitioners IHEANYICHUKWU QUINETTE I 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 0 211 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 12033.36 0 0 0 0 0 0 12033.36 0 0 1014726693 1073812715 10 Physicians HARRISON ANDREW 999999999 10 Adams 0 0 Radiology Diagnosis 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 0 115 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1548.67 0 13.49 0 0 0 0 0 0 1562.16 0 0 1014726937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10500.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10500.6 0 0 1014726984 1497119382 10 Physicians MANCY HAMZA F 999999999 19 Champaign 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 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 0 345.13 0 0 0 0 0 0 345.13 0 0 1014727027 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 1014727268 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 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 0 540.99 0 0 0 0 0 0 540.99 0 0 1014727478 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2180.11 0 0 0 0 0 0 0 0 0 0 0 0 0 2180.11 0 0 1014727527 10 Physicians 88 Richland 0 0 0 0 0 0 0 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 8.01 0 0 0 0 0 0 0 0 8.01 0 0 1014727609 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 9626.77 0 0 0 0 0 0 0 0 0 0 0 0 0 9626.77 0 0 1014727690 1861614810 12 Optometrists LYSTON KEITH 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 735.29 0 732 0 0 0 0 1467.29 0 0 1014727693 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15249.79 0 0 0 0 0 0 0 0 0 0 0 0 0 15249.79 0 0 1014727736 1972990265 10 Physicians KHERA SATINDERPAL 999999999 200 Cook 0 0 Radiology Diagnosis 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 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 0 414.5 0 0 0 0 0 0 0 0 414.5 0 0 1014727844 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 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 0 293.04 0 0 0 0 0 0 0 0 0 0 0 0 0 293.04 0 0 1014727904 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166.1 0 0 0 0 0 0 166.1 0 0 1014728153 16 Nurse Practitioners 81 Perry 0 0 0 0 0 0 0 0 0 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 39.86 0 0 0 0 0 0 39.86 0 0 1014728171 10 Physicians 101 Wabash 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 327.4 0 0 0 0 0 0 327.4 0 0 1014728216 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17043.18 0 0 0 0 0 0 0 0 0 0 0 0 0 17043.18 0 0 1014728380 1861923732 10 Physicians PABBA SWATHI 999999999 200 Cook 0 0 Emergency 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 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8418.92 0 0 0 0 0 0 8418.92 0 0 1014728410 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13833.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13833.9 0 0 1014728415 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21774.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21774.5 0 0 1014728476 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 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 88.29 0 0 0 0 0 0 88.29 0 0 1014728478 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20991.81 0 0 0 0 0 0 0 0 0 0 0 0 0 20991.81 0 0 1014728600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11765.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11765.34 0 0 1014728646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2614.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2614.98 0 0 1014728666 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 203.2 0 0 0 0 0 0 203.2 0 0 1014728728 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22293.74 0 0 0 0 0 0 0 0 0 0 0 0 0 22293.74 0 0 1014728740 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18626.45 0 0 0 0 0 0 0 0 0 0 0 0 0 18626.45 0 0 1014728744 1265831192 86 Clinical Social Worker(Encounter Only) WILCOX CHARLES C 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 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 3065.61 0 0 0 0 0 0 3065.61 0 0 1014728759 1629395199 10 Physicians PALARCZYK JENNIFER L 999999999 80 Peoria 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 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 1691.21 0 0 0 0 0 0 1691.21 0 0 1014728906 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 0 163 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 17264.39 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.39 0 0 1014729036 1740713007 10 Physicians KHAN SABRINA 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 12 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 202.9 0 1165.01 0 0 0 0 0 0 1367.91 0 0 1014729243 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 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 1014729284 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16420.31 0 0 0 0 0 0 0 0 0 0 0 0 0 16420.31 0 0 1014729358 1245691179 10 Physicians WAHOOD RAMA 999999999 200 Cook 0 0 0 0 0 14 0 0 0 0 0 0 5 0 54 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 5 0 75 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 5 0 75 0 0 0 0 0 0 0 0 0 603.84 0 0 0 0 0 0 44.19 0 2056.91 0 0 0 0 0 0 2704.94 0 0 1014729427 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 508.97 0 0 0 0 0 0 0 0 0 0 0 0 0 508.97 0 0 1014729442 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10580.75 0 0 0 0 0 0 0 0 0 0 0 0 0 10580.75 0 0 1014729476 1003270257 10 Physicians MBAKOP CORINNE 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 0 153 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 0 939.41 0 0 0 0 0 0 939.41 0 0 1014729599 1568097541 16 Nurse Practitioners HALICI ALTAN 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 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 0 383.53 0 0 0 0 0 0 383.53 0 0 1014729609 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9378.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9378.08 0 0 1014729622 1336568237 10 Physicians TARAZI CHRISTINA 999999999 200 Cook 0 0 Pediatrics 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 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.6 0 1519.04 0 0 0 0 0 0 1610.64 0 0 1014729654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16209.31 0 0 0 0 0 0 0 0 0 0 0 0 0 16209.31 0 0 1014730211 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 17948.43 0 0 0 0 0 0 0 0 0 0 0 0 0 17948.43 0 0 1014730239 1700303054 10 Physicians YOUSSEF AHMED M 999999999 108 Williamson 0 0 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 83 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 4897.19 0 0 0 0 0 0 4981.81 0 0 1014730451 1376920538 10 Physicians KIRSCH JORDAN M 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 2513.11 0 0 0 0 0 0 2513.11 0 0 1014730530 1720378003 10 Physicians KHAN OMAR 999999999 30 DuPage 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 0 467.04 0 0 0 0 0 0 0 0 467.04 0 0 1014730551 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28063.18 0 0 0 0 0 0 0 0 0 0 0 0 0 28063.18 0 0 1014730563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96.89 0 0 0 0 0 0 0 0 0 0 0 0 0 96.89 0 0 1014730571 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1837.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1837.11 0 0 1014730960 1881798387 22 Physical Therapists BONDOC DINAH 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 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 0 236.44 236.44 0 0 1014731190 1184266090 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE MASCOUTAH 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 12743.5 0 0 0 0 0 0 12743.5 0 0 1014731460 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24793.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24793.57 0 0 1014731590 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.97 0 0 0 0 0 0 0 0 0 0 0 0 0 266.97 0 0 1014731654 1154792059 10 Physicians ALBETAR RAMI 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 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 1710.7 0 0 0 0 0 0 1710.7 0 0 1014731663 10 Physicians 815 Indiana 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 81.22 0 0 0 0 0 0 81.22 0 0 1014731707 1164955746 13 Podiatrists STACK REBECCA 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 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 78.96 0 0 0 0 0 0 78.96 0 0 1014731768 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18011 0 0 0 0 0 0 0 0 0 0 0 0 0 18011 0 0 1014731818 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14929.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14929.6 0 0 1014731919 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 8942.64 0 0 0 0 0 0 0 0 0 0 0 0 0 8942.64 0 0 1014731955 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 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 3216.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3216.59 0 0 1014732044 1053773879 10 Physicians LEWANDOWSKI JOHN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.69 0 0 0 0 0 0 215.69 0 0 1014732109 1073153110 11 Dentists SHAH NOOPUR 999999999 96 St Clair 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 5236.42 0 0 0 0 0 0 0 0 0 0 0 2258.1 0 0 0 0 7494.52 0 0 1014732140 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 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 2232.81 0 0 0 0 0 0 2232.81 0 0 1014732221 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 49135.35 0 0 0 0 0 0 0 0 0 0 0 0 0 49135.35 0 0 1014732480 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 0 122.8 0 0 0 0 0 0 122.8 0 0 1014732560 1699392001 91 Waiver service provider--Adults (DHS/DDD) LARSON MELISSA 999999999 107 Will 0 0 0 0 0 0 0 13 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 8379.67 0 0 0 0 0 0 0 0 0 0 0 0 0 8379.67 0 0 1014732625 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16492 0 0 0 0 0 0 0 0 0 0 0 0 0 16492 0 0 1014732630 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8518.51 0 0 0 0 0 0 0 0 0 0 0 0 0 8518.51 0 0 1014732767 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4855.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4855.37 0 0 1014732899 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8329.86 0 0 0 0 0 0 0 0 0 0 0 0 0 8329.86 0 0 1014733077 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21211.6 0 0 0 0 0 0 0 0 0 0 0 0 0 21211.6 0 0 1014733169 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11059.2 0 0 0 0 0 0 0 0 0 0 0 0 0 11059.2 0 0 1014733177 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 35.24 0 0 0 0 0 0 35.24 0 0 1014733179 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 18445 0 0 0 0 0 0 0 0 0 0 0 0 0 18445 0 0 1014733276 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 20029.01 0 0 0 0 0 0 0 0 0 0 0 0 0 20029.01 0 0 1014733458 1245845031 16 Nurse Practitioners TUCKER AUSTIN 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 1028.33 0 0 0 0 0 0 1028.33 0 0 1014733459 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 0 436.32 0 0 0 0 0 0 0 0 0 0 0 0 0 436.32 0 0 1014733532 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 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 1014733562 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 0 0 0 0 0 0 0 0 0 0 1014733603 1912546326 16 Nurse Practitioners WASSELL CHRIS 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 771.28 0 0 0 0 0 0 771.28 0 0 1014733790 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10901.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10901.88 0 0 1014733810 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8592.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8592.65 0 0 1014734009 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4649.16 0 0 0 0 0 0 0 0 0 0 0 0 0 4649.16 0 0 1014734028 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11952.85 0 0 0 0 0 0 0 0 0 0 0 0 0 11952.85 0 0 1014734264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7041.22 0 0 0 0 0 0 0 0 0 0 0 0 0 7041.22 0 0 1014734277 1477196723 16 Nurse Practitioners SAUNDERS DANELLE 999999999 106 Whiteside 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 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 0 556.66 0 0 0 0 0 0 556.66 0 0 1014734432 1124651492 16 Nurse Practitioners CORBETT JACQUELINE HARRINGTON 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 0 156.86 0 0 0 0 0 0 156.86 0 0 1014734633 10 Physicians 47 Jackson 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.55 0 0 0 0 0 0 16.55 0 0 1014734781 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2454.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2454.36 0 0 1014734860 1174142111 89 Physician Assistant Only(Encounter Only) ELLEFSON SUMMER 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 23.37 0 0 0 0 0 0 23.37 0 0 1014734867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3774 0 0 0 0 0 0 0 0 0 0 0 0 0 3774 0 0 1014734934 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 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 1014735023 10 Physicians 89 Rock Island 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 9.71 0 0 0 0 0 0 9.71 0 0 1014735086 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8003.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8003.65 0 0 1014735276 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 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1014735305 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 0 130 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 15851.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15851.8 0 0 1014735403 1942826540 16 Nurse Practitioners OLDANI JOSEPH MICHAEL LOGAN 999999999 79 Ogle 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2442.86 0 0 0 0 0 0 2442.86 0 0 1014735405 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 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 9116.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9116.8 0 0 1014735407 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 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 0 0 0 0 0 0 0 0 0 0 0 0 3737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284629.16 0 0 0 0 0 0 0 0 0 0 0 0 0 284629.16 0 0 1014735827 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 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 80.46 80.46 0 0 1014735879 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 1014736066 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 83.7 0 0 0 0 0 0 83.7 0 0 1014736127 1336472083 16 Nurse Practitioners RHODES JEFFREY 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 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 0 268.52 0 0 0 0 0 0 268.52 0 0 1014736190 1710912399 10 Physicians GRIFFITH MARK N 999999999 19 Champaign 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 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 0 444.13 0 0 0 0 0 0 444.13 0 0 1014736292 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1691.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1691.93 0 0 1014736417 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1526.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1526.79 0 0 1014736526 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 62.74 0 0 0 0 0 0 62.74 0 0 1014736581 1932768025 16 Nurse Practitioners PATEL ARPITA 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 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 0 370.41 0 0 0 0 0 0 370.41 0 0 1014736684 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.34 0 0 0 0 0 0 94.34 0 0 1014736882 1174524474 10 Physicians PINNEY SEAN 999999999 30 DuPage 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 0 164 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 1854.26 0 0 0 0 0 0 1854.26 0 0 1014737049 1073149092 89 Physician Assistant Only(Encounter Only) KINNEY TERRA M 999999999 19 Champaign 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 0 102 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 2602.66 0 0 0 0 0 0 2609.06 0 0 1014737170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40608.47 0 0 0 0 0 0 0 0 0 0 0 0 0 40608.47 0 0 1014737258 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6827.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6827.09 0 0 1014737692 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21758.22 0 0 0 0 0 0 0 0 0 0 0 0 0 21758.22 0 0 1014737718 10 Physicians 80 Peoria 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 1014737733 4014737733 90 Waiver service provider--Elderly (DOA) ZIING ELDERLY CARE 999999999 200 Cook 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50881.74 0 0 0 0 0 0 0 0 0 0 0 0 0 50881.74 0 0 1014737775 1417913583 33 Nursing Facilities SULLIVAN REHAB HEALTH CC 619519490 78 Moultrie 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463760.65 0 0 0 0 0 0 0 463760.65 0 0 1014737978 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4258.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4258.02 0 0 1014738037 1336792738 16 Nurse Practitioners GUIAB KARLA 999999999 200 Cook 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 0 588 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 1361.69 0 0 0 0 0 0 1361.69 0 0 1014738050 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12243.07 0 0 0 0 0 0 0 0 0 0 0 0 0 12243.07 0 0 1014738116 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.83 0 0 0 0 0 0 76.83 0 0 1014738134 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6907.57 0 0 0 0 0 0 0 0 0 0 0 0 0 6907.57 0 0 1014738224 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 57.16 0 0 0 0 0 0 57.16 0 0 1014738247 89 Physician Assistant Only(Encounter Only) 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.85 0 0 0 0 0 0 23.85 0 0 1014738304 1881223998 16 Nurse Practitioners MIGLIARESE JACLYN 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 0 458.28 0 0 0 0 0 0 458.28 0 0 1014738316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10385.45 0 0 0 0 0 0 0 0 0 0 0 0 0 10385.45 0 0 1014738351 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 897.16 0 0 0 0 0 0 0 0 0 0 0 0 0 897.16 0 0 1014738581 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21191.79 0 0 0 0 0 0 0 0 0 0 0 0 0 21191.79 0 0 1014738636 1295700912 10 Physicians CHURCH ANN K 999999999 45 Henry 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 58 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3077.4 0 5678.11 0 0 0 0 0 0 8755.51 0 0 1014738667 1245723121 10 Physicians WALSH THOMAS 999999999 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 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 0 138.85 0 0 0 0 0 0 138.85 0 0 1014738826 16 Nurse Practitioners 108 Williamson 0 0 0 0 0 0 0 0 0 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 32.75 0 0 0 0 0 0 32.75 0 0 1014738832 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 0 153.12 0 0 0 0 0 0 153.12 0 0 1014738847 1245659069 10 Physicians FUNK AUGUST 999999999 19 Champaign 0 0 Orthopedic Surgery 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 0 104 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 21396.67 0 0 0 0 0 0 21396.67 0 0 1014738972 1447884630 28 Waiver service provider--Supportive living facility (HFS) CEDARHURST OF QUINCY 999999999 10 Adams 0 0 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 0 806 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97193.56 0 0 0 0 0 0 0 0 0 0 0 0 0 97193.56 0 0 1014739115 1710513221 10 Physicians REYNOLDS LUKE F 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 23 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.33 0 6554.66 0 0 0 0 0 0 6678.99 0 0 1014739211 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13854.77 0 0 0 0 0 0 0 0 0 0 0 0 0 13854.77 0 0 1014739212 1407388473 10 Physicians JAKVANI BAQIR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 23 0 0 0 0 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 0 127.02 0 702.65 0 0 0 0 0 0 829.67 0 0 1014739347 10 Physicians 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.69 0 21.07 0 0 0 0 0 0 143.76 0 0 1014739499 1992336903 22 Physical Therapists REID TUCKER 999999999 89 Rock Island 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 0 115 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 4629.88 4629.88 0 0 1014739527 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 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 4206.57 0 0 0 0 0 0 0 0 0 0 0 0 0 4206.57 0 0 1014739547 1972120913 11 Dentists YOON HONG KEUN 999999999 63 Macon 0 0 General Dentistry 0 0 321 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 1894 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 1894 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 52200.72 0 0 0 0 0 0 0 0 0 0 0 7903.35 0 0 0 0 60104.07 0 0 1014739823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7137.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7137.19 0 0 1014740000 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 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 4902.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4902.02 0 0 1014740069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7223.33 0 0 0 0 0 0 0 0 0 0 0 0 0 7223.33 0 0 1014740137 1245720846 16 Nurse Practitioners STROPE KATHRYN 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 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 0 131.96 0 0 0 0 0 0 131.96 0 0 1014740162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30040.03 0 0 0 0 0 0 0 0 0 0 0 0 0 30040.03 0 0 1014740297 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17155.45 0 0 0 0 0 0 0 0 0 0 0 0 0 17155.45 0 0 1014740300 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38151.55 0 0 0 0 0 0 0 0 0 0 0 0 0 38151.55 0 0 1014740635 1760995138 16 Nurse Practitioners HAUFLAIRE BLAIR J 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 0 326.6 0 0 0 0 0 0 326.6 0 0 1014740661 55 Early Intervention Services 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 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 1811.49 0 0 0 0 0 0 1811.49 0 0 1014740786 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 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 0 788.04 0 0 0 0 0 0 0 0 0 0 0 0 0 788.04 0 0 1014740789 1629677117 16 Nurse Practitioners ROLLINGS SHELBY 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 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 15.71 0 0 0 0 0 0 15.71 0 0 1014741095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3275.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3275.59 0 0 1014741209 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17007.31 0 0 0 0 0 0 0 0 0 0 0 0 0 17007.31 0 0 1014741232 11 Dentists 200 Cook 0 0 Maxillofacial Surgery 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.73 0 0 1014741286 1306004676 10 Physicians STEWART KURTIS 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 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 0 365.4 0 0 0 0 0 0 365.4 0 0 1014741403 1255965414 89 Physician Assistant Only(Encounter Only) BURKERT ALYSSA R 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 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 0 0 0 0 0 0 0 0 0 0 1014741512 1316599525 11 Dentists AOUN ALI 999999999 30 DuPage 0 0 General Dentistry 0 0 28 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 6535.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6535.58 0 0 1014741532 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7104.99 0 0 0 0 0 0 0 0 0 0 0 0 0 7104.99 0 0 1014741772 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 16878.74 0 0 0 0 0 0 0 0 0 0 0 0 0 16878.74 0 0 1014741792 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 0 161.42 0 0 0 0 0 0 161.42 0 0 1014741888 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1809.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1809.81 0 0 1014741981 1891314118 11 Dentists KO HARAM 999999999 200 Cook 0 0 General Dentistry 0 0 195 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 1049 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 33751.84 0 0 0 0 0 0 0 0 0 0 0 9408.75 0 0 0 0 43160.59 0 0 1014741983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16291.17 0 0 0 0 0 0 0 0 0 0 0 0 0 16291.17 0 0 1014742025 1619516556 11 Dentists PERALTA LUIS 999999999 200 Cook 0 0 General Dentistry 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1389.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1389.02 0 0 1014742035 1902290091 10 Physicians CHHABRA PANKAJ 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 132 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2571.72 0 235.98 0 0 0 0 0 0 2807.7 0 0 1014742261 10 Physicians 91 Sangamon 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 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 1014742355 1427439934 10 Physicians SAMORE WESLY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 203 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.6 3059.97 0 0 0 0 0 0 0 0 3082.57 0 0 1014742409 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 0 376.8 0 0 0 0 0 0 376.8 0 0 1014742436 1336249614 33 Nursing Facilities EFFINGHAM REHAB AND HEALTH CC 624011866 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 1416 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131995.16 0 0 0 0 0 0 0 131995.16 0 0 1014742471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4338.42 0 0 0 0 0 0 0 0 0 0 0 0 0 4338.42 0 0 1014742486 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11319.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11319.12 0 0 1014742639 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4726.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4726.85 0 0 1014742646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4954.17 0 0 0 0 0 0 0 0 0 0 0 0 0 4954.17 0 0 1014742774 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 0 0 0 0 1014742864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3009.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3009.25 0 0 1014743020 1164023644 16 Nurse Practitioners EAGAN KELLI 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 49.22 0 0 0 0 0 0 49.22 0 0 1014743250 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12668.84 0 0 0 0 0 0 0 0 0 0 0 0 0 12668.84 0 0 1014743271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30019.5 0 0 0 0 0 0 0 0 0 0 0 0 0 30019.5 0 0 1014743288 1609229277 12 Optometrists QUAN ADRIENNE C 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 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 0 313.06 0 0 0 0 0 0 313.06 0 0 1014743336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5942.14 0 0 0 0 0 0 0 0 0 0 0 0 0 5942.14 0 0 1014743394 1104269307 10 Physicians SINGER TISHA 999999999 107 Will 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 457 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3835.43 0 557.39 0 0 0 0 0 0 4392.82 0 0 1014743409 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1281.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1281.47 0 0 1014743460 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11319.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11319.52 0 0 1014743653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22406.55 0 0 0 0 0 0 0 0 0 0 0 0 0 22406.55 0 0 1014743734 1447871959 12 Optometrists COHEN KELLY A 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 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 1337.3 0 0 0 0 0 0 1337.3 0 0 1014743884 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25941.39 0 0 0 0 0 0 0 0 0 0 0 0 0 25941.39 0 0 1014743963 1174766653 33 Nursing Facilities PLEASANT VIEW REHAB AND HCC 612703004 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117649.42 0 0 0 0 0 0 0 117649.42 0 0 1014744128 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25759.03 0 0 0 0 0 0 0 0 0 0 0 0 0 25759.03 0 0 1014744279 1720626781 23 Occupational Therapists THIELMANN ALYSSA R 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 0 178 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 12893.69 12893.69 0 0 1014744414 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 0 148.18 0 0 0 0 0 0 148.18 0 0 1014744485 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1050.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1050.01 0 0 1014744531 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2717.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2717.14 0 0 1014744620 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9149.36 0 0 0 0 0 0 0 0 0 0 0 0 0 9149.36 0 0 1014744646 1821531682 33 Nursing Facilities RIVERSIDE REHAB & HEALTHCARE 999999999 65 Madison 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 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5555 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459677.48 0 0 0 0 0 0 0 459677.48 0 0 1014744782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19536.05 0 0 0 0 0 0 0 0 0 0 0 0 0 19536.05 0 0 1014744994 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8700.23 0 0 0 0 0 0 0 0 0 0 0 0 0 8700.23 0 0 1014745073 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2615.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2615.55 0 0 1014745361 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 73.15 0 0 0 0 0 0 0 0 0 0 0 0 0 73.15 0 0 1014745421 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14609.47 0 0 0 0 0 0 0 0 0 0 0 0 0 14609.47 0 0 1014745612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19942.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19942.3 0 0 1014745751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12937.75 0 0 0 0 0 0 0 0 0 0 0 0 0 12937.75 0 0 1014745957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1495.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1495.9 0 0 1014745973 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 0 214 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 11804.64 0 0 0 0 0 0 0 0 0 0 0 0 0 11804.64 0 0 1014746176 1235592270 10 Physicians GADDIS PRECIOUS M 999999999 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 25 0 39 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 38 0 78 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 38 0 78 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 2320.06 0 6850.85 0 0 0 0 0 0 9183.71 0 0 1014746340 1356631444 10 Physicians ORSCHELN EMILY SUZANNE 999999999 92 Schuyler 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1 0 0 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 20 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.25 0 8.81 0 0 0 0 0 0 320.06 0 0 1014746454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247.86 0 0 0 0 0 0 0 0 0 0 0 0 0 247.86 0 0 1014746616 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264.82 0 0 0 0 0 0 0 0 0 0 0 0 0 264.82 0 0 1014746716 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3837.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3837.77 0 0 1014746770 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.48 0 0 0 0 0 0 14.48 0 0 1014746851 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 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 8510.75 0 0 0 0 0 0 0 0 0 0 0 0 0 8510.75 0 0 1014746884 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15873 0 0 0 0 0 0 0 0 0 0 0 0 0 15873 0 0 1014746951 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17533.56 0 0 0 0 0 0 0 0 0 0 0 0 0 17533.56 0 0 1014747195 1518311919 10 Physicians NAGARAJAN PRIYA VEDA 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 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 0 901.62 0 0 0 0 0 0 901.62 0 0 1014747212 1477151702 33 Nursing Facilities ARCADIA CARE CLIFTON 999999999 46 Iroquois 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 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3535 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291763.31 0 0 0 0 0 0 0 291763.31 0 0 1014747293 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5967.5 0 0 0 0 0 0 0 0 0 0 0 0 0 5967.5 0 0 1014747336 22 Physical Therapists 109 Winnebago 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 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 85.93 85.93 0 0 1014747346 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 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 1014747731 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 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 0 0 0 0 0 0 0 0 0 0 1014747826 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25612.48 0 0 0 0 0 0 0 0 0 0 0 0 0 25612.48 0 0 1014747853 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8948.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8948.73 0 0 1014747943 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 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 0 620.48 0 0 0 0 0 0 0 0 0 0 0 0 0 620.48 0 0 1014748070 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4461.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4461.64 0 0 1014748160 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85.26 0 0 0 0 0 0 0 0 0 0 0 0 0 85.26 0 0 1014748275 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 0 277.01 277.01 0 0 1014748278 1902938673 10 Physicians DIANATI RITA 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 1014748307 1437546256 10 Physicians FRANASIAK RYAN 999999999 200 Cook 0 0 Emergency 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 0 119 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 3639.76 0 0 0 0 0 0 3639.76 0 0 1014748390 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.11 14.11 0 0 1014748471 10 Physicians 10 Adams 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 1014749041 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2975.68 0 0 0 0 0 0 0 0 0 0 0 0 0 2975.68 0 0 1014749063 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9010.6 0 0 0 0 0 0 0 0 0 0 0 0 0 9010.6 0 0 1014749144 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 1014749204 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8456.63 0 0 0 0 0 0 0 0 0 0 0 0 0 8456.63 0 0 1014749216 1568876407 10 Physicians PARDINAS GUTIERREZ MIGUEL A 999999999 10 Adams 0 0 Internal Medicine 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1586.21 0 0 0 0 0 0 1586.21 0 0 1014749233 1306946033 10 Physicians KOH DANIEL Y 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 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 31.01 0 0 0 0 0 0 31.01 0 0 1014749439 10 Physicians 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1014749490 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 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 9081.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9081.34 0 0 1014749614 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 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 16720.48 0 0 0 0 0 0 0 0 0 0 0 0 0 16720.48 0 0 1014749663 1245821941 16 Nurse Practitioners THOMPSON TYLER 999999999 27 Dekalb 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 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 1418.91 0 0 0 0 0 0 1418.91 0 0 1014749846 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 0 222 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 46860.27 0 0 0 0 0 0 0 0 0 0 0 0 0 46860.27 0 0 1014749854 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14846.02 0 0 0 0 0 0 0 0 0 0 0 0 0 14846.02 0 0 1014749890 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21261.68 0 0 0 0 0 0 0 0 0 0 0 0 0 21261.68 0 0 1014749931 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12466.43 0 0 0 0 0 0 0 0 0 0 0 0 0 12466.43 0 0 1014749944 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8204.39 0 0 0 0 0 0 0 0 0 0 0 0 0 8204.39 0 0 1014750116 1043856867 16 Nurse Practitioners STUEDEMANN TAELOR A 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 357.46 0 0 0 0 0 0 357.46 0 0 1014750220 1023379369 10 Physicians JUNGE TRAVIS J 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 378.17 0 0 0 0 0 0 378.17 0 0 1014750281 1831798933 16 Nurse Practitioners SIMON ROBIN E 999999999 91 Sangamon 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 0 141 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 0 991.78 0 0 0 0 0 0 991.78 0 0 1014750310 1710320114 10 Physicians FLYNN MEGAN 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 932.21 0 0 0 0 0 0 932.21 0 0 1014750626 10 Physicians 19 Champaign 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 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 1314.39 0 0 0 0 0 0 1314.39 0 0 1014750690 4014750690 72 Taxicabs and Livery Companies AATOM MEDICAL TRANSPORTATION 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 0 173 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 1294.17 0 0 0 0 0 0 1294.17 0 0 1014751032 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8693.21 0 0 0 0 0 0 0 0 0 0 0 0 0 8693.21 0 0 1014751113 1053842443 10 Physicians STACK KAROLINA 999999999 200 Cook 0 0 0 0 0 7 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1 0 27 0 0 0 0 0 0 0 0 0 806.8 0 0 0 0 0 0 71.86 0 1562.54 0 0 0 0 0 0 2441.2 0 0 1014751153 1760889182 10 Physicians FONSECA FUENTES XAVIER E 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 0 150 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 2783.05 0 0 0 0 0 0 2783.05 0 0 1014751252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7329.11 0 0 0 0 0 0 0 0 0 0 0 0 0 7329.11 0 0 1014751383 1609284355 16 Nurse Practitioners PIERJOK TRELANE E 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 148.79 0 0 0 0 0 0 148.79 0 0 1014751446 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.48 0 0 0 0 0 0 153.48 0 0 1014751519 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014751537 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.7 0 0 0 0 0 0 194.7 0 0 1014751566 1558715508 10 Physicians HOU EILEEN 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 36 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1070.13 0 8954.94 0 0 0 0 0 0 10025.07 0 0 1014751595 1518516749 23 Occupational Therapists FIORITO KYLE J 999999999 91 Sangamon 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829.94 829.94 0 0 1014751645 1275832024 10 Physicians DIETCH ZACHARY C 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 0 137 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 0 839.96 0 0 0 0 0 0 839.96 0 0 1014751711 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 0 100 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 15363.6 0 0 0 0 0 0 0 0 0 0 0 0 0 15363.6 0 0 1014751876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26403.99 0 0 0 0 0 0 0 0 0 0 0 0 0 26403.99 0 0 1014752056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1214.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1214.3 0 0 1014752066 1760897086 10 Physicians ZAHEER FATIMA N 999999999 30 DuPage 0 0 Pediatrics 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 8487.61 0 0 0 0 0 0 8487.61 0 0 1014752171 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19637.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19637.91 0 0 1014752191 1356961908 89 Physician Assistant Only(Encounter Only) BROUGH JESSICA L 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 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 0 235.88 0 0 0 0 0 0 235.88 0 0 1014752232 1821416165 10 Physicians PEREZ-TAMAYO ALEJANDRA 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 3 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.96 0 23074.65 0 0 0 0 0 0 23131.61 0 0 1014752521 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 0 132.5 0 0 0 0 0 0 0 0 132.5 0 0 1014752606 1447884788 16 Nurse Practitioners SANCHEZ MARICSA 999999999 108 Williamson 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 97 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 97 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 2680.09 0 0 0 0 0 0 2712.24 0 0 1014752779 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 516.22 0 0 0 0 0 0 0 0 0 0 0 0 0 516.22 0 0 1014752865 1568971505 10 Physicians BHAVSAR JAY A 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514.48 0 0 0 0 0 0 514.48 0 0 1014752891 1659574127 10 Physicians KINSEY RICHARD SHAWN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 48 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1572.44 0 1275 0 0 0 0 0 0 2847.44 0 0 1014752922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7988.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7988.97 0 0 1014752933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31785.86 0 0 0 0 0 0 0 0 0 0 0 0 0 31785.86 0 0 1014752997 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25169.56 0 0 0 0 0 0 0 0 0 0 0 0 0 25169.56 0 0 1014753027 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2971.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2971.78 0 0 1014753139 1043850472 16 Nurse Practitioners SOHN DIANA 999999999 200 Cook 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 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 1685.79 0 0 0 0 0 0 1685.79 0 0 1014753502 1881208478 11 Dentists GANGAJI POORNIMA 999999999 30 DuPage 0 0 0 0 17 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 2791.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2791.27 0 0 1014753622 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7264.83 0 0 0 0 0 0 0 0 0 0 0 0 0 7264.83 0 0 1014753650 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19340.64 0 0 0 0 0 0 0 0 0 0 0 0 0 19340.64 0 0 1014753803 1730282690 10 Physicians STAAT BARTON C 999999999 25 Crawford 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 23 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277.56 0 114.71 0 0 0 0 0 0 392.27 0 0 1014753841 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5776.44 0 0 0 0 0 0 0 0 0 0 0 0 0 5776.44 0 0 1014754083 1730612797 10 Physicians BEHNKE NATALIE 999999999 200 Cook 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 0 248 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 7201.49 0 0 0 0 0 0 7201.49 0 0 1014754135 1700236635 10 Physicians HARRIS ALEXANDER A 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 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 0 467.74 0 0 1014754175 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22739.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22739.42 0 0 1014754202 1962030635 16 Nurse Practitioners SCHAEFER MORGAN 999999999 80 Peoria 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 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 1655.97 0 0 0 0 0 0 1655.97 0 0 1014754320 10 Physicians 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014754363 1417574054 16 Nurse Practitioners CLEMANS KATHRYN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 577.19 0 0 0 0 0 0 577.19 0 0 1014754533 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1506.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1506.4 0 0 1014754547 1568626794 10 Physicians WALKER ROBERT N 999999999 24 Coles 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 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 0 702.95 0 0 0 0 0 0 0 0 702.95 0 0 1014754576 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 0 0 0 0 0 0 0 0 0 0 1014754766 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 5451.89 0 0 0 0 0 0 0 0 0 0 0 0 0 5451.89 0 0 1014754831 1356799787 10 Physicians HASE TRAVIS L 999999999 200 Cook 0 0 Emergency 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 0 121 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 4955.2 0 0 0 0 0 0 4955.2 0 0 1014754857 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3354.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3354.01 0 0 1014754900 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1946.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1946.31 0 0 1014754921 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 34.5 0 0 0 0 0 0 34.5 0 0 1014754949 1760964522 22 Physical Therapists CHASE BRIANNE 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545.02 545.02 0 0 1014754967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1497.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1497.21 0 0 1014754971 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12899.52 0 0 0 0 0 0 0 0 0 0 0 0 0 12899.52 0 0 1014754998 1952648412 22 Physical Therapists PAWLIKOWSKI EDYTA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 404.82 404.82 0 0 1014755085 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 0 280.34 0 0 0 0 0 0 280.34 0 0 1014755118 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4086.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4086.25 0 0 1014755198 1023520707 23 Occupational Therapists JAMES TABATHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 732.61 732.61 0 0 1014755664 1467847251 10 Physicians ADNEY SCOTT K 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 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 1014755874 86 Clinical Social Worker(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 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 4723.45 0 0 0 0 0 0 4723.45 0 0 1014755944 1124438643 10 Physicians PATEL GAYATRI BHAKTI 999999999 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604.66 0 0 0 0 0 0 604.66 0 0 1014755947 1659561835 10 Physicians KUCHLE NICHOLAS C 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 0 595.73 0 0 0 0 0 0 595.73 0 0 1014755949 1588270797 16 Nurse Practitioners HUMMEL TIFFANY L 999999999 60 Lee 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 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 0 589.78 0 0 0 0 0 0 589.78 0 0 1014756241 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 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 0 103.92 103.92 0 0 1014756326 1033548383 10 Physicians ABAZA YASMIN 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 0 323 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 43435.82 0 0 0 0 0 0 43435.82 0 0 1014756784 1164875118 16 Nurse Practitioners SIMMS DAWN L 999999999 107 Will 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 503.36 0 0 0 0 0 0 503.36 0 0 1014756885 1124502224 16 Nurse Practitioners VANDERMEER DAWN 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 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 1919.9 0 0 0 0 0 0 1919.9 0 0 1014757008 1699015461 10 Physicians SHAH HARITA 999999999 30 DuPage 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 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 0 972.63 0 0 0 0 0 0 972.63 0 0 1014757092 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20896.89 0 0 0 0 0 0 0 0 0 0 0 0 0 20896.89 0 0 1014757192 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 0 229.68 0 0 0 0 0 0 229.68 0 0 1014757242 92 Waiver service 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543.04 0 0 0 0 0 0 0 0 0 0 0 0 0 543.04 0 0 1014759224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13175.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13175.05 0 0 1014759268 10 Physicians 98 Tazewell 0 0 0 0 0 0 0 0 0 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 0 329.16 0 0 0 0 0 0 329.16 0 0 1014759438 1669733945 10 Physicians SEDIGHI MANESH REZA 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 0 116 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 1057.83 0 0 0 0 0 0 1057.83 0 0 1014759485 1205370269 33 Nursing Facilities RIVER CROSSING OF ST CHARLES 999999999 53 Kane 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 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5466 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8927.22 0 0 0 0 0 0 0 0 0 0 0 0 0 8927.22 0 0 1014762693 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 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 0 129.8 129.8 0 0 1014762724 1740837848 12 Optometrists BRAET ALEXANDRA M 999999999 56 Knox 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6627.22 0 2137.44 0 0 0 0 8764.66 0 0 1014762849 10 Physicians 47 Jackson 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 820.02 0 0 0 0 0 0 820.02 0 0 1014762858 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 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 0 195.9 195.9 0 0 1014763082 1003445099 16 Nurse Practitioners LAM TIMTIM 999999999 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399.83 0 0 0 0 0 0 399.83 0 0 1014763095 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 33.19 0 0 0 0 0 0 33.19 0 0 1014763241 1780065078 10 Physicians THANG LOC 999999999 80 Peoria 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 790.58 0 0 0 0 0 0 790.58 0 0 1014763299 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 301.95 0 0 0 0 0 0 0 0 0 0 0 0 0 301.95 0 0 1014763627 1578085700 10 Physicians ACHEBE IFEOMA N 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 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 0 627.16 0 0 0 0 0 0 627.16 0 0 1014763678 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 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 0 288.98 0 0 0 0 0 0 288.98 0 0 1014763926 1487034674 10 Physicians CHAKOS DANIEL 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 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 0 642.83 0 0 0 0 0 0 642.83 0 0 1014764083 10 Physicians 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 7047.06 0 0 1014764385 1215553896 70 Ambulance Service Providers "LIFENET, INC" 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 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 19740 0 0 0 0 0 0 19740 0 0 1014764534 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2908.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2908.38 0 0 1014764653 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13506.31 0 0 0 0 0 0 0 0 0 0 0 0 0 13506.31 0 0 1014764696 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 0 125.48 0 0 0 0 0 0 125.48 0 0 1014764787 10 Physicians 200 Cook 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 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 1282.46 0 0 0 0 0 0 1282.46 0 0 1014764821 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3876.66 0 0 0 0 0 0 0 0 0 0 0 0 0 3876.66 0 0 1014764832 1053626705 10 Physicians OSHOGWEMOH ISMAIL 999999999 19 Champaign 0 0 Obstetric-Gynecology 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 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 5734.44 0 0 0 0 0 0 5734.44 0 0 1014764928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2015.21 0 0 0 0 0 0 0 0 0 0 0 0 0 2015.21 0 0 1014765008 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 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 0 0 0 0 0 0 0 0 0 0 1014765078 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 2287.77 0 0 0 0 0 0 2287.77 0 0 1014765109 1720328842 10 Physicians JUNAID FAROOQ 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3875.41 0 0 0 0 0 0 3875.41 0 0 1014765123 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.08 0 0 0 0 0 0 59.08 0 0 1014765234 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 19.59 0 0 0 0 0 0 19.59 0 0 1014765395 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 445.15 0 0 0 0 0 0 445.15 0 0 1014765565 1962035089 16 Nurse Practitioners WHITE MELISSA 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 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 1014765636 1720531718 10 Physicians CHAWLA LAVNEET K 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4353.8 0 0 0 0 0 0 4353.8 0 0 1014765731 1184811135 10 Physicians KOCHAR SANDEEP 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 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 7.32 0 0 0 0 0 0 7.32 0 0 1014765855 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 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 1014765883 1467890145 10 Physicians AKOH CRAIG CHIKE 999999999 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 44 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.97 0 4193.55 0 0 0 0 0 0 5319.52 0 0 1014766164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4088.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4088.8 0 0 1014766362 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 1014766541 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 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 2894.62 0 0 0 0 0 0 2894.62 0 0 1014766595 1760001606 89 Physician Assistant Only(Encounter Only) PELSI NINA M 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 0 0 0 0 0 0 0 0 0 0 1014766661 13 Podiatrists 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 0 133 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 60.92 0 0 0 0 0 0 60.92 0 0 1014766669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 801.79 0 0 0 0 0 0 0 0 0 0 0 0 0 801.79 0 0 1014766704 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 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 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 10416.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10416.76 0 0 1014767426 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14188.58 0 0 0 0 0 0 0 0 0 0 0 0 0 14188.58 0 0 1014767460 1497355838 16 Nurse Practitioners ZAMORA ESMERALDA 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 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 0 497.59 0 0 0 0 0 0 497.59 0 0 1014767529 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19770.66 0 0 0 0 0 0 0 0 0 0 0 0 0 19770.66 0 0 1014767659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9065 0 0 0 0 0 0 0 0 0 0 0 0 0 9065 0 0 1014767685 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29492.87 0 0 0 0 0 0 0 0 0 0 0 0 0 29492.87 0 0 1014767771 1881945558 89 Physician Assistant Only(Encounter Only) JENSON MALLORY R 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 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 0 873.73 0 0 0 0 0 0 873.73 0 0 1014767900 1801201025 10 Physicians PAUL PRITIKANTA 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12454.5 0 0 0 0 0 0 12454.5 0 0 1014767973 1477973113 10 Physicians HWANG CHRISTOPHER K 999999999 200 Cook 0 0 Ophthalmology 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.82 0 2649.15 0 0 0 0 0 0 2658.97 0 0 1014768210 1316533177 16 Nurse Practitioners LEBAR BECKY S 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 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 2139.02 0 0 0 0 0 0 2139.02 0 0 1014768213 1508347451 60 Pharmacies EXACT CARE PHARMACY 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 9519 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4839.84 0 0 0 4839.84 0 0 1014768284 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32932.51 0 0 0 0 0 0 0 0 0 0 0 0 0 32932.51 0 0 1014768326 1518564194 16 Nurse Practitioners CERQUA SAMANTHA L 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 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 4231.98 0 0 0 0 0 0 4231.98 0 0 1014768933 1568852994 10 Physicians CHADHA ANGAD A 999999999 30 DuPage 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 0 156 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 2735.73 0 0 0 0 0 0 2735.73 0 0 1014768997 1174010441 10 Physicians ASGHAR MONEEB M 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 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 0 780.03 0 0 0 0 0 0 780.03 0 0 1014769009 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014769013 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 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 4401.73 0 0 0 0 0 0 0 0 0 0 0 0 0 4401.73 0 0 1014769057 1134658263 10 Physicians BERTUCCI NICHOLAS 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 157 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.4 0 3969.54 0 0 0 0 0 0 3976.94 0 0 1014769067 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1743.06 0 0 0 0 0 0 0 0 0 0 0 0 0 1743.06 0 0 1014769082 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1014769083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15280.62 0 0 0 0 0 0 0 0 0 0 0 0 0 15280.62 0 0 1014769094 1952832834 10 Physicians SHENOY TARA J 999999999 30 DuPage 0 0 0 0 0 82 0 0 0 0 0 0 42 0 103 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 50 0 143 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 50 0 143 0 0 0 0 0 0 0 0 0 6975.1 0 0 0 0 0 0 1212.48 0 6482.06 0 0 0 0 0 0 14669.64 0 0 1014769270 1760793293 10 Physicians ABDELSATTAR ZAID 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 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 67.22 0 0 0 0 0 0 67.22 0 0 1014769273 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 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 1516.92 1516.92 0 0 1014769339 1710593124 86 Clinical Social Worker(Encounter Only) LEEZER ANDREA N 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2502.81 0 0 0 0 0 0 2502.81 0 0 1014769638 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 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 1267.19 0 0 0 0 0 0 1267.19 0 0 1014769696 1437682382 10 Physicians MEHTA MIKE 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 813.54 0 0 0 0 0 0 813.54 0 0 1014769771 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 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 1014769777 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15184.35 0 0 0 0 0 0 0 0 0 0 0 0 0 15184.35 0 0 1014769904 86 Clinical Social Worker(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 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 89.51 0 0 0 0 0 0 89.51 0 0 1014769921 86 Clinical Social Worker(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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014769950 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1014769994 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8820.08 0 0 0 0 0 0 0 0 0 0 0 0 0 8820.08 0 0 1014770038 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12434.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12434.1 0 0 1014770184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19336.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19336.38 0 0 1014770301 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 1014770419 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 0 237 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 15037.61 0 0 0 0 0 0 0 0 0 0 0 0 0 15037.61 0 0 1014770455 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 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 45.07 0 0 0 0 0 0 45.07 0 0 1014770551 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12499.03 0 0 0 0 0 0 0 0 0 0 0 0 0 12499.03 0 0 1014770623 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10590 0 0 0 0 0 0 0 0 0 0 0 0 0 10590 0 0 1014770640 1528580065 16 Nurse Practitioners DUGAN KELLY 999999999 96 St Clair 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 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3651.8 0 0 0 0 0 0 3651.8 0 0 1014770915 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4239.62 0 0 0 0 0 0 0 0 0 0 0 0 0 4239.62 0 0 1014770969 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8577.56 0 0 0 0 0 0 0 0 0 0 0 0 0 8577.56 0 0 1014771060 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 0 726.64 0 0 0 0 0 0 0 0 0 0 0 0 0 726.64 0 0 1014771105 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 57953.68 0 0 0 0 0 0 0 0 0 0 0 0 0 57953.68 0 0 1014771340 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12933.37 0 0 0 0 0 0 0 0 0 0 0 0 0 12933.37 0 0 1014771373 1952714032 10 Physicians WEINBERG FRANK 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 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 2369.85 0 0 0 0 0 0 2369.85 0 0 1014771783 1619210242 10 Physicians LEE ESTHER 999999999 200 Cook 0 0 Pediatrics 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 0 230 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 36888.5 0 0 0 0 0 0 36888.5 0 0 1014771856 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.14 0 0 0 0 0 0 100.14 0 0 1014771979 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10403.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10403.56 0 0 1014772270 1326683236 16 Nurse Practitioners BRENNAN BRITTANY B 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 0 386.8 0 0 0 0 0 0 386.8 0 0 1014772279 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 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 14288.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14288.41 0 0 1014772310 1134767759 16 Nurse Practitioners MONGOUM PENE JUDITH 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 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 0 158.32 0 0 0 0 0 0 158.32 0 0 1014772414 1730130683 33 Nursing Facilities ALEDO REHAB HEALTH CARE CTR 612312707 74 Mercer 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1871 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165174.62 0 0 0 0 0 0 0 165174.62 0 0 1014772569 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6400.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6400.98 0 0 1014772646 1609405695 22 Physical Therapists SHARMA GARIMA 999999999 200 Cook 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 0 534 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 4463.24 4463.24 0 0 1014772727 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33929.23 0 0 0 0 0 0 0 0 0 0 0 0 0 33929.23 0 0 1014772810 1649728627 89 Physician Assistant Only(Encounter Only) PALM JACQUELINE 999999999 200 Cook 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 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 1394.97 0 0 0 0 0 0 1394.97 0 0 1014772874 1164470779 10 Physicians MCDONALD MEGAN E 999999999 53 Kane 0 0 Radiation Oncology 0 0 0 0 0 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 0 200.27 0 0 0 0 0 0 0 0 200.27 0 0 1014773105 1952749426 10 Physicians SIDDIQI NYAL 999999999 200 Cook 0 0 Internal Medicine 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 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7586.77 0 0 0 0 0 0 7586.77 0 0 1014773153 1467081919 12 Optometrists JAKUPOVIC AMELA 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 0 251.64 0 0 0 0 0 0 251.64 0 0 1014773176 1679182273 87 Psychologist(Encounter Only) GONZALEZ EMMANUEL 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 0 160 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 0 853.63 0 0 0 0 0 0 853.63 0 0 1014773320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 55999.21 0 0 0 0 0 0 0 0 0 0 0 0 0 55999.21 0 0 1014773357 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13611.32 0 0 0 0 0 0 0 0 0 0 0 0 0 13611.32 0 0 1014773510 1770042111 46 Ambulatory Surgical Treatment Centers OFALLON SURGICAL CENTER LLC 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 1014773575 1114535184 11 Dentists ROGERS TAYLOR 999999999 200 Cook 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1228.19 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 1980.89 0 0 1014773706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20472.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20472.5 0 0 1014773822 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20195.34 0 0 0 0 0 0 0 0 0 0 0 0 0 20195.34 0 0 1014773948 1669431748 10 Physicians PEER PETER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 447 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2949.8 0 165.21 0 0 0 0 0 0 3115.01 0 0 1014773989 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22107.95 0 0 0 0 0 0 0 0 0 0 0 0 0 22107.95 0 0 1014774025 1922286962 10 Physicians GARCIA TOMAS VICENTE A 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 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 1552.33 0 0 0 0 0 0 1552.33 0 0 1014774234 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31571.86 0 0 0 0 0 0 0 0 0 0 0 0 0 31571.86 0 0 1014774240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7251.44 0 0 0 0 0 0 0 0 0 0 0 0 0 7251.44 0 0 1014774484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 878.33 0 0 0 0 0 0 0 0 0 0 0 0 0 878.33 0 0 1014774740 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 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 6603 0 0 0 0 0 0 0 0 0 0 0 0 0 6603 0 0 1014774864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2100.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2100.95 0 0 1014774971 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25435.32 0 0 0 0 0 0 0 0 0 0 0 0 0 25435.32 0 0 1014775209 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4300.41 0 0 0 0 0 0 0 0 0 0 0 0 0 4300.41 0 0 1014775217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 427.25 0 0 0 0 0 0 0 0 0 0 0 0 0 427.25 0 0 1014775333 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 35 0 0 1014775410 1629496203 10 Physicians DAVIS ELISSA S 999999999 200 Cook 0 0 Orthopedic Surgery 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 88 0 0 0 0 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 0 0 2749.24 0 0 0 0 0 0 2749.24 0 0 1014775436 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1309.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.72 0 0 1014775586 89 Physician Assistant Only(Encounter Only) 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1014775681 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3298.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3298.35 0 0 1014775685 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.01 36.01 0 0 1014775713 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.4 0 0 0 0 0 0 207.4 0 0 1014775941 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24173.61 0 0 0 0 0 0 0 0 0 0 0 0 0 24173.61 0 0 1014776095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5770.55 0 0 0 0 0 0 0 0 0 0 0 0 0 5770.55 0 0 1014776150 1073763017 10 Physicians TOLEDO FRANCO LINA M 999999999 200 Cook 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1014776546 1194882514 10 Physicians VALERI ANDREA D 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 3 0 0 0 0 0 0 27 0 44 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 51 0 85 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 51 0 85 0 0 0 0 0 0 0 0 0 209.43 0 0 0 0 0 0 91.18 0 5115.65 0 0 0 0 0 0 5416.26 0 0 1014776554 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19243.56 0 0 0 0 0 0 0 0 0 0 0 0 0 19243.56 0 0 1014776564 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18472.79 0 0 0 0 0 0 0 0 0 0 0 0 0 18472.79 0 0 1014776740 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8623.03 0 0 0 0 0 0 0 0 0 0 0 0 0 8623.03 0 0 1014776784 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23173.9 0 0 0 0 0 0 0 0 0 0 0 0 0 23173.9 0 0 1014776901 1578094710 10 Physicians CHAN LUCAS 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 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 1200.72 0 0 0 0 0 0 1200.72 0 0 1014776926 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11825.91 0 0 0 0 0 0 0 0 0 0 0 0 0 11825.91 0 0 1014776927 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 3510.42 0 0 0 0 0 0 0 0 0 0 0 0 0 3510.42 0 0 1014777005 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 0 277 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 15049.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15049.52 0 0 1014777011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5720.84 0 0 0 0 0 0 0 0 0 0 0 0 0 5720.84 0 0 1014777227 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13060.56 0 0 0 0 0 0 0 0 0 0 0 0 0 13060.56 0 0 1014777266 1245865104 16 Nurse Practitioners TAPIA MICHAEL R 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 363.67 0 0 0 0 0 0 363.67 0 0 1014777493 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11379.72 0 0 0 0 0 0 0 0 0 0 0 0 0 11379.72 0 0 1014777745 1114549755 16 Nurse Practitioners BORDEIANU MARIA 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 0 0 0 0 0 0 0 0 0 0 0 1103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24699.35 0 0 0 0 0 0 24699.35 0 0 1014777864 1487150389 10 Physicians YASIN OWAIS 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 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 0 985.33 0 0 0 0 0 0 985.33 0 0 1014777967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22670.57 0 0 0 0 0 0 0 0 0 0 0 0 0 22670.57 0 0 1014778418 1508499047 16 Nurse Practitioners KLEINMAN SARAH L 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 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 0 798.08 0 0 0 0 0 0 798.08 0 0 1014778436 16 Nurse Practitioners 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 0 116.32 0 0 0 0 0 0 116.32 0 0 1014778802 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 638.63 0 0 0 0 0 0 0 0 0 0 0 0 0 638.63 0 0 1014778831 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 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 37213.43 0 0 0 0 0 0 0 0 0 0 0 0 0 37213.43 0 0 1014778886 1073151882 89 Physician Assistant Only(Encounter Only) ANDERSON BROOK MARIE 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 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 0 159.75 0 0 0 0 0 0 159.75 0 0 1014778932 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4033.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4033.37 0 0 1014779063 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8800.82 0 0 0 0 0 0 0 0 0 0 0 0 0 8800.82 0 0 1014779080 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9806.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9806.45 0 0 1014779298 1952928160 11 Dentists MAGEE DYLAN 999999999 200 Cook 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 161 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 4764.22 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 6645.97 0 0 1014779571 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22118.15 0 0 0 0 0 0 0 0 0 0 0 0 0 22118.15 0 0 1014779633 1851940571 89 Physician Assistant Only(Encounter Only) COSTINE MICHAEL 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 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 1650.63 0 0 0 0 0 0 1650.63 0 0 1014779638 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7222.36 0 0 0 0 0 0 0 0 0 0 0 0 0 7222.36 0 0 1014779681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 142.58 0 0 0 0 0 0 0 0 0 0 0 0 0 142.58 0 0 1014779786 1629542857 16 Nurse Practitioners LEWIS MIKALA M 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 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 0 222.7 0 0 0 0 0 0 222.7 0 0 1014779857 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2213.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2213.92 0 0 1014779858 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16357.11 0 0 0 0 0 0 0 0 0 0 0 0 0 16357.11 0 0 1014779870 1508476946 11 Dentists IDIARE ARIEL 999999999 200 Cook 0 0 General Dentistry 0 0 43 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 7934.87 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 9440.27 0 0 1014780029 1336602705 16 Nurse Practitioners VARMA AMRITA 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 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 74.4 0 0 0 0 0 0 74.4 0 0 1014780129 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3500.2 0 0 0 0 0 0 0 0 0 0 0 0 0 3500.2 0 0 1014780147 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12732.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12732.56 0 0 1014780223 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.2 13.2 0 0 1014780432 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8154.33 0 0 0 0 0 0 0 0 0 0 0 0 0 8154.33 0 0 1014780447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12954.78 0 0 0 0 0 0 0 0 0 0 0 0 0 12954.78 0 0 1014780468 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17411.68 0 0 0 0 0 0 0 0 0 0 0 0 0 17411.68 0 0 1014780578 1528680360 16 Nurse Practitioners HEMMER JENNIFER 999999999 60 Lee 0 0 0 0 0 0 0 0 0 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 0 312.24 0 0 0 0 0 0 312.24 0 0 1014780668 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12426.04 0 0 0 0 0 0 0 0 0 0 0 0 0 12426.04 0 0 1014780730 12 Optometrists 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 1014780774 1083255343 16 Nurse Practitioners ELLINGWOOD LISA 999999999 19 Champaign 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 0 157 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 4434.7 0 0 0 0 0 0 4434.7 0 0 1014780807 1508455908 40 Federally Qualified Health Centers AUNT MARTHA'S HUMBOLDT PARK CO 999999999 200 Cook 0 0 0 22 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4181.76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4181.76 0 0 1014781001 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18795.26 0 0 0 0 0 0 0 0 0 0 0 0 0 18795.26 0 0 1014781250 1265774616 10 Physicians ALRIFAI ABDULAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.61 0 5531.81 0 0 0 0 0 0 5543.42 0 0 1014781414 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 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 14072.26 0 0 0 0 0 0 0 0 0 0 0 0 0 14072.26 0 0 1014781605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1211.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1211.39 0 0 1014781688 1437773637 11 Dentists SALAMEH MAHMOUD 999999999 200 Cook 0 0 General Dentistry 0 0 144 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 632 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 15938.92 0 0 0 0 0 0 0 0 0 0 0 8656.05 0 0 0 0 24594.97 0 0 1014781728 4014781728 91 Waiver service provider--Adults (DHS/DDD) KLINE CHRISTINE D 999999999 91 Sangamon 0 0 0 0 0 0 0 9 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 30123.59 0 0 0 0 0 0 0 0 0 0 0 0 0 30123.59 0 0 1014781876 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13544.96 0 0 0 0 0 0 0 0 0 0 0 0 0 13544.96 0 0 1014781921 1851913651 89 Physician Assistant Only(Encounter Only) HENDERSON GRACE A 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 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 0 245.66 0 0 0 0 0 0 245.66 0 0 1014782019 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.6 0 0 0 0 0 0 1.6 0 0 1014782142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28445.76 0 0 0 0 0 0 0 0 0 0 0 0 0 28445.76 0 0 1014782261 1659981629 16 Nurse Practitioners DAVIDSMEIER EMILY A 999999999 91 Sangamon 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 0 107 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 3305.69 0 0 0 0 0 0 3305.69 0 0 1014782297 1801278916 10 Physicians LE VIET H 999999999 200 Cook 0 0 Neurology 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 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 0 830.71 0 0 0 0 0 0 830.71 0 0 1014782435 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 7117.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7117.63 0 0 1014782555 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1475.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1475.52 0 0 1014782557 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9461.2 0 0 0 0 0 0 0 0 0 0 0 0 0 9461.2 0 0 1014782836 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 11945.59 0 0 0 0 0 0 0 0 0 0 0 0 0 11945.59 0 0 1014782848 1538324660 10 Physicians ASSAAD PETER S 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 332 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 854 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 854 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11594.68 0 383.94 0 0 0 0 0 0 11978.62 0 0 1014782853 1144661976 10 Physicians MADDEN BRIAN 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 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 2562.19 0 0 0 0 0 0 2562.19 0 0 1014782929 1770123804 16 Nurse Practitioners RYAN TAYSHA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 870 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136462.45 0 0 0 0 0 0 136462.45 0 0 1014783090 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 31.01 0 0 0 0 0 0 31.01 0 0 1014783107 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5019.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5019.15 0 0 1014783297 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 1014783375 1073993358 10 Physicians MORAVINENI KAVYA 999999999 80 Peoria 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 0 141 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 5362.09 0 0 0 0 0 0 5362.09 0 0 1014783480 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20537.41 0 0 0 0 0 0 0 0 0 0 0 0 0 20537.41 0 0 1014783652 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 0 720.14 0 0 0 0 0 0 720.14 0 0 1014783705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28440.92 0 0 0 0 0 0 0 0 0 0 0 0 0 28440.92 0 0 1014783760 1679008692 10 Physicians KALINOWSKI MICHAEL B 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 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 0 161.4 0 0 0 0 0 0 161.4 0 0 1014783780 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12770.06 0 0 0 0 0 0 0 0 0 0 0 0 0 12770.06 0 0 1014783801 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14036.14 0 0 0 0 0 0 0 0 0 0 0 0 0 14036.14 0 0 1014783811 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 0 199.55 0 0 0 0 0 0 199.55 0 0 1014783813 10 Physicians 107 Will 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 1014784072 1235764218 16 Nurse Practitioners HARRIS COURTNEY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1584.9 0 0 0 0 0 0 1584.9 0 0 1014784347 1144719675 10 Physicians BERNAL MEJIA MANUEL 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 1130.49 0 0 0 0 0 0 1130.49 0 0 1014784365 1548604564 10 Physicians OCHOA JOANA E 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 5.57 0 328.16 0 0 0 0 0 0 333.73 0 0 1014784572 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4546.09 0 0 0 0 0 0 0 0 0 0 0 0 0 4546.09 0 0 1014784681 1386262012 22 Physical Therapists ASPIN SOPHIA M 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 0 155 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 10366.16 10366.16 0 0 1014784745 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 2519.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2519.03 0 0 1014784754 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 7497.09 0 0 0 0 0 0 0 0 0 0 0 0 0 7497.09 0 0 1014784834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5839.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5839.77 0 0 1014785062 1487189312 10 Physicians HARRINGTON JUSTIN 999999999 91 Sangamon 0 0 Emergency 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 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 0 386.28 0 0 0 0 0 0 386.28 0 0 1014785164 1598308785 16 Nurse Practitioners TURNER MARILOU 999999999 30 DuPage 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 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 2156.51 0 0 0 0 0 0 2156.51 0 0 1014785200 1851777056 23 Occupational Therapists CANTRELL CHRISTINE 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 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 0 349.22 349.22 0 0 1014785204 1144583113 10 Physicians VELLIMANA ANANTH K 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 18 0 0 0 0 0 0 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 7.52 0 1401.52 0 0 0 0 0 0 1409.04 0 0 1014785304 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 0 274 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 7265.16 0 0 0 0 0 0 0 0 0 0 0 0 0 7265.16 0 0 1014785481 1629416920 10 Physicians EVANS TYLER 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 3898.81 0 0 0 0 0 0 3898.81 0 0 1014785484 10 Physicians 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1315.16 0 0 0 0 0 0 1315.16 0 0 1014785559 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.16 0 0 0 0 0 0 0 0 0 0 0 0 0 17264.16 0 0 1014785912 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4081.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4081.64 0 0 1014785971 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19627.65 0 0 0 0 0 0 0 0 0 0 0 0 0 19627.65 0 0 1014786096 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14127.26 0 0 0 0 0 0 0 0 0 0 0 0 0 14127.26 0 0 1014786119 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 331.76 0 0 0 0 0 0 0 0 0 0 0 0 0 331.76 0 0 1014786124 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 0 121 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 2582.26 0 0 0 0 0 0 0 0 0 0 0 0 0 2582.26 0 0 1014786130 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014786248 1083655047 10 Physicians EMANUELE TULLIO 999999999 96 St Clair 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 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 0 248.15 0 0 0 0 0 0 248.15 0 0 1014786296 55 Early Intervention Services 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 0 235.84 0 0 0 0 0 0 235.84 0 0 1014786334 1528601127 16 Nurse Practitioners GOSNELL MICHELLE L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 520.17 0 0 0 0 0 0 520.17 0 0 1014786351 1356906317 12 Optometrists KOVACS MELANIE 999999999 200 Cook 0 0 Therapeutic 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 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 0 275.19 0 0 0 0 0 0 275.19 0 0 1014786570 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 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 0 219.15 219.15 0 0 1014786584 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9303.97 0 0 0 0 0 0 0 0 0 0 0 0 0 9303.97 0 0 1014786685 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 35.92 0 0 0 0 0 0 35.92 0 0 1014786741 1609491547 89 Physician Assistant Only(Encounter Only) WATKINS TAYLOR 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 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 0 848.04 0 0 0 0 0 0 848.04 0 0 1014786749 1912325366 10 Physicians LOEWENSTEIN DEVIN K 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 5842.42 0 0 0 0 0 0 5846.24 0 0 1014786801 1235545534 10 Physicians DAHA FARAZ 999999999 77 Morgan 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 0 139.97 0 0 0 0 0 0 139.97 0 0 1014787016 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 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 0 993.08 0 0 0 0 0 0 0 0 0 0 0 0 0 993.08 0 0 1014787113 1497377881 91 Waiver service provider--Adults (DHS/DDD) AVERY LEE 601622110 200 Cook 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 2298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2298 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94195.18 0 0 0 0 0 0 0 0 0 0 0 0 0 94195.18 0 0 1014787149 1740804046 16 Nurse Practitioners KAY LAUREN 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 2471.94 0 0 0 0 0 0 2536.24 0 0 1014787207 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19857.28 0 0 0 0 0 0 0 0 0 0 0 0 0 19857.28 0 0 1014787215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18490.01 0 0 0 0 0 0 0 0 0 0 0 0 0 18490.01 0 0 1014787311 1942837190 16 Nurse Practitioners OAKES TRICIA F 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 0 496.75 0 0 0 0 0 0 496.75 0 0 1014787340 1467066167 12 Optometrists MORGESON JORDAN 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8975.33 0 3279.36 0 0 0 0 12254.69 0 0 1014787406 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3849.74 0 0 0 0 0 0 0 0 0 0 0 0 0 3849.74 0 0 1014787680 1023669538 16 Nurse Practitioners NJEH JULIUS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6401.05 0 0 0 0 0 0 6401.05 0 0 1014787692 1962020560 16 Nurse Practitioners FUGATE AMY J 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 0 343.83 0 0 0 0 0 0 343.83 0 0 1014787825 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22947.28 0 0 0 0 0 0 0 0 0 0 0 0 0 22947.28 0 0 1014787868 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10090.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10090.5 0 0 1014787934 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 78.09 0 0 0 0 0 0 78.09 0 0 1014787985 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8309.82 0 0 0 0 0 0 0 0 0 0 0 0 0 8309.82 0 0 1014788172 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25725.34 0 0 0 0 0 0 0 0 0 0 0 0 0 25725.34 0 0 1014788322 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16445.04 0 0 0 0 0 0 0 0 0 0 0 0 0 16445.04 0 0 1014788356 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16144.78 0 0 0 0 0 0 0 0 0 0 0 0 0 16144.78 0 0 1014788623 1992327506 16 Nurse Practitioners OFFERMAN-IZZARELLI CHRISTINE 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 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 0 262.46 0 0 0 0 0 0 262.46 0 0 1014788644 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 1014788755 1316020225 10 Physicians ALDERETE JOSEPH F 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 1218.73 0 0 0 0 0 0 1218.73 0 0 1014788938 1497381941 16 Nurse Practitioners OMAR MAZOUZAH 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 0 223 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 1871.21 0 0 0 0 0 0 1871.21 0 0 1014789016 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20209.6 0 0 0 0 0 0 0 0 0 0 0 0 0 20209.6 0 0 1014789049 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 0 130 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 14972.87 0 0 0 0 0 0 0 0 0 0 0 0 0 14972.87 0 0 1014789076 1164571592 22 Physical Therapists GARCIA ADRIANA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 718.73 718.73 0 0 1014789408 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 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 8.2 0 0 0 0 0 0 8.2 0 0 1014789410 1275812083 16 Nurse Practitioners BENZON NATALIE A 999999999 200 Cook 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 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 996 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163562.92 0 0 0 0 0 0 163562.92 0 0 1014789416 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1518.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1518.35 0 0 1014789433 1568090769 89 Physician Assistant Only(Encounter Only) SCHNEIDER REBECCA 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 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 16.26 0 0 0 0 0 0 16.26 0 0 1014789546 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 0 138.28 0 0 0 0 0 0 138.28 0 0 1014789592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8742.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8742.68 0 0 1014789654 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13007.48 0 0 0 0 0 0 0 0 0 0 0 0 0 13007.48 0 0 1014789688 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014789857 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 7 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 53.91 0 0 0 53.91 0 0 1014789895 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3896.23 0 0 0 0 0 0 0 0 0 0 0 0 0 3896.23 0 0 1014789944 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.01 0 0 0 0 0 0 63.01 0 0 1014790149 1154949329 65 Independent Diagnostic Testing Facility (IDTF) APEX DIAGNOSTICS INC. 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 377 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2066.2 0 0 0 0 0 0 0 0 2066.2 0 0 1014790219 1346898921 16 Nurse Practitioners SIMOENS KELSEY 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 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 0 513.37 0 0 0 0 0 0 513.37 0 0 1014790390 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 0 121 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 9987.42 0 0 0 0 0 0 0 0 0 0 0 0 0 9987.42 0 0 1014790396 1851770457 10 Physicians DAHM JENNIFER 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 2 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3638.83 0 0 0 0 0 0 3638.83 0 0 1014790644 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7582.41 0 0 0 0 0 0 0 0 0 0 0 0 0 7582.41 0 0 1014790795 1164070603 16 Nurse Practitioners RASIN GUTJIERA 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 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 1767.2 0 0 0 0 0 0 1767.2 0 0 1014790849 4014790849 91 Waiver service provider--Adults (DHS/DDD) ROSS NOAH 999999999 200 Cook 0 0 0 0 0 0 0 7 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 14493.93 0 0 0 0 0 0 0 0 0 0 0 0 0 14493.93 0 0 1014790864 98 Waiver service provider--TBI (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 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 7354.15 0 0 0 0 0 0 0 0 0 0 0 0 0 7354.15 0 0 1014790899 90 Waiver service provider--Elderly (DOA) 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 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 3627 0 0 0 0 0 0 0 0 0 0 0 0 0 3627 0 0 1014790928 1639156367 10 Physicians LEONARD ERIC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 50 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704.53 0 13.49 0 0 0 0 0 0 718.02 0 0 1014790938 1568994044 10 Physicians KURZROK SAMANTHA R 999999999 200 Cook 0 0 Family 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 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 0 526.08 0 0 0 0 0 0 526.08 0 0 1014790962 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25900.87 0 0 0 0 0 0 0 0 0 0 0 0 0 25900.87 0 0 1014791217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.09 0 0 0 0 0 0 0 0 0 0 0 0 0 222.09 0 0 1014791308 1154420107 10 Physicians HOVSEPIAN MICHAEL 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 110 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2346.97 0 8.16 0 0 0 0 0 0 2355.13 0 0 1014791344 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 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 0 0 0 0 0 0 0 0 0 0 1014791424 1952837148 10 Physicians GROSPE GENA 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 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 0 807 0 0 0 0 0 0 807 0 0 1014791656 1982001996 60 Pharmacies SHIELDS FAMILY PHARMACY LLC 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4198 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5348.72 0 0 0 5348.72 0 0 1014791692 1154620458 10 Physicians COX CHRISTINE RAE 999999999 200 Cook 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 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 1273.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1273.01 0 0 1014792212 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21579.14 0 0 0 0 0 0 0 0 0 0 0 0 0 21579.14 0 0 1014792444 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29011.67 0 0 0 0 0 0 0 0 0 0 0 0 0 29011.67 0 0 1014792473 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1915.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1915.35 0 0 1014792518 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 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0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1163.98 0 0 0 0 0 0 1163.98 0 0 1014793550 1053845321 10 Physicians MASUD ABDULLAH 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 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 0 580.77 0 0 0 0 0 0 580.77 0 0 1014793743 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 17067.69 0 0 0 0 0 0 0 0 0 0 0 0 0 17067.69 0 0 1014793780 1174177562 16 Nurse Practitioners RHODES KRISTOPHER 999999999 63 Macon 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 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 1144.47 0 0 0 0 0 0 1144.47 0 0 1014793989 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526.08 0 0 0 0 0 0 0 0 0 0 0 0 0 526.08 0 0 1014794183 1831712835 16 Nurse Practitioners MCAULIFFE CLAIRE 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 0 134 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 1378.63 0 0 0 0 0 0 1378.63 0 0 1014794190 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 0 227 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 22645.48 0 0 0 0 0 0 0 0 0 0 0 0 0 22645.48 0 0 1014794293 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 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 17.96 0 0 0 0 0 0 17.96 0 0 1014794358 10 Physicians 30 DuPage 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 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 0 421.8 0 0 0 0 0 0 421.8 0 0 1014794499 1982232955 89 Physician Assistant Only(Encounter Only) MLADENOVA GIANNA 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 0 0 0 0 0 0 0 0 0 0 1014794561 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.95 0 0 0 0 0 0 0 0 18.95 0 0 1014794596 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 0 503.34 0 0 0 0 0 0 503.34 0 0 1014794896 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 7583.57 0 0 0 0 0 0 0 0 0 0 0 0 0 7583.57 0 0 1014794898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10436.77 0 0 0 0 0 0 0 0 0 0 0 0 0 10436.77 0 0 1014794911 1164998332 16 Nurse Practitioners GRESKOWIAK LESLIE A 999999999 30 DuPage 0 0 0 0 0 3 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 222.74 0 0 0 0 0 0 0 0 604.53 0 0 0 0 0 0 827.27 0 0 1014795055 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 0 105.82 0 0 0 0 0 0 0 0 0 0 0 0 0 105.82 0 0 1014795235 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 0 332 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 24120.01 0 0 0 0 0 0 0 0 0 0 0 0 0 24120.01 0 0 1014795295 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4282.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4282.25 0 0 1014795325 1417425547 16 Nurse Practitioners DOVERTE KEN GABRIEL 999999999 200 Cook 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 2155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8925.06 0 0 0 0 0 0 8925.06 0 0 1014795392 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 12.72 0 0 0 0 0 0 12.72 0 0 1014795474 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 0 170 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 17693.15 0 0 0 0 0 0 0 0 0 0 0 0 0 17693.15 0 0 1014795490 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25188.22 0 0 0 0 0 0 0 0 0 0 0 0 0 25188.22 0 0 1014795559 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014795567 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 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 21.47 0 0 0 0 0 0 21.47 0 0 1014795655 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15018.65 0 0 0 0 0 0 0 0 0 0 0 0 0 15018.65 0 0 1014795699 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7159 0 0 0 0 0 0 0 0 0 0 0 0 0 7159 0 0 1014795732 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4317.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4317.52 0 0 1014795746 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 66.4 0 0 0 0 0 0 66.4 0 0 1014795752 1386998482 89 Physician Assistant Only(Encounter Only) ERWIN KALIE 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 0 120 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 6424.51 0 0 0 0 0 0 6424.51 0 0 1014796087 89 Physician Assistant Only(Encounter Only) 68 Mason 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014796098 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6996.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6996.08 0 0 1014796230 1811523699 60 Pharmacies ETHOS PHARMACY 999999999 200 Cook 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 0 502 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14930 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44448.65 0 0 0 44448.65 0 0 1014796271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26045.69 0 0 0 0 0 0 0 0 0 0 0 0 0 26045.69 0 0 1014796366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23731.12 0 0 0 0 0 0 0 0 0 0 0 0 0 23731.12 0 0 1014796502 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 385.12 0 0 0 0 0 0 0 0 0 0 0 0 0 385.12 0 0 1014796505 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 0 136 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 12455.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12455.8 0 0 1014796560 1033691191 89 Physician Assistant Only(Encounter Only) BRADEN ASHTYNN R 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 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 1788.05 0 0 0 0 0 0 1788.05 0 0 1014796694 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7987.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7987.63 0 0 1014796759 1609864263 33 Nursing Facilities ASPEN REHAB AND HEALTH CARE 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50155.75 0 0 0 0 0 0 0 50155.75 0 0 1014796777 1023091972 10 Physicians CHAN ALEX 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 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 18 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.96 0 13.49 0 0 0 0 0 0 340.45 0 0 1014796896 1699313981 16 Nurse Practitioners BAUGHER JESSICA 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 0 107 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 1742.95 0 0 0 0 0 0 1742.95 0 0 1014796986 1023016789 10 Physicians CARR SHANNON L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.84 0 1066299.57 0 0 0 0 0 0 1066494.41 0 0 1014797097 1083842439 10 Physicians FULTZ KRISTOPHER R 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 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 2829.37 0 0 0 0 0 0 2829.37 0 0 1014797125 1447871900 12 Optometrists POURHOSSEINI PEDRAM 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 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 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 0 973.83 0 0 0 0 0 0 973.83 0 0 1014797147 1497262331 10 Physicians EHSANULLAH SYED U 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 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 0 498.14 0 0 0 0 0 0 498.14 0 0 1014797238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7418.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7418.19 0 0 1014797284 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13726.75 0 0 0 0 0 0 0 0 0 0 0 0 0 13726.75 0 0 1014797297 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9689.25 0 0 0 0 0 0 0 0 0 0 0 0 0 9689.25 0 0 1014797305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9037.13 0 0 0 0 0 0 0 0 0 0 0 0 0 9037.13 0 0 1014797398 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 0 190.48 0 0 0 0 0 0 190.48 0 0 1014797635 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1412.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1412.29 0 0 1014797783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10047.02 0 0 0 0 0 0 0 0 0 0 0 0 0 10047.02 0 0 1014797794 1720200124 10 Physicians DAHL AMY N 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 22 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 473.89 0 29.88 0 0 0 0 0 0 503.77 0 0 1014797814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21414.95 0 0 0 0 0 0 0 0 0 0 0 0 0 21414.95 0 0 1014797968 1174177513 89 Physician Assistant Only(Encounter Only) PETRESKI JESSICA 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 0 240 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 12028.59 0 0 0 0 0 0 12028.59 0 0 1014797991 1477074722 10 Physicians CHAUDHRY TALHAH T 999999999 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014798200 1699259036 89 Physician Assistant Only(Encounter Only) BAIG MERAJ 86 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 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 2863.08 0 0 0 0 0 0 2863.08 0 0 1014798369 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1962.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1962.68 0 0 1014798391 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 8253.96 0 0 0 0 0 0 0 0 0 0 0 0 0 8253.96 0 0 1014798440 1699386607 16 Nurse Practitioners ESPINOSA CATHERINE 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 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 0 282.47 0 0 0 0 0 0 282.47 0 0 1014798510 1205485364 16 Nurse Practitioners MAURER KAMI L 999999999 80 Peoria 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 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 2579.32 0 0 0 0 0 0 2579.32 0 0 1014798563 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4175.82 0 0 0 0 0 0 0 0 0 0 0 0 0 4175.82 0 0 1014798588 1184111536 36 Community mental health provider MCHENRY MAIN OFFICES 999999999 71 McHenry 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 1730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1770 0 0 1730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1770 0 0 273227.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 273852.48 0 0 547079.65 0 0 1014798684 1649897315 16 Nurse Practitioners STUCKEY KELSEY M 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 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 1055.26 0 0 0 0 0 0 1055.26 0 0 1014798833 10 Physicians 30 DuPage 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.08 0 0 0 0 0 0 87.08 0 0 1014798862 1982649133 10 Physicians NGUYEN HOANH T 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 0 377.73 0 0 0 0 0 0 377.73 0 0 1014799013 1790327609 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE EVASNTON 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 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 7282 0 0 0 0 0 0 7282 0 0 1014799030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1755.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1755.67 0 0 1014799150 10 Physicians 10 Adams 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 0 219.98 0 0 0 0 0 0 219.98 0 0 1014799236 1144406083 10 Physicians PULINI-FRANKS MARINA 999999999 101 Wabash 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 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 41.27 0 0 0 0 0 0 41.27 0 0 1014799248 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 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 1017.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1017.5 0 0 1014799257 1497160717 65 Independent Diagnostic Testing Facility (IDTF) "MEDICOMP, INC" 999999999 805 California 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 1014799290 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23381.4 0 0 0 0 0 0 0 0 0 0 0 0 0 23381.4 0 0 1014799423 1396363644 89 Physician Assistant Only(Encounter Only) GRIFFIN SHAREIKKA L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 433.1 0 0 0 0 0 0 433.1 0 0 1014799528 1184918294 10 Physicians SITARAMAN LALITHA 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 0 107 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 4229.36 0 0 0 0 0 0 4229.36 0 0 1014799552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1287.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1287.09 0 0 1014799750 1295367407 16 Nurse Practitioners RAMASKEVICIUTE EGLE 999999999 107 Will 0 0 0 0 0 2 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 1739.24 0 0 0 0 0 0 1758.44 0 0 1014799755 1790320802 89 Physician Assistant Only(Encounter Only) KUTSKA AMY 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 0 173 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 4148.82 0 0 0 0 0 0 4148.82 0 0 1014799899 1811480098 11 Dentists MIN KYUNGHWAN 999999999 200 Cook 0 0 0 0 96 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 9871.6 0 0 0 0 0 0 0 0 0 0 0 2634.45 0 0 0 0 12506.05 0 0 1014799944 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9548 0 0 0 0 0 0 0 0 0 0 0 0 0 9548 0 0 1014800178 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.68 0 0 0 0 0 0 0 0 149.68 0 0 1014800180 1164061594 16 Nurse Practitioners BICKMANN JONATHAN D 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 503.75 0 0 0 0 0 0 503.75 0 0 1014800375 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20691.88 0 0 0 0 0 0 0 0 0 0 0 0 0 20691.88 0 0 1014800637 1508480153 16 Nurse Practitioners ALLSUP SCOTT 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1352.94 0 0 0 0 0 0 1352.94 0 0 1014800653 1093178790 10 Physicians CHAMBERS MARIAH D 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 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 1208.3 0 0 0 0 0 0 1208.3 0 0 1014800685 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014800696 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 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 5077.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5077.58 0 0 1014800741 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15092.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15092.96 0 0 1014800829 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.46 0 0 0 0 0 0 15.46 0 0 1014800886 1932682325 89 Physician Assistant Only(Encounter Only) SCHAFFNER HARDY CAMILLE 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 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 1005.85 0 0 0 0 0 0 1005.85 0 0 1014800921 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1006.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1006.88 0 0 1014800966 1952530180 10 Physicians PATEL ROOCHA 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 467 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 652 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13120.05 0 781.2 0 0 0 0 0 0 13901.25 0 0 1014800979 1720529944 10 Physicians WOJCIECHOWSKI MONICA JOLANTA 999999999 200 Cook 0 0 Family Practice 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 40 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 21.33 0 0 0 0 0 0 0 0 330.05 0 0 0 0 0 0 351.38 0 0 1014801030 10 Physicians 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 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 1014801044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4249.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4249.08 0 0 1014801073 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 0 0 0 0 0 0 0 0 0 0 1014801297 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2750.63 0 0 0 0 0 0 0 0 0 0 0 0 0 2750.63 0 0 1014801311 1215356670 10 Physicians SANSOM SARAH E 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 2369.05 0 0 0 0 0 0 2369.05 0 0 1014801381 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1583.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1583.59 0 0 1014801404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18097 0 0 0 0 0 0 0 0 0 0 0 0 0 18097 0 0 1014801543 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1280.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1280.3 0 0 1014801675 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22515.92 0 0 0 0 0 0 0 0 0 0 0 0 0 22515.92 0 0 1014801721 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 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 28.36 0 0 0 0 0 0 28.36 0 0 1014801851 10 Physicians 10 Adams 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.48 0 0 0 0 0 0 0 0 58.48 0 0 1014802011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8887.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8887.6 0 0 1014802081 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8210.02 0 0 0 0 0 0 0 0 0 0 0 0 0 8210.02 0 0 1014802323 1063894608 10 Physicians FLORES-RUIZ JAIME E 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 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 0 415.81 0 0 0 0 0 0 415.81 0 0 1014802354 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21411.2 0 0 0 0 0 0 0 0 0 0 0 0 0 21411.2 0 0 1014802544 1457733396 10 Physicians JAMI ASMA 999999999 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 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 1014802602 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23012.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23012.85 0 0 1014802640 10 Physicians 91 Sangamon 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 47.75 0 21.07 0 0 0 0 0 0 68.82 0 0 1014802811 1710587464 16 Nurse Practitioners SCHULTE CARRIE 999999999 53 Kane 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 23 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.46 0 0 0 0 0 0 23.46 0 0 1014802836 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5643.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5643.95 0 0 1014803030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10543.78 0 0 0 0 0 0 0 0 0 0 0 0 0 10543.78 0 0 1014803176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6806.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6806.1 0 0 1014803352 1427657634 16 Nurse Practitioners GREGG ASHLEY 999999999 53 Kane 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 0 162 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 3883.94 0 0 0 0 0 0 3883.94 0 0 1014803356 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6371.15 0 0 0 0 0 0 0 0 0 0 0 0 0 6371.15 0 0 1014803446 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 0 171 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 14799.4 0 0 0 0 0 0 0 0 0 0 0 0 0 14799.4 0 0 1014803488 1184931735 22 Physical Therapists ABDALLAH JAMIL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 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 1170.76 1170.76 0 0 1014803674 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34865.28 0 0 0 0 0 0 0 0 0 0 0 0 0 34865.28 0 0 1014803904 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20692.03 0 0 0 0 0 0 0 0 0 0 0 0 0 20692.03 0 0 1014804023 1265065007 16 Nurse Practitioners HARGRAVES HOPE 999999999 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 0 217 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 2105.08 0 0 0 0 0 0 2105.08 0 0 1014804054 1629028782 10 Physicians SMITH CHRISTOPHER L 999999999 200 Cook 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 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 1205.24 0 0 0 0 0 0 1205.24 0 0 1014804091 1508464637 16 Nurse Practitioners HOGG TRICIA 999999999 19 Champaign 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 0 100 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 1286.99 0 0 0 0 0 0 1286.99 0 0 1014804137 1093349912 16 Nurse Practitioners HALFORD NICHOLAS W 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3407.19 0 0 0 0 0 0 3407.19 0 0 1014804270 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2140.51 0 0 0 0 0 0 0 0 0 0 0 0 0 2140.51 0 0 1014804274 1740641745 48 Rural Health Clinics GIBSON AREA PRIMARY CARE 609362000 35 Ford 0 0 0 43 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5992.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5992.42 0 0 1014804318 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1014804325 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 1014804510 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 121.11 0 0 0 0 0 0 0 0 0 0 0 0 0 121.11 0 0 1014804607 1427136373 16 Nurse Practitioners WENTLAND HOLLY 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 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 1396.32 0 0 0 0 0 0 1396.32 0 0 1014804670 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21054.39 0 0 0 0 0 0 0 0 0 0 0 0 0 21054.39 0 0 1014804708 1518578459 91 Waiver service provider--Adults (DHS/DDD) MORAGA ALYANNA 999999999 200 Cook 0 0 0 0 0 0 0 25 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 47604.63 0 0 0 0 0 0 0 0 0 0 0 0 0 47604.63 0 0 1014804879 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 0 438.63 0 0 0 0 0 0 438.63 0 0 1014804927 1811359649 10 Physicians CONLEY KEVIN L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.1 0 2565.28 0 0 0 0 0 0 2643.38 0 0 1014805074 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20222.3 0 0 0 0 0 0 0 0 0 0 0 0 0 20222.3 0 0 1014805184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7749.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7749.71 0 0 1014805219 4014805219 72 Taxicabs and Livery Companies AMERICAN HEALTHCARE TRANSPORTA 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 1320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19262.71 0 0 0 0 0 0 19262.71 0 0 1014805493 10 Physicians 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.52 0 0 0 0 0 0 105.52 0 0 1014805529 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7691.38 0 0 0 0 0 0 0 0 0 0 0 0 0 7691.38 0 0 1014806023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 212.8 0 0 0 0 0 0 0 0 0 0 0 0 0 212.8 0 0 1014806029 10 Physicians 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 0 474.72 0 0 0 0 0 0 474.72 0 0 1014806076 1952961997 60 Pharmacies THE APOTHECARY SHOPPE 999999999 32 Edwards 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 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9758 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8414.47 0 0 0 8414.47 0 0 1014806306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3760.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3760.56 0 0 1014806399 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2866.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2866.53 0 0 1014806432 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3605.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3605.69 0 0 1014806513 1770761082 33 Nursing Facilities POLO REHABILITATION AND HCC 999999999 79 Ogle 0 0 0 0 0 0 0 0 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 0 546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27905.82 0 0 0 0 0 0 0 27905.82 0 0 1014806608 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 2041.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2041.53 0 0 1014806688 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19960.63 0 0 0 0 0 0 0 0 0 0 0 0 0 19960.63 0 0 1014806794 1326194093 10 Physicians KAMATH-RAYNE BEENA 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 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 2768.76 0 0 0 0 0 0 2768.76 0 0 1014806921 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14510.98 0 0 0 0 0 0 0 0 0 0 0 0 0 14510.98 0 0 1014806937 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 0 200 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 14534.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14534.53 0 0 1014807136 10 Physicians 30 DuPage 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.24 0 0 0 0 0 0 293.24 0 0 1014807267 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11760 0 0 0 0 0 0 0 0 0 0 0 0 0 11760 0 0 1014807413 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22643.95 0 0 0 0 0 0 0 0 0 0 0 0 0 22643.95 0 0 1014807529 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10042.59 0 0 0 0 0 0 0 0 0 0 0 0 0 10042.59 0 0 1014807554 1164764874 10 Physicians HARRISON RACHEL K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 104 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7096.71 0 2756.63 0 0 0 0 0 0 9853.34 0 0 1014807557 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3675.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3675.62 0 0 1014807629 1215538004 16 Nurse Practitioners WILTON JORDANNA R 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 0 388.28 0 0 0 0 0 0 388.28 0 0 1014807674 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 14781.16 0 0 0 0 0 0 0 0 0 0 0 0 0 14781.16 0 0 1014807692 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1014807706 4014807706 92 Waiver service provider--Disability (DHS/DRS) ADVANTAGE IN-HOME SERVICES 999999999 826 Missouri 0 0 0 0 0 0 0 11 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 126476.63 0 0 0 0 0 0 0 0 0 0 0 0 0 126476.63 0 0 1014807844 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 11052.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11052.52 0 0 1014807956 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19774.08 0 0 0 0 0 0 0 0 0 0 0 0 0 19774.08 0 0 1014808254 1245610963 10 Physicians ADELMAN AVRAM 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.87 0 0 0 0 0 0 0 0 173.87 0 0 1014808343 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 74.95 0 0 0 0 0 0 74.95 0 0 1014808518 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7899.11 0 0 0 0 0 0 0 0 0 0 0 0 0 7899.11 0 0 1014808648 1558981951 89 Physician Assistant Only(Encounter Only) EANDI BRETT 999999999 80 Peoria 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 0 184 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 5417.83 0 0 0 0 0 0 5417.83 0 0 1014808669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19263.31 0 0 0 0 0 0 0 0 0 0 0 0 0 19263.31 0 0 1014808789 1699229435 10 Physicians SHIN JASON J 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 34 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497.08 0 3785.88 0 0 0 0 0 0 4282.96 0 0 1014808890 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11096.12 0 0 0 0 0 0 0 0 0 0 0 0 0 11096.12 0 0 1014808945 1649877416 16 Nurse Practitioners CAUDLE RACHEL M 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 0 102 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 0 115.82 0 0 0 0 0 0 115.82 0 0 1014808949 1386233591 27 Behavioral Health Clinic "FEEL GOOD COUNSELING CENTER, L" 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 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 21516.2 0 0 21516.2 0 0 1014809040 1467915488 33 Nursing Facilities ELEVATE ST ANDREW LIVING COMM 999999999 200 Cook 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3926 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 487989.34 0 0 0 0 0 0 0 487989.34 0 0 1014809058 1184985566 10 Physicians MERZKANI MASSINI A 999999999 200 Cook 0 0 Internal Medicine 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 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 448.72 0 0 0 0 0 0 448.72 0 0 1014809200 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 27431.62 0 0 0 0 0 0 0 0 0 0 0 0 0 27431.62 0 0 1014809209 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 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 5043.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5043.08 0 0 1014809319 1164756755 63 Other Providers of Medical Equipment/Supplies (Non-registered) INNOVATIVE SUPPLY GROUP LLC 999999999 831 New Jersey 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 0 243 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 5442.7 0 0 0 0 0 0 5442.7 0 0 1014809374 1932640075 10 Physicians ARFEEN MOHAMMAD 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.53 0 0 0 0 0 0 176.53 0 0 1014809489 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1519.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1519.8 0 0 1014809570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1604.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1604.53 0 0 1014809704 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17315.06 0 0 0 0 0 0 0 0 0 0 0 0 0 17315.06 0 0 1014809766 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3696.48 0 0 0 0 0 0 0 0 0 0 0 0 0 3696.48 0 0 1014809820 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 0 124.43 0 0 0 0 0 0 124.43 0 0 1014809898 1932634003 10 Physicians STOJAK BRIAN J 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 12 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.53 0 889.91 0 0 0 0 0 0 911.44 0 0 1014809945 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1247.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.24 0 0 1014810056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15945.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15945.86 0 0 1014810245 1073154688 16 Nurse Practitioners SCHWARTZ RENA 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 0 470 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2848.93 0 0 0 0 0 0 2848.93 0 0 1014810260 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1383.35 0 0 0 0 0 0 0 0 0 0 0 0 0 1383.35 0 0 1014810465 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 1014810563 16 Nurse Practitioners 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 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 1014810588 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24143.24 0 0 0 0 0 0 0 0 0 0 0 0 0 24143.24 0 0 1014810607 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19258.74 0 0 0 0 0 0 0 0 0 0 0 0 0 19258.74 0 0 1014810615 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 572.27 0 0 0 0 0 0 0 0 0 0 0 0 0 572.27 0 0 1014810631 1659520823 10 Physicians DUQUE MARVIN 999999999 24 Coles 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 0 156 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 1642.24 0 0 0 0 0 0 1642.24 0 0 1014810929 1215338033 22 Physical Therapists PASLEY JORDAN D 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 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 4856.75 4856.75 0 0 1014811089 1326689696 89 Physician Assistant Only(Encounter Only) MAAS LINDSAY 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 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 0 0 0 0 0 0 0 0 0 0 1014811221 1275186397 16 Nurse Practitioners JACKSON NEHA 999999999 109 Winnebago 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 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 1188.95 0 0 0 0 0 0 1188.95 0 0 1014811290 1407498314 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE MORTON VILLA 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9930 0 0 0 0 0 0 9930 0 0 1014811594 1922219567 10 Physicians RILEY MELISSA M 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 0 125 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 19509.8 0 0 0 0 0 0 19509.8 0 0 1014811645 1174136451 60 Pharmacies "GENOA HEALTHCARE, LLC" 999999999 60 Lee 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 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5002 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5362.24 0 0 0 5362.24 0 0 1014811688 1164479788 10 Physicians RODRIGUEZ GILMER 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 0 161 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 3704.3 0 0 0 0 0 0 3704.3 0 0 1014811713 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18160.16 0 0 0 0 0 0 0 0 0 0 0 0 0 18160.16 0 0 1014811805 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 907.03 0 0 0 0 0 0 0 0 0 0 0 0 0 907.03 0 0 1014811959 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21631.87 0 0 0 0 0 0 0 0 0 0 0 0 0 21631.87 0 0 1014812043 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.94 0 0 0 123.94 0 0 1014812064 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23870 0 0 0 0 0 0 0 0 0 0 0 0 0 23870 0 0 1014812430 1528440757 10 Physicians CHALASANI SWATHI 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 4442.39 0 0 0 0 0 0 4573.39 0 0 1014812518 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10671.67 0 0 0 0 0 0 0 0 0 0 0 0 0 10671.67 0 0 1014812560 1871912527 10 Physicians MEKKI MARWA 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 4366.36 0 0 0 0 0 0 4366.36 0 0 1014812565 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 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 61.92 61.92 0 0 1014812664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6685.24 0 0 0 0 0 0 0 0 0 0 0 0 0 6685.24 0 0 1014812955 1588215214 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE BRADLEY 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 12081.5 0 0 0 0 0 0 12081.5 0 0 1014813125 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 0 133 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 7471.81 0 0 0 0 0 0 0 0 0 0 0 0 0 7471.81 0 0 1014813247 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.1 0 0 0 0 0 0 45.1 0 0 1014813389 10 Physicians 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 43.54 0 0 0 0 0 0 43.54 0 0 1014813526 1790713329 10 Physicians HOLLINS LORI-LINELL 999999999 19 Champaign 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 83.26 0 0 0 0 0 0 95.28 0 0 1014813696 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 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 361 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70160.07 0 0 0 0 0 0 0 0 0 0 0 0 0 70160.07 0 0 1014813984 1356992630 10 Physicians HAYAJNEH WAIL 999999999 200 Cook 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 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 3423.8 0 0 0 0 0 0 3423.8 0 0 1014814090 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 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 0 448.32 448.32 0 0 1014814225 1912430208 10 Physicians CARVALHO DO AMARAL ANA PAULA 999999999 200 Cook 0 0 0 0 0 6 0 0 0 0 0 0 10 0 68 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 151 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 11 0 151 0 0 0 0 0 0 0 0 0 436.06 0 0 0 0 0 0 190.94 0 6328.69 0 0 0 0 0 0 6955.69 0 0 1014814234 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 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 3976.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3976.51 0 0 1014814308 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 0 211.04 0 0 0 0 0 0 211.04 0 0 1014814419 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014814431 1770716664 22 Physical Therapists ANDERSEN LAUREN B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 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 2389.52 2389.52 0 0 1014814524 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15307.18 0 0 0 0 0 0 0 0 0 0 0 0 0 15307.18 0 0 1014814653 1871062588 23 Occupational Therapists HOELZER ELYSE A 999999999 200 Cook 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 0 232 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 2243.9 2243.9 0 0 1014814790 1316573330 55 Early Intervention Services MOSLEY KENDRAH 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 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39856.91 0 0 0 0 0 0 39856.91 0 0 1014814796 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 261.24 0 0 0 0 0 0 261.24 0 0 1014814807 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23190.86 0 0 0 0 0 0 0 0 0 0 0 0 0 23190.86 0 0 1014815027 1386881902 10 Physicians PHEREZ FRANCISCO 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 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 0 850.12 0 0 0 0 0 0 850.12 0 0 1014815198 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3577.07 0 0 0 0 0 0 0 0 0 0 0 0 0 3577.07 0 0 1014815476 1114520210 33 Nursing Facilities FARGO HEALTH CARE CENTER 999999999 200 Cook 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 0 167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 476987.08 0 0 0 0 0 0 0 476987.08 0 0 1014815572 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21039.01 0 0 0 0 0 0 0 0 0 0 0 0 0 21039.01 0 0 1014815583 10 Physicians 63 Macon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.96 0 13.49 0 0 0 0 0 0 133.45 0 0 1014815639 1710320593 10 Physicians AYAT JOSEPH 999999999 200 Cook 0 0 Internal Medicine 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 0 129 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 2098.01 0 0 0 0 0 0 2098.01 0 0 1014815718 16 Nurse Practitioners 53 Kane 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 5 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 0 0 168.79 0 0 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0 0 1014816390 1780214528 89 Physician Assistant Only(Encounter Only) SILVER MICHELLE 999999999 200 Cook 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 0 123 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 4582.84 0 0 0 0 0 0 4582.84 0 0 1014816472 1497301311 89 Physician Assistant Only(Encounter Only) STANCROFF JENNIFER 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 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 0 709.89 0 0 0 0 0 0 709.89 0 0 1014816522 1932466208 10 Physicians KIM THOMAS 999999999 200 Cook 0 0 Radiation Oncology 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 0 473 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 5272.82 0 0 0 0 0 0 5272.82 0 0 1014816539 1760619282 10 Physicians WANG XI 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 17 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 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Hospitals CARLE BROMENN MEDICAL CENTER 999999999 72 McLean DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 3 2 0 0 1001 0 0 0 0 543 0 0 0 1224 0 0 0 0 0 3 2 0 0 1386 0 0 0 0 603 0 0 0 2585 0 0 0 0 0 3 2 0 0 1407 0 0 0 0 2959 0 0 0 2631 0 0 0 0 0 20.81 589.59 0 0 162829.7 0 0 0 0 1112958.37 0 0 0 186483.1 0 0 0 0 0 1462881.57 0 0 1014819034 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 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 56.1 56.1 0 0 1014819154 1811377864 10 Physicians DELISCA GADINI O 999999999 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 1 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.12 0 3727.26 0 0 0 0 0 0 3730.38 0 0 1014819297 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 14122.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14122.9 0 0 1014822723 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25611.24 0 0 0 0 0 0 0 0 0 0 0 0 0 25611.24 0 0 1014822769 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014822790 1538708003 16 Nurse Practitioners TITAK KIMBERLY 999999999 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.56 0 0 0 0 0 0 149.56 0 0 1014822801 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7854.1 0 0 0 0 0 0 0 0 0 0 0 0 0 7854.1 0 0 1014822865 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13394.69 0 0 0 0 0 0 0 0 0 0 0 0 0 13394.69 0 0 1014822983 1366054116 89 Physician Assistant Only(Encounter Only) BLAHA STEPHANIE N 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 54.17 0 0 0 0 0 0 54.17 0 0 1014823116 1144844572 16 Nurse Practitioners WENNERSTROM AMBER 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 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24544.41 0 0 0 0 0 0 24544.41 0 0 1014823308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2119.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2119.76 0 0 1014823408 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 2062.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2062.52 0 0 1014823591 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341.88 0 0 0 0 0 0 0 0 0 0 0 0 0 341.88 0 0 1014823696 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6692.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6692.63 0 0 1014823706 1629506159 10 Physicians COCHRANE JOHN T 999999999 200 Cook 0 0 Pediatrics 0 0 0 18 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 1511.69 0 0 0 0 0 0 0 0 1109.23 0 0 0 0 0 0 2620.92 0 0 1014823929 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4223.72 0 0 0 0 0 0 0 0 0 0 0 0 0 4223.72 0 0 1014823955 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17308.57 0 0 0 0 0 0 0 0 0 0 0 0 0 17308.57 0 0 1014824629 1144822396 16 Nurse Practitioners GREEAR AMANDA M 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 0 264.3 0 0 0 0 0 0 264.3 0 0 1014824659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24397.16 0 0 0 0 0 0 0 0 0 0 0 0 0 24397.16 0 0 1014824965 1942701669 16 Nurse Practitioners NOWACKI REBECCA 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 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 1014825101 1326302761 10 Physicians POOWANAWITTAYAKOM NONGNOOCH 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 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 1502.51 0 0 0 0 0 0 1502.51 0 0 1014825127 1255785903 10 Physicians PAN JOANNA E 999999999 200 Cook 0 0 Family Practice 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 0 329 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 6187.31 0 0 0 0 0 0 6187.31 0 0 1014825209 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 24.25 0 0 0 0 0 0 24.25 0 0 1014825240 1255694600 10 Physicians GADDOR MOATAZ M 999999999 53 Kane 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 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 1284.36 0 0 0 0 0 0 1284.36 0 0 1014825587 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11510.09 0 0 0 0 0 0 0 0 0 0 0 0 0 11510.09 0 0 1014825740 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6570.35 0 0 0 0 0 0 0 0 0 0 0 0 0 6570.35 0 0 1014825785 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 1014825910 1942667498 89 Physician Assistant Only(Encounter Only) SUTFIN JESSICA 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 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 0 687.74 0 0 0 0 0 0 687.74 0 0 1014825954 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25409.61 0 0 0 0 0 0 0 0 0 0 0 0 0 25409.61 0 0 1014825979 10 Physicians 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 58.79 0 98.44 0 0 0 0 0 0 157.23 0 0 1014826004 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 81.79 0 0 0 0 0 0 81.79 0 0 1014826049 10 Physicians 51 Jo Daviess 0 0 Pediatrics 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 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 0 0 0 0 0 0 0 0 0 0 0 0 1014826122 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2373.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2373.35 0 0 1014826250 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 39 0 0 1014826271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 674.97 0 0 0 0 0 0 0 0 0 0 0 0 0 674.97 0 0 1014826348 1215340781 10 Physicians FRITZ BRAXTON 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 4 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5 0 4 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 34.31 0 134.42 0 0 0 0 0 0 233.03 0 0 1014826492 1265870349 10 Physicians CARLO ANDREW D 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 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 1839.81 0 0 0 0 0 0 1839.81 0 0 1014826594 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 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 0 166.29 166.29 0 0 1014826599 1144854779 16 Nurse Practitioners MULLINS MEGAN E 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 1010.02 0 0 0 0 0 0 1010.02 0 0 1014826612 1932563244 23 Occupational Therapists PE ASHLEY L 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 0 174 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 12318.32 12318.32 0 0 1014826670 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 3058.16 0 0 0 0 0 0 0 0 0 0 0 0 0 3058.16 0 0 1014826731 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 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 0 261.21 261.21 0 0 1014826840 1386084101 10 Physicians PALMER JAIME 999999999 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 1 0 51 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 75 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 75 0 0 0 0 0 0 0 0 0 167.51 0 0 0 0 0 0 2.49 0 3822 0 0 0 0 0 0 3992 0 0 1014826860 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24461.23 0 0 0 0 0 0 0 0 0 0 0 0 0 24461.23 0 0 1014826993 1083136261 70 Ambulance Service Providers MAZON VERONA KINSMAN RESCUE SQ 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 8615.29 0 0 0 0 0 0 8615.29 0 0 1014827045 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 15409.85 0 0 0 0 0 0 0 0 0 0 0 0 0 15409.85 0 0 1014827184 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22667.46 0 0 0 0 0 0 0 0 0 0 0 0 0 22667.46 0 0 1014827270 1760855571 16 Nurse Practitioners MYERS STEPHANIE 999999999 25 Crawford 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014827419 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24738.54 0 0 0 0 0 0 0 0 0 0 0 0 0 24738.54 0 0 1014827461 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 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 0 132.82 132.82 0 0 1014827483 1841296530 10 Physicians LEE KATRINA L 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 7 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.69 0 8241.32 0 0 0 0 0 0 8290.01 0 0 1014827639 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 32.96 0 0 0 0 0 0 32.96 0 0 1014827690 83 Prepaid health plan--Managed care community network NEXTLEVEL HEALTH 60606 200 Cook 0 0 "48,276" 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260494212.3 0 1014827776 1295171627 10 Physicians MOUM SARAH J 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 109 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7088.75 0 577.83 0 0 0 0 0 0 7666.58 0 0 1014827865 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12938.53 0 0 0 0 0 0 0 0 0 0 0 0 0 12938.53 0 0 1014827906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7722.63 0 0 0 0 0 0 0 0 0 0 0 0 0 7722.63 0 0 1014827961 1609462068 16 Nurse Practitioners BOYD GEOFFREY A 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 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 0 225.35 0 0 0 0 0 0 225.35 0 0 1014827988 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22165.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22165.22 0 0 1014828051 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2807.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2807.33 0 0 1014828112 1629682471 22 Physical Therapists PETERSON RACHEL 999999999 108 Williamson 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 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 1005.21 1005.21 0 0 1014828164 1538140322 10 Physicians WHITE DOUGLAS 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 10 0 1 0 0 0 0 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 28.2 0 0 0 0 0 0 0 0 28.2 0 0 1014828330 89 Physician Assistant Only(Encounter Only) 15 Bureau 0 0 0 0 0 0 0 0 0 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 6.48 0 0 0 0 0 0 6.48 0 0 1014828397 1952821662 10 Physicians SALADA CULLEN M 999999999 200 Cook 0 0 General 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 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 0 788.66 0 0 0 0 0 0 788.66 0 0 1014828454 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14953.85 0 0 0 0 0 0 0 0 0 0 0 0 0 14953.85 0 0 1014828458 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 0 159 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 19041.75 0 0 0 0 0 0 0 0 0 0 0 0 0 19041.75 0 0 1014828528 1548265960 10 Physicians DEPAOLIS DION 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 12 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.51 0 8.12 0 0 0 0 0 0 88.63 0 0 1014828633 1356494710 10 Physicians VER STEEG KYLE R 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 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 1475.94 0 0 0 0 0 0 1475.94 0 0 1014828893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22532.35 0 0 0 0 0 0 0 0 0 0 0 0 0 22532.35 0 0 1014829040 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014829052 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23886.83 0 0 0 0 0 0 0 0 0 0 0 0 0 23886.83 0 0 1014829091 16 Nurse Practitioners 10 Adams 0 0 0 0 0 0 0 0 0 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 0 189.92 0 0 0 0 0 0 189.92 0 0 1014829126 1720474307 10 Physicians LEE CHENG-TING 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0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.39 0 2296.74 0 0 0 0 0 0 2487.13 0 0 1014844651 1982201505 11 Dentists RODRIGUEZ ASHLEY 999999999 200 Cook 0 0 0 0 273 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 1318 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 1318 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 38432.13 0 0 0 0 0 0 0 0 0 0 0 5645.25 0 0 0 0 44077.38 0 0 1014844709 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 1014844814 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20671.53 0 0 0 0 0 0 0 0 0 0 0 0 0 20671.53 0 0 1014845099 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 1.97 0 0 0 0 0 0 1.97 0 0 1014845170 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 0 129 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 22524.6 0 0 0 0 0 0 0 0 0 0 0 0 0 22524.6 0 0 1014845180 1740815331 47 Local Education Agencies HORIZON SCIENCE ACADEMY-MCKINL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8121.11 0 8121.11 0 0 1014845282 1154671741 10 Physicians MALHOTRA GURVEEN 999999999 47 Jackson 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 0 444 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 6751.5 0 0 0 0 0 0 6751.5 0 0 1014845313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6587.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6587.81 0 0 1014845333 1477718302 10 Physicians MAASSEN NICHOLAS H 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 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 2670.72 0 0 0 0 0 0 2670.72 0 0 1014845578 1063459329 33 Nursing Facilities DECATUR REHAB HEALTH CARE CTR 625221841 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 1872 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 253488.7 0 0 0 0 0 0 0 253488.7 0 0 1014845584 1922412717 10 Physicians VOLKERDING ANDREA MARIE 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3074.64 0 0 0 0 0 0 3074.64 0 0 1014845746 1063620540 10 Physicians BANGASH AFFAAN 999999999 63 Macon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 13838 0 0 1014850149 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1084.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1084.93 0 0 1014850376 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 20789.56 0 0 0 0 0 0 0 0 0 0 0 0 0 20789.56 0 0 1014850423 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1106.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1106.67 0 0 1014850438 1912071937 10 Physicians LAUKAITIS CHRISTINA M 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 430.48 0 0 0 0 0 0 430.48 0 0 1014851009 24 Speech Therapists 73 Menard 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900.61 900.61 0 0 1014851075 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 154.15 154.15 0 0 1014851207 1679920250 86 Clinical Social Worker(Encounter Only) WATSON KATHRYN C 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 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 2160.98 0 0 0 0 0 0 2160.98 0 0 1014851512 1306208541 10 Physicians CROSS ADAM R 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 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 6240.31 0 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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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290.27 0 0 0 0 0 0 290.27 0 0 1014853889 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 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 1644.28 0 0 0 0 0 0 0 0 0 0 0 0 0 1644.28 0 0 1014853992 1821600693 16 Nurse Practitioners BOSAW TONYA A 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 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 0 360.92 0 0 0 0 0 0 360.92 0 0 1014854004 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 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 0 786.05 786.05 0 0 1014854105 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 12582.3 0 0 1014859871 1760073340 16 Nurse Practitioners MAGIN KASSANDRA 999999999 47 Jackson 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 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1308.35 0 0 0 0 0 0 1308.35 0 0 1014859979 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9150.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9150.04 0 0 1014860030 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1900.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1900.6 0 0 1014860060 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014860194 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1014860511 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 129.83 0 0 0 0 0 0 0 0 0 0 0 0 0 129.83 0 0 1014860524 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 1014860527 1073000410 10 Physicians PATEL TRISHA 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 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 0 508.51 0 0 0 0 0 0 508.51 0 0 1014860580 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 602.36 0 0 0 0 0 0 0 0 0 0 0 0 0 602.36 0 0 1014860667 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14448.95 0 0 0 0 0 0 0 0 0 0 0 0 0 14448.95 0 0 1014860800 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12889.69 0 0 0 0 0 0 0 0 0 0 0 0 0 12889.69 0 0 1014860840 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 0 0 0 0 0 0 0 0 0 0 1014861122 1982023396 10 Physicians HAIDER SAMRAN 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 0 271 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 5498.1 0 0 0 0 0 0 5498.1 0 0 1014861178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 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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 2635 0 0 0 0 0 0 2635 0 0 1014862727 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10372.96 0 0 0 0 0 0 0 0 0 0 0 0 0 10372.96 0 0 1014862768 1588197677 10 Physicians MOORE CHELSEA 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 0 177 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 2619.83 0 0 0 0 0 0 2619.83 0 0 1014863006 1538426770 10 Physicians KHAN ASIM 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 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 1479.5 0 0 0 0 0 0 1479.5 0 0 1014863183 1982969960 10 Physicians SINGH ARTI 999999999 91 Sangamon 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 0 781 0 0 0 0 0 0 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0 0 1014864346 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 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 1026.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1026.8 0 0 1014864354 1295379543 16 Nurse Practitioners ROJO CLARENCE 608051441 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 0 296.03 0 0 0 0 0 0 296.03 0 0 1014864462 1578114773 23 Occupational Therapists PATROULIS LESSIG SOPHIA E 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 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 6952.93 6952.93 0 0 1014864707 1508283821 10 Physicians ALDULESCU MONICA 999999999 30 DuPage 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 0 142 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 0 427.18 0 0 0 0 0 0 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1014866380 63 Other Providers of Medical Equipment/Supplies (Non-registered) 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 48.46 0 0 0 0 0 0 48.46 0 0 1014866475 4014866475 71 Medicar Provider JEAN TRANSPORTATION BUSINESS 999999999 53 Kane 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 1024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13393.62 0 0 0 0 0 0 13393.62 0 0 1014866512 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 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 0 358.76 358.76 0 0 1014866539 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2904.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2904.12 0 0 1014866635 1366062788 89 Physician Assistant Only(Encounter Only) HAUER ELIZABETH 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 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 0 815.06 0 0 0 0 0 0 815.06 0 0 1014866637 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 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 2291.52 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.52 0 0 1014866676 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 20870.31 0 0 0 0 0 0 0 0 0 0 0 0 0 20870.31 0 0 1014867005 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 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 16557.59 0 0 0 0 0 0 0 0 0 0 0 0 0 16557.59 0 0 1014867108 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1468.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1468.62 0 0 1014867117 1033590336 10 Physicians MANNIX JAIMEE E 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 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 19.6 0 79.02 0 0 0 0 0 0 98.62 0 0 1014867175 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 78.09 0 0 0 0 0 0 78.09 0 0 1014867196 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 161.63 0 0 0 0 0 0 0 0 0 0 0 0 0 161.63 0 0 1014867247 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0 0 3906.39 0 0 1014867781 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12568.16 0 0 0 0 0 0 0 0 0 0 0 0 0 12568.16 0 0 1014867822 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 20483.21 0 0 0 0 0 0 0 0 0 0 0 0 0 20483.21 0 0 1014867852 16 Nurse Practitioners 109 Winnebago 0 0 0 0 0 0 0 0 0 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 0 133.7 0 0 0 0 0 0 133.7 0 0 1014867882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10827.94 0 0 0 0 0 0 0 0 0 0 0 0 0 10827.94 0 0 1014868008 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 0 184 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 20203.73 0 0 0 0 0 0 0 0 0 0 0 0 0 20203.73 0 0 1014868056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 649.48 0 0 0 0 0 0 0 0 0 0 0 0 0 649.48 0 0 1014868216 1306454582 25 Audiologists YANOUZAS LAUREN 999999999 200 Cook 0 0 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 0 541 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 8188.07 8188.07 0 0 1014868232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7550.95 0 0 0 0 0 0 0 0 0 0 0 0 0 7550.95 0 0 1014868357 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 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 7030.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7030.8 0 0 1014868424 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014868545 1679993455 10 Physicians PRADHAN SHASHWATI 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 958.86 0 0 0 0 0 0 958.86 0 0 1014868665 1184273633 16 Nurse Practitioners SCHWERMAN KENNETH 999999999 33 Effingham 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 0 275.85 0 0 0 0 0 0 275.85 0 0 1014868709 92 Waiver service provider--Disability (DHS/DRS) 91 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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 64.59 0 0 0 0 0 0 0 0 0 0 0 0 0 64.59 0 0 1014869612 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 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 4.42 0 0 0 0 0 0 4.42 0 0 1014869699 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6583.02 0 0 0 0 0 0 0 0 0 0 0 0 0 6583.02 0 0 1014869701 16 Nurse Practitioners 92 Schuyler 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.74 0 0 0 0 0 0 62.74 0 0 1014869717 1619219011 10 Physicians KAVIANI ATHRA 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 28 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 25.49 0 0 0 0 0 0 0 0 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CATHERINE ANN 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55.45 0 5401.12 0 0 0 0 0 0 5456.57 0 0 1014870288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34259.18 0 0 0 0 0 0 0 0 0 0 0 0 0 34259.18 0 0 1014870339 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9803.03 0 0 0 0 0 0 0 0 0 0 0 0 0 9803.03 0 0 1014870409 1487287397 16 Nurse Practitioners HILL RENEE 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 0 889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3539.02 0 0 0 0 0 0 3539.02 0 0 1014870543 1124398847 10 Physicians GARCIA SAENZ SICILIA MAURICIO 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 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 1020.96 0 0 0 0 0 0 1020.96 0 0 1014870662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12592.45 0 0 0 0 0 0 0 0 0 0 0 0 0 12592.45 0 0 1014870749 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 150.66 0 0 0 0 0 0 0 0 0 0 0 0 0 150.66 0 0 1014871095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 997.11 0 0 0 0 0 0 0 0 0 0 0 0 0 997.11 0 0 1014871223 55 Early Intervention Services 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 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 3407.98 0 0 0 0 0 0 3407.98 0 0 1014871274 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014871315 1801434733 16 Nurse Practitioners ISCHAR CHERYL L 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 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 0 476.89 0 0 0 0 0 0 476.89 0 0 1014871401 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 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 0 110.3 0 0 0 0 0 0 110.3 0 0 1014871439 1568418358 10 Physicians AGRAWAL BHARAT 999999999 200 Cook 0 0 Internal Medicine 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 1778.24 0 0 0 0 0 0 1778.24 0 0 1014871464 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2745.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2745.6 0 0 1014871486 1649805623 16 Nurse Practitioners SIKORSKI KIMBERLY S 999999999 24 Coles 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 0 156 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 3128.61 0 0 0 0 0 0 3128.61 0 0 1014871498 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.79 18.79 0 0 1014871541 1114460839 33 Nursing Facilities RIVER CROSSING OF EAST PEORIA 999999999 98 Tazewell 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 0 246 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5642 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 659688.39 0 0 0 0 0 0 0 659688.39 0 0 1014871568 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 79.72 0 0 0 0 0 0 79.72 0 0 1014871693 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325.56 0 0 0 0 0 0 0 0 0 0 0 0 0 325.56 0 0 1014871806 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11017.77 0 0 0 0 0 0 0 0 0 0 0 0 0 11017.77 0 0 1014872011 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 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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 4235.96 0 0 0 0 0 0 4235.96 0 0 1014872713 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 0 125.8 0 0 0 0 0 0 125.8 0 0 1014872952 1992267637 60 Pharmacies GENOA HEALTHCARE LLC 999999999 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 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4329 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15966.45 0 0 0 15966.45 0 0 1014872966 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 668.36 0 0 0 0 0 0 0 0 0 0 0 0 0 668.36 0 0 1014873020 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29272.67 0 0 0 0 0 0 0 0 0 0 0 0 0 29272.67 0 0 1014873239 1427433416 10 Physicians SAMPATHGIRI KRUTHIKA 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 0 282 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 2265.54 0 0 0 0 0 0 2265.54 0 0 1014873251 1699208348 10 Physicians PHILANDER SHANNON ALI 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 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 0 170.13 0 0 0 0 0 0 170.13 0 0 1014873373 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11991.26 0 0 0 0 0 0 0 0 0 0 0 0 0 11991.26 0 0 1014873942 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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 16044 0 0 0 0 0 0 16044 0 0 1014875100 1841816980 23 Occupational Therapists FRIDLUND VALERIE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52368.23 52368.23 0 0 1014875164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 224.17 0 0 0 0 0 0 0 0 0 0 0 0 0 224.17 0 0 1014875283 16 Nurse Practitioners 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 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 1014875564 1518990704 33 Nursing Facilities SHELBYVILLE REHAB HEALTH CC 999999999 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 1458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133531.57 0 0 0 0 0 0 0 133531.57 0 0 1014875893 1932349792 10 Physicians DHAWAN VIKAS 999999999 80 Peoria 0 0 Orthopedic Surgery 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 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 5001.32 0 0 0 0 0 0 5001.32 0 0 1014875935 1285241877 40 Federally Qualified Health Centers REA CLINIC BENTON 999999999 36 Franklin 0 0 0 154 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 596 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18547.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18547.98 0 0 1014876067 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11454.46 0 0 0 0 0 0 0 0 0 0 0 0 0 11454.46 0 0 1014876083 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3728.12 0 0 0 0 0 0 0 0 0 0 0 0 0 3728.12 0 0 1014876167 1215391099 10 Physicians ORTMAN GRACE 999999999 200 Cook 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 0 200 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 4161.64 0 0 0 0 0 0 4161.64 0 0 1014876173 10 Physicians 80 Peoria 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 0 207.4 0 0 0 0 0 0 207.4 0 0 1014876487 1558726034 16 Nurse Practitioners ROWLAND MELISSA D 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 0 306.96 0 0 0 0 0 0 306.96 0 0 1014876726 1356935100 16 Nurse Practitioners KOSYDOR JAYDA L 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 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 0 416.64 0 0 0 0 0 0 416.64 0 0 1014876776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9572.41 0 0 0 0 0 0 0 0 0 0 0 0 0 9572.41 0 0 1014876975 1518340603 10 Physicians BIEBER KATIE B 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281.24 0 658.41 0 0 0 0 0 0 939.65 0 0 1014877159 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 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2592.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.96 0 0 2618.5 0 0 1014877192 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 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.66 0 152.96 0 0 0 0 0 0 160.62 0 0 1014877259 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40520.09 0 0 0 0 0 0 0 0 0 0 0 0 0 40520.09 0 0 1014877264 1124401070 10 Physicians ALNAFOOSI ZAINAB 999999999 91 Sangamon 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 0 328 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 6204.73 0 0 0 0 0 0 6204.73 0 0 1014877275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3762.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3762.3 0 0 1014877378 27 Behavioral Health Clinic 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 712.6 0 0 712.6 0 0 1014877484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38258.4 0 0 0 0 0 0 0 0 0 0 0 0 0 38258.4 0 0 1014877517 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1009.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1009.36 0 0 1014877563 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 73.4 0 0 0 0 0 0 73.4 0 0 1014877685 1558972364 16 Nurse Practitioners STEPHEN ANU J 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 29.76 0 0 0 0 0 0 29.76 0 0 1014877970 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1695.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1695.16 0 0 1014878081 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10818.99 0 0 0 0 0 0 0 0 0 0 0 0 0 10818.99 0 0 1014878101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7178.28 0 0 0 0 0 0 0 0 0 0 0 0 0 7178.28 0 0 1014878115 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 281.13 0 0 0 0 0 0 0 0 0 0 0 0 0 281.13 0 0 1014878357 1891189163 10 Physicians TIAGONCE ADAM 999999999 30 DuPage 0 0 Anesthesiology 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 1058.58 0 0 0 0 0 0 1058.58 0 0 1014878414 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17545.61 0 0 0 0 0 0 0 0 0 0 0 0 0 17545.61 0 0 1014878424 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4575.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4575.85 0 0 1014878528 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23878.68 0 0 0 0 0 0 0 0 0 0 0 0 0 23878.68 0 0 1014878557 1932739497 33 Nursing Facilities ARCADIA CARE DANVILLE 999999999 100 Vermilion 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 0 252 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755994.88 0 0 0 0 0 0 0 755994.88 0 0 1014878593 1104225648 16 Nurse Practitioners CHIPEPO MWEEMBA 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 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 82.54 0 0 0 0 0 0 82.54 0 0 1014878686 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19291.8 0 0 0 0 0 0 0 0 0 0 0 0 0 19291.8 0 0 1014878726 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 21283 0 0 0 0 0 0 0 0 0 0 0 0 0 21283 0 0 1014878737 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22578.91 0 0 0 0 0 0 0 0 0 0 0 0 0 22578.91 0 0 1014878975 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24450.15 0 0 0 0 0 0 0 0 0 0 0 0 0 24450.15 0 0 1014879001 1245889393 55 Early Intervention Services ALLEN SARAH R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 7806.59 0 0 0 0 0 0 7806.59 0 0 1014879095 1811545296 22 Physical Therapists WILLIAMS KASSI 999999999 91 Sangamon 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 0 149 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 12298.78 12298.78 0 0 1014879106 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 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 3493.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3493.7 0 0 1014879124 1740609015 10 Physicians COLLINS ELIZABETH A 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 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 1004.59 0 0 0 0 0 0 1004.59 0 0 1014879348 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 204.27 0 0 0 0 0 0 0 0 0 0 0 0 0 204.27 0 0 1014879415 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 22839.7 0 0 0 0 0 0 0 0 0 0 0 0 0 22839.7 0 0 1014879419 1992234504 10 Physicians TENEGRA NICOLE G 999999999 91 Sangamon 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 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 0 981.92 0 0 0 0 0 0 981.92 0 0 1014879490 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 1.23 0 0 0 0 0 0 1.23 0 0 1014879517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5060.82 0 0 0 0 0 0 0 0 0 0 0 0 0 5060.82 0 0 1014879600 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23067.1 0 0 0 0 0 0 0 0 0 0 0 0 0 23067.1 0 0 1014879608 55 Early Intervention Services 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 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 4772.7 0 0 0 0 0 0 4772.7 0 0 1014879632 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1725.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1725.51 0 0 1014879734 1063056919 89 Physician Assistant Only(Encounter Only) GLIATIS ANASTASIA 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 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 0 508.26 0 0 0 0 0 0 508.26 0 0 1014879805 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 257.08 0 0 0 0 0 0 0 0 0 0 0 0 0 257.08 0 0 1014879826 1720493877 10 Physicians KATTA PRASANTH 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 6 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.69 0 1616.75 0 0 0 0 0 0 1747.44 0 0 1014879839 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 208.96 0 0 0 0 0 0 0 0 0 0 0 0 0 208.96 0 0 1014879952 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 10109.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10109.88 0 0 1014879964 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 78.09 0 0 0 0 0 0 78.09 0 0 1014879968 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 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 17.86 0 0 0 0 0 0 0 0 17.86 0 0 1014880022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24028.89 0 0 0 0 0 0 0 0 0 0 0 0 0 24028.89 0 0 1014880052 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14722.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14722.68 0 0 1014880240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1419.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1419.48 0 0 1014880295 1124514989 16 Nurse Practitioners CHO CHRISTINE 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 0 204 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 2632.04 0 0 0 0 0 0 2632.04 0 0 1014880548 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.88 0 0 0 0 0 0 59.88 0 0 1014880568 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 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 1014880794 1972549210 10 Physicians BERESKIN GAYLE F 999999999 200 Cook 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 0 171 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 1114.32 0 0 0 0 0 0 1114.32 0 0 1014880820 1205446226 11 Dentists KIM DOO HYUN 999999999 200 Cook 0 0 0 0 213 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1144 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1144 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 41407.12 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 42536.17 0 0 1014880960 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014881139 1053542076 10 Physicians PEARCE CHARLES 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 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 0 386.91 0 0 0 0 0 0 386.91 0 0 1014881161 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 37.62 0 0 0 0 0 0 0 0 0 0 0 0 0 37.62 0 0 1014881184 1730543984 10 Physicians STEAR TIMOTHY J 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 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 3138.05 0 0 0 0 0 0 3138.05 0 0 1014881315 1851990667 16 Nurse Practitioners AMODEO NATALIE 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 0 668.82 0 0 0 0 0 0 668.82 0 0 1014881490 1356973762 16 Nurse Practitioners SHAW STACEY 999999999 30 DuPage 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 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 3551.93 0 0 0 0 0 0 3551.93 0 0 1014881629 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 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 1098.8 1098.8 0 0 1014881665 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30760.86 0 0 0 0 0 0 0 0 0 0 0 0 0 30760.86 0 0 1014881689 1043850068 16 Nurse Practitioners BELL LAUREN E 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 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 1628.98 0 0 0 0 0 0 1628.98 0 0 1014881736 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 706.94 0 0 0 0 0 0 0 0 0 0 0 0 0 706.94 0 0 1014881995 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130.66 0 0 0 0 0 0 130.66 0 0 1014882165 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 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 1546.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1546.6 0 0 1014882320 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 22.6 0 0 1014882333 1386237659 16 Nurse Practitioners ANDERSON AUDREY 999999999 91 Sangamon 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 0 447.74 0 0 0 0 0 0 447.74 0 0 1014882391 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24776.3 0 0 0 0 0 0 0 0 0 0 0 0 0 24776.3 0 0 1014882400 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 14559.98 0 0 0 0 0 0 0 0 0 0 0 0 0 14559.98 0 0 1014882484 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11646.02 0 0 0 0 0 0 0 0 0 0 0 0 0 11646.02 0 0 1014882602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37936.6 0 0 0 0 0 0 0 0 0 0 0 0 0 37936.6 0 0 1014882745 16 Nurse Practitioners 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 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 0 210.53 0 0 0 0 0 0 210.53 0 0 1014882772 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16677.09 0 0 0 0 0 0 0 0 0 0 0 0 0 16677.09 0 0 1014882785 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7703.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7703.5 0 0 1014882818 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11434.37 0 0 0 0 0 0 0 0 0 0 0 0 0 11434.37 0 0 1014882994 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 443.96 0 0 0 0 0 0 0 0 0 0 0 0 0 443.96 0 0 1014883033 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 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 1489.5 0 0 0 0 0 0 1489.5 0 0 1014883038 1033696877 12 Optometrists CHEE MEGAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1091.51 0 1737.78 0 0 0 0 2829.29 0 0 1014883141 4014883141 72 Taxicabs and Livery Companies BELL'LA TRANSPORTATION SERVICE 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 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8115.31 0 0 0 0 0 0 8115.31 0 0 1014883375 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11375.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11375.52 0 0 1014883551 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 8303.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8303.88 0 0 1014883554 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 28742.97 0 0 0 0 0 0 0 0 0 0 0 0 0 28742.97 0 0 1014883859 1558609008 61 Independent Laboratories "BIODIAGNOSTIC LABS, INC" 999999999 833 New York 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 1014 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43846.86 0 0 0 0 0 0 0 0 43846.86 0 0 1014883927 1033516935 16 Nurse Practitioners EYER KELLY S 999999999 88 Richland 0 0 0 0 0 6 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 207 0 0 0 0 0 0 0 0 0 559.84 0 0 0 0 0 0 0 0 3135.46 0 0 0 0 0 0 3695.3 0 0 1014884201 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19890.97 0 0 0 0 0 0 0 0 0 0 0 0 0 19890.97 0 0 1014884226 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 0 455 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 56815.59 0 0 0 0 0 0 0 0 0 0 0 0 0 56815.59 0 0 1014884227 1407380769 10 Physicians BATCHU NAGARJUN 999999999 200 Cook 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 0 118 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 5010.82 0 0 0 0 0 0 5010.82 0 0 1014884611 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 0 132 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 7189.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7189.45 0 0 1014884643 1013362888 10 Physicians THOMAS CATHERINE J 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 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 0 226.14 0 0 0 0 0 0 226.14 0 0 1014884677 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1093.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1093.83 0 0 1014884747 1700238813 10 Physicians MAHMOOD SAJID 999999999 200 Cook 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.67 0 0 0 0 0 0 83.67 0 0 1014884774 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33115.11 0 0 0 0 0 0 0 0 0 0 0 0 0 33115.11 0 0 1014884953 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41877.7 0 0 0 0 0 0 0 0 0 0 0 0 0 41877.7 0 0 1014885023 1457979189 11 Dentists LEEZER KENNETH 999999999 200 Cook 0 0 General Dentistry 0 0 36 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 6695.82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6695.82 0 0 1014885390 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 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 0 249.95 0 0 0 0 0 0 249.95 0 0 1014885398 1811520117 16 Nurse Practitioners MCENERNEY CAITLIN M 999999999 200 Cook 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 1 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 136.2 0 0 0 0 0 0 0 0 568 0 0 0 0 0 0 704.2 0 0 1014885431 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 637.02 0 0 0 0 0 0 0 0 0 0 0 0 0 637.02 0 0 1014885539 1750505442 10 Physicians MANGUBAT CYNTHIA P 999999999 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 4 0 30 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 48 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 48 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 23.28 0 2080.89 0 0 0 0 0 0 2209.13 0 0 1014885548 10 Physicians 47 Jackson 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.27 0 0 0 0 0 0 108.27 0 0 1014885568 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 0 131 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 17728.92 0 0 0 0 0 0 0 0 0 0 0 0 0 17728.92 0 0 1014885759 1629502687 10 Physicians PAYLOR YOLANDA 999999999 200 Cook 0 0 Family Practice 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 2296.09 0 0 0 0 0 0 2296.09 0 0 1014886019 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 724.1 0 0 0 0 0 0 0 0 0 0 0 0 0 724.1 0 0 1014886031 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014886222 1588195531 10 Physicians CHAUDHRY FIRAZ 999999999 200 Cook 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 0 301 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 5342.71 0 0 0 0 0 0 5342.71 0 0 1014886239 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014886249 1508497660 16 Nurse Practitioners MILLER MARIA 999999999 106 Whiteside 0 0 0 0 0 4 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 44.95 0 0 0 0 0 0 0 0 1055.24 0 0 0 0 0 0 1100.19 0 0 1014886442 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 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 4684.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4684.31 0 0 1014886514 1932741824 89 Physician Assistant Only(Encounter Only) POAD JESSICA 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 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 64.76 0 0 0 0 0 0 64.76 0 0 1014886609 1740891209 16 Nurse Practitioners CARTINA KATHERINE A 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 0 412 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 0 710.54 0 0 0 0 0 0 710.54 0 0 1014886696 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 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 0 243.8 243.8 0 0 1014886705 1801231006 10 Physicians NAST JOSHUA R 999999999 30 DuPage 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 0 956.77 0 0 0 0 0 0 956.77 0 0 1014886837 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11881.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11881.36 0 0 1014886864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 897.79 0 0 0 0 0 0 0 0 0 0 0 0 0 897.79 0 0 1014887181 1598308090 16 Nurse Practitioners MORIE JOSEPH M 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 0 112 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 0 300.07 0 0 0 0 0 0 300.07 0 0 1014887288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635.08 0 0 0 0 0 0 0 0 0 0 0 0 0 635.08 0 0 1014887374 1811192099 10 Physicians COX BRETT WAYNE 999999999 200 Cook 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 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 0 497.55 0 0 0 0 0 0 497.55 0 0 1014887496 94 Waiver service provider--Children's support (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 0 161 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 18606.66 0 0 0 0 0 0 0 0 0 0 0 0 0 18606.66 0 0 1014887528 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11250.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11250.78 0 0 1014887955 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23457.7 0 0 0 0 0 0 0 0 0 0 0 0 0 23457.7 0 0 1014888067 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 1070.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1070.89 0 0 1014888101 1568012292 16 Nurse Practitioners GONZALEZ MARTA 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 0 479.95 0 0 0 0 0 0 479.95 0 0 1014888117 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14065.89 0 0 0 0 0 0 0 0 0 0 0 0 0 14065.89 0 0 1014888157 1164061479 16 Nurse Practitioners WOOD STEVEN T 999999999 109 Winnebago 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 1908.89 0 0 0 0 0 0 1908.89 0 0 1014888158 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23872.72 0 0 0 0 0 0 0 0 0 0 0 0 0 23872.72 0 0 1014888305 1194174110 10 Physicians STEVENSON EMILY M 999999999 200 Cook 0 0 Dermatology 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 0 108 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 0 923.76 0 0 0 0 0 0 923.76 0 0 1014888310 1710578117 89 Physician Assistant Only(Encounter Only) JOHNSON PARKER B 999999999 72 McLean 0 0 0 0 0 0 0 0 0 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 9.41 0 0 0 0 0 0 9.41 0 0 1014888448 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 258.04 0 0 0 0 0 0 0 0 0 0 0 0 0 258.04 0 0 1014888461 10 Physicians 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 76.83 0 0 0 0 0 0 76.83 0 0 1014888517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8248.94 0 0 0 0 0 0 0 0 0 0 0 0 0 8248.94 0 0 1014888568 1699156737 10 Physicians MAROOF SHAHRAM 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 0 138 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 3553.3 0 0 0 0 0 0 3553.3 0 0 1014888857 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.26 0 0 0 0 0 0 132.26 0 0 1014889051 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20589.27 0 0 0 0 0 0 0 0 0 0 0 0 0 20589.27 0 0 1014889065 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 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 4444.75 0 0 0 0 0 0 0 0 0 0 0 0 0 4444.75 0 0 1014889520 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 0 131 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 13963.93 0 0 0 0 0 0 0 0 0 0 0 0 0 13963.93 0 0 1014889658 1902212327 10 Physicians MICHALOWITZ ANDREW J 999999999 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 3 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.64 0 6719 0 0 0 0 0 0 6747.64 0 0 1014889767 1073005922 10 Physicians SATHER NICOLE K 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1588.03 0 0 0 0 0 0 1588.03 0 0 1014889773 1578927125 10 Physicians YADAV MUKESH K 999999999 19 Champaign 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 0 274 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 3379.83 0 0 0 0 0 0 3379.83 0 0 1014889842 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 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 4706.67 0 0 0 0 0 0 0 0 0 0 0 0 0 4706.67 0 0 1014889867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 53387.06 0 0 0 0 0 0 0 0 0 0 0 0 0 53387.06 0 0 1014889947 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13676.55 0 0 0 0 0 0 0 0 0 0 0 0 0 13676.55 0 0 1014889989 1972701928 10 Physicians SZYMCZAK JOHN M 999999999 109 Winnebago 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142.17 0 0 0 0 0 0 142.17 0 0 1014890093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1603.13 0 0 0 0 0 0 0 0 0 0 0 0 0 1603.13 0 0 1014890113 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23228.28 0 0 0 0 0 0 0 0 0 0 0 0 0 23228.28 0 0 1014890212 10 Physicians 101 Wabash 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 45.82 0 0 0 0 0 0 45.82 0 0 1014890230 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7548.13 0 0 0 0 0 0 0 0 0 0 0 0 0 7548.13 0 0 1014890328 1700317963 10 Physicians MEADOW NATHANIEL 999999999 30 DuPage 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 0 267 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 3096.5 0 0 0 0 0 0 3096.5 0 0 1014890432 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5848.04 0 0 0 0 0 0 0 0 0 0 0 0 0 5848.04 0 0 1014890554 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7234.05 0 0 0 0 0 0 0 0 0 0 0 0 0 7234.05 0 0 1014890608 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15317.69 0 0 0 0 0 0 0 0 0 0 0 0 0 15317.69 0 0 1014890616 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14194.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14194.88 0 0 1014890684 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21676.13 0 0 0 0 0 0 0 0 0 0 0 0 0 21676.13 0 0 1014890697 1538490735 22 Physical Therapists SLAASTAD CATHERINE 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 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 0 339.13 339.13 0 0 1014890893 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3741.14 0 0 0 0 0 0 0 0 0 0 0 0 0 3741.14 0 0 1014890908 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12364.49 0 0 0 0 0 0 0 0 0 0 0 0 0 12364.49 0 0 1014891014 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 819.27 0 0 0 0 0 0 0 0 0 0 0 0 0 819.27 0 0 1014891233 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.99 0 0 0 0 0 0 0 0 0 0 0 0 0 129.99 0 0 1014891254 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7734.88 0 0 0 0 0 0 0 0 0 0 0 0 0 7734.88 0 0 1014891350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21930 0 0 0 0 0 0 0 0 0 0 0 0 0 21930 0 0 1014891396 1215401591 16 Nurse Practitioners VERBUS ASHLEY S 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 25.85 0 0 0 0 0 0 25.85 0 0 1014891442 1952711582 10 Physicians BARONOWSKY ALEX V 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 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 0 796.75 0 0 0 0 0 0 796.75 0 0 1014891527 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4676.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4676.34 0 0 1014891569 1962977223 16 Nurse Practitioners BELANGER KRISTINA 999999999 200 Cook 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 0 107 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 32.15 0 0 0 0 0 0 0 0 2800.09 0 0 0 0 0 0 2832.24 0 0 1014891595 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 398.2 0 0 0 0 0 0 0 0 0 0 0 0 0 398.2 0 0 1014891620 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.86 0 0 0 0 0 0 0 0 0 0 0 0 0 8805.86 0 0 1014891626 86 Clinical Social Worker(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 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 0 345.44 0 0 0 0 0 0 345.44 0 0 1014891665 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12063.03 0 0 0 0 0 0 0 0 0 0 0 0 0 12063.03 0 0 1014891757 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1205.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1205.04 0 0 1014891872 1295389385 16 Nurse Practitioners KELLY CHRISTINA 999999999 70 McDonough 0 0 0 0 0 0 0 0 0 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 53.83 0 0 0 0 0 0 53.83 0 0 1014891891 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 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 1014891963 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16079.66 0 0 0 0 0 0 0 0 0 0 0 0 0 16079.66 0 0 1014892223 1164044707 16 Nurse Practitioners THIND SONAM 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014892235 1689087439 10 Physicians GULAYA KARAN S 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 388 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463 0 173 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1676.95 0 2577.8 0 0 0 0 0 0 4254.75 0 0 1014892363 1437115417 33 Nursing Facilities ARCOLA HEALTH CARE CENTER 999999999 29 Douglas 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 2673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288015.77 0 0 0 0 0 0 0 288015.77 0 0 1014892464 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 24576.37 0 0 0 0 0 0 0 0 0 0 0 0 0 24576.37 0 0 1014892539 1427412725 10 Physicians FISCHER JEAN V 999999999 200 Cook 0 0 0 0 0 0 0 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 0 346.28 0 0 0 0 0 0 0 0 346.28 0 0 1014892593 1003425786 87 Psychologist(Encounter Only) WEIDEN BRYCIE 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 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 86.73 0 0 0 0 0 0 86.73 0 0 1014892599 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23912.79 0 0 0 0 0 0 0 0 0 0 0 0 0 23912.79 0 0 1014892662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3879.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3879.04 0 0 1014892722 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21851.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21851.9 0 0 1014892879 1568082311 16 Nurse Practitioners OCEGUERA ERIKA 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 0 309.14 0 0 0 0 0 0 309.14 0 0 1014892988 1578093795 13 Podiatrists DENDEN SHARIF 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 0 208 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 1358.07 0 0 0 0 0 0 1358.07 0 0 1014893410 1881250355 61 Independent Laboratories LABORATORY CORPORATION OF AMER 999999999 200 Cook 0 0 0 0 0 0 0 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 79.69 0 0 0 0 0 0 0 0 79.69 0 0 1014893466 1235528225 61 Independent Laboratories NSTX INC 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83944.74 0 0 0 0 0 0 0 0 83944.74 0 0 1014893549 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16268.28 0 0 0 0 0 0 0 0 0 0 0 0 0 16268.28 0 0 1014893815 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 0 248 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 17642.32 0 0 0 0 0 0 0 0 0 0 0 0 0 17642.32 0 0 1014893821 1083956320 10 Physicians MCCOY BRIDGET K 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 885.02 0 0 0 0 0 0 885.02 0 0 1014893822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 327.47 0 0 0 0 0 0 0 0 0 0 0 0 0 327.47 0 0 1014893832 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 20517.75 0 0 0 0 0 0 0 0 0 0 0 0 0 20517.75 0 0 1014893890 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19774.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19774.22 0 0 1014894124 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21303.5 0 0 0 0 0 0 0 0 0 0 0 0 0 21303.5 0 0 1014894466 1033157888 10 Physicians ZWICK MATTHEW 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 85 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1230.93 0 21.07 0 0 0 0 0 0 1252 0 0 1014894565 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 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 0 390.45 0 0 0 0 0 0 390.45 0 0 1014894695 1760944987 11 Dentists ATEN KYLE 999999999 200 Cook 0 0 Orthodontist 0 0 125 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 48918.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48918.25 0 0 1014894865 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 25781.17 0 0 0 0 0 0 0 0 0 0 0 0 0 25781.17 0 0 1014894892 13 Podiatrists 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 0 145.86 0 0 0 0 0 0 145.86 0 0 1014895014 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22878.63 0 0 0 0 0 0 0 0 0 0 0 0 0 22878.63 0 0 1014895092 1831504356 10 Physicians SHAH NICK B 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 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 0 0 345.02 0 0 0 0 0 0 345.02 0 0 1014895244 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19145.28 0 0 0 0 0 0 0 0 0 0 0 0 0 19145.28 0 0 1014895460 1255862835 10 Physicians PERSCH JASMIN A 999999999 200 Cook 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 0 196 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 12117.87 0 0 0 0 0 0 12117.87 0 0 1014895633 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8925.51 0 0 0 0 0 0 0 0 0 0 0 0 0 8925.51 0 0 1014895644 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12611.08 0 0 0 0 0 0 0 0 0 0 0 0 0 12611.08 0 0 1014895780 1689103798 10 Physicians COOPER CRYSTAL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 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 5575.71 0 0 0 0 0 0 5575.71 0 0 1014895786 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14459.34 0 0 0 0 0 0 0 0 0 0 0 0 0 14459.34 0 0 1014895956 1164905014 16 Nurse Practitioners WILLIAMS TRIPLETT FELICIA 999999999 200 Cook 0 0 0 0 0 10 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 788.58 0 0 0 0 0 0 0 0 1071.51 0 0 0 0 0 0 1860.09 0 0 1014896029 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 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 0 405.48 0 0 0 0 0 0 405.48 0 0 1014896141 1134581317 10 Physicians TANCREDI MARK 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 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 1713.88 0 0 0 0 0 0 1713.88 0 0 1014896184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7725.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7725.2 0 0 1014896283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14947.69 0 0 0 0 0 0 0 0 0 0 0 0 0 14947.69 0 0 1014896290 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22064.14 0 0 0 0 0 0 0 0 0 0 0 0 0 22064.14 0 0 1014896472 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13032.9 0 0 0 0 0 0 0 0 0 0 0 0 0 13032.9 0 0 1014896487 1093034977 10 Physicians COHEN ERICA 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425.55 0 0 0 0 0 0 425.55 0 0 1014896649 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 43.54 0 0 0 0 0 0 43.54 0 0 1014896768 1164943726 10 Physicians WENDY CHEN 999999999 30 DuPage 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 0 126.51 0 0 0 0 0 0 126.51 0 0 1014897047 1104362755 16 Nurse Practitioners CALABAZARON ARVIE 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4715.17 0 0 0 0 0 0 4715.17 0 0 1014897173 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 0 136 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 9614.99 0 0 0 0 0 0 0 0 0 0 0 0 0 9614.99 0 0 1014897379 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 0 177 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 9179.1 0 0 0 0 0 0 0 0 0 0 0 0 0 9179.1 0 0 1014897402 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 49.22 0 0 0 0 0 0 49.22 0 0 1014897411 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 0 165.02 0 0 0 0 0 0 165.02 0 0 1014897543 1427457480 10 Physicians LEE MATTHEW S 999999999 53 Kane 0 0 Urology 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 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.94 0 745.94 0 0 0 0 0 0 753.88 0 0 1014897549 1326677535 16 Nurse Practitioners ROSE ANGIE 999999999 10 Adams 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 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 1177.6 0 0 0 0 0 0 1177.6 0 0 1014897607 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5720.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5720.74 0 0 1014897781 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.21 0 0 0 0 0 0 0 0 0 0 0 0 0 97.21 0 0 1014897829 1003363540 13 Podiatrists THOMAS DARLA 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 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 0 917.82 0 0 0 0 0 0 917.82 0 0 1014897874 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27991.82 0 0 0 0 0 0 0 0 0 0 0 0 0 27991.82 0 0 1014897903 1609305234 10 Physicians STROMDAHL KATHRYN 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 645.85 0 0 0 0 0 0 645.85 0 0 1014897962 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15230.11 0 0 0 0 0 0 0 0 0 0 0 0 0 15230.11 0 0 1014898080 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 52.51 0 0 0 0 0 0 52.51 0 0 1014898423 1962880419 10 Physicians KAO RICHARD 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 1021.71 0 0 0 0 0 0 1021.71 0 0 1014898469 1174162895 16 Nurse Practitioners ROSIER YANICK 999999999 53 Kane 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 0 199 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 3025.25 0 0 0 0 0 0 3025.25 0 0 1014898499 1366050775 22 Physical Therapists LODHIA SERINA D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 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 0 802.22 802.22 0 0 1014898713 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5347.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5347.64 0 0 1014898810 1457975153 89 Physician Assistant Only(Encounter Only) HALL SAMANTHA 999999999 65 Madison 0 0 0 0 0 0 0 0 0 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 0 292.88 0 0 0 0 0 0 292.88 0 0 1014899474 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20690.9 0 0 0 0 0 0 0 0 0 0 0 0 0 20690.9 0 0 1014899529 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 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 0 294.42 0 0 0 0 0 0 294.42 0 0 1014899723 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2441.85 0 0 0 0 0 0 0 0 0 0 0 0 0 2441.85 0 0 1014899925 1851996649 24 Speech Therapists SALAZAR JULIANNE 999999999 30 DuPage 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 0 131 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 9646.82 9646.82 0 0 1014899928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23487.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23487.5 0 0 1014900061 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 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 4193.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4193.52 0 0 1014900077 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2392.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2392.15 0 0 1014900197 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15348.83 0 0 0 0 0 0 0 0 0 0 0 0 0 15348.83 0 0 1014900224 1215583117 16 Nurse Practitioners ABERNATHY LOREN A 999999999 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 3542.66 0 0 0 0 0 0 3542.66 0 0 1014900225 1033591565 10 Physicians HEBERER MATTHEW 999999999 45 Henry 0 0 0 0 0 0 0 0 0 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 1306.78 0 0 0 0 0 0 1306.78 0 0 1014900229 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 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 0 0 0 0 0 0 0 0 0 0 1014900272 1477178820 89 Physician Assistant Only(Encounter Only) STATEN BRADLEY 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 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 0 397.24 0 0 0 0 0 0 397.24 0 0 1014900349 1306210919 89 Physician Assistant Only(Encounter Only) DRESBACH EMILY J 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 0 116.48 0 0 0 0 0 0 116.48 0 0 1014900382 1134118987 10 Physicians FRETZIN MICHAEL H 999999999 57 Lake 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 5 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.18 0 245.6 0 0 0 0 0 0 259.78 0 0 1014900451 1457523508 10 Physicians FOBI-NUNGA NICOLE F 999999999 45 Henry 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 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 0 238.24 0 0 0 0 0 0 238.24 0 0 1014900463 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21391.92 0 0 0 0 0 0 0 0 0 0 0 0 0 21391.92 0 0 1014900495 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6788.05 0 0 0 0 0 0 0 0 0 0 0 0 0 6788.05 0 0 1014900560 1467087486 16 Nurse Practitioners WILLIAMS JULIANNA T 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 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 0 482.64 0 0 0 0 0 0 482.64 0 0 1014900612 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 295.66 0 0 0 0 0 0 0 0 0 0 0 0 0 295.66 0 0 1014900682 1821539032 10 Physicians CHARARA LAYA K 999999999 53 Kane 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 0 250 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 4946.93 0 0 0 0 0 0 4946.93 0 0 1014900691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4395.6 0 0 0 0 0 0 0 0 0 0 0 0 0 4395.6 0 0 1014900702 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 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 0 430.2 0 0 0 0 0 0 430.2 0 0 1014900764 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5125.93 0 0 0 0 0 0 0 0 0 0 0 0 0 5125.93 0 0 1014900788 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 87.26 0 0 0 0 0 0 87.26 0 0 1014900881 1720634728 60 Pharmacies MARA PHARMACY 999999999 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 1711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122387.64 0 0 0 122387.64 0 0 1014901194 12 Optometrists 200 Cook 0 0 Diagnostic 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.96 0 0 0 0 0 0 17.96 0 0 1014901257 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 799.98 0 0 0 0 0 0 0 0 0 0 0 0 0 799.98 0 0 1014901266 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 33117.72 0 0 0 0 0 0 0 0 0 0 0 0 0 33117.72 0 0 1014901398 1093919714 10 Physicians HOUSTON LILLIAN J 999999999 91 Sangamon 0 0 Psychiatry 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 0 316 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 10018.13 0 0 0 0 0 0 10018.13 0 0 1014901441 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10662.37 0 0 0 0 0 0 0 0 0 0 0 0 0 10662.37 0 0 1014901743 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23671.25 0 0 0 0 0 0 0 0 0 0 0 0 0 23671.25 0 0 1014901912 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 775.74 0 0 0 0 0 0 0 0 0 0 0 0 0 775.74 0 0 1014902046 1255750410 10 Physicians RAJPOOT RAVI 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 959 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1409 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19126.71 0 35.18 0 0 0 0 0 0 19161.89 0 0 1014902109 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 27057.22 0 0 0 0 0 0 0 0 0 0 0 0 0 27057.22 0 0 1014902252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 364.56 0 0 0 0 0 0 0 0 0 0 0 0 0 364.56 0 0 1014902275 1952943649 89 Physician Assistant Only(Encounter Only) PORUCZNIK ALEXANDER 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 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 0 138.43 0 0 0 0 0 0 138.43 0 0 1014902348 16 Nurse Practitioners 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014902475 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 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 7126.57 0 0 0 0 0 0 0 0 0 0 0 0 0 7126.57 0 0 1014902626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175.2 0 0 0 0 0 0 0 0 0 0 0 0 0 175.2 0 0 1014902696 1760016547 16 Nurse Practitioners TERRONEZ ANN F 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 0 167 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 1793.27 0 0 0 0 0 0 1793.27 0 0 1014902738 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483.62 0 0 0 0 0 0 0 0 0 0 0 0 0 483.62 0 0 1014902823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5797.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5797.47 0 0 1014902884 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14993.92 0 0 0 0 0 0 0 0 0 0 0 0 0 14993.92 0 0 1014902902 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6904.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6904.4 0 0 1014902917 1902224967 10 Physicians WILKIE NICHOLAS E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116 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 2804.17 0 0 0 0 0 0 2804.17 0 0 1014903203 1992124762 10 Physicians KHAN SHAJI M 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 125 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1449.28 0 2575.68 0 0 0 0 0 0 4024.96 0 0 1014903603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6540.38 0 0 0 0 0 0 0 0 0 0 0 0 0 6540.38 0 0 1014903679 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7575 0 0 0 0 0 0 0 0 0 0 0 0 0 7575 0 0 1014903716 1184992265 10 Physicians SANTIAGO RODRIGUEZ JOSE R 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.52 0 3432.2 0 0 0 0 0 0 3454.72 0 0 1014904144 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 12.88 0 0 0 0 0 0 12.88 0 0 1014904194 1447877121 16 Nurse Practitioners BUTTON COURTNEY L 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 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 0 453.84 0 0 0 0 0 0 453.84 0 0 1014904476 1942661483 10 Physicians CHEN YOLANDE 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 0 256 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 12780.39 0 0 0 0 0 0 12780.39 0 0 1014904619 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 15.7 0 0 0 0 0 0 15.7 0 0 1014904847 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10044.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10044.76 0 0 1014904941 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 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 2008.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2008.47 0 0 1014905299 11 Dentists 200 Cook 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 0 137.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.5 0 0 1014905329 10 Physicians 30 DuPage 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 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 0 224.37 0 0 0 0 0 0 224.37 0 0 1014905407 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 2 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 4731.55 4731.55 0 0 1014905433 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5009.74 0 0 0 0 0 0 0 0 0 0 0 0 0 5009.74 0 0 1014905798 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1004.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1004.18 0 0 1014905825 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9305.54 0 0 0 0 0 0 0 0 0 0 0 0 0 9305.54 0 0 1014906029 1265962609 10 Physicians BURKHARTSMEIER COLE J 999999999 87 Randolph 0 0 Emergency Medicine 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 1425.56 0 0 0 0 0 0 1425.56 0 0 1014906102 1609239243 10 Physicians MIDKIFF MEGAN 999999999 200 Cook 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 0 190 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 4023.12 0 0 0 0 0 0 4023.12 0 0 1014906122 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 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 0 470.97 470.97 0 0 1014906207 1508405853 16 Nurse Practitioners KMIECIK HEATHER 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 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 2221.6 0 0 0 0 0 0 2221.6 0 0 1014906227 1780111427 10 Physicians FLEMING EMILY R 999999999 24 Coles 0 0 Emergency 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 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 0 555.04 0 0 0 0 0 0 555.04 0 0 1014906367 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6121.28 0 0 0 0 0 0 0 0 0 0 0 0 0 6121.28 0 0 1014906388 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21678.3 0 0 0 0 0 0 0 0 0 0 0 0 0 21678.3 0 0 1014906505 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26188.14 0 0 0 0 0 0 0 0 0 0 0 0 0 26188.14 0 0 1014906528 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7865.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7865.51 0 0 1014906570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5967.86 0 0 0 0 0 0 0 0 0 0 0 0 0 5967.86 0 0 1014906655 1891104915 10 Physicians AL-KHADRA YASSER 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 243.94 0 0 0 0 0 0 243.94 0 0 1014906715 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19879.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19879.22 0 0 1014906792 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14907.66 0 0 0 0 0 0 0 0 0 0 0 0 0 14907.66 0 0 1014906822 1881707602 10 Physicians EVANS RICHARD B 999999999 89 Rock Island 0 0 Internal Medicine 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 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 0 203.97 0 0 0 0 0 0 203.97 0 0 1014906899 1992190821 10 Physicians DE LA ROSA SARA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 12 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.94 0 11334.98 0 0 0 0 0 0 11521.92 0 0 1014906991 1770923559 10 Physicians BECK EMILY 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.23 0 0 0 0 0 0 114.23 0 0 1014907060 30 General Hospitals 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 5 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 63741.6 0 0 0 0 0 0 0 0 0 0 0 0 0 63741.6 0 0 1014912136 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2698.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2698.92 0 0 1014912160 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25960 0 0 0 0 0 0 0 0 0 0 0 0 0 25960 0 0 1014912324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23765.78 0 0 0 0 0 0 0 0 0 0 0 0 0 23765.78 0 0 1014912362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20739.32 0 0 0 0 0 0 0 0 0 0 0 0 0 20739.32 0 0 1014912763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2683.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2683.56 0 0 1014912839 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 26.62 0 0 0 0 0 0 26.62 0 0 1014912887 1063061745 16 Nurse Practitioners SALINAS HARLEY 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 0 231 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 7383.7 0 0 0 0 0 0 7383.7 0 0 1014912910 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 87.19 0 0 0 0 0 0 87.19 0 0 1014913178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5179.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5179.62 0 0 1014913287 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 0 116 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 6180.55 0 0 0 0 0 0 0 0 0 0 0 0 0 6180.55 0 0 1014913323 1548759186 10 Physicians KHADEER MOHAMMED 999999999 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 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 3130.89 0 0 0 0 0 0 3130.89 0 0 1014913469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10071.54 0 0 0 0 0 0 0 0 0 0 0 0 0 10071.54 0 0 1014913503 1477086239 10 Physicians BENNETT ADRIAN 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 0 133 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 0 997.65 0 0 0 0 0 0 997.65 0 0 1014913518 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 0 143 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 16772.83 0 0 0 0 0 0 0 0 0 0 0 0 0 16772.83 0 0 1014913571 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 1088.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1088.25 0 0 1014913657 1396158846 86 Clinical Social Worker(Encounter Only) DEADY CAITLIN 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 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 0 209.24 0 0 0 0 0 0 209.24 0 0 1014913903 1588841324 22 Physical Therapists ROSENSTEIN NATALIE F 999999999 53 Kane 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 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 0 673.49 673.49 0 0 1014914039 1013371996 16 Nurse Practitioners LAROY VALERIE 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 0 163.96 0 0 0 0 0 0 163.96 0 0 1014914107 1982145280 10 Physicians MARMOL CHRISTINA 999999999 200 Cook 0 0 Family Practice 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 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 2477.31 0 0 0 0 0 0 2477.31 0 0 1014914121 1053367250 10 Physicians STEWART JOHN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 1 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 1402.41 0 0 0 0 0 0 0 0 1431.89 0 0 1014914324 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13983.66 0 0 0 0 0 0 0 0 0 0 0 0 0 13983.66 0 0 1014914373 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4455.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4455.4 0 0 1014914398 1194757823 10 Physicians PULJU JAMES H 999999999 53 Kane 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 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 0 939.82 0 0 0 0 0 0 939.82 0 0 1014914430 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1926.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1926.59 0 0 1014914438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10199.42 0 0 0 0 0 0 0 0 0 0 0 0 0 10199.42 0 0 1014914449 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 0 139.21 0 0 0 0 0 0 139.21 0 0 1014914556 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1224.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1224.31 0 0 1014914786 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2703.09 0 0 0 0 0 0 0 0 0 0 0 0 0 2703.09 0 0 1014914844 1033477070 10 Physicians SHAHAN CHARLES P 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361.45 0 0 0 0 0 0 1361.45 0 0 1014914915 1144886466 16 Nurse Practitioners GALVIN SARAH L 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 0 144.08 0 0 0 0 0 0 144.08 0 0 1014915073 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 2690.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2690.92 0 0 1014915210 1164483111 10 Physicians PARVEN STEPHEN 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 60 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635.08 0 0 0 0 0 0 0 0 635.08 0 0 1014915562 10 Physicians 89 Rock Island 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 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 1.27 0 0 0 0 0 0 1.27 0 0 1014915594 1730787532 91 Waiver service provider--Adults (DHS/DDD) WARREN ELIZABETH 999999999 91 Sangamon 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104575.81 0 0 0 0 0 0 0 0 0 0 0 0 0 104575.81 0 0 1014915911 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11879.23 0 0 0 0 0 0 0 0 0 0 0 0 0 11879.23 0 0 1014915920 1912393265 10 Physicians AL-AWQATI MINA 999999999 200 Cook 0 0 Internal Medicine 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 0 129 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 3873.26 0 0 0 0 0 0 3873.26 0 0 1014915980 10 Physicians 91 Sangamon 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 0 219.98 0 0 0 0 0 0 219.98 0 0 1014916104 1265054001 33 Nursing Facilities PEARL OF NAPERVILLE THE 999999999 30 DuPage 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 0 325 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859535.73 0 0 0 0 0 0 0 859535.73 0 0 1014916143 1245877893 16 Nurse Practitioners ALWAWI HANEEN 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 0 761.76 0 0 0 0 0 0 761.76 0 0 1014916225 1518597509 23 Occupational Therapists HARTMAN THEODORE J 999999999 71 McHenry 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 0 171 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 2457.39 2457.39 0 0 1014916406 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15172.96 0 0 0 0 0 0 0 0 0 0 0 0 0 15172.96 0 0 1014916529 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 8416.73 0 0 0 0 0 0 0 0 0 0 0 0 0 8416.73 0 0 1014916664 10 Physicians 108 Williamson 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 0 518.9 0 0 0 0 0 0 518.9 0 0 1014916674 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 13.19 0 0 0 0 0 0 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0 0 0 2115.6 0 0 1014917768 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11141.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11141.36 0 0 1014917795 1962880047 10 Physicians ROBERTSON SHAWN D 999999999 200 Cook 0 0 Emergency 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 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 1822.14 0 0 0 0 0 0 1822.14 0 0 1014917808 1750990271 16 Nurse Practitioners MCCARTHY CAITLIN M 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 884.7 0 0 0 0 0 0 884.7 0 0 1014917823 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 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 0 128.13 128.13 0 0 1014918004 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1356.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1356.39 0 0 1014918218 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 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 1184.45 0 0 0 0 0 0 1184.45 0 0 1014918236 1316572332 22 Physical Therapists GRIBLER ALAINA 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 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 2718.94 2718.94 0 0 1014918421 1386170181 10 Physicians DANDAMUDI RAJA S 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 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 1401.29 0 0 0 0 0 0 1401.29 0 0 1014918492 98 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0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1014918982 1568562858 33 Nursing Facilities EL PASO HEALTH CARE CENTER 617381309 110 Woodford 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 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324437.28 0 0 0 0 0 0 0 324437.28 0 0 1014919018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25071.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25071.2 0 0 1014919318 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 0 226.36 0 0 0 0 0 0 226.36 0 0 1014919346 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25886.36 0 0 0 0 0 0 0 0 0 0 0 0 0 25886.36 0 0 1014919711 1356581540 48 Rural Health Clinics CMH RURAL HEALTH - MED CENTER 999999999 25 Crawford 0 0 0 153 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13155.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13155.97 0 0 1014919941 1992179881 89 Physician Assistant Only(Encounter Only) COKER KATHRYN D 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 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 0 429.72 0 0 0 0 0 0 429.72 0 0 1014920012 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1014920040 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2222.06 0 0 0 0 0 0 0 0 0 0 0 0 0 2222.06 0 0 1014920408 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 9313.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9313.26 0 0 1014920584 1790381168 16 Nurse Practitioners PRYBYLOWSKI CHARLES B 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 89.64 0 0 0 0 0 0 0 0 581.28 0 0 0 0 0 0 670.92 0 0 1014920691 13 Podiatrists 31 Edgar 0 0 0 0 0 0 0 0 0 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 0 873.19 0 0 0 0 0 0 873.19 0 0 1014920863 16 Nurse Practitioners 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 429.8 0 0 0 0 0 0 429.8 0 0 1014921050 1205065737 10 Physicians EL LAKKIS IASS 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 0 216.76 0 0 0 0 0 0 216.76 0 0 1014921305 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20968.65 0 0 0 0 0 0 0 0 0 0 0 0 0 20968.65 0 0 1014921356 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 0 659.63 0 0 0 0 0 0 0 0 0 0 0 0 0 659.63 0 0 1014921373 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 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 1012.65 0 0 0 0 0 0 1012.65 0 0 1014921682 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12449.23 0 0 0 0 0 0 0 0 0 0 0 0 0 12449.23 0 0 1014921802 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 83.7 0 0 0 0 0 0 83.7 0 0 1014921849 1811950264 10 Physicians MOUNT MARK R 999999999 10 Adams 0 0 Otolaryngology 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 0 134 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 2283.15 0 0 0 0 0 0 2283.15 0 0 1014921995 1477554897 10 Physicians HOGARTH JEAN MAX 999999999 200 Cook 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 666.81 0 0 0 0 0 0 666.81 0 0 1014922169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8931.02 0 0 0 0 0 0 0 0 0 0 0 0 0 8931.02 0 0 1014922255 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15277.89 0 0 0 0 0 0 0 0 0 0 0 0 0 15277.89 0 0 1014922286 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 12010.95 0 0 0 0 0 0 0 0 0 0 0 0 0 12010.95 0 0 1014922397 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7155.01 0 0 0 0 0 0 0 0 0 0 0 0 0 7155.01 0 0 1014922407 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22093.12 0 0 0 0 0 0 0 0 0 0 0 0 0 22093.12 0 0 1014922444 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014922504 16 Nurse Practitioners 33 Effingham 0 0 0 0 0 0 0 0 0 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 6.7 0 0 0 0 0 0 6.7 0 0 1014922603 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46.27 0 0 0 0 0 0 46.27 0 0 1014922623 1447639422 10 Physicians LAFLEUR TORI A 999999999 80 Peoria 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 0 466.1 0 0 0 0 0 0 466.1 0 0 1014922814 1780870428 10 Physicians BOUMBER YANIS 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 0 282 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 41738.3 0 0 0 0 0 0 41738.3 0 0 1014923033 1750927182 16 Nurse Practitioners SPANO KIMBERLY A 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 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 0 221.49 0 0 0 0 0 0 221.49 0 0 1014923066 10 Physicians 106 Whiteside 0 0 0 0 0 0 0 0 0 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 0 192.88 0 0 0 0 0 0 192.88 0 0 1014923174 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4049.16 0 0 0 0 0 0 0 0 0 0 0 0 0 4049.16 0 0 1014923279 1023054954 10 Physicians MECCIA ALEXANDRIA Z 999999999 200 Cook 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 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 75.27 0 0 0 0 0 0 75.27 0 0 1014923400 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17427.39 0 0 0 0 0 0 0 0 0 0 0 0 0 17427.39 0 0 1014923404 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14105.63 0 0 0 0 0 0 0 0 0 0 0 0 0 14105.63 0 0 1014923761 1104428572 91 Waiver service provider--Adults (DHS/DDD) BIRKLA DEANNA 999999999 91 Sangamon 0 0 0 0 0 0 0 9 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 23851.14 0 0 0 0 0 0 0 0 0 0 0 0 0 23851.14 0 0 1014923918 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 0 198 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 10720.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10720.93 0 0 1014924170 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 1014924513 1871120600 88 Other behavior health professional JACKSON JESSICA 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 395.9 0 0 0 0 0 0 395.9 0 0 1014924605 1538597828 86 Clinical Social Worker(Encounter Only) SCHMIDT STACY C 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 0 151 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 4640.56 0 0 0 0 0 0 4640.56 0 0 1014924784 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23931.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23931.6 0 0 1014924822 57 Home Nursing Agency 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 0 101 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 48332.94 0 0 0 0 0 0 0 0 0 0 0 0 0 48332.94 0 0 1014924895 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 26653.74 0 0 0 0 0 0 0 0 0 0 0 0 0 26653.74 0 0 1014924905 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14202.63 0 0 0 0 0 0 0 0 0 0 0 0 0 14202.63 0 0 1014924916 1205491875 16 Nurse Practitioners NKWOCHA CORNELIA 999999999 35 Ford 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 0 408 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 3840.15 0 0 0 0 0 0 3840.15 0 0 1014924936 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 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 0 237.61 0 0 0 0 0 0 237.61 0 0 1014924951 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 3773.04 0 0 0 0 0 0 0 0 0 0 0 0 0 3773.04 0 0 1014925154 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20593.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20593.66 0 0 1014925173 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 0 405.8 0 0 0 0 0 0 405.8 0 0 1014925259 1942825633 61 Independent Laboratories HDL LABS 999999999 826 Missouri 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 0 261 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 3623.36 0 0 0 0 0 0 0 0 3623.36 0 0 1014925275 1811089691 10 Physicians NOH PAUL H 999999999 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 12 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.9 0 4076.57 0 0 0 0 0 0 4094.47 0 0 1014925292 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 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 66.19 0 0 0 0 0 0 66.19 0 0 1014925417 1063851186 10 Physicians KAJ-CARBAIDWALA BATUL 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 0 132 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 8498.65 0 0 0 0 0 0 8498.65 0 0 1014925464 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 0 281 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 25740 0 0 0 0 0 0 0 0 0 0 0 0 0 25740 0 0 1014925469 1770986200 10 Physicians SAYEED HUMA O 999999999 30 DuPage 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 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 5480.67 0 0 0 0 0 0 5480.67 0 0 1014925525 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19174.95 0 0 0 0 0 0 0 0 0 0 0 0 0 19174.95 0 0 1014925526 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15282.4 0 0 0 0 0 0 0 0 0 0 0 0 0 15282.4 0 0 1014925546 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.18 0 0 0 0 0 0 163.18 0 0 1014925602 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24609.9 0 0 0 0 0 0 0 0 0 0 0 0 0 24609.9 0 0 1014926081 1932711389 16 Nurse Practitioners STANLEY BREEZY S 999999999 56 Knox 0 0 0 0 0 0 0 0 0 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 0 240.56 0 0 0 0 0 0 240.56 0 0 1014926090 1689990590 16 Nurse Practitioners HAHN MICHELLE 999999999 106 Whiteside 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 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 0 394.19 0 0 0 0 0 0 394.19 0 0 1014926133 1740836253 16 Nurse Practitioners KLAUS ABBY 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 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 0 651.36 0 0 0 0 0 0 651.36 0 0 1014926335 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 989.52 0 0 0 0 0 0 0 0 0 0 0 0 0 989.52 0 0 1014926552 1265084875 11 Dentists GUVVA VENKATA SIVA REDDY 999999999 96 St Clair 0 0 General Dentistry 0 0 39 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 197 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 5634.27 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 7139.67 0 0 1014926568 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17374.78 0 0 0 0 0 0 0 0 0 0 0 0 0 17374.78 0 0 1014926651 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 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 0 651.59 0 0 0 0 0 0 651.59 0 0 1014926771 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7057.77 0 0 0 0 0 0 0 0 0 0 0 0 0 7057.77 0 0 1014926915 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19888.05 0 0 0 0 0 0 0 0 0 0 0 0 0 19888.05 0 0 1014926928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31380.83 0 0 0 0 0 0 0 0 0 0 0 0 0 31380.83 0 0 1014926969 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 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 23684.41 0 0 0 0 0 0 0 0 0 0 0 0 0 23684.41 0 0 1014926991 1043659238 10 Physicians CHOE DANIEL J 999999999 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 215.25 0 0 0 0 0 0 0 0 215.25 0 0 1014927018 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25441.05 0 0 0 0 0 0 0 0 0 0 0 0 0 25441.05 0 0 1014927500 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 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 0 223.3 223.3 0 0 1014927602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3000.78 0 0 0 0 0 0 0 0 0 0 0 0 0 3000.78 0 0 1014927921 1699195701 10 Physicians MASON EVAN G 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 330 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3865.17 0 109.61 0 0 0 0 0 0 3974.78 0 0 1014927928 1639527229 10 Physicians BABIN LISA 604631428 200 Cook 0 0 Family Practice 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 0 299 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 4691.24 0 0 0 0 0 0 4691.24 0 0 1014928163 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 43.54 0 0 0 0 0 0 43.54 0 0 1014928251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 414.69 0 0 0 0 0 0 0 0 0 0 0 0 0 414.69 0 0 1014928273 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 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 4010.63 0 0 0 0 0 0 0 0 0 0 0 0 0 4010.63 0 0 1014928285 1346401411 10 Physicians BORHANI AMIR A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 273 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 339 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6084.84 0 59.15 0 0 0 0 0 0 6143.99 0 0 1014928309 1659726602 10 Physicians SCORE SAMANTHA A 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 5 0 23 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 15.51 0 3009.58 0 0 0 0 0 0 3031.49 0 0 1014928349 1326645193 16 Nurse Practitioners NASH COLLEEN 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 0 353.14 0 0 0 0 0 0 353.14 0 0 1014928543 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6761.51 0 0 0 0 0 0 0 0 0 0 0 0 0 6761.51 0 0 1014928594 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8425.56 0 0 0 0 0 0 0 0 0 0 0 0 0 8425.56 0 0 1014928693 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21385.23 0 0 0 0 0 0 0 0 0 0 0 0 0 21385.23 0 0 1014928897 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6687.96 0 0 0 0 0 0 0 0 0 0 0 0 0 6687.96 0 0 1014929067 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23096.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23096.32 0 0 1014929141 1780217992 16 Nurse Practitioners WALSH TIFFANY 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 0 108 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 2780.73 0 0 0 0 0 0 2780.73 0 0 1014929185 1659366037 16 Nurse Practitioners MILLER JOHN J 999999999 70 McDonough 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 1611.08 0 0 0 0 0 0 1611.08 0 0 1014929224 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24439.57 0 0 0 0 0 0 0 0 0 0 0 0 0 24439.57 0 0 1014929275 75 Department of Alcohol and Substance Abuse Provider 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 6270.56 0 0 6270.56 0 0 1014929417 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 0 282 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 20549.84 0 0 0 0 0 0 0 0 0 0 0 0 0 20549.84 0 0 1014929444 1790327336 11 Dentists ELKHADRA ABDULA 999999999 200 Cook 0 0 0 0 31 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 5179.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5179.9 0 0 1014929554 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25475.78 0 0 0 0 0 0 0 0 0 0 0 0 0 25475.78 0 0 1014929557 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12600.72 0 0 0 0 0 0 0 0 0 0 0 0 0 12600.72 0 0 1014929662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2380.65 0 0 0 0 0 0 0 0 0 0 0 0 0 2380.65 0 0 1014929690 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 3722.21 0 0 0 0 0 0 0 0 0 0 0 0 0 3722.21 0 0 1014929732 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17490.2 0 0 0 0 0 0 0 0 0 0 0 0 0 17490.2 0 0 1014929734 1558597278 10 Physicians WANG LIN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 99 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 550.28 0 34.89 0 0 0 0 0 0 585.17 0 0 1014929877 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11674.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11674.8 0 0 1014929984 1154738748 89 Physician Assistant Only(Encounter Only) JONES STACIA 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 0 244 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 2309.93 0 0 0 0 0 0 2309.93 0 0 1014929987 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3756.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3756.72 0 0 1014929993 1083962229 89 Physician Assistant Only(Encounter Only) RANDOLPH ELIZABETH K 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 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 0 395.16 0 0 0 0 0 0 395.16 0 0 1014930115 1043665987 10 Physicians MILES TAYLOR M 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 0 502.05 0 0 0 0 0 0 502.05 0 0 1014930141 1679130793 27 Behavioral Health Clinic WARRENVILLE YOUTH AND FAMILY S 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 6277.29 0 0 6277.29 0 0 1014930296 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 16.01 0 0 0 0 0 0 16.01 0 0 1014930318 1447755434 10 Physicians BURROUGHS SARAH 999999999 30 DuPage 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 0 0 0 0 0 0 0 0 0 0 1014930479 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126.26 0 0 0 0 0 0 126.26 0 0 1014930509 1821290750 10 Physicians MUFTI KASHIF 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 37 0 0 0 0 0 0 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 31.94 0 907.73 0 0 0 0 0 0 939.67 0 0 1014930515 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 0 231 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 17066.94 0 0 0 0 0 0 0 0 0 0 0 0 0 17066.94 0 0 1014930665 10 Physicians 10 Adams 0 0 Family Practice 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 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 2.98 0 1.95 0 0 0 0 0 0 4.93 0 0 1014930720 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18233.6 0 0 0 0 0 0 0 0 0 0 0 0 0 18233.6 0 0 1014930949 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 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 0 313.27 0 0 0 0 0 0 313.27 0 0 1014930997 1285244814 33 Nursing Facilities SERENITY OF GALESBURG 999999999 56 Knox 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 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3038 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 310725.57 0 0 0 0 0 0 0 310725.57 0 0 1014931073 1790199933 10 Physicians MELVANI VINESH R 999999999 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 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 0 426.82 0 0 0 0 0 0 426.82 0 0 1014931187 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9946.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9946.45 0 0 1014931237 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 667.81 0 0 0 0 0 0 0 0 0 0 0 0 0 667.81 0 0 1014931251 50 Home Health Agencies - In Home 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 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 12950 0 0 0 0 0 0 12950 0 0 1014931823 10 Physicians 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 0 244.7 0 0 0 0 0 0 244.7 0 0 1014932035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 651.3 0 0 0 0 0 0 0 0 0 0 0 0 0 651.3 0 0 1014932051 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20671.53 0 0 0 0 0 0 0 0 0 0 0 0 0 20671.53 0 0 1014932110 4014932110 90 Waiver service provider--Elderly (DOA) "SAFARI CARE, INC" 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 1226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1226 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123868.68 0 0 0 0 0 0 0 0 0 0 0 0 0 123868.68 0 0 1014932385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 882.17 0 0 0 0 0 0 0 0 0 0 0 0 0 882.17 0 0 1014932648 1407172083 10 Physicians OCHOA REINA OLGA L 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 552.1 0 0 0 0 0 0 552.1 0 0 1014932650 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10554.96 0 0 0 0 0 0 0 0 0 0 0 0 0 10554.96 0 0 1014932874 1316203995 10 Physicians STRICSEK GEOFFREY P 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.02 0 14362.19 0 0 0 0 0 0 14402.21 0 0 1014933197 1598285959 10 Physicians LE TRUNG Q 999999999 91 Sangamon 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 0 150 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 1690.1 0 0 0 0 0 0 1690.1 0 0 1014933303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 53943.52 0 0 0 0 0 0 0 0 0 0 0 0 0 53943.52 0 0 1014933368 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9151.36 0 0 0 0 0 0 0 0 0 0 0 0 0 9151.36 0 0 1014933460 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 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 2022.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2022.79 0 0 1014933489 1770191496 16 Nurse Practitioners HICKEY KATHERINE 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 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 30 0 0 0 0 0 0 30 0 0 1014933594 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24896 0 0 0 0 0 0 0 0 0 0 0 0 0 24896 0 0 1014933773 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10222.13 0 0 0 0 0 0 0 0 0 0 0 0 0 10222.13 0 0 1014933954 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18467.1 0 0 0 0 0 0 0 0 0 0 0 0 0 18467.1 0 0 1014933960 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 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 0 436.27 436.27 0 0 1014934319 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 46.45 0 0 0 0 0 0 46.45 0 0 1014934349 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15348.36 0 0 0 0 0 0 0 0 0 0 0 0 0 15348.36 0 0 1014934558 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31648.82 0 0 0 0 0 0 0 0 0 0 0 0 0 31648.82 0 0 1014934625 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 1014934633 1720214901 10 Physicians ROTH EIRA 999999999 200 Cook 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 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 0 383.65 0 0 0 0 0 0 0 0 383.65 0 0 1014934689 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440.86 0 0 0 0 0 0 0 0 0 0 0 0 0 440.86 0 0 1014934736 61 Independent Laboratories 837 Oklahoma 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.85 0 0 0 0 0 0 0 0 197.85 0 0 1014934944 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15930.14 0 0 0 0 0 0 0 0 0 0 0 0 0 15930.14 0 0 1014934952 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15140.3 0 0 0 0 0 0 0 0 0 0 0 0 0 15140.3 0 0 1014934975 1417914623 10 Physicians MIZIKAR WILLIAM E 999999999 10 Adams 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 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 0 914.95 0 0 0 0 0 0 914.95 0 0 1014934983 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16084.47 0 0 0 0 0 0 0 0 0 0 0 0 0 16084.47 0 0 1014935104 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1108.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1108.93 0 0 1014935152 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22029.84 0 0 0 0 0 0 0 0 0 0 0 0 0 22029.84 0 0 1014935205 1538795398 16 Nurse Practitioners CEBULA MARCIN 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 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 1222.27 0 0 0 0 0 0 1222.27 0 0 1014935218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4833.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4833.84 0 0 1014935453 1578752465 86 Clinical Social Worker(Encounter Only) YANT SARA 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 0 249 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 1109.92 0 0 0 0 0 0 1109.92 0 0 1014935476 1194169557 13 Podiatrists GARCIA CARMEN 999999999 200 Cook 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 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5537.89 0 0 0 0 0 0 5537.89 0 0 1014935492 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1014935863 1528460847 16 Nurse Practitioners NEWBANKS THERESA 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 68.32 0 0 0 0 0 0 68.32 0 0 1014935948 10 Physicians 88 Richland 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 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1014935967 1619222577 16 Nurse Practitioners FISHER KELLI 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 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 0 108.56 0 0 0 0 0 0 108.56 0 0 1014936101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5083.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5083.16 0 0 1014936110 1780158998 11 Dentists KECK-FLORY BRITTANY A 999999999 20 Christian 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 185 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 7215.61 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 7591.96 0 0 1014936222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17243.13 0 0 0 0 0 0 0 0 0 0 0 0 0 17243.13 0 0 1014936339 1467738328 86 Clinical Social Worker(Encounter Only) BRUSH CYNTHIA 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 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 4105.22 0 0 0 0 0 0 4105.22 0 0 1014936360 1417484924 10 Physicians FANCHER KENDALL G 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 0 155 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 1850.97 0 0 0 0 0 0 1850.97 0 0 1014936448 1497385082 16 Nurse Practitioners JASTILLANO SEAN 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 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 0 817.48 0 0 0 0 0 0 817.48 0 0 1014936530 91 Waiver service provider--Adults (DHS/DDD) 78 Moultrie 0 0 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 2893.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2893.77 0 0 1014936721 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3660.52 0 0 0 0 0 0 0 0 0 0 0 0 0 3660.52 0 0 1014936725 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6986.31 0 0 0 0 0 0 0 0 0 0 0 0 0 6986.31 0 0 1014936785 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16030.95 0 0 0 0 0 0 0 0 0 0 0 0 0 16030.95 0 0 1014936788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7895.8 0 0 0 0 0 0 0 0 0 0 0 0 0 7895.8 0 0 1014936855 1144816596 16 Nurse Practitioners BECKWITH FELICHA 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 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 64.08 0 0 0 0 0 0 64.08 0 0 1014936896 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15961.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15961.9 0 0 1014937107 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8517.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8517.84 0 0 1014937110 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 30.44 0 0 0 0 0 0 30.44 0 0 1014937223 1114568821 16 Nurse Practitioners BLANNER KELLY 631600352 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 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 0 450.94 0 0 0 0 0 0 450.94 0 0 1014937250 1487629929 10 Physicians RIESZ DAVID 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 77 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1591.28 0 42.72 0 0 0 0 0 0 1634 0 0 1014937328 1770100414 48 Rural Health Clinics MDH PEDIATRIC CLINIC 999999999 70 McDonough 0 0 0 137 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 467 0 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19419.56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19419.56 0 0 1014937430 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14715.58 0 0 0 0 0 0 0 0 0 0 0 0 0 14715.58 0 0 1014937491 1598318255 11 Dentists CHOI YON 999999999 80 Peoria 0 0 General Dentistry 0 0 260 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1733 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 1733 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 63650.43 0 0 0 0 0 0 0 0 0 0 0 6774.3 0 0 0 0 70424.73 0 0 1014937733 10 Physicians 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014938039 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 741.09 0 0 0 0 0 0 0 0 0 0 0 0 0 741.09 0 0 1014938063 4014938063 90 Waiver service provider--Elderly (DOA) ACTIVECARE HOME CARE 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 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116842.05 0 0 0 0 0 0 0 0 0 0 0 0 0 116842.05 0 0 1014938147 57 Home Nursing Agency 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 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 4127.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4127.2 0 0 1014938204 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 0 108.56 0 0 0 0 0 0 108.56 0 0 1014938290 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18566.14 0 0 0 0 0 0 0 0 0 0 0 0 0 18566.14 0 0 1014938302 1255750220 10 Physicians THORNTON LAUREN V 999999999 47 Jackson 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3672.7 0 0 0 0 0 0 3672.7 0 0 1014938526 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7375.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7375.64 0 0 1014938583 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11268.28 0 0 0 0 0 0 0 0 0 0 0 0 0 11268.28 0 0 1014938700 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.74 30.74 0 0 1014938709 1477192839 16 Nurse Practitioners JONES EBONY O 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 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 0 824.69 0 0 0 0 0 0 824.69 0 0 1014938739 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 0 326.92 0 0 0 0 0 0 326.92 0 0 1014938754 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 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 1993.39 0 0 0 0 0 0 1993.39 0 0 1014938933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28373.8 0 0 0 0 0 0 0 0 0 0 0 0 0 28373.8 0 0 1014938967 1891108452 10 Physicians FRANCO JOEL 999999999 65 Madison 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 0 157 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 2419.9 0 0 0 0 0 0 2419.9 0 0 1014939089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8475.98 0 0 0 0 0 0 0 0 0 0 0 0 0 8475.98 0 0 1014939166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5437.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5437.88 0 0 1014939194 1588097596 10 Physicians HASSAN ATIF KHAWAJA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 4 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7467.66 0 0 0 0 0 0 7467.66 0 0 1014939224 1861059834 13 Podiatrists KHAN SHAHEERA 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 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 14.88 0 0 0 0 0 0 14.88 0 0 1014939347 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 0 306 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 14083.16 0 0 0 0 0 0 0 0 0 0 0 0 0 14083.16 0 0 1014939354 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20898.36 0 0 0 0 0 0 0 0 0 0 0 0 0 20898.36 0 0 1014939463 1760544332 10 Physicians MURRAY ANIKA 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 0 267 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 2285.64 0 0 0 0 0 0 2285.64 0 0 1014939509 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 15071.21 0 0 0 0 0 0 0 0 0 0 0 0 0 15071.21 0 0 1014939630 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 16.76 0 0 0 0 0 0 16.76 0 0 1014939744 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20288.3 0 0 0 0 0 0 0 0 0 0 0 0 0 20288.3 0 0 1014939768 1932664224 30 General Hospitals OAK MEADOWS DIALYSIS 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 39 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 9327.32 0 0 0 0 0 9327.32 0 0 1014939812 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1147.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.91 0 0 1014939879 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 1014940104 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1044.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1044.1 0 0 1014940209 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25794.9 0 0 0 0 0 0 0 0 0 0 0 0 0 25794.9 0 0 1014940601 1477948396 10 Physicians FLANNERY JAMES L 999999999 80 Peoria 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 9 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140.61 0 21.07 0 0 0 0 0 0 161.68 0 0 1014940737 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11935.68 0 0 0 0 0 0 0 0 0 0 0 0 0 11935.68 0 0 1014940782 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22848.98 0 0 0 0 0 0 0 0 0 0 0 0 0 22848.98 0 0 1014940936 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18765.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18765.8 0 0 1014940990 1649725151 16 Nurse Practitioners ALLAN STUART A 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 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 0 562.44 0 0 0 0 0 0 562.44 0 0 1014941106 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 50.24 0 0 0 0 0 0 0 0 50.24 0 0 1014941211 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 0 773.95 0 0 0 0 0 0 0 0 0 0 0 0 0 773.95 0 0 1014941319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2297.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2297.3 0 0 1014941363 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23744.38 0 0 0 0 0 0 0 0 0 0 0 0 0 23744.38 0 0 1014941435 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 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 12984.97 0 0 0 0 0 0 0 0 0 0 0 0 0 12984.97 0 0 1014941576 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23574.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23574.3 0 0 1014941775 1558975078 16 Nurse Practitioners GRANDI LAUREN 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 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.95 0 0 0 0 0 0 88.95 0 0 1014941801 1437640984 10 Physicians TEDNES MICHAEL 999999999 200 Cook 0 0 Emergency 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 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 2963.38 0 0 0 0 0 0 2963.38 0 0 1014941829 1013484138 23 Occupational Therapists MOMEYER ELIZABETH 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 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 3837.08 3837.08 0 0 1014941842 1598304941 16 Nurse Practitioners BRYANT SIMONE 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 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1721.29 0 0 0 0 0 0 1721.29 0 0 1014941853 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.02 0 0 0 0 0 0 62.02 0 0 1014941885 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 441.78 0 0 0 0 0 0 0 0 0 0 0 0 0 441.78 0 0 1014941990 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5001.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5001.3 0 0 1014942151 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1247.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1247.25 0 0 1014942223 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2933.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2933.58 0 0 1014942243 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 466.98 0 0 0 0 0 0 0 0 0 0 0 0 0 466.98 0 0 1014942272 16 Nurse Practitioners 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.6 0 0 0 0 0 0 121.6 0 0 1014942339 87 Psychologist(Encounter Only) 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 7.5 0 0 0 0 0 0 7.5 0 0 1014942567 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 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 61.08 61.08 0 0 1014942639 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2728.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2728.77 0 0 1014942770 11 Dentists 200 Cook 0 0 Pedodontics 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 0 341.17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 341.17 0 0 1014942848 1639772700 11 Dentists RANA SARASWATI 999999999 96 St Clair 0 0 General Dentistry 0 0 34 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 4763.77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4763.77 0 0 1014942883 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 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 27.09 27.09 0 0 1014943172 4014943172 72 Taxicabs and Livery Companies UPFRONT TRANSPORTATION 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 0 300 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 2571.4 0 0 0 0 0 0 2571.4 0 0 1014943190 65 Independent Diagnostic Testing Facility (IDTF) 821 Maryland 0 0 0 0 0 0 0 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 0 202.45 0 0 0 0 0 0 0 0 202.45 0 0 1014943455 10 Physicians 19 Champaign 0 0 Pediatrics 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 91.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.02 0 0 1014943564 1528615010 89 Physician Assistant Only(Encounter Only) DELAHERA ALEXANDRA 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 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 4389.65 0 0 0 0 0 0 4389.65 0 0 1014943746 1255755252 91 Waiver service provider--Adults (DHS/DDD) MAXFIELD NICOLE D 999999999 91 Sangamon 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14192.07 0 0 0 0 0 0 0 0 0 0 0 0 0 14192.07 0 0 1014943801 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 25649.14 0 0 0 0 0 0 0 0 0 0 0 0 0 25649.14 0 0 1014943824 86 Clinical Social Worker(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 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 0 222.64 0 0 0 0 0 0 222.64 0 0 1014943975 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 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 1014944285 1962014183 16 Nurse Practitioners SWANSON ERIC D 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 332.68 0 0 0 0 0 0 332.68 0 0 1014944305 10 Physicians 25 Crawford 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106.28 0 0 0 0 0 0 106.28 0 0 1014944309 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21701.24 0 0 0 0 0 0 0 0 0 0 0 0 0 21701.24 0 0 1014944428 87 Psychologist(Encounter Only) 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 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 1014944484 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 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 53.02 0 0 0 0 0 0 53.02 0 0 1014944803 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 0 162 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 14456.64 0 0 0 0 0 0 0 0 0 0 0 0 0 14456.64 0 0 1014944868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12590 0 0 0 0 0 0 0 0 0 0 0 0 0 12590 0 0 1014944873 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 317.3 0 0 0 0 0 0 0 0 0 0 0 0 0 317.3 0 0 1014944906 1851925622 16 Nurse Practitioners SHAUGHNESSY LAUREN 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 0 469.2 0 0 0 0 0 0 469.2 0 0 1014944960 1427378298 10 Physicians LEITMAN DAVID A 631600352 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 36 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 521.51 0 21.07 0 0 0 0 0 0 542.58 0 0 1014945039 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 1014945084 1679116966 16 Nurse Practitioners ALI RENA 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 0 695.13 0 0 0 0 0 0 695.13 0 0 1014945112 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 52665.86 0 0 0 0 0 0 0 0 0 0 0 0 0 52665.86 0 0 1014945174 1679004956 10 Physicians SADIK ADAM 999999999 200 Cook 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 10 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 326.83 0 0 0 0 0 0 0 0 598.47 0 0 0 0 0 0 925.3 0 0 1014945283 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 1014945342 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 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 64.53 0 0 0 0 0 0 64.53 0 0 1014945433 1467879809 10 Physicians LUGER DANIEL 999999999 200 Cook 0 0 Internal Medicine 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 0 409 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 3171.21 0 0 0 0 0 0 3171.21 0 0 1014945718 1407482219 40 Federally Qualified Health Centers ACCESS BRICKYARD FAMILY HEALTH 999999999 200 Cook 0 0 0 240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69050.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69050.7 0 0 1014945763 1255862637 10 Physicians FERNANDEZ RAYNIERI 999999999 80 Peoria 0 0 Internal Medicine 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 0 372 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 5831.7 0 0 0 0 0 0 5831.7 0 0 1014945768 1215570908 89 Physician Assistant Only(Encounter Only) HOMANN BROOKE L 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 0 206.02 0 0 0 0 0 0 206.02 0 0 1014945785 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21733.8 0 0 0 0 0 0 0 0 0 0 0 0 0 21733.8 0 0 1014945949 10 Physicians 63 Macon 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 0 243.94 0 0 0 0 0 0 243.94 0 0 1014946135 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4304.35 0 0 0 0 0 0 0 0 0 0 0 0 0 4304.35 0 0 1014946320 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 64.59 0 0 0 0 0 0 0 0 0 0 0 0 0 64.59 0 0 1014946346 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14951.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14951.45 0 0 1014946452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2905.17 0 0 0 0 0 0 0 0 0 0 0 0 0 2905.17 0 0 1014946744 1336554427 10 Physicians WUENSTEL ANDREW M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3598.92 0 0 0 0 0 0 3598.92 0 0 1014946893 1700423696 48 Rural Health Clinics JCH MEDICAL GROUP- JERSEYVILLE 999999999 50 Jersey 0 0 0 155 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 10346.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10346.94 0 0 1014946904 1801428982 16 Nurse Practitioners WOLFF KATIE 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 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 0 322.88 0 0 0 0 0 0 322.88 0 0 1014946999 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 21245.4 0 0 0 0 0 0 0 0 0 0 0 0 0 21245.4 0 0 1014947089 1588215248 11 Dentists AJAM ZAYNA 999999999 107 Will 0 0 General Dentistry 0 0 26 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 5182.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5182.95 0 0 1014947129 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 73.4 0 0 0 0 0 0 73.4 0 0 1014947334 1811492788 10 Physicians PILE JUSTIN E 999999999 200 Cook 0 0 Emergency 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 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 0 581.78 0 0 0 0 0 0 581.78 0 0 1014947644 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 1694.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1694.11 0 0 1014947699 1104874056 10 Physicians SCHOFIELD MICHELLE W 999999999 200 Cook 0 0 Psychiatry 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 0 378 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 9948.68 0 0 0 0 0 0 9948.68 0 0 1014947809 1336742568 16 Nurse Practitioners ANNANG EMMANUEL 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 0 188 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 1508.45 0 0 0 0 0 0 1508.45 0 0 1014947843 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4110.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4110.96 0 0 1014948051 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10272.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10272.71 0 0 1014948197 1285240473 16 Nurse Practitioners DEGUZMAN LENNY 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 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 0 0 0 0 0 0 0 0 0 0 1014948211 1942838586 89 Physician Assistant Only(Encounter Only) YZEIRAJ DENISA 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 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 1367.49 0 0 0 0 0 0 1367.49 0 0 1014948271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 627.72 0 0 0 0 0 0 0 0 0 0 0 0 0 627.72 0 0 1014948542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17937.95 0 0 0 0 0 0 0 0 0 0 0 0 0 17937.95 0 0 1014948842 1205271632 10 Physicians HASAN AYESHA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 93 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11223.09 0 13908.49 0 0 0 0 0 0 25131.58 0 0 1014948867 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 0 157 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 13514.76 0 0 0 0 0 0 0 0 0 0 0 0 0 13514.76 0 0 1014948910 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 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 688 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36573.27 0 0 0 0 0 0 0 0 0 0 0 0 0 36573.27 0 0 1014948988 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 49.22 0 0 0 0 0 0 49.22 0 0 1014949038 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 25303.19 0 0 0 0 0 0 0 0 0 0 0 0 0 25303.19 0 0 1014949047 1023125838 10 Physicians FORE PETER 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 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 0 683.43 0 0 0 0 0 0 683.43 0 0 1014949074 1346856424 16 Nurse Practitioners ZUNKER KEELY 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 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 1014949123 1043742885 10 Physicians AHN PAULINE 999999999 200 Cook 0 0 Pediatrics 0 0 0 66 0 0 0 0 0 0 39 0 94 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 54 0 137 0 0 0 0 0 0 0 0 0 182 0 0 0 0 0 0 54 0 137 0 0 0 0 0 0 0 0 0 5998.69 0 0 0 0 0 0 1996.99 0 6356.18 0 0 0 0 0 0 14351.86 0 0 1014949294 10 Physicians 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 0 191.66 0 0 0 0 0 0 191.66 0 0 1014949322 1962041582 16 Nurse Practitioners DARDEN CAITLIN 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 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 1450.31 0 0 0 0 0 0 1450.31 0 0 1014949350 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 711.91 0 0 0 0 0 0 0 0 0 0 0 0 0 711.91 0 0 1014949366 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 34011.37 0 0 0 0 0 0 0 0 0 0 0 0 0 34011.37 0 0 1014949477 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6691.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6691.08 0 0 1014949611 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4049.22 0 0 0 0 0 0 0 0 0 0 0 0 0 4049.22 0 0 1014949744 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 112.45 0 0 0 0 0 0 112.45 0 0 1014949872 1215164553 10 Physicians SAATEE SIAVOSH 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 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 2378.84 0 0 0 0 0 0 2378.84 0 0 1014949989 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 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 3320.03 0 0 0 0 0 0 0 0 0 0 0 0 0 3320.03 0 0 1014950032 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 35 0 0 0 0 0 0 35 0 0 1014950057 1861092108 16 Nurse Practitioners LUKER JOHN 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 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 2087.09 0 0 0 0 0 0 2087.09 0 0 1014950203 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 1014950295 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 92.77 0 0 0 0 0 0 92.77 0 0 1014950410 1336777515 16 Nurse Practitioners ROBERTS PAULA L 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 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 0 466.4 0 0 0 0 0 0 466.4 0 0 1014950489 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.35 0 0 0 0 0 0 0 0 0 0 0 0 0 668.35 0 0 1014950707 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 0 334 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 20810.9 0 0 0 0 0 0 0 0 0 0 0 0 0 20810.9 0 0 1014950822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20862.04 0 0 0 0 0 0 0 0 0 0 0 0 0 20862.04 0 0 1014950947 80 Prepaid health plan--Health maintenance organization "MOLINA HEALTHCARE OF ILLINOIS," 60523 30 DuPage 0 0 "220,984" 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 913519701.7 0 1014951132 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10722.55 0 0 0 0 0 0 0 0 0 0 0 0 0 10722.55 0 0 1014951133 57 Home Nursing Agency 30 DuPage 0 0 0 0 0 0 0 5 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 9016 0 0 0 0 0 0 0 0 0 0 0 0 0 9016 0 0 1014951271 1659620029 10 Physicians HODGES JAMES 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 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1014951285 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4825.53 0 0 0 0 0 0 0 0 0 0 0 0 0 4825.53 0 0 1014951287 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11761.56 0 0 0 0 0 0 0 0 0 0 0 0 0 11761.56 0 0 1014951333 1699317594 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE PEORIA HEIGHTS 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 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 6620 0 0 0 0 0 0 6620 0 0 1014951438 1952504441 10 Physicians RIKHYE SOMI 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 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 0 403.38 0 0 0 0 0 0 403.38 0 0 1014951462 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 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 67.22 0 0 0 0 0 0 67.22 0 0 1014951485 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 19593.88 0 0 0 0 0 0 0 0 0 0 0 0 0 19593.88 0 0 1014951542 1255712162 10 Physicians WARRIOR KRISHNAN 999999999 200 Cook 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 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 0 614.82 0 0 0 0 0 0 614.82 0 0 1014951878 1912524265 11 Dentists HALLORAN LAUREN ELIZABETH 999999999 89 Rock Island 0 0 General Dentistry 0 0 221 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 1171 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 1171 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 44016.13 0 0 0 0 0 0 0 0 0 0 0 3010.8 0 0 0 0 47026.93 0 0 1014951899 1053948976 11 Dentists GEE SHERRY 999999999 200 Cook 0 0 General Dentistry 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2730 0 0 1014951913 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 0 0 0 0 0 0 0 0 0 0 1014951948 1578055521 12 Optometrists UHLENHOPP ALEX J 999999999 40 Grundy 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 213.49 0 0 0 0 0 0 213.49 0 0 1014952084 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7232.4 0 0 0 0 0 0 0 0 0 0 0 0 0 7232.4 0 0 1014952149 1740759687 97 Waiver service provider--Children's residential (DHS/DDD) WERKEMA KAREN 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 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 7429.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7429.2 0 0 1014952396 1841680287 10 Physicians CHEEMA ADEELA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.6 0 2275.48 0 0 0 0 0 0 2278.08 0 0 1014952412 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7184.87 0 0 0 0 0 0 0 0 0 0 0 0 0 7184.87 0 0 1014952461 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 0 218 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 23539.06 0 0 0 0 0 0 0 0 0 0 0 0 0 23539.06 0 0 1014952517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1825.71 0 0 0 0 0 0 0 0 0 0 0 0 0 1825.71 0 0 1014952945 1003426974 16 Nurse Practitioners CAGUNGUN VINCENT P 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 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 0 740.26 0 0 0 0 0 0 740.26 0 0 1014952956 1922512060 16 Nurse Practitioners CARY DIANA 999999999 109 Winnebago 0 0 0 0 0 2 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 159.92 0 0 0 0 0 0 0 0 3430.53 0 0 0 0 0 0 3590.45 0 0 1014953121 1023490372 10 Physicians GREER ANDREW 999999999 200 Cook 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 0 255 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 2713.38 0 0 0 0 0 0 0 0 2713.38 0 0 1014953217 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 51712.91 0 0 0 0 0 0 0 0 0 0 0 0 0 51712.91 0 0 1014953222 1932707775 91 Waiver service provider--Adults (DHS/DDD) OLLER JODI 999999999 91 Sangamon 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 714 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50333.01 0 0 0 0 0 0 0 0 0 0 0 0 0 50333.01 0 0 1014953541 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10179.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10179.36 0 0 1014953690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11599.16 0 0 0 0 0 0 0 0 0 0 0 0 0 11599.16 0 0 1014954076 1639761570 16 Nurse Practitioners JACOBS ERICA 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 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 0 327.65 0 0 0 0 0 0 327.65 0 0 1014954179 94 Waiver service provider--Children's support (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 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 11812.6 0 0 0 0 0 0 0 0 0 0 0 0 0 11812.6 0 0 1014954259 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 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 0 0 0 0 0 0 0 0 0 0 1014954865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 137.32 0 0 0 0 0 0 0 0 0 0 0 0 0 137.32 0 0 1014954905 10 Physicians 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014955043 1841881000 91 Waiver service provider--Adults (DHS/DDD) MCGRIER-HOWARD VIOUNETTE 999999999 91 Sangamon 0 0 0 0 0 0 0 16 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 3384.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3384.33 0 0 1014955187 1609492214 16 Nurse Practitioners HOFFMAN JENNA MARIE 999999999 200 Cook 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 0 675 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 2153.05 0 0 0 0 0 0 2153.05 0 0 1014955370 1821085390 10 Physicians MURAKAMI CAROL 999999999 63 Macon 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 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 0 141.79 0 0 0 0 0 0 141.79 0 0 1014955440 1205253481 10 Physicians NESHEIM DAVID W 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 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 1193.14 0 0 0 0 0 0 1193.14 0 0 1014955516 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 1014955526 10 Physicians 109 Winnebago 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 1014955535 1346298395 10 Physicians ARCHIBALD GORDON R 999999999 19 Champaign 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 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.5 0 0 0 0 0 0 0 0 527.5 0 0 1014955719 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13283.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13283.7 0 0 1014955721 1629357462 10 Physicians HOUSHMAND GOLBAHAR 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 13 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 165.27 0 474.85 0 0 0 0 0 0 640.12 0 0 1014955803 1568015568 11 Dentists MAHDI MOHAMMED 999999999 30 DuPage 0 0 General Dentistry 0 0 102 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 362 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12034.22 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 12410.57 0 0 1014956009 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 24 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 11683.76 0 0 0 0 0 11683.76 0 0 1014956022 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 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 0 463.52 0 0 0 0 0 0 463.52 0 0 1014956040 1033640198 10 Physicians BIN MAHFODH ABDULLAH 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 0 429.22 0 0 0 0 0 0 429.22 0 0 1014956072 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 22213.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22213.42 0 0 1014956101 1881055762 10 Physicians JEROME JASON 999999999 200 Cook 0 0 Emergency Medicine 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 0 273 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 11153.66 0 0 0 0 0 0 11153.66 0 0 1014956130 1710511399 30 General Hospitals FRESENIUS KIDNEY CARE MADISON 999999999 65 Madison DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1497.14 0 0 0 0 0 1497.14 0 0 1014956265 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21381.99 0 0 0 0 0 0 0 0 0 0 0 0 0 21381.99 0 0 1014956292 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.08 0 0 0 0 0 0 0 0 0 0 0 0 0 217.08 0 0 1014956314 1417583501 16 Nurse Practitioners DETERS KRISTOPHER 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 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 0 666.15 0 0 0 0 0 0 666.15 0 0 1014956572 1598104390 10 Physicians CREEDEN SEAN G 999999999 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 460 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 664 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15538.79 0 64.83 0 0 0 0 0 0 15603.62 0 0 1014956593 1679180921 16 Nurse Practitioners KALETA MARY G 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 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 0 536.39 0 0 0 0 0 0 536.39 0 0 1014956677 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 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 3759.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3759.5 0 0 1014956807 1306379268 10 Physicians DUARTE MICHAEL 999999999 200 Cook 0 0 Family Practice 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 75 0 0 0 0 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 0 0 373.4 0 0 0 0 0 0 373.4 0 0 1014956881 1720516800 10 Physicians KISHI PATRICK G 999999999 200 Cook 0 0 Emergency 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 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 3501.25 0 0 0 0 0 0 3501.25 0 0 1014956939 89 Physician Assistant Only(Encounter Only) 15 Bureau 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1014956963 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29756.99 0 0 0 0 0 0 0 0 0 0 0 0 0 29756.99 0 0 1014957076 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 13829.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13829.37 0 0 1014957084 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 94.5 0 0 0 0 0 0 94.5 0 0 1014957310 1760731681 10 Physicians DUNN JENNIFER A 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598.39 0 0 0 0 0 0 598.39 0 0 1014957319 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3908.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3908.68 0 0 1014957350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2194.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2194.1 0 0 1014957545 1154751493 22 Physical Therapists SARBIESKI AMANDA M 999999999 40 Grundy 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 0 129 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 1039.34 1039.34 0 0 1014957754 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15870.67 0 0 0 0 0 0 0 0 0 0 0 0 0 15870.67 0 0 1014957817 16 Nurse Practitioners 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 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 13.08 0 0 0 0 0 0 13.08 0 0 1014957934 1790226629 16 Nurse Practitioners BASTIAN TINU 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 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 0 205.21 0 0 0 0 0 0 205.21 0 0 1014957945 1386900611 63 Other Providers of Medical Equipment/Supplies (Non-registered) PATIENT CARE MEDICAL 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19690.82 0 0 0 0 0 0 19690.82 0 0 1014957954 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 711.3 0 0 0 0 0 0 0 0 0 0 0 0 0 711.3 0 0 1014957963 1740712090 16 Nurse Practitioners VICTOR NICOLE E 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 47.62 0 0 0 0 0 0 47.62 0 0 1014958028 1740745116 60 Pharmacies VORAC PHARMACY LLC 999999999 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 4917 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3195.12 0 0 0 3195.12 0 0 1014958112 10 Physicians 24 Coles 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.92 0 0 0 0 0 0 59.92 0 0 1014958234 1588043772 10 Physicians MERAM MARY KATHERINE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 4 0 57 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 72 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 72 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 130.86 0 10035.96 0 0 0 0 0 0 10251.44 0 0 1014958509 1881232817 23 Occupational Therapists POLITES ELENI 999999999 109 Winnebago 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 0 155 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 0 843.35 843.35 0 0 1014958511 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 94.07 0 0 0 0 0 0 94.07 0 0 1014958577 1023616653 22 Physical Therapists SCHNEIDER MARGARET S 999999999 42 Hancock 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 264 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 2849.21 2849.21 0 0 1014958674 10 Physicians 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 81.33 0 0 0 0 0 0 81.33 0 0 1014958988 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41778.69 0 0 0 0 0 0 0 0 0 0 0 0 0 41778.69 0 0 1014958992 16 Nurse Practitioners 87 Randolph 0 0 0 0 0 0 0 0 0 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 1014958993 1417492638 91 Waiver service provider--Adults (DHS/DDD) COX MYESHA 999999999 91 Sangamon 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102321.09 0 0 0 0 0 0 0 0 0 0 0 0 0 102321.09 0 0 1014958998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4181.27 0 0 0 0 0 0 0 0 0 0 0 0 0 4181.27 0 0 1014959068 1518237585 10 Physicians ALI MIR MAHAMED 999999999 91 Sangamon 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 0 158 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 3604.13 0 0 0 0 0 0 3604.13 0 0 1014959136 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 0 107 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 19681.9 0 0 0 0 0 0 0 0 0 0 0 0 0 19681.9 0 0 1014959164 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2435.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2435.29 0 0 1014959310 1487263349 16 Nurse Practitioners SKALICKY JEFFREY 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 1013.29 0 0 0 0 0 0 1013.29 0 0 1014959499 1033743653 16 Nurse Practitioners MILENKOFF KOURTNEY A 999999999 200 Cook 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 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 32.15 0 0 0 0 0 0 0 0 2852.04 0 0 0 0 0 0 2884.19 0 0 1014959610 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18955.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18955.2 0 0 1014959657 1356979629 16 Nurse Practitioners INCZAUSKIS KATHRYN M 999999999 54 Kankakee 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 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 1904.96 0 0 0 0 0 0 1904.96 0 0 1014959705 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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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 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 680 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2800.27 0 0 0 0 0 0 2800.27 0 0 1014960833 10 Physicians 80 Peoria 0 0 Colon - Rectal 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014960876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3116.39 0 0 0 0 0 0 0 0 0 0 0 0 0 3116.39 0 0 1014961090 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 790.16 0 0 0 0 0 0 0 0 0 0 0 0 0 790.16 0 0 1014961106 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 10816.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10816.41 0 0 1014961204 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 0 119.2 0 0 0 0 0 0 119.2 0 0 1014961488 1841838737 86 Clinical Social Worker(Encounter Only) TIMMERMANN KATE 999999999 72 McLean 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 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 0 332.81 0 0 0 0 0 0 332.81 0 0 1014961490 1205441490 11 Dentists MAKKI AYAS 999999999 200 Cook 0 0 Orthodontist 0 0 27 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 7730.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7730.5 0 0 1014961695 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.97 38.97 0 0 1014961739 1356945091 16 Nurse Practitioners NORTON MALLORY 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 0 117 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 4009.2 0 0 0 0 0 0 4009.2 0 0 1014961965 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31053.42 0 0 0 0 0 0 0 0 0 0 0 0 0 31053.42 0 0 1014962002 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5812.15 0 0 0 0 0 0 0 0 0 0 0 0 0 5812.15 0 0 1014962037 1568817815 10 Physicians STABO NICHOLAS J 999999999 109 Winnebago 0 0 Radiology Diagnosis 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 36 0 1 0 0 0 0 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 0 214.37 0 0 0 0 0 0 0 0 214.37 0 0 1014962056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10094.99 0 0 0 0 0 0 0 0 0 0 0 0 0 10094.99 0 0 1014962102 1689013351 10 Physicians MORENO JONATHAN D 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.68 0 278.36 0 0 0 0 0 0 303.04 0 0 1014962109 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10589.6 0 0 0 0 0 0 0 0 0 0 0 0 0 10589.6 0 0 1014962308 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.09 0 0 0 0 0 0 0 0 0 0 0 0 0 54.09 0 0 1014962328 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 55.85 0 0 0 0 0 0 0 0 0 0 0 0 0 55.85 0 0 1014962349 1578880068 10 Physicians HERBERT RYAN T 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 176.52 0 0 0 0 0 0 0 0 884.05 0 0 0 0 0 0 1060.57 0 0 1014962554 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 1935.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1935.44 0 0 1014962678 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 0 834.35 0 0 0 0 0 0 0 0 0 0 0 0 0 834.35 0 0 1014962828 1801420559 16 Nurse Practitioners DONG JIA 999999999 24 Coles 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 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 1751.21 0 0 0 0 0 0 1751.21 0 0 1014962951 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6053.19 0 0 0 0 0 0 0 0 0 0 0 0 0 6053.19 0 0 1014963022 1164045589 55 Early Intervention Services COVARRUBIAS CINTHYA J 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 0 256 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 14735.41 0 0 0 0 0 0 14735.41 0 0 1014963027 1669867974 10 Physicians REGIS JUDE 999999999 57 Lake 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 0 174 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 5225.03 0 0 0 0 0 0 5225.03 0 0 1014963109 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21860.14 0 0 0 0 0 0 0 0 0 0 0 0 0 21860.14 0 0 1014963144 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2028.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2028.95 0 0 1014963176 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4790.84 0 0 0 0 0 0 0 0 0 0 0 0 0 4790.84 0 0 1014963265 1083174064 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 606115938 200 Cook 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 44 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1177.66 0 6853.98 0 0 0 0 8031.64 0 0 1014963294 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 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 20586.62 0 0 0 0 0 0 0 0 0 0 0 0 0 20586.62 0 0 1014963326 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22051.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22051.26 0 0 1014963453 1538554001 10 Physicians THOMAS ALLISON BROOKE 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 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 0 231.85 0 0 0 0 0 0 231.85 0 0 1014963581 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6487.51 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.51 0 0 1014963610 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1269.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1269.85 0 0 1014963612 1528528106 63 Other Providers of Medical Equipment/Supplies (Non-registered) "SHORELINE MEDICAL EQUIPMENT, L" 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 0 205 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 10673.06 0 0 0 0 0 0 10673.06 0 0 1014963661 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 387.22 0 0 0 0 0 0 0 0 0 0 0 0 0 387.22 0 0 1014963692 1306943980 10 Physicians LAGU TARA C 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 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 1014963718 1174116685 89 Physician Assistant Only(Encounter Only) PATEL DIPALEI HARESH 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 0 326 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 5073.91 0 0 0 0 0 0 5073.91 0 0 1014963763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13450.45 0 0 0 0 0 0 0 0 0 0 0 0 0 13450.45 0 0 1014963882 1518374784 10 Physicians TEITELBAUM JORDAN I 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 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 2033.9 0 0 0 0 0 0 2033.9 0 0 1014963885 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18770.84 0 0 0 0 0 0 0 0 0 0 0 0 0 18770.84 0 0 1014963941 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17285.25 0 0 0 0 0 0 0 0 0 0 0 0 0 17285.25 0 0 1014963953 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22762.05 0 0 0 0 0 0 0 0 0 0 0 0 0 22762.05 0 0 1014964260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21813.95 0 0 0 0 0 0 0 0 0 0 0 0 0 21813.95 0 0 1014964320 1144753062 10 Physicians BALOCH LUQMAN 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 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 0 534.37 0 0 0 0 0 0 534.37 0 0 1014964338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 879.23 0 0 0 0 0 0 0 0 0 0 0 0 0 879.23 0 0 1014964459 1356759401 10 Physicians TARIQ ALI 999999999 91 Sangamon 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 0 360 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 1853.39 0 0 0 0 0 0 1853.39 0 0 1014964585 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 3686.79 0 0 0 0 0 0 0 0 0 0 0 0 0 3686.79 0 0 1014964877 1407110307 10 Physicians MAY ADAM M 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 0 119 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 0 897.81 0 0 0 0 0 0 897.81 0 0 1014964888 1417444787 10 Physicians TURBOW LYNDSEY 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 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 0 807.87 0 0 0 0 0 0 807.87 0 0 1014964890 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 30348.51 0 0 0 0 0 0 0 0 0 0 0 0 0 30348.51 0 0 1014964905 10 Physicians 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 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 3187.61 0 0 0 0 0 0 3187.61 0 0 1014965062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1338.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1338.36 0 0 1014965116 1588808034 10 Physicians ANDERSON ERIC R 999999999 80 Peoria 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 0 124 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 4288.73 0 0 0 0 0 0 4288.73 0 0 1014965236 1275011710 16 Nurse Practitioners MACEL REBECCA R 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 0 351.61 0 0 0 0 0 0 351.61 0 0 1014965306 1093313314 24 Speech Therapists KAISER EMILY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 325 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 24043.08 24043.08 0 0 1014965326 1831716745 60 Pharmacies TWO RIVERS PHARMACY 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 2370 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57116.33 0 0 0 57116.33 0 0 1014965394 1336199926 10 Physicians MAJAHALME SILJA 999999999 80 Peoria 0 0 Internal Medicine 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 0 289 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 1609.97 0 0 0 0 0 0 1609.97 0 0 1014965484 1710510060 16 Nurse Practitioners BUDMANDAKH GERELMAA 999999999 200 Cook 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 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 1589.48 0 0 0 0 0 0 1589.48 0 0 1014965550 10 Physicians 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.44 0 0 0 0 0 0 124.44 0 0 1014965816 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 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 1120.8 1120.8 0 0 1014965846 1104171347 10 Physicians DELA CRUZ JUDY EMIL 999999999 40 Grundy 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 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 1014965867 1679823991 10 Physicians AAGAARD JENS PHILIP V 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 0 222 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 4054.38 0 0 0 0 0 0 4054.38 0 0 1014965985 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 2099.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2099.19 0 0 1014966017 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 425.99 0 0 0 0 0 0 0 0 0 0 0 0 0 425.99 0 0 1014966269 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 10.01 0 0 0 0 0 0 10.01 0 0 1014966469 1578198420 16 Nurse Practitioners WARGO JESSICA 999999999 200 Cook 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 0 964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153122.77 0 0 0 0 0 0 153122.77 0 0 1014966470 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 1014966603 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13059.82 0 0 0 0 0 0 0 0 0 0 0 0 0 13059.82 0 0 1014966710 1720589385 16 Nurse Practitioners GUNDERSON CANDICE 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 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 0 211.57 0 0 0 0 0 0 211.57 0 0 1014966725 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3072.86 0 0 0 0 0 0 0 0 0 0 0 0 0 3072.86 0 0 1014966763 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3216.77 0 0 0 0 0 0 0 0 0 0 0 0 0 3216.77 0 0 1014966877 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13870.41 0 0 0 0 0 0 0 0 0 0 0 0 0 13870.41 0 0 1014966958 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 0 166 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 11715.28 0 0 0 0 0 0 0 0 0 0 0 0 0 11715.28 0 0 1014966981 1689010373 10 Physicians BIEBER EWA 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 20 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 2347.17 0 0 0 0 0 0 2347.17 0 0 1014967287 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 0 223 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 24000.19 0 0 0 0 0 0 0 0 0 0 0 0 0 24000.19 0 0 1014967320 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8575.49 0 0 0 0 0 0 0 0 0 0 0 0 0 8575.49 0 0 1014967384 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.35 0 0 0 0 0 0 0 0 0 0 0 0 0 82.35 0 0 1014967605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 244.47 0 0 0 0 0 0 0 0 0 0 0 0 0 244.47 0 0 1014967637 1477948214 10 Physicians SAYOOD SENA 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 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 23.76 0 0 0 0 0 0 23.76 0 0 1014967698 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 0 101 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 6092.06 0 0 0 0 0 0 0 0 0 0 0 0 0 6092.06 0 0 1014967709 10 Physicians 19 Champaign 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314.54 0 0 0 0 0 0 314.54 0 0 1014967810 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 11446.7 0 0 0 0 0 0 0 0 0 0 0 0 0 11446.7 0 0 1014967838 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 762.97 0 0 0 0 0 0 0 0 0 0 0 0 0 762.97 0 0 1014967968 1831189448 10 Physicians BARKLEY CRAIG 999999999 200 Cook 0 0 Urology 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 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 29 0 0 0 0 0 0 0 0 0 43.54 0 0 0 0 0 0 1.2 0 435.78 0 0 0 0 0 0 480.52 0 0 1014968111 1629661863 22 Physical Therapists BELL ZACHARY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 332.04 332.04 0 0 1014968335 1174913917 10 Physicians COFFEY PATRICK 999999999 107 Will 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 26 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 754 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.62 0 3720.69 0 0 0 0 0 0 3825.31 0 0 1014968545 16 Nurse Practitioners 69 Massac 0 0 0 0 0 0 0 0 0 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 22.8 0 0 0 0 0 0 22.8 0 0 1014968551 1285164277 10 Physicians WILSON ROBERT KENT 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 11.2 0 0 0 0 0 0 11.2 0 0 1014968586 1558633008 10 Physicians EL-HALAWANY HANI 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 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 0 920.23 0 0 0 0 0 0 920.23 0 0 1014968609 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14364.77 0 0 0 0 0 0 0 0 0 0 0 0 0 14364.77 0 0 1014968714 1013259241 10 Physicians BASTIAN ZACHARY 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 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 2289.05 0 0 0 0 0 0 2289.05 0 0 1014968872 1902255417 10 Physicians YASIN EHAB 999999999 109 Winnebago 0 0 Physical Medicine/Rehabilitation 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 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.02 0 1.11 0 0 0 0 0 0 92.13 0 0 1014968882 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 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 13678.79 0 0 0 0 0 0 0 0 0 0 0 0 0 13678.79 0 0 1014969085 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14212.6 0 0 0 0 0 0 0 0 0 0 0 0 0 14212.6 0 0 1014969116 1194351668 89 Physician Assistant Only(Encounter Only) NORTHCUTT JUSTIN L 999999999 57 Lake 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 0 218 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 2087.44 0 0 0 0 0 0 2087.44 0 0 1014969130 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17653.9 0 0 0 0 0 0 0 0 0 0 0 0 0 17653.9 0 0 1014969196 1053842138 10 Physicians PATEL HARSH B 999999999 53 Kane 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1959.56 0 0 0 0 0 0 1959.56 0 0 1014969570 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23117.76 0 0 0 0 0 0 0 0 0 0 0 0 0 23117.76 0 0 1014969869 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 0 219 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 17647.52 0 0 0 0 0 0 0 0 0 0 0 0 0 17647.52 0 0 1014969984 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14752.62 0 0 0 0 0 0 0 0 0 0 0 0 0 14752.62 0 0 1014970179 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5002.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5002.2 0 0 1014970234 1649830092 61 Independent Laboratories STAT LABORATORY INC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 527.11 0 0 0 0 0 0 0 0 527.11 0 0 1014970243 1407456171 16 Nurse Practitioners VANDERMEY SHAUNA 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 88.02 0 0 0 0 0 0 0 0 3902.62 0 0 0 0 0 0 3990.64 0 0 1014970574 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 0 0 0 0 0 0 0 0 0 0 1014970592 1447884481 86 Clinical Social Worker(Encounter Only) BENNETT SARA J 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1679.84 0 0 0 0 0 0 1679.84 0 0 1014970697 1386962223 10 Physicians MATHEW KELLI D 999999999 200 Cook 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 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 0 243.34 0 0 0 0 0 0 243.34 0 0 1014970823 89 Physician Assistant Only(Encounter Only) 101 Wabash 0 0 0 0 0 0 0 0 0 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 1014970915 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2009.04 0 0 0 0 0 0 0 0 0 0 0 0 0 2009.04 0 0 1014970946 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 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 5511.71 5511.71 0 0 1014971148 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3781.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3781.19 0 0 1014971313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7199.73 0 0 0 0 0 0 0 0 0 0 0 0 0 7199.73 0 0 1014971367 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2550.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2550.25 0 0 1014971466 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 443.57 0 0 0 0 0 0 0 0 0 0 0 0 0 443.57 0 0 1014971527 1770901753 25 Audiologists RISLEY ROBERT 999999999 200 Cook 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 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 14419.14 14419.14 0 0 1014971603 1669034476 55 Early Intervention Services MURRY MELISSA 999999999 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 10675.82 0 0 0 0 0 0 10675.82 0 0 1014971821 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15617.53 0 0 0 0 0 0 0 0 0 0 0 0 0 15617.53 0 0 1014971983 1710986427 10 Physicians KUKIELKA GILBERT L 999999999 25 Crawford 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 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 0 420.99 0 0 0 0 0 0 420.99 0 0 1014972007 1962840843 10 Physicians PATEL HENA 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1843.61 0 0 0 0 0 0 1843.61 0 0 1014972156 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 0 968.66 0 0 0 0 0 0 0 0 0 0 0 0 0 968.66 0 0 1014972171 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 1848.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1848.44 0 0 1014972230 1154855104 10 Physicians ABEBE ABIY 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 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 1014972281 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24839.93 0 0 0 0 0 0 0 0 0 0 0 0 0 24839.93 0 0 1014972385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4459.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4459.69 0 0 1014972407 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 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 22.18 0 0 0 0 0 0 22.18 0 0 1014972472 1700429040 89 Physician Assistant Only(Encounter Only) SIDERAS WILLIAM 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 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 1637.67 0 0 0 0 0 0 1637.67 0 0 1014972519 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 2508.37 0 0 0 0 0 0 0 0 0 0 0 0 0 2508.37 0 0 1014972553 10 Physicians 63 Macon 0 0 0 0 0 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 5.22 0 11.95 0 0 0 0 0 0 23.57 0 0 1014972659 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15446.34 0 0 0 0 0 0 0 0 0 0 0 0 0 15446.34 0 0 1014972734 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 0 882.01 882.01 0 0 1014972938 1013527043 11 Dentists KHAN MALIHA 999999999 200 Cook 0 0 General Dentistry 0 0 87 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 17993.3 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 18746 0 0 1014973042 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13280.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13280.99 0 0 1014973106 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 36.15 0 0 0 0 0 0 36.15 0 0 1014973240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 26988.17 0 0 0 0 0 0 0 0 0 0 0 0 0 26988.17 0 0 1014973321 1255861001 10 Physicians GUDURA TARIKU 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 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 0 685.55 0 0 0 0 0 0 685.55 0 0 1014973332 1780115485 10 Physicians SINGH ARUSHI 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 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 0 159.43 0 0 0 0 0 0 159.43 0 0 1014973361 1679007116 10 Physicians GATLIN TISCHELLE K 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.76 0 645.85 0 0 0 0 0 0 871.61 0 0 1014973418 1134534597 10 Physicians BAKER JOSHUA J 999999999 200 Cook 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 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 7057.6 0 0 0 0 0 0 7057.6 0 0 1014973467 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 83.64 0 0 0 0 0 0 0 0 0 0 0 0 0 83.64 0 0 1014973664 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 295.34 0 0 0 0 0 0 0 0 0 0 0 0 0 295.34 0 0 1014973745 1417583527 89 Physician Assistant Only(Encounter Only) PATEL HINABEN 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 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 0 960.18 0 0 0 0 0 0 960.18 0 0 1014973766 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 0 261 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 20506.5 0 0 0 0 0 0 0 0 0 0 0 0 0 20506.5 0 0 1014973782 10 Physicians 60 Lee 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 38.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.4 0 0 1014973793 1003201104 10 Physicians VON THAER SARAH 999999999 30 DuPage 0 0 Anesthesiology 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 3669.53 0 0 0 0 0 0 3669.53 0 0 1014973878 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20389.32 0 0 0 0 0 0 0 0 0 0 0 0 0 20389.32 0 0 1014973912 1194184796 89 Physician Assistant Only(Encounter Only) STARKS CHRISTINA L 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 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 0 266.6 0 0 0 0 0 0 266.6 0 0 1014974183 1235587338 10 Physicians LESCANO NICOLAS A 999999999 200 Cook 0 0 Psychiatry 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 0 344 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 4439.2 0 0 0 0 0 0 4439.2 0 0 1014974184 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14590.05 0 0 0 0 0 0 0 0 0 0 0 0 0 14590.05 0 0 1014974219 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 0 102.27 0 0 0 0 0 0 102.27 0 0 1014974543 10 Physicians 63 Macon 0 0 0 0 0 0 0 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 21.53 0 0 0 0 0 0 0 0 21.53 0 0 1014974674 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 3993.16 0 0 0 0 0 0 0 0 0 0 0 0 0 3993.16 0 0 1014974675 89 Physician Assistant Only(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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 152.82 0 0 0 0 0 0 152.82 0 0 1014974852 1790764124 10 Physicians OPFER ERIN K 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 25 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593.67 0 8.81 0 0 0 0 0 0 602.48 0 0 1014975072 1649432618 10 Physicians CENSOPLANO NINA M 999999999 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 8458.34 0 0 0 0 0 0 8458.34 0 0 1014975078 1265752901 10 Physicians PARIKH ANALKUMAR 999999999 200 Cook 0 0 Internal Medicine 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 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.87 0 2392.75 0 0 0 0 0 0 2396.62 0 0 1014975183 16 Nurse Practitioners 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.5 0 0 0 0 0 0 74.5 0 0 1014975200 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4473.01 0 0 0 0 0 0 0 0 0 0 0 0 0 4473.01 0 0 1014975232 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 2857.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2857.3 0 0 1014975370 1447552153 16 Nurse Practitioners ZOKVIC DOREEN 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 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 1000.59 0 0 0 0 0 0 1000.59 0 0 1014975534 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 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 1014975580 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3945.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3945.7 0 0 1014975581 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7374.28 0 0 0 0 0 0 0 0 0 0 0 0 0 7374.28 0 0 1014975630 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5388.17 0 0 0 0 0 0 0 0 0 0 0 0 0 5388.17 0 0 1014975659 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 275.63 0 0 0 0 0 0 0 0 0 0 0 0 0 275.63 0 0 1014975714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1444.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1444.25 0 0 1014975721 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 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 4775.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4775.08 0 0 1014975752 1396290417 63 Other Providers of Medical Equipment/Supplies (Non-registered) MIDWEST MEDICAL SUPPLIES & EQU 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123437.54 0 1114.66 0 0 0 0 124552.2 0 0 1014975818 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 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 0 412.29 0 0 0 0 0 0 0 0 0 0 0 0 0 412.29 0 0 1014976059 1689206005 89 Physician Assistant Only(Encounter Only) GAROFALO JAMIE 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 0 104 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 0 987.24 0 0 0 0 0 0 987.24 0 0 1014976134 1083253306 89 Physician Assistant Only(Encounter Only) DENNEHEY CHARLES 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 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 0 253.3 0 0 0 0 0 0 253.3 0 0 1014976410 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 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 2454.89 2454.89 0 0 1014976529 1700478328 16 Nurse Practitioners BROCK RACHEL 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 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 0 388.15 0 0 0 0 0 0 388.15 0 0 1014976563 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 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 15276.8 0 0 0 0 0 0 0 0 0 0 0 0 0 15276.8 0 0 1014976574 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 25.65 0 0 0 0 0 0 25.65 0 0 1014976587 1861919284 89 Physician Assistant Only(Encounter Only) THOMAS JAMAINE R 999999999 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 101.3 0 0 0 0 0 0 101.3 0 0 1014976737 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014976774 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 3132.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3132.84 0 0 1014976959 1376916379 63 Other Providers of Medical Equipment/Supplies (Non-registered) IMPACT MEDICAL SERVICES LLC 999999999 826 Missouri 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 3701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3701 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170538.23 0 0 0 0 0 0 170538.23 0 0 1014977170 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22458.26 0 0 0 0 0 0 0 0 0 0 0 0 0 22458.26 0 0 1014977191 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1066.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1066.34 0 0 1014977266 1578198974 75 Department of Alcohol and Substance Abuse Provider CENTERSTONE OF ILLINOIS INC 999999999 99 Union 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 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100524.72 0 0 100524.72 0 0 1014977350 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 0 168.85 0 0 0 0 0 0 168.85 0 0 1014977392 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 25310.79 0 0 0 0 0 0 0 0 0 0 0 0 0 25310.79 0 0 1014977465 1609418516 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE FOREST PARK 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 0 126 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 20853 0 0 0 0 0 0 20853 0 0 1014977539 1134186968 10 Physicians SURI DAESMAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.35 0 167.59 0 0 0 0 0 0 221.94 0 0 1014977655 1225632623 16 Nurse Practitioners SHOWALTER KRISTI 999999999 53 Kane 0 0 0 0 0 6 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 462.4 0 0 0 0 0 0 0 0 1360.82 0 0 0 0 0 0 1823.22 0 0 1014977774 1447782578 10 Physicians ABU ALULA SAMER 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 0 441.38 0 0 0 0 0 0 441.38 0 0 1014978016 1326696766 16 Nurse Practitioners OANES EMMA 60612 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 57.82 0 0 0 0 0 0 57.82 0 0 1014978026 1538541982 10 Physicians FRASER LINDSEY W 999999999 200 Cook 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 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 2804.75 0 0 0 0 0 0 2804.75 0 0 1014978037 1760741938 10 Physicians OTHMAN DAVID 60612 200 Cook 0 0 Dermatology 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 0 113.36 0 0 0 0 0 0 113.36 0 0 1014978263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4597.52 0 0 0 0 0 0 0 0 0 0 0 0 0 4597.52 0 0 1014978341 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4150.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4150.08 0 0 1014978406 1124545603 12 Optometrists CORBIN STEPHANIE M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1564.76 0 817.32 0 0 0 0 2382.08 0 0 1014978469 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 201.36 0 0 0 0 0 0 201.36 0 0 1014978607 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 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 2878.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2878.39 0 0 1014978666 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 60.23 0 0 0 0 0 0 0 0 0 0 0 0 0 60.23 0 0 1014978673 1497385264 16 Nurse Practitioners GHERMAN MAYA O 999999999 57 Lake 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 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 1307.81 0 0 0 0 0 0 1307.81 0 0 1014978722 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19350.24 0 0 0 0 0 0 0 0 0 0 0 0 0 19350.24 0 0 1014978827 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13450.86 0 0 0 0 0 0 0 0 0 0 0 0 0 13450.86 0 0 1014979033 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 0 289 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 16597.19 0 0 0 0 0 0 0 0 0 0 0 0 0 16597.19 0 0 1014979085 1174701411 10 Physicians MALIK MOHAMMAD Z 999999999 80 Peoria 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 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 0 752.01 0 0 0 0 0 0 752.01 0 0 1014979144 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 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 14408.8 0 0 0 0 0 0 0 0 0 0 0 0 0 14408.8 0 0 1014979169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12526.67 0 0 0 0 0 0 0 0 0 0 0 0 0 12526.67 0 0 1014979171 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6465.49 0 0 0 0 0 0 0 0 0 0 0 0 0 6465.49 0 0 1014979199 1235520040 10 Physicians STARK MADELINE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.51 0 2779.17 0 0 0 0 0 0 2856.68 0 0 1014979367 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 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 0 110.16 110.16 0 0 1014979526 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.64 0 0 0 0 0 0 0 0 0 0 0 0 0 211.64 0 0 1014979529 1194805002 10 Physicians HOLMGREN CALLA M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 114 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7460.05 0 4361.2 0 0 0 0 0 0 11821.25 0 0 1014979541 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 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 0 280.45 0 0 0 0 0 0 280.45 0 0 1014979663 1770979684 10 Physicians HUTZ MICHAEL 999999999 200 Cook 0 0 Otolaryngology 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 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 0 938.75 0 0 0 0 0 0 938.75 0 0 1014979757 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.4 0 0 0 0 0 0 0 0 0 0 0 0 0 62.4 0 0 1014979774 1649775024 10 Physicians COOPER TYLER S 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 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 0 863.1 0 0 0 0 0 0 863.1 0 0 1014979856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6775.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6775.58 0 0 1014979859 1689817389 90 Waiver service provider--Elderly (DOA) EVEREST HEALTHCARE SOLUTIONS 605048150 30 DuPage 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169079.04 0 0 0 0 0 0 0 0 0 0 0 0 0 169079.04 0 0 1014980100 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2500.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2500.6 0 0 1014980179 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13131.06 0 0 0 0 0 0 0 0 0 0 0 0 0 13131.06 0 0 1014980472 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1014980534 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 9109.31 0 0 0 0 0 0 0 0 0 0 0 0 0 9109.31 0 0 1014980561 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14683.66 0 0 0 0 0 0 0 0 0 0 0 0 0 14683.66 0 0 1014980624 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8226.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8226.6 0 0 1014980648 1043813165 16 Nurse Practitioners MIWA ELISABETH 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 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 0 769.75 0 0 0 0 0 0 769.75 0 0 1014980746 1265532493 33 Nursing Facilities VANDALIA REHAB HEALTH CC 624712535 34 Fayette 0 0 0 0 0 0 0 0 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 1909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129428.09 0 0 0 0 0 0 0 129428.09 0 0 1014980772 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.16 0 0 0 0 0 0 174.16 0 0 1014980894 1134623689 10 Physicians PATEL NICHOLAS 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 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 1066.8 0 0 0 0 0 0 1066.8 0 0 1014980978 1366933848 91 Waiver service provider--Adults (DHS/DDD) MURDOCK CRYSTAL R 999999999 91 Sangamon 0 0 0 0 0 0 0 17 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 4817.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4817.12 0 0 1014981014 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17730.45 0 0 0 0 0 0 0 0 0 0 0 0 0 17730.45 0 0 1014981107 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 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 2813.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2813.84 0 0 1014981132 1700134293 10 Physicians JEAN NATHALIE 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 2326.06 0 0 0 0 0 0 2326.06 0 0 1014981142 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 31.01 0 0 0 0 0 0 31.01 0 0 1014981206 91 Waiver service provider--Adults (DHS/DDD) 87 Randolph 0 0 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 3548.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3548.65 0 0 1014981258 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 0 0 0 0 0 2 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 14710.13 0 0 0 0 0 0 0 0 0 0 0 0 0 14710.13 0 0 1014981362 1780229831 16 Nurse Practitioners HOEKSTRA ABIGAIL 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 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 1050.77 0 0 0 0 0 0 1050.77 0 0 1014981365 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 5432.21 0 0 0 0 0 0 0 0 0 0 0 0 0 5432.21 0 0 1014981421 1023626025 23 Occupational Therapists MORALES AMANDA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 423.46 423.46 0 0 1014981429 89 Physician Assistant Only(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 0 0 0 0 0 0 0 0 0 0 1014981541 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4313.48 0 0 0 0 0 0 0 0 0 0 0 0 0 4313.48 0 0 1014981652 1356725832 10 Physicians ZAHEER MUHAMMAD 999999999 107 Will 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 23 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9 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 272.3 0 0 0 0 0 0 0 0 964.95 0 0 0 0 0 0 1237.25 0 0 1014989240 1982212221 89 Physician Assistant Only(Encounter Only) KUNZ RYAN P 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 0 0 0 0 0 0 0 0 0 0 1014989280 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1717.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1717.61 0 0 1014989281 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 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 5063.69 0 0 0 0 0 0 0 0 0 0 0 0 0 5063.69 0 0 1014989363 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 0 136 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 7146.92 0 0 0 0 0 0 0 0 0 0 0 0 0 7146.92 0 0 1014989406 1932713435 16 Nurse Practitioners TRILIKIS LORI 999999999 80 Peoria 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 2274.36 0 0 0 0 0 0 2274.36 0 0 1014989523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24740.65 0 0 0 0 0 0 0 0 0 0 0 0 0 24740.65 0 0 1014989575 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 74.5 0 0 0 0 0 0 74.5 0 0 1014989647 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 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24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9188.14 0 0 0 0 0 0 0 0 0 0 0 0 0 9188.14 0 0 1014990380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3465.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3465.35 0 0 1014990571 1346432374 86 Clinical Social Worker(Encounter Only) HOLLIS PAMELA 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 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 0 752.27 0 0 0 0 0 0 752.27 0 0 1014990575 1578092805 10 Physicians ZEGLEN ANDRZEJ S 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 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 0 864 0 0 0 0 0 0 864 0 0 1014990748 1639661481 11 Dentists TAQVI MOHAMMAD Z 999999999 200 Cook 0 0 General Dentistry 0 0 89 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 406 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23218.97 0 0 0 0 0 0 0 0 0 0 0 0 0 23218.97 0 0 1014995656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2036.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2036.56 0 0 1014995668 1639786270 16 Nurse Practitioners FROST MARISSA L 999999999 60 Lee 0 0 0 0 0 2 0 0 0 0 0 0 0 0 25 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 85.65 0 0 0 0 0 0 0 0 1012.79 0 0 0 0 0 0 1098.44 0 0 1014995760 1891800603 87 Psychologist(Encounter Only) KURTH SHANNA 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 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 0 248.72 0 0 0 0 0 0 248.72 0 0 1014995816 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 713.46 0 0 0 0 0 0 0 0 0 0 0 0 0 713.46 0 0 1014995945 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22877.47 0 0 0 0 0 0 0 0 0 0 0 0 0 22877.47 0 0 1014996056 1477186492 36 Community mental health provider LITTLE CITY FOUNDATION 999999999 200 Cook 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 233.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1995.65 0 0 2229.13 0 0 1014996206 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29761.52 0 0 0 0 0 0 0 0 0 0 0 0 0 29761.52 0 0 1014996228 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 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 3228.71 3228.71 0 0 1014996261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21700.93 0 0 0 0 0 0 0 0 0 0 0 0 0 21700.93 0 0 1014996264 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 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 10210.17 0 0 0 0 0 0 0 0 0 0 0 0 0 10210.17 0 0 1014996471 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 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 0 191.17 0 0 0 0 0 0 191.17 0 0 1014996518 4014996518 72 Taxicabs and Livery Companies PREMIAONE INC. 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 1588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1588 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12434.46 0 0 0 0 0 0 12434.46 0 0 1014996569 1881245405 30 General Hospitals FRESENIUS KIDNEY CARE BLOOMING 999999999 72 McLean DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3681.37 0 0 0 0 0 3681.37 0 0 1014996671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269.47 0 0 0 0 0 0 0 0 0 0 0 0 0 269.47 0 0 1014996683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6374.79 0 0 0 0 0 0 0 0 0 0 0 0 0 6374.79 0 0 1014996851 1124544978 16 Nurse Practitioners MALINIS KATHLEEN A 999999999 53 Kane 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 0 235 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 1786.22 0 0 0 0 0 0 1786.22 0 0 1014996915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11419.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11419.84 0 0 1014996929 1205114477 10 Physicians MIYATA KANA 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 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 1667.9 0 0 0 0 0 0 1667.9 0 0 1014997023 1386181949 16 Nurse Practitioners GRIEGO ANDREA 999999999 70 McDonough 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 0 749.89 0 0 0 0 0 0 749.89 0 0 1014997041 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19877.88 0 0 0 0 0 0 0 0 0 0 0 0 0 19877.88 0 0 1014997169 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3450.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3450.3 0 0 1014997315 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6373.02 0 0 0 0 0 0 0 0 0 0 0 0 0 6373.02 0 0 1014997438 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12880.89 0 0 0 0 0 0 0 0 0 0 0 0 0 12880.89 0 0 1014997626 1710461777 60 Pharmacies JCH MEDICAL EQUIPMENT 999999999 50 Jersey 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 0 849.2 0 0 0 0 0 0 849.2 0 0 1014997802 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9348.79 0 0 0 0 0 0 0 0 0 0 0 0 0 9348.79 0 0 1014997864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21895.86 0 0 0 0 0 0 0 0 0 0 0 0 0 21895.86 0 0 1014997942 1093120974 10 Physicians KONANUR KYLASH 999999999 30 DuPage 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3277.33 0 0 0 0 0 0 3277.33 0 0 1014998015 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.03 45.03 0 0 1014998045 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 1132.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.46 0 0 1014998048 1730254095 33 Nursing Facilities DOCTORS NURSING AND REHAB CTR 628811028 66 Marion 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 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3985 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 327188.44 0 0 0 0 0 0 0 327188.44 0 0 1014998121 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 15.58 0 0 0 0 0 0 15.58 0 0 1014998378 1538690318 10 Physicians JAMES MELISSA 999999999 200 Cook 0 0 Pediatrics 0 0 0 13 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 651.99 0 0 0 0 0 0 0 0 938.21 0 0 0 0 0 0 1590.2 0 0 1014998381 1649867821 16 Nurse Practitioners PRIMBAS RICHELLE 999999999 200 Cook 0 0 0 0 0 3 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 85 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 70.7 0 0 0 0 0 0 0 0 3362.92 0 0 0 0 0 0 3433.62 0 0 1014998559 1184251480 60 Pharmacies PRISM PHARMACY AURORA LLC 999999999 53 Kane 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 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14518 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12511.79 0 0 0 12511.79 0 0 1014998607 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 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 16603.56 0 0 0 0 0 0 0 0 0 0 0 0 0 16603.56 0 0 1014998752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7403.98 0 0 0 0 0 0 0 0 0 0 0 0 0 7403.98 0 0 1014999055 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 276.76 0 0 0 0 0 0 0 0 0 0 0 0 0 276.76 0 0 1014999072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2369.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2369.53 0 0 1014999207 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 217 0 0 1014999247 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 1014999261 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 0 180 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 14195.95 0 0 0 0 0 0 0 0 0 0 0 0 0 14195.95 0 0 1014999275 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23229.82 0 0 0 0 0 0 0 0 0 0 0 0 0 23229.82 0 0 1014999298 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1900.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1900.78 0 0 1014999327 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11346.9 0 0 0 0 0 0 0 0 0 0 0 0 0 11346.9 0 0 1014999408 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 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 3304.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3304.84 0 0 1014999415 1275193062 16 Nurse Practitioners FINCH JENNIFER C 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 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1393.48 0 0 0 0 0 0 1393.48 0 0 1014999455 1902856081 16 Nurse Practitioners MOORE TAMELA A 999999999 109 Winnebago 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 1169.73 0 0 0 0 0 0 1169.73 0 0 1014999567 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.84 0 0 103.84 0 0 1014999569 1770104960 16 Nurse Practitioners WRIGHT ASHLEE 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 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 1014999573 1295232544 10 Physicians NEWBURN LINDSAY A 999999999 200 Cook 0 0 Pediatrics 0 0 0 7 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 608.97 0 0 0 0 0 0 4.4 0 694.67 0 0 0 0 0 0 1308.04 0 0 1014999652 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19263.07 0 0 0 0 0 0 0 0 0 0 0 0 0 19263.07 0 0 1014999742 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 1014999796 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 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 0 182.97 0 0 0 0 0 0 182.97 0 0 1014999860 61 Independent Laboratories 109 Winnebago 0 0 0 0 0 0 0 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 28.96 0 0 0 0 0 0 0 0 28.96 0 0 1014999943 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21022.11 0 0 0 0 0 0 0 0 0 0 0 0 0 21022.11 0 0 1014999995 1043848823 16 Nurse Practitioners BENNETT ANDRE 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 0 574.18 0 0 0 0 0 0 574.18 0 0 1015000001 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 20054.2 0 0 0 0 0 0 0 0 0 0 0 0 0 20054.2 0 0 1015000016 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6388.8 0 0 0 0 0 0 0 0 0 0 0 0 0 6388.8 0 0 1015000160 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27478.62 0 0 0 0 0 0 0 0 0 0 0 0 0 27478.62 0 0 1015000218 1003336660 10 Physicians GROVER GAGANDEEP 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 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 1245.52 0 0 0 0 0 0 1245.52 0 0 1015000289 1255877031 89 Physician Assistant Only(Encounter Only) WEISS JAMI 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 56.69 0 0 0 0 0 0 56.69 0 0 1015000359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16318.97 0 0 0 0 0 0 0 0 0 0 0 0 0 16318.97 0 0 1015000792 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 26196.87 0 0 0 0 0 0 0 0 0 0 0 0 0 26196.87 0 0 1015000906 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 256.75 0 0 0 0 0 0 0 0 0 0 0 0 0 256.75 0 0 1015000987 1700141017 10 Physicians ASHKIANI MOHAMMAD 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 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 82.54 0 0 0 0 0 0 82.54 0 0 1015001240 1174954069 16 Nurse Practitioners MANDELL CHERYL K 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 0 398.89 0 0 0 0 0 0 398.89 0 0 1015001325 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22685.03 0 0 0 0 0 0 0 0 0 0 0 0 0 22685.03 0 0 1015001570 1144674508 10 Physicians MORAVEK MICHAEL R 999999999 200 Cook 0 0 Clinical Pathology 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 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 0 363.99 0 0 0 0 0 0 0 0 363.99 0 0 1015001801 1750919403 16 Nurse Practitioners RIKHMAN LUIZA 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 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 1741.51 0 0 0 0 0 0 1741.51 0 0 1015001846 1790301331 16 Nurse Practitioners EGUIA CLAUDYN 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 0 152 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 0 829.34 0 0 0 0 0 0 829.34 0 0 1015002189 1396105698 89 Physician Assistant Only(Encounter Only) HERSHBARGER JEANETTE E 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 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 0 627.24 0 0 0 0 0 0 627.24 0 0 1015002320 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21329.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21329.25 0 0 1015002364 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23909.01 0 0 0 0 0 0 0 0 0 0 0 0 0 23909.01 0 0 1015002369 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7625.37 0 0 0 0 0 0 0 0 0 0 0 0 0 7625.37 0 0 1015002626 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 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 0 288.6 0 0 0 0 0 0 288.6 0 0 1015002761 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 0 143.51 143.51 0 0 1015002800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2742.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2742.56 0 0 1015002850 1508276783 10 Physicians HARDY-HENRY ANNE E 999999999 47 Jackson 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 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.2 0 0 0 0 0 0 878.2 0 0 1015002898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23390.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23390.29 0 0 1015002989 1083137897 10 Physicians MOSTUFA QUAZI A 999999999 10 Adams 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 0 298 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 2391.41 0 0 0 0 0 0 2391.41 0 0 1015003205 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6998.98 0 0 0 0 0 0 0 0 0 0 0 0 0 6998.98 0 0 1015003259 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 0 160 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 5177.04 0 0 0 0 0 0 0 0 0 0 0 0 0 5177.04 0 0 1015003292 10 Physicians 200 Cook 0 0 Urology 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 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.76 0 129.9 0 0 0 0 0 0 133.66 0 0 1015003392 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10992.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10992.93 0 0 1015003468 1114466885 10 Physicians BADSHAH MOAVIZ B 999999999 80 Peoria 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 0 152 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 1915.65 0 0 0 0 0 0 1915.65 0 0 1015003521 1386203610 89 Physician Assistant Only(Encounter Only) TIGUE TAYLOR M 606776473 200 Cook 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 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 1810.36 0 0 0 0 0 0 1810.36 0 0 1015003550 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11585.11 0 0 0 0 0 0 0 0 0 0 0 0 0 11585.11 0 0 1015003585 1982293825 16 Nurse Practitioners NOVAK DEVIN 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 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 0 0 0 0 0 0 0 0 0 0 1015003852 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10852 0 0 0 0 0 0 0 0 0 0 0 0 0 10852 0 0 1015004002 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14213.5 0 0 0 0 0 0 0 0 0 0 0 0 0 14213.5 0 0 1015004138 1982246898 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE FAIRFIELD 999999999 104 Wayne 0 0 0 0 0 0 0 0 0 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 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 10261 0 0 0 0 0 0 10261 0 0 1015004186 1578194965 16 Nurse Practitioners CROMER BRITTANY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.77 0 0 0 0 0 0 67.77 0 0 1015004211 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3562.12 0 0 0 0 0 0 0 0 0 0 0 0 0 3562.12 0 0 1015004321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10665.32 0 0 0 0 0 0 0 0 0 0 0 0 0 10665.32 0 0 1015004462 22 Physical Therapists 109 Winnebago 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 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 0 382.62 382.62 0 0 1015004583 1881012383 10 Physicians ZARLING BRADLEY J 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 73 0 0 0 0 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 0 0 2586.68 0 0 0 0 0 0 2586.68 0 0 1015004620 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22370.53 0 0 0 0 0 0 0 0 0 0 0 0 0 22370.53 0 0 1015004621 1891177051 10 Physicians CAPOCCIA EDWARD 999999999 37 Fulton 0 0 Urology 0 0 0 0 0 0 0 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 0 365.37 0 0 0 0 0 0 365.37 0 0 1015004681 1417552092 16 Nurse Practitioners BUSKOHL MISTY 999999999 53 Kane 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 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 0 720.09 0 0 0 0 0 0 720.09 0 0 1015004901 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 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 8723.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8723.38 0 0 1015004902 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3743.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3743.47 0 0 1015005077 1508291584 86 Clinical Social Worker(Encounter Only) MCGARRY ELIZABETH D 999999999 82 Piatt 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1417.41 0 0 0 0 0 0 1417.41 0 0 1015005161 1235340621 10 Physicians TARIGOPULA MADHUSUDHAN 999999999 200 Cook 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 0 129 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 1155.78 0 0 0 0 0 0 1155.78 0 0 1015005279 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12507.15 0 0 0 0 0 0 0 0 0 0 0 0 0 12507.15 0 0 1015005327 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27377.67 0 0 0 0 0 0 0 0 0 0 0 0 0 27377.67 0 0 1015005382 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 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 3467.32 3467.32 0 0 1015005394 1952959652 48 Rural Health Clinics LITCHFIELD URGENT CARE 999999999 76 Montgomery 0 0 0 27 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 2696.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2696.7 0 0 1015005519 1881643492 10 Physicians TAYOUN HITHAM R 999999999 108 Williamson 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162.07 0 0 0 0 0 0 0 0 162.07 0 0 1015005558 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3604.43 0 0 0 0 0 0 0 0 0 0 0 0 0 3604.43 0 0 1015005566 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2575.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2575.54 0 0 1015005601 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7330.07 0 0 0 0 0 0 0 0 0 0 0 0 0 7330.07 0 0 1015005656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2926.91 0 0 0 0 0 0 0 0 0 0 0 0 0 2926.91 0 0 1015005715 1942737689 10 Physicians SANDHU SONYA 999999999 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 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 0 709.28 0 0 0 0 0 0 709.28 0 0 1015005835 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 585.9 0 0 0 0 0 0 0 0 0 0 0 0 0 585.9 0 0 1015005851 86 Clinical Social Worker(Encounter Only) 98 Tazewell 0 0 0 0 0 0 0 0 0 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 0 966.58 0 0 0 0 0 0 966.58 0 0 1015005917 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8970.78 0 0 0 0 0 0 0 0 0 0 0 0 0 8970.78 0 0 1015006047 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 0 220 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 24228.05 0 0 0 0 0 0 0 0 0 0 0 0 0 24228.05 0 0 1015006170 1881285443 16 Nurse Practitioners SOCHACKI RENATA 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 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 32 0 0 0 0 0 0 32 0 0 1015006248 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 25958.46 0 0 0 0 0 0 0 0 0 0 0 0 0 25958.46 0 0 1015006292 1215994322 86 Clinical Social Worker(Encounter Only) AMRO ALICE F 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 0 130 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 0 242.82 0 0 0 0 0 0 242.82 0 0 1015006501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8165.36 0 0 0 0 0 0 0 0 0 0 0 0 0 8165.36 0 0 1015006681 1750818555 10 Physicians IJAZ AMBER 999999999 200 Cook 0 0 Family Practice 0 0 0 10 0 0 0 0 0 0 7 0 35 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 7 0 51 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 7 0 51 0 0 0 0 0 0 0 0 0 327.75 0 0 0 0 0 0 34.16 0 1372.57 0 0 0 0 0 0 1734.48 0 0 1015006829 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5186.89 0 0 0 0 0 0 0 0 0 0 0 0 0 5186.89 0 0 1015006911 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.26 0 0 0 0 0 0 23.26 0 0 1015007338 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1015007715 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1693.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1693.84 0 0 1015007778 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20050.99 0 0 0 0 0 0 0 0 0 0 0 0 0 20050.99 0 0 1015007911 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18281.33 0 0 0 0 0 0 0 0 0 0 0 0 0 18281.33 0 0 1015008010 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7902.6 0 0 0 0 0 0 0 0 0 0 0 0 0 7902.6 0 0 1015008180 1699202630 89 Physician Assistant Only(Encounter Only) MOTTET JORDAN J 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 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 1774.58 0 0 0 0 0 0 1774.58 0 0 1015008252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16305.38 0 0 0 0 0 0 0 0 0 0 0 0 0 16305.38 0 0 1015008327 1639525371 10 Physicians MOORE PATRICK 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 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 0 249.69 0 0 0 0 0 0 249.69 0 0 1015008341 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24357.12 0 0 0 0 0 0 0 0 0 0 0 0 0 24357.12 0 0 1015008560 1811349541 10 Physicians WATSON BRENDAN M 999999999 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 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 21.32 0 399.65 0 0 0 0 0 0 420.97 0 0 1015009032 1518346253 10 Physicians SYED NICOLE Z 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 38.55 0 0 0 0 0 0 5.17 0 578.35 0 0 0 0 0 0 622.07 0 0 1015009065 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23210.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23210.32 0 0 1015009072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1140.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1140.18 0 0 1015009125 1265032221 16 Nurse Practitioners ROBERTS LINDSAY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 432.57 0 0 0 0 0 0 432.57 0 0 1015009236 1790387157 16 Nurse Practitioners SANDLER MAYA 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 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 1074.36 0 0 0 0 0 0 1074.36 0 0 1015009306 1104811876 10 Physicians STEIGER CHARLES 999999999 80 Peoria 0 0 Urology 0 0 0 1 0 0 0 0 0 0 1 0 6 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 133.6 0 0 0 0 0 0 1.43 0 56.43 0 0 0 0 0 0 191.46 0 0 1015009416 10 Physicians 91 Sangamon 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 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 1015009655 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 747.22 0 0 0 0 0 0 0 0 0 0 0 0 0 747.22 0 0 1015009656 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 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 7225.99 0 0 0 0 0 0 0 0 0 0 0 0 0 7225.99 0 0 1015009770 10 Physicians 91 Sangamon 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 40.19 0 0 0 0 0 0 40.19 0 0 1015009904 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 383.66 0 0 0 0 0 0 0 0 0 0 0 0 0 383.66 0 0 1015009920 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 355.69 0 0 0 0 0 0 0 0 0 0 0 0 0 355.69 0 0 1015010069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19061.65 0 0 0 0 0 0 0 0 0 0 0 0 0 19061.65 0 0 1015010110 1922622943 11 Dentists GUEVARA ALDO 999999999 89 Rock Island 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 961 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 27421.31 0 0 0 0 0 0 0 0 0 0 0 10928 0 0 0 0 38349.31 0 0 1015010252 1093312977 16 Nurse Practitioners GRANDOLFO JULIE A 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 1706.44 0 0 0 0 0 0 1706.44 0 0 1015010297 1699095208 10 Physicians MEHTA BHAVI D 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 815.25 0 0 0 0 0 0 815.25 0 0 1015010417 1013968213 10 Physicians LELAND KRISTIN A 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 49 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764.52 0 8.81 0 0 0 0 0 0 773.33 0 0 1015010434 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4457.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4457.26 0 0 1015010484 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9074.17 0 0 0 0 0 0 0 0 0 0 0 0 0 9074.17 0 0 1015010553 1669088621 16 Nurse Practitioners TURCZYN JESSICA R 999999999 15 Bureau 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 0 123 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 1113.88 0 0 0 0 0 0 1113.88 0 0 1015010721 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 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 0 146.49 0 0 0 0 0 0 146.49 0 0 1015010815 1285273805 94 Waiver service provider--Children's support (DHS/DDD) WEYMAN SAMANTHA 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 0 287 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 13373.85 0 0 0 0 0 0 0 0 0 0 0 0 0 13373.85 0 0 1015010901 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.39 3.39 0 0 1015010962 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7225.47 0 0 0 0 0 0 0 0 0 0 0 0 0 7225.47 0 0 1015010966 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 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 0 330.09 330.09 0 0 1015011093 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 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 3.27 0 0 0 0 0 0 3.27 0 0 1015011101 1467400861 10 Physicians LEE JONATHON 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 26 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 741.42 0 7.26 0 0 0 0 0 0 748.68 0 0 1015011118 1811287816 10 Physicians FULLER JOSEPH 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 123 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1944.25 0 42.14 0 0 0 0 0 0 1986.39 0 0 1015011139 1881117091 10 Physicians GROVER SANA 999999999 19 Champaign 0 0 Internal Medicine 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 34 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 330.6 0 1923.3 0 0 0 0 0 0 2253.9 0 0 1015011185 55 Early Intervention Services 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 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 1162.18 0 0 0 0 0 0 1162.18 0 0 1015011354 1922560101 16 Nurse Practitioners EVERSGERD AMANDA 999999999 65 Madison 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 0 138 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 1001.43 0 0 0 0 0 0 1001.43 0 0 1015011356 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 0 206 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 16472.82 0 0 0 0 0 0 0 0 0 0 0 0 0 16472.82 0 0 1015011731 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 0 122 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 9005.5 0 0 0 0 0 0 0 0 0 0 0 0 0 9005.5 0 0 1015012038 1366092975 16 Nurse Practitioners NIMELY RACHEL J 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 348 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.91 0 0 8210.11 0 0 0 0 0 0 8399.02 0 0 1015012146 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15132.45 0 0 0 0 0 0 0 0 0 0 0 0 0 15132.45 0 0 1015012264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6225.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6225.63 0 0 1015012387 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.28 0 0 0 0 0 0 0 0 0 0 0 0 0 67.28 0 0 1015012439 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 0 0 0 0 0 0 0 0 0 0 1015012578 1659808491 10 Physicians FREITAG KELSEY 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 0 298 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 2712.55 0 0 0 0 0 0 2712.55 0 0 1015012640 1215554191 22 Physical Therapists HOECKER BAYLEE P 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 0 104 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 7771.66 7771.66 0 0 1015012922 16 Nurse Practitioners 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.34 0 0 0 0 0 0 10.34 0 0 1015013023 10 Physicians 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 81.79 0 0 0 0 0 0 81.79 0 0 1015013290 1922324011 10 Physicians NAZINITSKY ALLISON LOUISE 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1015013580 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 755.38 0 0 0 0 0 0 0 0 0 0 0 0 0 755.38 0 0 1015013675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19272.73 0 0 0 0 0 0 0 0 0 0 0 0 0 19272.73 0 0 1015013705 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 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 2734.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2734.2 0 0 1015013934 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 0 187 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 5459.48 0 0 0 0 0 0 0 0 0 0 0 0 0 5459.48 0 0 1015013948 1962864595 10 Physicians KUTLU KATHRYN 999999999 30 DuPage 0 0 Anesthesiology 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 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3816.41 0 0 0 0 0 0 3816.41 0 0 1015014029 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21483 0 0 0 0 0 0 0 0 0 0 0 0 0 21483 0 0 1015014091 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18558.8 0 0 0 0 0 0 0 0 0 0 0 0 0 18558.8 0 0 1015014107 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 1540.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1540.7 0 0 1015014144 1609482066 16 Nurse Practitioners GIELOW MATHEW G 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 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 0 347.95 0 0 0 0 0 0 347.95 0 0 1015014419 10 Physicians 37 Fulton 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 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 1015014541 1942791702 10 Physicians RUDOLPH MATTHEW J 999999999 200 Cook 0 0 Family Practice 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 2.6 0 248.76 0 0 0 0 0 0 251.36 0 0 1015014573 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4951.94 0 0 0 0 0 0 0 0 0 0 0 0 0 4951.94 0 0 1015014780 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3820.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3820.5 0 0 1015014799 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18327.65 0 0 0 0 0 0 0 0 0 0 0 0 0 18327.65 0 0 1015014809 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 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 5213.39 0 0 0 0 0 0 0 0 0 0 0 0 0 5213.39 0 0 1015015033 1285083352 13 Podiatrists NARCISI FRANK L 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 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 1696.64 0 0 0 0 0 0 1696.64 0 0 1015015197 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 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 8691.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8691.76 0 0 1015015490 24 Speech Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1061.18 1061.18 0 0 1015015511 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 0 453.32 0 0 0 0 0 0 453.32 0 0 1015015621 1497372866 63 Other Providers of Medical Equipment/Supplies (Non-registered) ELEVATE CARE NORTH BRANCH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 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1477915551 10 Physicians LOU MICHAEL X 999999999 53 Kane 0 0 Pediatrics 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 0 236 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 2011.94 0 0 0 0 0 0 2011.94 0 0 1015018863 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2753.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2753.15 0 0 1015018881 1760462162 10 Physicians PEREZ-YOUNG IRENE 999999999 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 383 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 541 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3099.63 0 56.08 0 0 0 0 0 0 3155.71 0 0 1015019157 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 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 0 527.35 0 0 0 0 0 0 527.35 0 0 1015019212 92 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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 0 413.79 0 0 0 0 0 0 413.79 0 0 1015020911 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.88 0 0 0 0 0 0 68.88 0 0 1015020943 10 Physicians 10 Adams 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 0 343.72 0 0 0 0 0 0 343.72 0 0 1015020966 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 22839.25 0 0 0 0 0 0 0 0 0 0 0 0 0 22839.25 0 0 1015020975 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 0 136 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 12568.16 0 0 0 0 0 0 0 0 0 0 0 0 0 12568.16 0 0 1015021058 1528449634 10 Physicians FISCHER LIAM JAMES 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 419 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6574.63 0 47.53 0 0 0 0 0 0 6622.16 0 0 1015021192 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 0 169.59 0 0 0 0 0 0 169.59 0 0 1015021206 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5226.96 0 0 0 0 0 0 0 0 0 0 0 0 0 5226.96 0 0 1015021285 1386172245 10 Physicians DHAMI KANWARPREET 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 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 0 423.61 0 0 0 0 0 0 423.61 0 0 1015021336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 891.38 0 0 0 0 0 0 0 0 0 0 0 0 0 891.38 0 0 1015021343 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 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 11665.84 0 0 0 0 0 0 0 0 0 0 0 0 0 11665.84 0 0 1015021354 1831669365 16 Nurse Practitioners ZAJAC KRISTA M 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 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 0 229.46 0 0 0 0 0 0 229.46 0 0 1015021383 16 Nurse Practitioners 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 78.09 0 0 0 0 0 0 78.09 0 0 1015021426 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 83.23 0 0 0 0 0 0 83.23 0 0 1015021468 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 1015021473 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 16578.46 0 0 0 0 0 0 0 0 0 0 0 0 0 16578.46 0 0 1015021557 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 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 7614.07 0 0 0 0 0 0 0 0 0 0 0 0 0 7614.07 0 0 1015021649 1831570498 10 Physicians SCHOTT TREVOR H 999999999 109 Winnebago 0 0 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 21 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 314.94 0 755.11 0 0 0 0 0 0 1070.05 0 0 1015021813 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 0 140 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 11164.01 0 0 0 0 0 0 0 0 0 0 0 0 0 11164.01 0 0 1015021937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15162.81 0 0 0 0 0 0 0 0 0 0 0 0 0 15162.81 0 0 1015022062 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3875.05 0 0 0 0 0 0 0 0 0 0 0 0 0 3875.05 0 0 1015022182 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3362.14 0 0 0 0 0 0 0 0 0 0 0 0 0 3362.14 0 0 1015022573 10 Physicians 30 DuPage 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 203.48 0 0 0 0 0 0 203.48 0 0 1015022745 10 Physicians 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.94 0 0 0 0 0 0 0 0 52.94 0 0 1015022855 1285260414 16 Nurse Practitioners HOWELL DANIEL L 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 117 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 1765.01 0 0 0 0 0 0 1771.41 0 0 1015022872 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 48958.39 0 0 0 0 0 0 0 0 0 0 0 0 0 48958.39 0 0 1015022989 1619539871 16 Nurse Practitioners KAMGA KENGNE MICHEL H 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 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 0 634.74 0 0 0 0 0 0 634.74 0 0 1015023199 1700412046 16 Nurse Practitioners DONALDSON WHITNEY 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 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 620 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3853.51 0 0 0 0 0 0 3853.51 0 0 1015023468 1730567512 13 Podiatrists BALOGUN FEYINTOLU 999999999 200 Cook 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 2106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2766.69 0 0 0 0 0 0 2766.69 0 0 1015023509 1831619022 10 Physicians KOESTER CAMERON 999999999 91 Sangamon 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 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 2120.13 0 0 0 0 0 0 2120.13 0 0 1015023562 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21396.48 0 0 0 0 0 0 0 0 0 0 0 0 0 21396.48 0 0 1015023565 1295261253 10 Physicians JARAVA DAVID 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 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 0 287.45 0 0 0 0 0 0 287.45 0 0 1015023774 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 47.77 0 0 0 0 0 0 47.77 0 0 1015024393 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 293.38 0 0 0 0 0 0 293.38 0 0 1015024578 1932716925 16 Nurse Practitioners PATTERSON OLIVIA 999999999 10 Adams 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 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 3642.62 0 0 0 0 0 0 3642.62 0 0 1015024728 1033678529 89 Physician Assistant Only(Encounter Only) EISSES JENNA 999999999 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.97 0 0 0 0 0 0 120.97 0 0 1015024782 1003440769 86 Clinical Social Worker(Encounter Only) REFVIK KIRSTEN 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 0 125 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 4005.11 0 0 0 0 0 0 4005.11 0 0 1015024833 1417302126 10 Physicians NAIK VISHAL V 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 0 569.38 0 0 0 0 0 0 569.38 0 0 1015024922 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 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 14764.66 0 0 0 0 0 0 0 0 0 0 0 0 0 14764.66 0 0 1015025034 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20372.08 0 0 0 0 0 0 0 0 0 0 0 0 0 20372.08 0 0 1015025414 16 Nurse Practitioners 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337.7 0 0 0 0 0 0 337.7 0 0 1015025490 1730146960 86 Clinical Social Worker(Encounter Only) MULDER ELYN 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 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6129.68 0 0 0 0 0 0 6129.68 0 0 1015025591 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1015025657 1831633627 16 Nurse Practitioners DAVIS NNEKA P 731279711 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 0 234 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 4593.33 0 0 0 0 0 0 4593.33 0 0 1015025710 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 0 293.38 0 0 0 0 0 0 293.38 0 0 1015025756 1154978161 89 Physician Assistant Only(Encounter Only) LIM BRANDON 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 0 0 0 0 0 0 0 0 0 0 1015025841 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 529.26 0 0 0 0 0 0 0 0 0 0 0 0 0 529.26 0 0 1015025999 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22684.21 0 0 0 0 0 0 0 0 0 0 0 0 0 22684.21 0 0 1015026024 1679005227 10 Physicians BELMONT MICHAEL L 999999999 200 Cook 0 0 Internal 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 0 103 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 1477.86 0 0 0 0 0 0 1477.86 0 0 1015026102 12 Optometrists 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 0 110.72 0 0 0 0 0 0 110.72 0 0 1015026298 1194781807 33 Nursing Facilities ROYAL OAKS CARE CENTER 614433503 45 Henry 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 0 185 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5158 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 673299.67 0 0 0 0 0 0 0 673299.67 0 0 1015026316 1669026795 12 Optometrists BRADLEY CHELSEA S 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 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 1151.65 0 0 0 0 0 0 1151.65 0 0 1015026405 1568071132 16 Nurse Practitioners DAVIS CYNTHIA S 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 0 0 0 0 0 0 0 0 0 0 1015026456 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 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 2159.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2159.12 0 0 1015026624 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 709.59 0 0 0 0 0 0 0 0 0 0 0 0 0 709.59 0 0 1015026818 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18773.96 0 0 0 0 0 0 0 0 0 0 0 0 0 18773.96 0 0 1015026828 1346697380 11 Dentists ANDREWS LYNDON L 999999999 200 Cook 0 0 0 0 6 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 1320.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1320.55 0 0 1015026982 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12697.74 0 0 0 0 0 0 0 0 0 0 0 0 0 12697.74 0 0 1015027012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8933.79 0 0 0 0 0 0 0 0 0 0 0 0 0 8933.79 0 0 1015027022 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 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 4552.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4552.56 0 0 1015027121 1629569082 12 Optometrists WILLIAMS MASON 999999999 109 Winnebago 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.59 0 0 0 0 0 0 120.59 0 0 1015027183 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24310.11 0 0 0 0 0 0 0 0 0 0 0 0 0 24310.11 0 0 1015027186 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1019.99 0 0 0 0 0 0 0 0 0 0 0 0 0 1019.99 0 0 1015027218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2982.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2982.7 0 0 1015027242 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015027300 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 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0 0 0 0 0 5353.44 0 0 1015032431 1548703085 33 Nursing Facilities DEERFIELD CROSSING NORTHBROOK 999999999 200 Cook 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 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2050729.43 0 0 0 0 0 0 0 2050729.43 0 0 1015032501 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 0 155 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 23408.81 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.81 0 0 1015032578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30186.69 0 0 0 0 0 0 0 0 0 0 0 0 0 30186.69 0 0 1015032603 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 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999999999 80 Peoria 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 0 182 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 5325.12 0 0 0 0 0 0 5325.12 0 0 1015033564 1548687635 10 Physicians BUTLER BENNETT 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 16 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.12 0 5823.5 0 0 0 0 0 0 6003.62 0 0 1015033663 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36886.6 0 0 0 0 0 0 0 0 0 0 0 0 0 36886.6 0 0 1015033704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16481.83 0 0 0 0 0 0 0 0 0 0 0 0 0 16481.83 0 0 1015033712 1548724578 16 Nurse Practitioners ABRAHAM JOHNY 999999999 30 DuPage 0 0 0 0 0 8 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 728.04 0 0 0 0 0 0 0 0 3551.86 0 0 0 0 0 0 4279.9 0 0 1015033927 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24463.55 0 0 0 0 0 0 0 0 0 0 0 0 0 24463.55 0 0 1015034072 1063969376 10 Physicians ENRIQUEZ CAMILLE 999999999 19 Champaign 0 0 Emergency 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 0 224 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 7131.69 0 0 0 0 0 0 7131.69 0 0 1015034148 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19792.41 0 0 0 0 0 0 0 0 0 0 0 0 0 19792.41 0 0 1015034191 1548887003 24 Speech Therapists ALEKSA VILIJA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26511.47 26511.47 0 0 1015034208 1144615436 10 Physicians PEDONE ERIC 999999999 200 Cook 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 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 3249.53 0 0 0 0 0 0 3249.53 0 0 1015034478 1932542578 10 Physicians PATEL DEVIN 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 2 0 263 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 501 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.66 0 4062.91 0 0 0 0 0 0 4112.57 0 0 1015034509 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18984.56 0 0 0 0 0 0 0 0 0 0 0 0 0 18984.56 0 0 1015034564 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 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 5437.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5437.52 0 0 1015034610 1669736682 10 Physicians HAROON JUNAID 999999999 47 Jackson 0 0 Thoracic Surgery 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 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 8894.55 0 0 0 0 0 0 8894.55 0 0 1015034631 1104126671 89 Physician Assistant Only(Encounter Only) GERMANN MATTHEW 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 0 235 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 3921.55 0 0 0 0 0 0 3921.55 0 0 1015034638 1568733541 16 Nurse Practitioners MILLER HEIDI K 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 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 1827.59 0 0 0 0 0 0 1827.59 0 0 1015034741 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4554.33 0 0 0 0 0 0 0 0 0 0 0 0 0 4554.33 0 0 1015034832 1578068979 10 Physicians TYLE ANEESH 999999999 200 Cook 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 1 0 25 0 0 0 0 0 0 0 0 0 252.14 0 0 0 0 0 0 15.7 0 346.71 0 0 0 0 0 0 614.55 0 0 1015034875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14868.03 0 0 0 0 0 0 0 0 0 0 0 0 0 14868.03 0 0 1015035049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6419.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6419.81 0 0 1015035103 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12092.78 0 0 0 0 0 0 0 0 0 0 0 0 0 12092.78 0 0 1015035154 1457674582 10 Physicians ALI VAN H 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 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 2629.55 0 0 0 0 0 0 2629.55 0 0 1015035203 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 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 4477.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4477.4 0 0 1015035225 1265052856 89 Physician Assistant Only(Encounter Only) LATIMER KIRSTIN M 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 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 0 521.37 0 0 0 0 0 0 521.37 0 0 1015035264 1982022810 10 Physicians SHEPARD KIRK 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 0 109 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 1654 0 0 0 0 0 0 1654 0 0 1015035401 1285268417 16 Nurse Practitioners ODON STEPHEN 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 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 1504.02 0 0 0 0 0 0 1504.02 0 0 1015035587 72 Taxicabs and Livery Companies 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 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 78.16 0 0 0 0 0 0 78.16 0 0 1015035619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1847.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1847.61 0 0 1015035651 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 0 151.67 151.67 0 0 1015035738 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 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 0 684.57 684.57 0 0 1015035748 1174963920 10 Physicians ABBAS MALIHA 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 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 0 347.7 0 0 0 0 0 0 347.7 0 0 1015035831 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173 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 6175.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6175.91 0 0 1015036081 1619486818 89 Physician Assistant Only(Encounter Only) KING AARON J 999999999 109 Winnebago 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 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 0 192.77 0 0 0 0 0 0 192.77 0 0 1015036113 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2996.01 0 0 0 0 0 0 0 0 0 0 0 0 0 2996.01 0 0 1015036286 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 0 212.89 0 0 0 0 0 0 212.89 0 0 1015036336 91 Waiver service provider--Adults (DHS/DDD) 848 Virginia 0 0 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 5172.97 0 0 0 0 0 0 0 0 0 0 0 0 0 5172.97 0 0 1015036420 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 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 0 166.34 0 0 0 0 0 0 166.34 0 0 1015036527 1407489578 55 Early Intervention Services PIOTROWSKI ELIZABETH A 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 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 3626.04 0 0 0 0 0 0 3626.04 0 0 1015036544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24477.81 0 0 0 0 0 0 0 0 0 0 0 0 0 24477.81 0 0 1015036620 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 1015036742 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13953.61 0 0 0 0 0 0 0 0 0 0 0 0 0 13953.61 0 0 1015036789 1518318716 10 Physicians KHAZAI LADAN 999999999 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1391.56 0 0 0 0 0 0 1391.56 0 0 1015037131 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9377.11 0 0 0 0 0 0 0 0 0 0 0 0 0 9377.11 0 0 1015037342 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 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 5152.62 0 0 0 0 0 0 0 0 0 0 0 0 0 5152.62 0 0 1015037387 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22920.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22920.06 0 0 1015037546 1659915171 16 Nurse Practitioners WILDERMAN AMANDA 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 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 0 179.4 0 0 0 0 0 0 179.4 0 0 1015037581 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14130.07 0 0 0 0 0 0 0 0 0 0 0 0 0 14130.07 0 0 1015037666 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 78.09 0 0 0 0 0 0 78.09 0 0 1015037844 1073133138 89 Physician Assistant Only(Encounter Only) KADAKIA TOSHA R 999999999 80 Peoria 0 0 0 0 0 1 0 0 0 0 0 0 0 0 93 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 124 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 2249.6 0 0 0 0 0 0 2281.75 0 0 1015037858 4015037858 72 Taxicabs and Livery Companies KIND CARE ILLINOIS 999999999 30 DuPage 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 3076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38009.66 0 0 0 0 0 0 38009.66 0 0 1015037917 1124659123 75 Department of Alcohol and Substance Abuse Provider "LAKE COUNTY CENTER, LLC" 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23955.33 0 0 23955.33 0 0 1015037959 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20734.35 0 0 0 0 0 0 0 0 0 0 0 0 0 20734.35 0 0 1015038164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5728.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5728.8 0 0 1015038168 91 Waiver service provider--Adults (DHS/DDD) 78 Moultrie 0 0 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 16304.42 0 0 0 0 0 0 0 0 0 0 0 0 0 16304.42 0 0 1015038199 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 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 3706.36 0 0 0 0 0 0 0 0 0 0 0 0 0 3706.36 0 0 1015038299 1003458902 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE ST ELMO 999999999 34 Fayette 0 0 0 0 0 0 0 0 0 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 4303 0 0 0 0 0 0 4303 0 0 1015038394 1134572225 10 Physicians O'HALLORAN JANE A 999999999 200 Cook 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 0 257.55 0 0 0 0 0 0 257.55 0 0 1015038432 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29104.31 0 0 0 0 0 0 0 0 0 0 0 0 0 29104.31 0 0 1015038450 1518315928 10 Physicians BHAKTA AMAR 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 0 137 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 2027.89 0 0 0 0 0 0 2027.89 0 0 1015038492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 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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 7514.96 0 0 0 0 0 0 0 0 0 0 0 0 0 7514.96 0 0 1015038758 1457823742 89 Physician Assistant Only(Encounter Only) REHME SAMANTHA 999999999 106 Whiteside 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 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 0 342.56 0 0 0 0 0 0 342.56 0 0 1015038822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3745.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3745.99 0 0 1015039032 1831504067 10 Physicians SAMSON SHOJI O 999999999 80 Peoria 0 0 Pediatrics 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 0 159 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 47873.8 0 0 0 0 0 0 47873.8 0 0 1015039048 1225516248 16 Nurse Practitioners HALBERG STEPHANIE 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 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 1789.05 0 0 0 0 0 0 1789.05 0 0 1015039236 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3127.06 0 0 0 0 0 0 0 0 0 0 0 0 0 3127.06 0 0 1015039267 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 49.22 0 0 0 0 0 0 49.22 0 0 1015039454 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74.48 0 0 0 0 0 0 74.48 0 0 1015039484 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 19024.68 0 0 0 0 0 0 0 0 0 0 0 0 0 19024.68 0 0 1015039674 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.98 0 0 0 54.98 0 0 1015039744 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24479.52 0 0 0 0 0 0 0 0 0 0 0 0 0 24479.52 0 0 1015039810 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 26.81 0 0 0 0 0 0 26.81 0 0 1015039879 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17430.52 0 0 0 0 0 0 0 0 0 0 0 0 0 17430.52 0 0 1015039898 1326010356 10 Physicians LAMPERT PAUL 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 28 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 778.03 0 13.49 0 0 0 0 0 0 791.52 0 0 1015039904 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3141.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3141.65 0 0 1015040019 1609492933 86 Clinical Social Worker(Encounter Only) CICERO THOMAS 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 0 124 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 0 678.82 0 0 0 0 0 0 678.82 0 0 1015040040 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 0 0 0 0 0 0 0 0 0 0 1015040044 1912524703 16 Nurse Practitioners BENNETT CORA 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 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 589 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1029.37 0 0 0 0 0 0 1029.37 0 0 1015040127 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23366.52 0 0 0 0 0 0 0 0 0 0 0 0 0 23366.52 0 0 1015040182 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.24 0 0 0 0 0 0 69.24 0 0 1015040240 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 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 0 257.39 0 0 0 0 0 0 257.39 0 0 1015040258 1922638048 22 Physical Therapists WNUK SYLWIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1601.05 1601.05 0 0 1015040763 1619389178 11 Dentists DEOL SHERRY 999999999 200 Cook 0 0 Orthodontist 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 3190.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3190.5 0 0 1015040792 1871722116 10 Physicians RATHINAMANICKAM HARINI 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1915.37 0 0 0 0 0 0 1915.37 0 0 1015040956 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1375.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1375.41 0 0 1015040957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 28745.13 0 0 0 0 0 0 0 0 0 0 0 0 0 28745.13 0 0 1015040984 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 160.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 855.3 0 0 1016.26 0 0 1015041007 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 1015041025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469.73 0 0 0 0 0 0 0 0 0 0 0 0 0 469.73 0 0 1015041037 86 Clinical Social Worker(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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015041184 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 0 108.52 0 0 0 0 0 0 0 0 0 0 0 0 0 108.52 0 0 1015041193 1518344704 10 Physicians VO DANIEL 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 0 207.07 0 0 0 0 0 0 207.07 0 0 1015041239 1780831529 10 Physicians ALRIFAI AHMED 999999999 30 DuPage 0 0 Internal Medicine 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 0 685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4945.16 0 0 0 0 0 0 4945.16 0 0 1015041280 1215376421 10 Physicians YEH AMY 999999999 200 Cook 0 0 Emergency Medicine 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 0 618.54 0 0 0 0 0 0 618.54 0 0 1015041568 1194139725 10 Physicians GEORGES RICARDO A 999999999 35 Ford 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 13 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 0 687.94 0 0 0 0 0 0 687.94 0 0 1015041614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3513.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3513.88 0 0 1015041677 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 0 263 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 22969.45 0 0 0 0 0 0 0 0 0 0 0 0 0 22969.45 0 0 1015041808 1013564962 16 Nurse Practitioners ISLEY JODI L 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 0 106 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 6550.46 0 0 0 0 0 0 6550.46 0 0 1015041847 1053658377 87 Psychologist(Encounter Only) RICHTER BENJAMIN J 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 792.95 0 0 0 0 0 0 792.95 0 0 1015041884 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4214.82 0 0 0 0 0 0 0 0 0 0 0 0 0 4214.82 0 0 1015041988 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115.92 115.92 0 0 1015042028 16 Nurse Practitioners 51 Jo Daviess 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015042211 1831295138 10 Physicians WU JOYCE 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 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 4663.93 0 0 0 0 0 0 4663.93 0 0 1015042376 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22250.86 0 0 0 0 0 0 0 0 0 0 0 0 0 22250.86 0 0 1015042523 1053950410 16 Nurse Practitioners DHARANI SOHAIL 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1538 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 16076.11 0 0 0 0 0 0 16076.11 0 0 1015042701 1932633849 10 Physicians SHAH KUSHAL D 999999999 200 Cook 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 2 0 25 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 50 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 50 0 0 0 0 0 0 0 0 0 38.55 0 0 0 0 0 0 3.94 0 1488.29 0 0 0 0 0 0 1530.78 0 0 1015042717 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 0 267 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 19512.36 0 0 0 0 0 0 0 0 0 0 0 0 0 19512.36 0 0 1015042956 1588763635 10 Physicians MOURAD AMR 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 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 33.13 0 0 0 0 0 0 0 0 33.13 0 0 1015042973 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30023.28 0 0 0 0 0 0 0 0 0 0 0 0 0 30023.28 0 0 1015042988 1134787864 30 General Hospitals BEACH PARK DIALYSIS 999999999 57 Lake 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 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35903.55 0 0 0 0 0 35903.55 0 0 1015043082 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23953.46 0 0 0 0 0 0 0 0 0 0 0 0 0 23953.46 0 0 1015043110 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1690.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1690.09 0 0 1015043182 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12108.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12108.6 0 0 1015043241 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1800.25 0 0 0 0 0 0 0 0 0 0 0 0 0 1800.25 0 0 1015043503 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 1015043945 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16453.58 0 0 0 0 0 0 0 0 0 0 0 0 0 16453.58 0 0 1015044164 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.01 36.01 0 0 1015044200 1669416590 10 Physicians MOORE DANIEL H 999999999 49 Jefferson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.9 0 7192.52 0 0 0 0 0 0 7249.42 0 0 1015044528 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 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 25308.66 0 0 0 0 0 0 0 0 0 0 0 0 0 25308.66 0 0 1015044663 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1478.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1478.02 0 0 1015044697 1700236072 10 Physicians MATZUMURA UMEMOTO GONZALO 999999999 19 Champaign 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 1391.26 0 0 0 0 0 0 1391.26 0 0 1015044732 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 2860.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2860.05 0 0 1015044816 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.79 0 0 0 0 0 0 101.79 0 0 1015044861 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749.89 0 0 0 0 0 0 0 0 0 0 0 0 0 749.89 0 0 1015044875 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 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 4765.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4765.32 0 0 1015044914 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3211.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3211.6 0 0 1015044920 1154322147 89 Physician Assistant Only(Encounter Only) DESHPANDE NISHA M 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 19.2 0 0 0 0 0 0 0 0 313.62 0 0 0 0 0 0 332.82 0 0 1015045029 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 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 28280.09 0 0 0 0 0 0 0 0 0 0 0 0 0 28280.09 0 0 1015045260 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 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 10255.41 0 0 0 0 0 0 0 0 0 0 0 0 0 10255.41 0 0 1015045277 86 Clinical Social Worker(Encounter Only) 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015045298 1255964573 28 Waiver service provider--Supportive living facility (HFS) "COTTAGES AT SALEM, THE" 999999999 66 Marion 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53967.61 0 0 0 0 0 0 0 0 0 0 0 0 0 53967.61 0 0 1015045346 1518436757 60 Pharmacies ILLINOIS CANCERCARE 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 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 1053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18915.21 0 0 0 18915.21 0 0 1015045378 1700031382 10 Physicians SHENJE LINCOLN T 999999999 91 Sangamon 0 0 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 2 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.64 0 2773.62 0 0 0 0 0 0 2781.26 0 0 1015045390 55 Early Intervention Services 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 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 1319.48 0 0 0 0 0 0 1319.48 0 0 1015045496 1679119945 16 Nurse Practitioners ANSTEE REBECCA JUNE 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 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 0 293.54 0 0 0 0 0 0 293.54 0 0 1015045586 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 44740.47 0 0 0 0 0 0 0 0 0 0 0 0 0 44740.47 0 0 1015045677 1497119408 10 Physicians GANTI AMITHA 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8437.58 0 0 0 0 0 0 8437.58 0 0 1015045835 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10704.39 0 0 0 0 0 0 0 0 0 0 0 0 0 10704.39 0 0 1015045854 1447699087 10 Physicians PORTER ANNE 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 139 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 247 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8539.05 0 2202.25 0 0 0 0 0 0 10741.3 0 0 1015045892 1023648664 11 Dentists JUNG JAE UNG 999999999 19 Champaign 0 0 General Dentistry 0 0 279 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 1276 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 1276 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 45032.78 0 0 0 0 0 0 0 0 0 0 0 13172.25 0 0 0 0 58205.03 0 0 1015046012 10 Physicians 200 Cook 0 0 Anesthesiology 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 0 0 9.12 0 0 0 0 0 0 9.12 0 0 1015046099 1982230124 16 Nurse Practitioners THOMPSON BRADLEY DAVID 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 624.01 0 0 0 0 0 0 624.01 0 0 1015046530 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3450.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3450.3 0 0 1015046740 1831185859 22 Physical Therapists MAASKE DAVID JAY 999999999 30 DuPage 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 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 0 758.93 758.93 0 0 1015046928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3002.18 0 0 0 0 0 0 0 0 0 0 0 0 0 3002.18 0 0 1015046981 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22710 0 0 0 0 0 0 0 0 0 0 0 0 0 22710 0 0 1015046993 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 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 1954.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1954.31 0 0 1015047043 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2883.08 0 0 0 0 0 0 0 0 0 0 0 0 0 2883.08 0 0 1015047050 1255973152 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE PRINCETON 999999999 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 7944 0 0 0 0 0 0 7944 0 0 1015047068 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7191.69 0 0 0 0 0 0 0 0 0 0 0 0 0 7191.69 0 0 1015047089 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2786.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2786.79 0 0 1015047129 1144852831 24 Speech Therapists OGDEN CHRISTY 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 0 123 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 9026.41 9026.41 0 0 1015047192 1982086864 86 Clinical Social Worker(Encounter Only) WINKLER CARRIE A 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 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 3642.05 0 0 0 0 0 0 3642.05 0 0 1015047317 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 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 3639.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3639.09 0 0 1015047327 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.69 13.69 0 0 1015047571 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16843.98 0 0 0 0 0 0 0 0 0 0 0 0 0 16843.98 0 0 1015047685 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 3941.29 0 0 0 0 0 0 0 0 0 0 0 0 0 3941.29 0 0 1015047863 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.98 0 0 0 0 0 0 260.98 0 0 1015047890 1720604713 16 Nurse Practitioners ENRIGHT NICKETTE 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 0 147.52 0 0 0 0 0 0 147.52 0 0 1015048142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6391.88 0 0 0 0 0 0 0 0 0 0 0 0 0 6391.88 0 0 1015048846 1912515248 16 Nurse Practitioners RAZ CAMILLE 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 43.54 0 0 0 0 0 0 43.54 0 0 1015049170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21206.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21206.9 0 0 1015049222 1952986168 25 Audiologists JEON CAROLYN 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 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 0 152.27 152.27 0 0 1015049291 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23345.51 0 0 0 0 0 0 0 0 0 0 0 0 0 23345.51 0 0 1015049330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2732.76 0 0 0 0 0 0 0 0 0 0 0 0 0 2732.76 0 0 1015049572 1053965806 25 Audiologists CHESNUT KATHERINE A 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 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 0 272.63 272.63 0 0 1015049636 1639776859 24 Speech Therapists BURNS LAUREN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284 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 17329.96 17329.96 0 0 1015049655 1750842522 16 Nurse Practitioners CHICON AIDA 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 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 0 761.36 0 0 0 0 0 0 761.36 0 0 1015049670 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4451.09 0 0 0 0 0 0 0 0 0 0 0 0 0 4451.09 0 0 1015049800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9484.53 0 0 0 0 0 0 0 0 0 0 0 0 0 9484.53 0 0 1015049936 1659809879 10 Physicians BAIG RUBINA S 999999999 54 Kankakee 0 0 0 0 0 5 0 0 0 0 0 0 4 0 39 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 4 0 56 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 4 0 56 0 0 0 0 0 0 0 0 0 253.36 0 0 0 0 0 0 15.62 0 2285.01 0 0 0 0 0 0 2553.99 0 0 1015049984 86 Clinical Social Worker(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 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 2994.02 0 0 0 0 0 0 2994.02 0 0 1015050045 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 0 0 0 0 0 0 0 0 0 0 1015050140 1154752814 10 Physicians RICHMOND MARCIE 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 0 455.42 0 0 0 0 0 0 455.42 0 0 1015050170 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 73.4 0 0 0 0 0 0 73.4 0 0 1015050211 1497195291 10 Physicians SONG SHUANG 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 0 204.54 0 0 0 0 0 0 204.54 0 0 1015050280 11 Dentists 200 Cook 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.1 0 0 1015050453 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15776.5 0 0 0 0 0 0 0 0 0 0 0 0 0 15776.5 0 0 1015050494 10 Physicians 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 0 918.49 0 0 0 0 0 0 918.49 0 0 1015050697 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 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 0 228.96 0 0 0 0 0 0 228.96 0 0 1015050867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 436.46 0 0 0 0 0 0 0 0 0 0 0 0 0 436.46 0 0 1015050915 1700291051 10 Physicians MURRAY-TORRES TERESA 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 1887.37 0 0 0 0 0 0 1887.37 0 0 1015050919 1538600820 16 Nurse Practitioners AREND CATHERINE 605029458 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 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 25.4 0 0 0 0 0 0 25.4 0 0 1015050920 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24533.96 0 0 0 0 0 0 0 0 0 0 0 0 0 24533.96 0 0 1015051070 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 51.76 0 0 0 0 0 0 51.76 0 0 1015051255 36 Community mental health provider 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.45 0 0 19.45 0 0 1015051514 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 0 270 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 14261.28 0 0 0 0 0 0 0 0 0 0 0 0 0 14261.28 0 0 1015051557 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25116.91 0 0 0 0 0 0 0 0 0 0 0 0 0 25116.91 0 0 1015051690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12015.63 0 0 0 0 0 0 0 0 0 0 0 0 0 12015.63 0 0 1015051706 1124446976 10 Physicians DEGESYS KRISTINA 999999999 200 Cook 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 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4397.45 0 0 0 0 0 0 4397.45 0 0 1015051707 1710593124 88 Other behavior health professional LEEZER ANDREA 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 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 0 588.14 0 0 0 0 0 0 588.14 0 0 1015051744 1184623381 10 Physicians FALLON MICHAEL J 999999999 10 Adams 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7091.95 0 0 0 0 0 0 7091.95 0 0 1015051820 1265698849 10 Physicians MUNNS STEPHANIE 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 1100.26 0 0 0 0 0 0 1100.26 0 0 1015051837 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23989.24 0 0 0 0 0 0 0 0 0 0 0 0 0 23989.24 0 0 1015052002 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2354.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2354.45 0 0 1015052028 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 1015052031 1750912770 16 Nurse Practitioners DORETTI TINA L 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 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 0 657.66 0 0 0 0 0 0 657.66 0 0 1015052155 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 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 54.93 0 0 0 0 0 0 54.93 0 0 1015052235 1043868136 89 Physician Assistant Only(Encounter Only) NORWOOD SAGE M 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 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 0 243.02 0 0 0 0 0 0 243.02 0 0 1015052245 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 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 5.54 0 91.48 0 0 0 0 0 0 97.02 0 0 1015052256 1265819601 10 Physicians KHAN MUHAMMAD REHAN 999999999 80 Peoria 0 0 Pediatrics 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 5044.62 0 0 0 0 0 0 5044.62 0 0 1015052538 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1099.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1099.97 0 0 1015052594 10 Physicians 200 Cook 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1106.65 0 0 0 0 0 0 1106.65 0 0 1015052635 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 968.46 0 0 0 0 0 0 0 0 0 0 0 0 0 968.46 0 0 1015052702 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6187.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6187.91 0 0 1015052705 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10499.3 0 0 0 0 0 0 0 0 0 0 0 0 0 10499.3 0 0 1015052864 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015053023 1881236792 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE ELGIN 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13240 0 0 0 0 0 0 13240 0 0 1015053058 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 5971.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5971.77 0 0 1015053192 1912462870 16 Nurse Practitioners ISSAC JANZE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3656.28 0 0 0 0 0 0 3656.28 0 0 1015053362 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.69 0 0 0 0 0 0 0 0 0 0 0 0 0 16.69 0 0 1015053419 1003442880 16 Nurse Practitioners VICENCIO CANDICE J 999999999 109 Winnebago 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 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 0 202.31 0 0 0 0 0 0 202.31 0 0 1015053501 10 Physicians 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 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 0 239.19 0 0 0 0 0 0 239.19 0 0 1015053598 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25737.74 0 0 0 0 0 0 0 0 0 0 0 0 0 25737.74 0 0 1015053643 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 1015053732 10 Physicians 89 Rock Island 0 0 Urology 0 0 0 0 0 0 0 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 0 168.64 0 0 0 0 0 0 168.64 0 0 1015053750 1942481148 33 Nursing Facilities FLANAGAN REHABILITATION HCC 999999999 61 Livingston 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2017 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200562.91 0 0 0 0 0 0 0 200562.91 0 0 1015053764 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20724.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20724.44 0 0 1015053989 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.78 0 0 0 0 0 0 83.78 0 0 1015054033 1457882946 10 Physicians TARBUTTON MORGAN 999999999 200 Cook 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 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 50.73 0 0 0 0 0 0 50.73 0 0 1015054055 1023634318 11 Dentists AFANEH HANEEN 999999999 200 Cook 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 293 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 9010.97 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 10140.02 0 0 1015054087 1780145904 16 Nurse Practitioners BRUNO JASON R 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 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 0 100.41 0 0 0 0 0 0 100.41 0 0 1015054179 87 Psychologist(Encounter Only) 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 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 0 425.51 0 0 0 0 0 0 425.51 0 0 1015054386 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 21921.02 0 0 0 0 0 0 0 0 0 0 0 0 0 21921.02 0 0 1015054515 1598864654 33 Nursing Facilities SWANSEA REHAB HEALTH CC 622264213 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 2042 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195241.07 0 0 0 0 0 0 0 195241.07 0 0 1015054624 1518524214 16 Nurse Practitioners MILES SARAH J 999999999 200 Cook 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 0 963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159660.18 0 0 0 0 0 0 159660.18 0 0 1015054750 1750920385 16 Nurse Practitioners MURPHY KEELY 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 0 371.62 0 0 0 0 0 0 371.62 0 0 1015054822 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9381.35 0 0 0 0 0 0 0 0 0 0 0 0 0 9381.35 0 0 1015054854 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 0 184.2 0 0 0 0 0 0 184.2 0 0 1015054879 1861041980 48 Rural Health Clinics OSF MEDICAL GROUP-GODFREY 999999999 65 Madison 0 0 0 645 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1916 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1916 0 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47822.09 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47822.09 0 0 1015054891 1003347394 10 Physicians LEB STEPHEN 999999999 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015055039 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11133.63 0 0 0 0 0 0 0 0 0 0 0 0 0 11133.63 0 0 1015055058 1497346415 33 Nursing Facilities APERION CARE WESTCHESTER 999999999 200 Cook 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 605662.64 0 0 0 0 0 0 0 605662.64 0 0 1015055093 1508228222 10 Physicians SCHMITZ JEREMY 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 0 0 0 0 0 0 0 0 0 0 1015055167 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015055202 1326577057 10 Physicians CURRAN JOANNA 999999999 200 Cook 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 592.31 0 0 0 0 0 0 592.31 0 0 1015055365 11 Dentists 98 Tazewell 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 0 108.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.35 0 0 1015055415 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1625.16 1625.16 0 0 1015055524 1043720691 48 Rural Health Clinics FAMILY HEALTH CARE OF WATSEKA 999999999 46 Iroquois 0 0 0 119 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10651.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10651.18 0 0 1015055547 1518311224 10 Physicians POLICHT KATHERINE 999999999 200 Cook 0 0 Pediatrics 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 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 3017.38 0 0 0 0 0 0 3017.38 0 0 1015055578 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 0 141.12 0 0 0 0 0 0 141.12 0 0 1015055679 1528675733 16 Nurse Practitioners MINER MARCELLA A 999999999 45 Henry 0 0 0 0 0 0 0 0 0 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 0 867.44 0 0 0 0 0 0 867.44 0 0 1015055736 1497108211 10 Physicians JAIN SAKSHI 999999999 200 Cook 0 0 Internal Medicine 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 0 505 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 1658.89 0 0 0 0 0 0 1658.89 0 0 1015055980 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3846.23 0 0 0 0 0 0 0 0 0 0 0 0 0 3846.23 0 0 1015056051 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16687.24 0 0 0 0 0 0 0 0 0 0 0 0 0 16687.24 0 0 1015056264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1115.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1115.18 0 0 1015056318 1649893389 16 Nurse Practitioners O'DELL BROOKANN 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 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 0 556.03 0 0 0 0 0 0 556.03 0 0 1015056362 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12698.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12698.4 0 0 1015056383 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1282.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1282.76 0 0 1015056386 1801358908 16 Nurse Practitioners GOULD JESICA 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 0 120 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 1081.79 0 0 0 0 0 0 1081.79 0 0 1015056451 1588681498 10 Physicians PAGUIA RICHARD A 999999999 53 Kane 0 0 Internal Medicine 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 0 262 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 4107.8 0 0 0 0 0 0 4107.8 0 0 1015056480 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2396.61 0 0 0 0 0 0 0 0 0 0 0 0 0 2396.61 0 0 1015056716 1093773954 10 Physicians CHIANG GEORGE 999999999 80 Peoria 0 0 Urology 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 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 4.36 0 1127.19 0 0 0 0 0 0 1131.55 0 0 1015056776 1437797727 16 Nurse Practitioners KYONKA JONATHAN C 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 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 0 298.69 0 0 0 0 0 0 298.69 0 0 1015056957 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18394.65 0 0 0 0 0 0 0 0 0 0 0 0 0 18394.65 0 0 1015057036 10 Physicians 80 Peoria 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 1926.4 0 0 0 0 0 0 1926.4 0 0 1015057139 1265419006 10 Physicians KRAMBECK AMY E 999999999 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3919.86 0 0 0 0 0 0 3919.86 0 0 1015057143 16 Nurse Practitioners 35 Ford 0 0 0 0 0 0 0 0 0 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 0 267.42 0 0 0 0 0 0 267.42 0 0 1015057196 1245305051 16 Nurse Practitioners AMFAHR CAROL 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 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 0 275.41 0 0 0 0 0 0 275.41 0 0 1015057257 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 0 114 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 14432 0 0 0 0 0 0 0 0 0 0 0 0 0 14432 0 0 1015057390 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11845.13 0 0 0 0 0 0 0 0 0 0 0 0 0 11845.13 0 0 1015057538 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14501.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14501.39 0 0 1015057652 1144868605 16 Nurse Practitioners ANDERSON SAMANTHA R 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 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 0 537.16 0 0 0 0 0 0 537.16 0 0 1015057666 1083148464 10 Physicians WEIMER KATRINA 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1933.4 0 0 0 0 0 0 1933.4 0 0 1015057814 1396384533 89 Physician Assistant Only(Encounter Only) SHERWOOD DANIEL H 999999999 47 Jackson 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 0 134 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 1849.81 0 0 0 0 0 0 1849.81 0 0 1015057895 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 0 146.8 0 0 0 0 0 0 146.8 0 0 1015057953 1689206492 89 Physician Assistant Only(Encounter Only) WATKINS NICHOLAS D 999999999 24 Coles 0 0 0 0 0 4 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 102 0 0 0 0 0 0 0 0 0 330.7 0 0 0 0 0 0 0 0 2601.55 0 0 0 0 0 0 2932.25 0 0 1015058061 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.1 0 0 0 0 0 0 0 0 0 0 0 0 0 65.1 0 0 1015058108 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4971.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4971.45 0 0 1015058248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11041.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11041.36 0 0 1015058358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26366.4 0 0 0 0 0 0 0 0 0 0 0 0 0 26366.4 0 0 1015058399 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 0 168.85 0 0 0 0 0 0 168.85 0 0 1015058537 1437708674 40 Federally Qualified Health Centers SIU CENTER FOR FAMILY MEDICINE 629011400 47 Jackson 0 0 0 320 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1385 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1385 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50152.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50152.61 0 0 1015058543 1457572216 10 Physicians COHEN INBAL 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 319.48 0 0 0 0 0 0 0 0 319.48 0 0 1015058677 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16641.13 0 0 0 0 0 0 0 0 0 0 0 0 0 16641.13 0 0 1015058755 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23918.3 0 0 0 0 0 0 0 0 0 0 0 0 0 23918.3 0 0 1015058788 1396131843 10 Physicians FERRARESI STEPHEN 999999999 19 Champaign 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 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 1449.32 0 0 0 0 0 0 1449.32 0 0 1015058850 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3597.27 0 0 0 0 0 0 0 0 0 0 0 0 0 3597.27 0 0 1015058904 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2305.84 2305.84 0 0 1015058905 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15168.78 0 0 0 0 0 0 0 0 0 0 0 0 0 15168.78 0 0 1015058926 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015058988 1730713546 16 Nurse Practitioners SCOTT KIM 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 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 0 719.91 0 0 0 0 0 0 719.91 0 0 1015059003 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19251.83 0 0 0 0 0 0 0 0 0 0 0 0 0 19251.83 0 0 1015059026 1700204880 10 Physicians SAME ROBERT V 999999999 107 Will 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 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 0 484.86 0 0 0 0 0 0 484.86 0 0 1015059105 4015059105 90 Waiver service provider--Elderly (DOA) "RELIACARE, LTD" 999999999 30 DuPage 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119908.23 0 0 0 0 0 0 0 0 0 0 0 0 0 119908.23 0 0 1015059232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.44 0 0 0 0 0 0 0 0 0 0 0 0 0 48.44 0 0 1015059242 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 401.75 0 0 0 0 0 0 0 0 0 0 0 0 0 401.75 0 0 1015059278 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241.41 0 0 0 0 0 0 0 0 0 0 0 0 0 241.41 0 0 1015059359 1073137550 25 Audiologists BROCKNER ALEXANDRA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 605.03 605.03 0 0 1015059748 1487298121 16 Nurse Practitioners NEWREN CHELSEA A 999999999 57 Lake 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 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 0 104.96 0 0 0 0 0 0 0 0 569.5 0 0 0 0 0 0 674.46 0 0 1015060009 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 330.06 0 0 0 0 0 0 0 0 0 0 0 0 0 330.06 0 0 1015060044 1598785644 87 Psychologist(Encounter Only) REGAN THERESA 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 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484.15 0 0 0 0 0 0 484.15 0 0 1015060156 1164816567 10 Physicians BRUNNER JACOB P 999999999 30 DuPage 0 0 Otolaryngology 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 1685.2 0 0 0 0 0 0 1685.2 0 0 1015060162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11819 0 0 0 0 0 0 0 0 0 0 0 0 0 11819 0 0 1015060177 1144797887 16 Nurse Practitioners BOBAK ALICIA 999999999 200 Cook 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 0 708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7698.54 0 0 0 0 0 0 7698.54 0 0 1015060218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20907.49 0 0 0 0 0 0 0 0 0 0 0 0 0 20907.49 0 0 1015060219 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1631.11 0 0 0 0 0 0 0 0 0 0 0 0 0 1631.11 0 0 1015060297 1740675719 10 Physicians BAKHSH WAJEEH R 999999999 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 9 0 0 0 0 0 0 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 11.1 0 523.09 0 0 0 0 0 0 534.19 0 0 1015060314 1083052856 10 Physicians KENNEDY AIMEE A 999999999 80 Peoria 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 0 244 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 26137.25 0 0 0 0 0 0 26137.25 0 0 1015060351 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18188.54 0 0 0 0 0 0 0 0 0 0 0 0 0 18188.54 0 0 1015060370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3742.27 0 0 0 0 0 0 0 0 0 0 0 0 0 3742.27 0 0 1015060380 1851754386 10 Physicians VENUTI KRISTEN ROSE 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 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 2072.75 0 0 0 0 0 0 2072.75 0 0 1015060422 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 15311.31 0 0 0 0 0 0 0 0 0 0 0 0 0 15311.31 0 0 1015060585 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 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 1778 1778 0 0 1015060693 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1015060734 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16699.15 0 0 0 0 0 0 0 0 0 0 0 0 0 16699.15 0 0 1015060819 1568082964 16 Nurse Practitioners BUKO MORGAN E 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 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 0 537.07 0 0 0 0 0 0 537.07 0 0 1015060867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16530.17 0 0 0 0 0 0 0 0 0 0 0 0 0 16530.17 0 0 1015060878 1689014276 10 Physicians CHEESMAN ROCCA ANTONIO 999999999 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.24 0 8712.13 0 0 0 0 0 0 8811.37 0 0 1015060915 1104018720 10 Physicians SANDERS TIMOTHY A 608052701 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 0 180 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 28937.23 0 0 0 0 0 0 28937.23 0 0 1015061030 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 64.08 0 0 0 0 0 0 64.08 0 0 1015061212 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 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 1387.96 0 0 0 0 0 0 1387.96 0 0 1015061285 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 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 0 790.92 0 0 0 0 0 0 0 0 0 0 0 0 0 790.92 0 0 1015061565 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 1400.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1400.16 0 0 1015061677 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22329.3 0 0 0 0 0 0 0 0 0 0 0 0 0 22329.3 0 0 1015061784 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 0 602.44 0 0 0 0 0 0 602.44 0 0 1015061785 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 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 3803.46 0 0 0 0 0 0 0 0 0 0 0 0 0 3803.46 0 0 1015061835 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27815.09 0 0 0 0 0 0 0 0 0 0 0 0 0 27815.09 0 0 1015061922 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 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 1230.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1230.39 0 0 1015062042 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 957.79 0 0 0 0 0 0 0 0 0 0 0 0 0 957.79 0 0 1015062180 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.97 38.97 0 0 1015062257 1942835707 89 Physician Assistant Only(Encounter Only) TROUTNER DANIEL 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 24.25 0 0 0 0 0 0 24.25 0 0 1015062414 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 651.2 0 0 0 0 0 0 0 0 0 0 0 0 0 651.2 0 0 1015062503 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1883.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1883.68 0 0 1015062559 1295358810 16 Nurse Practitioners STANDEFER ANDREW 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 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 1944.44 0 0 0 0 0 0 1944.44 0 0 1015062618 1003336363 23 Occupational Therapists WEIRATHER SARAH M 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 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 16513.77 16513.77 0 0 1015062626 1013418953 91 Waiver service provider--Adults (DHS/DDD) NEUMANN JONATHON 999999999 91 Sangamon 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83089.2 0 0 0 0 0 0 0 0 0 0 0 0 0 83089.2 0 0 1015062736 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 0 366.54 0 0 0 0 0 0 0 0 0 0 0 0 0 366.54 0 0 1015062835 1558976514 16 Nurse Practitioners KINNEY JANICE N 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 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 0 543.55 0 0 0 0 0 0 543.55 0 0 1015062889 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19531.12 0 0 0 0 0 0 0 0 0 0 0 0 0 19531.12 0 0 1015062967 1528487436 10 Physicians CICCOTTI MICHAEL C 999999999 53 Kane 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 12 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.22 0 1345.65 0 0 0 0 0 0 1523.87 0 0 1015063244 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3858.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3858.69 0 0 1015063253 1679129985 16 Nurse Practitioners SALSBERRY CATHERINE E 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 1105.53 0 0 0 0 0 0 1105.53 0 0 1015063364 1679108351 48 Rural Health Clinics HSHS MEDICAL GROUP FAMILY MEDI 999999999 33 Effingham 0 0 0 141 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16599.31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16599.31 0 0 1015063523 1073013629 16 Nurse Practitioners COURTS JENNIFER M 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 0 139 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 1088.42 0 0 0 0 0 0 1088.42 0 0 1015063589 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 26585.05 0 0 0 0 0 0 0 0 0 0 0 0 0 26585.05 0 0 1015063599 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16431.09 0 0 0 0 0 0 0 0 0 0 0 0 0 16431.09 0 0 1015063619 1104353622 10 Physicians BRAY KORBIN 999999999 200 Cook 0 0 Family Practice 0 0 0 10 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 941.84 0 0 0 0 0 0 0 0 1972.41 0 0 0 0 0 0 2914.25 0 0 1015063666 1174532121 10 Physicians LEVINSOHN DAVID 999999999 10 Adams 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 0 103 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 2348.53 0 0 0 0 0 0 2348.53 0 0 1015063742 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15392.41 0 0 0 0 0 0 0 0 0 0 0 0 0 15392.41 0 0 1015063867 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 0 145.97 0 0 0 0 0 0 145.97 0 0 1015063913 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5756.57 0 0 0 0 0 0 0 0 0 0 0 0 0 5756.57 0 0 1015064045 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20135.4 0 0 0 0 0 0 0 0 0 0 0 0 0 20135.4 0 0 1015064115 1679990121 10 Physicians DELAPP KIMBERLY 999999999 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 7 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77.56 0 2244.53 0 0 0 0 0 0 2322.09 0 0 1015064164 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7665.52 0 0 0 0 0 0 0 0 0 0 0 0 0 7665.52 0 0 1015064211 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 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 2021.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2021.16 0 0 1015064349 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 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 2232.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2232.55 0 0 1015064422 1730622457 33 Nursing Facilities CARE CENTER AT CENTER GROVE 999999999 65 Madison 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 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4928 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511764.68 0 0 0 0 0 0 0 511764.68 0 0 1015064580 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 161.48 0 0 0 0 0 0 0 0 0 0 0 0 0 161.48 0 0 1015064650 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015064720 1477915445 10 Physicians GOLDEN ANDREW 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 208 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4444.49 0 0 0 0 0 0 4444.49 0 0 1015064879 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 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 1884.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1884.41 0 0 1015064958 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6079.53 0 0 0 0 0 0 0 0 0 0 0 0 0 6079.53 0 0 1015064993 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 0 153.5 0 0 0 0 0 0 153.5 0 0 1015065022 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16854.31 0 0 0 0 0 0 0 0 0 0 0 0 0 16854.31 0 0 1015065090 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 16537.21 0 0 0 0 0 0 0 0 0 0 0 0 0 16537.21 0 0 1015065100 1962625756 16 Nurse Practitioners AZTLAN-KEAHEY EVELYN ANGEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196976.41 0 0 0 0 0 0 196976.41 0 0 1015065323 20 Registered nurse 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.5 0 0 0 0 0 0 71.5 0 0 1015065376 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15111.57 0 0 0 0 0 0 0 0 0 0 0 0 0 15111.57 0 0 1015065454 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 1015065594 1255816211 16 Nurse Practitioners POELL LAUREN 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 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 0 186.3 0 0 0 0 0 0 186.3 0 0 1015065596 1447571823 10 Physicians EMMANUEL NEELMINI B 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 656 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1008 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8279.08 0 24.17 0 0 0 0 0 0 8303.25 0 0 1015065820 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84.04 0 0 0 0 0 0 84.04 0 0 1015065921 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9978.52 0 0 0 0 0 0 0 0 0 0 0 0 0 9978.52 0 0 1015065934 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7948.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7948.71 0 0 1015066150 1215579107 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE CAPITOL 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 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 14729.5 0 0 0 0 0 0 14729.5 0 0 1015066162 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22979.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22979.06 0 0 1015066183 1659928398 16 Nurse Practitioners BROWN JANIETA 999999999 30 DuPage 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 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 111.36 0 0 0 0 0 0 0 0 322.93 0 0 0 0 0 0 434.29 0 0 1015066196 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.39 0 0 0 0 0 0 118.39 0 0 1015066457 1386987410 10 Physicians GATES KELLIE N 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.41 0 999.63 0 0 0 0 0 0 1093.04 0 0 1015066761 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1015066808 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 0 122.54 0 0 0 0 0 0 122.54 0 0 1015066887 1730568213 10 Physicians WANG CHEN Y 999999999 200 Cook 0 0 Family 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 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 19.72 0 0 0 0 0 0 19.72 0 0 1015066905 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 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 1795.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1795.95 0 0 1015066997 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24560.58 0 0 0 0 0 0 0 0 0 0 0 0 0 24560.58 0 0 1015067028 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41367.14 0 0 0 0 0 0 0 0 0 0 0 0 0 41367.14 0 0 1015067078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.25 0 0 0 0 0 0 0 0 0 0 0 0 0 132.25 0 0 1015067177 1710594353 33 Nursing Facilities "CITADEL OF BOURBONNAIS, THE" 999999999 54 Kankakee 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 0 214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5061 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519460.81 0 0 0 0 0 0 0 519460.81 0 0 1015067251 1881089951 10 Physicians BEAN MATTHEW C 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 990 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1326 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7883.47 0 515.29 0 0 0 0 0 0 8398.76 0 0 1015067279 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19169.7 0 0 0 0 0 0 0 0 0 0 0 0 0 19169.7 0 0 1015067398 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 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 28745.95 0 0 0 0 0 0 0 0 0 0 0 0 0 28745.95 0 0 1015067467 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 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 6079.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6079.63 0 0 1015067553 1053948521 89 Physician Assistant Only(Encounter Only) CLUTTER MICAH L 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 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 0 194.15 0 0 0 0 0 0 194.15 0 0 1015067611 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 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 31726.89 0 0 0 0 0 0 0 0 0 0 0 0 0 31726.89 0 0 1015067794 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24103.27 0 0 0 0 0 0 0 0 0 0 0 0 0 24103.27 0 0 1015067887 1093312001 16 Nurse Practitioners LLOYD MARA D 999999999 200 Cook 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 0 444 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 2892.33 0 0 0 0 0 0 2892.33 0 0 1015067973 1982208609 89 Physician Assistant Only(Encounter Only) KELLEY SARAH D 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 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 1479.37 0 0 0 0 0 0 1479.37 0 0 1015068008 1811511249 11 Dentists CHAMI ISTFAN 999999999 200 Cook 0 0 General Dentistry 0 0 41 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 237 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 8899.55 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 10028.6 0 0 1015068373 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8362.43 0 0 0 0 0 0 0 0 0 0 0 0 0 8362.43 0 0 1015068471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4302.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4302.66 0 0 1015068489 1205207941 24 Speech Therapists GERDTS MICHI 999999999 30 DuPage 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 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 4922.44 4922.44 0 0 1015068539 10 Physicians 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 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 0 125.44 0 0 0 0 0 0 125.44 0 0 1015068693 1396277570 10 Physicians MARKS AMY E 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3379.64 0 0 0 0 0 0 3379.64 0 0 1015068919 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20849.38 0 0 0 0 0 0 0 0 0 0 0 0 0 20849.38 0 0 1015069004 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9332.51 0 0 0 0 0 0 0 0 0 0 0 0 0 9332.51 0 0 1015069051 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13638.89 0 0 0 0 0 0 0 0 0 0 0 0 0 13638.89 0 0 1015069065 1982041745 10 Physicians MALICAY MARGARET M 999999999 200 Cook 0 0 Family Practice 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 16 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 432.13 0 0 0 0 0 0 528.73 0 0 1015069113 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4350.29 0 0 0 0 0 0 0 0 0 0 0 0 0 4350.29 0 0 1015069190 1407273774 10 Physicians CEILESH ALYSSA 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2003.78 0 0 0 0 0 0 2003.78 0 0 1015069240 1952788796 10 Physicians SINCLAIR PATRICK R 999999999 200 Cook 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 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 3360.36 0 0 0 0 0 0 3360.36 0 0 1015069429 1174970545 10 Physicians FEDRO EMILY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5425.88 0 0 0 0 0 0 5425.88 0 0 1015069736 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23009.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23009.49 0 0 1015069794 1073147161 22 Physical Therapists KLOCKENGA HAYDEN 999999999 49 Jefferson 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 0 223 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 1887.4 1887.4 0 0 1015069886 1972199461 16 Nurse Practitioners KINDRED KATHERINE A 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 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 0 310.63 0 0 0 0 0 0 310.63 0 0 1015070214 1295230159 10 Physicians HUSAIN FAISAL 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 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 1315.81 0 0 0 0 0 0 1315.81 0 0 1015070226 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24346.39 0 0 0 0 0 0 0 0 0 0 0 0 0 24346.39 0 0 1015070345 1912491168 16 Nurse Practitioners MALLOY MAGDALENA 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 320 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 7166.92 0 0 0 0 0 0 7166.92 0 0 1015070463 10 Physicians 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 0 236.56 0 0 0 0 0 0 236.56 0 0 1015070472 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1720.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1720.8 0 0 1015070495 1942640693 10 Physicians OKOYE OBI T 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.62 0 4209.32 0 0 0 0 0 0 4229.94 0 0 1015070600 1194336107 16 Nurse Practitioners COOPER LAURA 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 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 2613.33 0 0 0 0 0 0 2613.33 0 0 1015070705 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1015070854 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11721.36 0 0 0 0 0 0 0 0 0 0 0 0 0 11721.36 0 0 1015070874 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015070896 1881236818 55 Early Intervention Services CRUISE KIRSTIN 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 0 235 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 13544.01 0 0 0 0 0 0 13544.01 0 0 1015070914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 718.94 0 0 0 0 0 0 0 0 0 0 0 0 0 718.94 0 0 1015070920 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 0 161 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 14287.28 0 0 0 0 0 0 0 0 0 0 0 0 0 14287.28 0 0 1015071008 1134738800 16 Nurse Practitioners HULFACHOR BENJAMIN S 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 0 906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 906 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6333.91 0 0 0 0 0 0 6333.91 0 0 1015071038 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20512.8 0 0 0 0 0 0 0 0 0 0 0 0 0 20512.8 0 0 1015071086 1447710421 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 606594113 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2542.75 0 9048.14 0 0 0 0 11590.89 0 0 1015071175 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10537.14 0 0 0 0 0 0 0 0 0 0 0 0 0 10537.14 0 0 1015071218 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30615.41 0 0 0 0 0 0 0 0 0 0 0 0 0 30615.41 0 0 1015071239 1235744228 91 Waiver service provider--Adults (DHS/DDD) ABURROMAN CHELSEA 999999999 30 DuPage 0 0 0 0 0 0 0 14 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 13773.59 0 0 0 0 0 0 0 0 0 0 0 0 0 13773.59 0 0 1015071288 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 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 0 432.19 0 0 0 0 0 0 432.19 0 0 1015071632 1073798344 16 Nurse Practitioners YOUNGQUIST KAREN 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 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 0 203.55 0 0 0 0 0 0 203.55 0 0 1015071704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1067.06 0 0 0 0 0 0 0 0 0 0 0 0 0 1067.06 0 0 1015071745 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5034.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5034.47 0 0 1015071921 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30187.45 0 0 0 0 0 0 0 0 0 0 0 0 0 30187.45 0 0 1015072186 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 3762.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3762.69 0 0 1015072195 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4989.58 0 0 0 0 0 0 0 0 0 0 0 0 0 4989.58 0 0 1015072380 1265895247 10 Physicians SIDDIQUI HINA 999999999 200 Cook 0 0 Pediatrics 0 0 0 5 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 153.4 0 0 0 0 0 0 0 0 198.29 0 0 0 0 0 0 351.69 0 0 1015072481 1609892793 33 Nursing Facilities ROSICLARE REHAB & HEALTH CC 999999999 43 Hardin 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 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167694.99 0 0 0 0 0 0 0 167694.99 0 0 1015072538 16 Nurse Practitioners 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 49.22 0 0 0 0 0 0 49.22 0 0 1015072565 1184622615 10 Physicians ABRAMS LAURIE 999999999 63 Macon 0 0 Radiology Diagnosis 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 1549.9 0 0 0 0 0 0 0 0 1549.9 0 0 1015072696 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4260.17 0 0 0 0 0 0 0 0 0 0 0 0 0 4260.17 0 0 1015072729 1992236087 13 Podiatrists KIBLER KURT A 999999999 19 Champaign 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 0 178 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 1867.25 0 0 0 0 0 0 1867.25 0 0 1015072744 1174131320 11 Dentists AHMAD SARA 999999999 96 St Clair 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 810 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 32958.42 0 0 0 0 0 0 0 0 0 0 0 12419.55 0 0 0 0 45377.97 0 0 1015073134 1750766788 16 Nurse Practitioners AUGUSTINE DANA 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 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 1015073300 1649709825 10 Physicians JONES WESLEY M 999999999 200 Cook 0 0 Emergency 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 0 106 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 3900.77 0 0 0 0 0 0 3900.77 0 0 1015073344 1093172744 11 Dentists SCHAEFER BENJAMIN 999999999 19 Champaign 0 0 Maxillofacial Surgery 0 0 53 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 11013.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11013.81 0 0 1015073369 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14944.49 0 0 0 0 0 0 0 0 0 0 0 0 0 14944.49 0 0 1015073413 10 Physicians 108 Williamson 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 8.54 0 0 0 0 0 0 0 0 8.54 0 0 1015073423 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 6150.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6150.9 0 0 1015073493 1720625601 55 Early Intervention Services RAFFERTY SHANE P 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 0 235 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 11051.9 0 0 0 0 0 0 11051.9 0 0 1015073664 1205469988 16 Nurse Practitioners CHANEY JENNIFER L 999999999 80 Peoria 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 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 5009.98 0 0 0 0 0 0 5009.98 0 0 1015073917 1881295541 16 Nurse Practitioners DURST BRITNEY J 999999999 80 Peoria 0 0 0 0 0 4 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 96.45 0 0 0 0 0 0 0 0 2431.94 0 0 0 0 0 0 2528.39 0 0 1015074049 1326524729 89 Physician Assistant Only(Encounter Only) SLATTERY MARY-KATHERINE 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 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 69.33 0 0 0 0 0 0 69.33 0 0 1015074167 1427694462 16 Nurse Practitioners SCHULTZ TESSA 999999999 200 Cook 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 5124.12 0 0 0 0 0 0 5124.12 0 0 1015074194 1710510391 89 Physician Assistant Only(Encounter Only) MACKEY MICHAELA ROSE 999999999 200 Cook 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 13 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 24.6 0 0 0 0 0 0 0 0 362.29 0 0 0 0 0 0 386.89 0 0 1015074196 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 61.76 0 0 0 0 0 0 61.76 0 0 1015074243 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1495.7 1495.7 0 0 1015074316 1902412604 16 Nurse Practitioners BROWN ROSHANA 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 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 0 207.63 0 0 0 0 0 0 207.63 0 0 1015074443 1346777869 10 Physicians ROBERTS MADELEINE 999999999 200 Cook 0 0 0 0 0 37 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 3517.24 0 0 0 0 0 0 0 0 784.71 0 0 0 0 0 0 4301.95 0 0 1015074485 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1913.65 0 0 0 0 0 0 0 0 0 0 0 0 0 1913.65 0 0 1015074535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27924.03 0 0 0 0 0 0 0 0 0 0 0 0 0 27924.03 0 0 1015074589 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10109.13 0 0 0 0 0 0 0 0 0 0 0 0 0 10109.13 0 0 1015074624 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 48.71 0 0 0 0 0 0 0 0 0 0 0 0 0 48.71 0 0 1015074692 1427608090 16 Nurse Practitioners BELCINA JENNELYN M 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 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 2353.88 0 0 0 0 0 0 2353.88 0 0 1015074702 1164462172 16 Nurse Practitioners PRATT VANESSA D 999999999 91 Sangamon 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 0 104 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 1441.3 0 0 0 0 0 0 1441.3 0 0 1015074803 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 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 0 851.99 851.99 0 0 1015074858 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 16788.42 0 0 0 0 0 0 0 0 0 0 0 0 0 16788.42 0 0 1015074926 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5186.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5186.3 0 0 1015074943 1932724135 11 Dentists HUSSAIN SAMRA N 999999999 107 Will 0 0 General Dentistry 0 0 89 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 24129.61 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 24882.31 0 0 1015075130 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12641.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12641.42 0 0 1015075169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1349.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1349.34 0 0 1015075210 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 89.54 0 0 0 0 0 0 0 0 0 0 0 0 0 89.54 0 0 1015075340 1154748226 10 Physicians LEE REBECCA 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3032.81 0 0 0 0 0 0 3032.81 0 0 1015075411 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22884.96 0 0 0 0 0 0 0 0 0 0 0 0 0 22884.96 0 0 1015075437 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 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 24890.43 0 0 0 0 0 0 0 0 0 0 0 0 0 24890.43 0 0 1015075646 10 Physicians 91 Sangamon 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.19 0 0 0 0 0 0 0 0 41.19 0 0 1015075676 87 Psychologist(Encounter Only) 71 McHenry 0 0 0 0 0 0 0 0 0 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 51.49 0 0 0 0 0 0 51.49 0 0 1015075975 22 Physical 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 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 0 544.63 544.63 0 0 1015076081 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 3385.42 0 0 0 0 0 0 0 0 0 0 0 0 0 3385.42 0 0 1015076087 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8877.4 0 0 0 0 0 0 0 0 0 0 0 0 0 8877.4 0 0 1015076225 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17594.91 0 0 0 0 0 0 0 0 0 0 0 0 0 17594.91 0 0 1015076274 1184258824 60 Pharmacies AUSTIN OUTPATIENT PHARMACY LLC 999999999 200 Cook 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 0 903 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11007.74 0 0 0 11007.74 0 0 1015076376 86 Clinical Social Worker(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 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 1589.62 0 0 0 0 0 0 1589.62 0 0 1015076697 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5333.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5333.52 0 0 1015076750 1033539721 10 Physicians BARTINDALE MATTHEW R 999999999 107 Will 0 0 Otolaryngology 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 0 148 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 4028.44 0 0 0 0 0 0 4028.44 0 0 1015076828 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 31.01 0 0 0 0 0 0 31.01 0 0 1015076971 1710427133 16 Nurse Practitioners DESHABATHINI LAXMI 999999999 30 DuPage 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 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6734.91 0 0 0 0 0 0 6734.91 0 0 1015076989 1467496331 10 Physicians REED ROB 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 450 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 715 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6038.67 0 310.07 0 0 0 0 0 0 6348.74 0 0 1015077162 1275015349 12 Optometrists SURTI BIANCA P 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 0 882.1 0 0 0 0 0 0 882.1 0 0 1015077292 1386283455 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCOLNLAND HOME MEDICAL EQUIP 999999999 34 Fayette 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3014.43 0 579.36 0 0 0 0 3593.79 0 0 1015077712 1508462326 16 Nurse Practitioners BLAND RACHEL A 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 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 5337.4 0 0 0 0 0 0 5337.4 0 0 1015077755 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11321.69 0 0 0 0 0 0 0 0 0 0 0 0 0 11321.69 0 0 1015077815 1801413265 11 Dentists MONTOYA JONATHAN A 999999999 200 Cook 0 0 General Dentistry 0 0 40 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 6127.17 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 7256.22 0 0 1015077834 1497375307 89 Physician Assistant Only(Encounter Only) MITCHELL KATHERINE KEARNEY 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 0 113.86 0 0 0 0 0 0 113.86 0 0 1015078177 10 Physicians 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 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 1015078306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 51816.29 0 0 0 0 0 0 0 0 0 0 0 0 0 51816.29 0 0 1015078397 1104456961 16 Nurse Practitioners SHODIYA OLUBUKOLA E 999999999 200 Cook 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 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2517.94 0 0 0 0 0 0 2517.94 0 0 1015078684 1528588928 10 Physicians NAATE NUEKI 999999999 91 Sangamon 0 0 Internal Medicine 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 7 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.36 0 814.77 0 0 0 0 0 0 837.13 0 0 1015078757 1548802598 16 Nurse Practitioners BALABAN YELENA 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 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 0 468.37 0 0 0 0 0 0 468.37 0 0 1015078775 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23305.8 0 0 0 0 0 0 0 0 0 0 0 0 0 23305.8 0 0 1015078825 1760026009 60 Pharmacies GENOA HEALTHCARE LLC 999999999 56 Knox 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 1295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42785.55 0 0 0 42785.55 0 0 1015078937 1417555897 16 Nurse Practitioners ROGERS CARLA R 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 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 0 153.61 0 0 0 0 0 0 153.61 0 0 1015078965 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 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 6745.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6745.77 0 0 1015078990 1033733795 11 Dentists CARDENAS CHRISTINA E 999999999 200 Cook 0 0 General Dentistry 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22655.55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22655.55 0 0 1015079076 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10094.36 0 0 0 0 0 0 0 0 0 0 0 0 0 10094.36 0 0 1015079155 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5826.33 0 0 0 0 0 0 0 0 0 0 0 0 0 5826.33 0 0 1015079254 1306482518 16 Nurse Practitioners BUSTOS MARY 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 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 0 940.52 0 0 0 0 0 0 940.52 0 0 1015079479 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8811.79 0 0 0 0 0 0 0 0 0 0 0 0 0 8811.79 0 0 1015084698 1508270430 10 Physicians HARDING MEGHAN 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 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 3797.16 0 0 0 0 0 0 3797.16 0 0 1015084748 1487255568 16 Nurse Practitioners LOCUS ASHLEY L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 1 0 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.28 0 0 513.12 0 0 0 0 0 0 699.4 0 0 1015084809 1184157224 10 Physicians RASHID MUJTABA M 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 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 1027.2 0 0 0 0 0 0 1027.2 0 0 1015084851 1457956989 87 Psychologist(Encounter Only) TAN MICHELLE Y 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 0 133 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 6152.56 0 0 0 0 0 0 6152.56 0 0 1015085314 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23036.2 0 0 0 0 0 0 0 0 0 0 0 0 0 23036.2 0 0 1015085348 1629674916 89 Physician Assistant Only(Encounter Only) GALLO RACHAEL 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 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 1614.37 0 0 0 0 0 0 1614.37 0 0 1015085480 1700297983 10 Physicians MARSH MELANIE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.39 0 2092.12 0 0 0 0 0 0 2229.51 0 0 1015085586 10 Physicians 60 Lee 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015085630 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 49920.42 0 0 0 0 0 0 0 0 0 0 0 0 0 49920.42 0 0 1015085882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3116.56 0 0 0 0 0 0 0 0 0 0 0 0 0 3116.56 0 0 1015086047 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1970 0 0 0 0 0 0 0 0 0 0 0 0 0 1970 0 0 1015086090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5603.99 0 0 0 0 0 0 0 0 0 0 0 0 0 5603.99 0 0 1015086277 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9178.5 0 0 0 0 0 0 0 0 0 0 0 0 0 9178.5 0 0 1015086389 1750720843 10 Physicians DRAGU DRITAN 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 27.54 0 451.75 0 0 0 0 0 0 479.29 0 0 1015086392 1730723446 89 Physician Assistant Only(Encounter Only) TORTORICI CHRISTINA 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 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 0 602.61 0 0 0 0 0 0 602.61 0 0 1015086559 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19155.76 0 0 0 0 0 0 0 0 0 0 0 0 0 19155.76 0 0 1015086605 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971.36 971.36 0 0 1015086625 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11286.21 0 0 0 0 0 0 0 0 0 0 0 0 0 11286.21 0 0 1015086626 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14529.9 0 0 0 0 0 0 0 0 0 0 0 0 0 14529.9 0 0 1015086679 1588672984 89 Physician Assistant Only(Encounter Only) RAGONA CHARLES P 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 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 1468.81 0 0 0 0 0 0 1468.81 0 0 1015086824 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 4900.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4900.26 0 0 1015086851 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 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 12914.01 0 0 0 0 0 0 0 0 0 0 0 0 0 12914.01 0 0 1015086933 1154779718 10 Physicians BARCELO BIANCA E 999999999 200 Cook 0 0 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 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 95.11 0 0 0 0 0 0 95.11 0 0 1015086960 1134750243 48 Rural Health Clinics TRINITY HEALTH AND WELLNESS LL 999999999 22 Clay 0 0 0 217 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23131.46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23131.46 0 0 1015087036 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18494.08 0 0 0 0 0 0 0 0 0 0 0 0 0 18494.08 0 0 1015087231 1225520216 10 Physicians BUSSIE KYLIE 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 246.04 0 0 0 0 0 0 0 0 607.52 0 0 0 0 0 0 853.56 0 0 1015087232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3233.23 0 0 0 0 0 0 0 0 0 0 0 0 0 3233.23 0 0 1015087251 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15700.95 0 0 0 0 0 0 0 0 0 0 0 0 0 15700.95 0 0 1015087392 10 Physicians 53 Kane 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 33.95 0 0 0 0 0 0 33.95 0 0 1015087496 1609405869 16 Nurse Practitioners ROSC ALEXANDER 999999999 53 Kane 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 0 912.17 0 0 0 0 0 0 912.17 0 0 1015087511 10 Physicians 25 Crawford 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 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 1015087536 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 0 441.21 0 0 0 0 0 0 441.21 0 0 1015087538 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 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 0 770.32 0 0 0 0 0 0 0 0 0 0 0 0 0 770.32 0 0 1015087658 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 392.82 0 0 0 0 0 0 0 0 0 0 0 0 0 392.82 0 0 1015087663 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 0 0 0 0 0 0 0 0 0 0 1015087686 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 16298.98 0 0 0 0 0 0 0 0 0 0 0 0 0 16298.98 0 0 1015087765 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 15813.29 0 0 0 0 0 0 0 0 0 0 0 0 0 15813.29 0 0 1015087900 1235776048 97 Waiver service provider--Children's residential (DHS/DDD) CARTER TONEE 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 0 204 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 11549.79 0 0 0 0 0 0 0 0 0 0 0 0 0 11549.79 0 0 1015087982 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4104.05 0 0 0 0 0 0 0 0 0 0 0 0 0 4104.05 0 0 1015088105 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12954.81 0 0 0 0 0 0 0 0 0 0 0 0 0 12954.81 0 0 1015088343 1841604345 16 Nurse Practitioners JOSE ESHA 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 22 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 6.4 0 0 0 0 0 0 0 0 1028.05 0 0 0 0 0 0 1034.45 0 0 1015088359 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 339.1 0 0 0 0 0 0 0 0 0 0 0 0 0 339.1 0 0 1015088473 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2134.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2134.77 0 0 1015088571 1376197699 60 Pharmacies THE MEDICINE SHOPPE 622362306 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 1814 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2948.66 0 0 0 2948.66 0 0 1015088724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36702.02 0 0 0 0 0 0 0 0 0 0 0 0 0 36702.02 0 0 1015088869 1720494396 10 Physicians DEBARTOLO JOSEPH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 382 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 573 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10518.43 0 565.08 0 0 0 0 0 0 11083.51 0 0 1015088891 1528027398 10 Physicians GIESE ELIZABETH A 999999999 200 Cook 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 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.72 0 123.88 0 0 0 0 0 0 141.6 0 0 1015088990 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5214 0 0 0 0 0 0 0 0 0 0 0 0 0 5214 0 0 1015089250 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11283.97 0 0 0 0 0 0 0 0 0 0 0 0 0 11283.97 0 0 1015089307 10 Physicians 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.03 0 0 0 0 0 0 0 0 7.03 0 0 1015089428 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2469.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2469.6 0 0 1015089438 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3386.24 0 0 0 0 0 0 0 0 0 0 0 0 0 3386.24 0 0 1015089473 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 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 2647.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2647.02 0 0 1015089697 1063037711 89 Physician Assistant Only(Encounter Only) PETROWICH DESTINY 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 65.38 0 0 0 0 0 0 65.38 0 0 1015089699 1730725755 22 Physical Therapists GRIFFITH RYAN 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 0 115 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 1125.32 1125.32 0 0 1015089875 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 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 0 167.33 0 0 0 0 0 0 167.33 0 0 1015089976 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 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 5502.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5502.46 0 0 1015090026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22659.88 0 0 0 0 0 0 0 0 0 0 0 0 0 22659.88 0 0 1015090107 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 31.01 0 0 0 0 0 0 31.01 0 0 1015090242 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1533.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1533.93 0 0 1015090409 86 Clinical Social Worker(Encounter Only) 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 349.71 0 0 0 0 0 0 349.71 0 0 1015090623 1114905411 89 Physician Assistant Only(Encounter Only) BLOM ARIC 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 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1015090735 1700065265 10 Physicians ZENOOZ NAVID 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 61 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2137.17 0 76.7 0 0 0 0 0 0 2213.87 0 0 1015090894 61 Independent Laboratories 811 Georgia 0 0 0 0 0 0 0 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 1205.28 0 0 0 0 0 0 0 0 1205.28 0 0 1015090937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17391.11 0 0 0 0 0 0 0 0 0 0 0 0 0 17391.11 0 0 1015091177 1306475488 16 Nurse Practitioners BOOKER-SHELTON SHADAE 999999999 79 Ogle 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 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 598 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1836.82 0 0 0 0 0 0 1836.82 0 0 1015091462 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 458.28 0 0 0 0 0 0 0 0 0 0 0 0 0 458.28 0 0 1015091648 1255987293 24 Speech Therapists WADDELL KERBY L 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 0 382 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 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0 0 0 15218.21 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 17099.96 0 0 1015092236 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22301.91 0 0 0 0 0 0 0 0 0 0 0 0 0 22301.91 0 0 1015092354 91 Waiver service provider--Adults (DHS/DDD) 839 Pennsylvania 0 0 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 1573.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1573.22 0 0 1015092366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13707.76 0 0 0 0 0 0 0 0 0 0 0 0 0 13707.76 0 0 1015092382 11 Dentists 27 Dekalb 0 0 General Dentistry 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 0 114.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.8 0 0 1015092473 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16423.11 0 0 0 0 0 0 0 0 0 0 0 0 0 16423.11 0 0 1015092735 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 18618.6 0 0 0 0 0 0 0 0 0 0 0 0 0 18618.6 0 0 1015092833 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4065.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4065.81 0 0 1015092837 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 671.74 0 0 0 0 0 0 0 0 0 0 0 0 0 671.74 0 0 1015093010 1558734897 22 Physical Therapists WELCH ALLISON 999999999 109 Winnebago 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 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2586.48 2586.48 0 0 1015093077 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39098.08 0 0 0 0 0 0 0 0 0 0 0 0 0 39098.08 0 0 1015093261 1447529789 87 Psychologist(Encounter Only) MORRIS JASON 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 0 159 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 1107.04 0 0 0 0 0 0 1107.04 0 0 1015093279 1750866000 86 Clinical Social Worker(Encounter Only) FRAZIN DAVID 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 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 0 433.92 0 0 0 0 0 0 433.92 0 0 1015093358 1245860287 23 Occupational Therapists STOVER ANNA L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 413 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 27934.88 27934.88 0 0 1015093398 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 0 100.19 0 0 0 0 0 0 100.19 0 0 1015093733 1073048369 10 Physicians FIELDS ZACHARY T 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 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 0 518.68 0 0 0 0 0 0 518.68 0 0 1015093749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23801.36 0 0 0 0 0 0 0 0 0 0 0 0 0 23801.36 0 0 1015094363 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324.08 0 0 0 0 0 0 0 0 0 0 0 0 0 324.08 0 0 1015094514 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11355.32 0 0 0 0 0 0 0 0 0 0 0 0 0 11355.32 0 0 1015094544 1427684281 89 Physician Assistant Only(Encounter Only) SMRECZAK CHRISTOPHER 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 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 4.32 0 0 0 0 0 0 4.32 0 0 1015094690 4015094690 71 Medicar Provider ACCURATE TRANSIT 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 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9468.81 0 0 0 0 0 0 9468.81 0 0 1015094705 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 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 0 193.22 0 0 0 0 0 0 193.22 0 0 1015094730 1700351723 16 Nurse Practitioners AUREL VALERIE 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 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 1349.88 0 0 0 0 0 0 1349.88 0 0 1015094847 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27216.94 0 0 0 0 0 0 0 0 0 0 0 0 0 27216.94 0 0 1015094989 1083222368 16 Nurse Practitioners ROSARIO IZOLDA 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 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7675.28 0 0 0 0 0 0 7675.28 0 0 1015095012 86 Clinical Social Worker(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 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 3746.29 0 0 0 0 0 0 3746.29 0 0 1015095147 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 0 1015095178 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5331.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5331.2 0 0 1015095185 1093379877 62 Opticians / Optical Companies EYE Q OPTIQUE 606125554 200 Cook 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 58 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 16296.2 0 0 1015095536 16 Nurse Practitioners 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 49.91 0 0 0 0 0 0 49.91 0 0 1015095653 1194387225 10 Physicians ASWANI YASHANT 999999999 80 Peoria 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 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.87 0 0 0 0 0 0 0 0 83.87 0 0 1015095860 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13856.27 0 0 0 0 0 0 0 0 0 0 0 0 0 13856.27 0 0 1015095920 1689172835 89 Physician Assistant Only(Encounter Only) AYALA CAROLINA 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 0 337.12 0 0 0 0 0 0 337.12 0 0 1015095989 1538702022 16 Nurse Practitioners OLANIYAN TOLULOPE 999999999 71 McHenry 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 0 120 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 3487.88 0 0 0 0 0 0 3487.88 0 0 1015096181 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22622.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22622.2 0 0 1015096224 1942833306 16 Nurse Practitioners IGBINOBA OSASUMWEN O 999999999 200 Cook 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 0 595 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 10087.67 0 0 0 0 0 0 10087.67 0 0 1015096314 1124547567 89 Physician Assistant Only(Encounter Only) DEWS ARIEL M 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 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 0 162.12 0 0 0 0 0 0 162.12 0 0 1015096401 1942832696 55 Early Intervention Services RENNIE AMY 999999999 98 Tazewell 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 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 699 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36606.97 0 0 0 0 0 0 36606.97 0 0 1015096530 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14175.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14175.15 0 0 1015096561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.37 0 0 0 0 0 0 0 0 0 0 0 0 0 522.37 0 0 1015096576 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 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 14685.52 0 0 0 0 0 0 0 0 0 0 0 0 0 14685.52 0 0 1015096648 10 Physicians 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 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 27.2 0 0 0 0 0 0 27.2 0 0 1015096667 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 0 140 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 30046.39 0 0 0 0 0 0 0 0 0 0 0 0 0 30046.39 0 0 1015096734 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1214.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1214.43 0 0 1015096804 1316571151 16 Nurse Practitioners DEKOLD ELLEN 999999999 200 Cook 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 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 705.95 0 0 0 0 0 0 705.95 0 0 1015096825 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 1015096929 1841424751 16 Nurse Practitioners LUSTER SONIA A 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 947.21 0 0 0 0 0 0 947.21 0 0 1015096992 1902428147 33 Nursing Facilities APERION CARE GLENWOOD 999999999 200 Cook 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 0 324 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7908 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1130611.34 0 0 0 0 0 0 0 1130611.34 0 0 1015097012 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 0 118 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 14517.82 0 0 0 0 0 0 0 0 0 0 0 0 0 14517.82 0 0 1015105086 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 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 1015105098 10 Physicians 87 Randolph 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.83 0 0 0 0 0 0 93.83 0 0 1015105395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35680.87 0 0 0 0 0 0 0 0 0 0 0 0 0 35680.87 0 0 1015105516 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 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0 0 0 0 0 0 0 0 0 0 0 0 171 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 171 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2059.12 0 4.59 0 0 0 0 0 0 2063.71 0 0 1015106430 1154527166 16 Nurse Practitioners HERNANDEZ ANTONIA 999999999 107 Will 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 0 255 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 3781.34 0 0 0 0 0 0 3781.34 0 0 1015106482 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5942.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5942.2 0 0 1015106572 1215220413 10 Physicians MURGA-ZAMALLOA CARLOS 999999999 200 Cook 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 0 435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 435 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3781.07 0 0 0 0 0 0 0 0 3781.07 0 0 1015106714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25790.38 0 0 0 0 0 0 0 0 0 0 0 0 0 25790.38 0 0 1015106741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7878 0 0 0 0 0 0 0 0 0 0 0 0 0 7878 0 0 1015106828 1235578956 10 Physicians GENERE NATALIA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 24 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 0 539.73 0 0 0 0 0 0 539.73 0 0 1015106881 10 Physicians 815 Indiana 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 1015106957 1912501917 24 Speech Therapists PINAS CATHERINE 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55919 55919 0 0 1015107015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8741.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8741.84 0 0 1015107028 16 Nurse Practitioners 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.04 0 0 0 0 0 0 18.04 0 0 1015107363 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1958.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1958.91 0 0 1015107366 1568707198 23 Occupational Therapists POLLACK JENNIFER 605442723 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 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 0 787.44 787.44 0 0 1015107460 4015107460 91 Waiver service provider--Adults (DHS/DDD) LOETE DARCI 999999999 91 Sangamon 0 0 0 0 0 0 0 7 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 2884.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2884.14 0 0 1015108513 1437184678 16 Nurse Practitioners LUKOWSKI LILLIAN I 999999999 45 Henry 0 0 0 0 0 0 0 0 0 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 0 199.65 0 0 0 0 0 0 199.65 0 0 1015108576 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4583.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4583.4 0 0 1015108643 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 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 38970.75 0 0 0 0 0 0 0 0 0 0 0 0 0 38970.75 0 0 1015109018 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4053.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4053.96 0 0 1015109117 10 Physicians 81 Perry 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 0 313.7 0 0 0 0 0 0 313.7 0 0 1015109391 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518.66 0 0 0 0 0 0 0 0 0 0 0 0 0 518.66 0 0 1015109395 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 0 162.46 0 0 0 0 0 0 162.46 0 0 1015109626 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8749.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8749.44 0 0 1015109827 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 932.19 0 0 0 0 0 0 0 0 0 0 0 0 0 932.19 0 0 1015109859 1629059357 10 Physicians GUNN MARK 999999999 25 Crawford 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 2860.03 0 0 0 0 0 0 2860.03 0 0 1015110136 1043889553 89 Physician Assistant Only(Encounter Only) MEINERS CAYLEY 999999999 47 Jackson 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 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 1903.47 0 0 0 0 0 0 1903.47 0 0 1015110189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10557 0 0 0 0 0 0 0 0 0 0 0 0 0 10557 0 0 1015110311 1952984239 33 Nursing Facilities BELLA TERRA LAGRANGE 999999999 200 Cook 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 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 377386.95 0 0 0 0 0 0 0 377386.95 0 0 1015110692 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 0 475.8 0 0 0 0 0 0 475.8 0 0 1015111089 1659866713 10 Physicians GUPTA VISHAL 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 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 0 736.79 0 0 0 0 0 0 736.79 0 0 1015111192 10 Physicians 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1015111231 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 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 0 822.14 0 0 0 0 0 0 0 0 0 0 0 0 0 822.14 0 0 1015111358 1144790114 16 Nurse Practitioners SHAHROKH BEHNOOSH 999999999 53 Kane 0 0 0 0 0 3 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 0 0 0 0 0 6.3 0 0 1015111561 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 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 0 234.55 0 0 0 0 0 0 234.55 0 0 1015111657 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 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 2170.4 0 0 0 0 0 0 0 0 0 0 0 0 0 2170.4 0 0 1015111949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12255.05 0 0 0 0 0 0 0 0 0 0 0 0 0 12255.05 0 0 1015112114 1154903920 16 Nurse Practitioners JOHNSON DERICK P 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 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 0 137.09 0 0 0 0 0 0 137.09 0 0 1015113353 1134236508 10 Physicians LE FRANCIS 999999999 80 Peoria 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 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 0 282.94 0 0 0 0 0 0 282.94 0 0 1015113647 1669884896 10 Physicians GREENBERG LAWRENCE A 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 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 0 336.67 0 0 0 0 0 0 336.67 0 0 1015113678 55 Early Intervention Services 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 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 1733.22 0 0 0 0 0 0 1733.22 0 0 1015113726 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 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 1221.92 0 0 0 0 0 0 1221.92 0 0 1015113868 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6691.08 0 0 0 0 0 0 0 0 0 0 0 0 0 6691.08 0 0 1015114630 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 0 119.72 0 0 0 0 0 0 119.72 0 0 1015114632 1285252320 12 Optometrists RAICHURA ANJALI 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 0 225.76 0 0 0 0 0 0 225.76 0 0 1015115192 1013290451 10 Physicians NAGA YEHIA 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 0 728.18 0 0 0 0 0 0 728.18 0 0 1015115703 1265756233 10 Physicians BAKER JOE 999999999 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 4 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36.15 0 2972.24 0 0 0 0 0 0 3008.39 0 0 1015115883 1811510506 89 Physician Assistant Only(Encounter Only) WUNSCH KRISTA 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 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 1015115939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1519.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1519.73 0 0 1015116021 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3196 0 0 0 0 0 0 0 0 0 0 0 0 0 3196 0 0 1015116413 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1119.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1119.61 0 0 1015116607 94 Waiver service provider--Children's support (DHS/DDD) 94 Shelby 0 0 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 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0 0 0 0 0 0 1223.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1223.88 0 0 1015117743 1881167302 16 Nurse Practitioners JABER RONDA O 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 216.87 0 0 0 0 0 0 216.87 0 0 1015118023 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 1004.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1004.81 0 0 1015118112 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14295.49 0 0 0 0 0 0 0 0 0 0 0 0 0 14295.49 0 0 1015118151 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4164.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4164.36 0 0 1015118461 1730772633 16 Nurse Practitioners BENTELE KIMBERLEY A 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 43.54 0 0 0 0 0 0 43.54 0 0 1015118534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3459.5 0 0 0 0 0 0 0 0 0 0 0 0 0 3459.5 0 0 1015118690 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6294.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6294.6 0 0 1015118751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1379.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1379.83 0 0 1015118812 1487035887 10 Physicians MOJARRAD MOHAMMADALI 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 34 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.33 0 0 0 0 0 0 0 0 552.33 0 0 1015119040 1205366812 10 Physicians BOSHKOVSKA SPASESKI MAJA 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1453.21 0 0 0 0 0 0 1453.21 0 0 1015119067 63 Other Providers of Medical Equipment/Supplies (Non-registered) 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 334.22 0 0 0 0 334.22 0 0 1015119935 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 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 4914.79 0 0 0 0 0 0 0 0 0 0 0 0 0 4914.79 0 0 1015120010 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 0 0 0 0 0 0 0 0 0 0 1015120191 1730685561 16 Nurse Practitioners PAPA ARSHAD 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 312.14 0 0 0 0 0 0 312.14 0 0 1015120468 1407465552 16 Nurse Practitioners PATEL NILAP 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 88.19 0 0 0 0 0 0 88.19 0 0 1015120544 1073044293 10 Physicians MCFARLAND ADAM P 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 2 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.8 0 2389.39 0 0 0 0 0 0 2440.19 0 0 1015120552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19912.38 0 0 0 0 0 0 0 0 0 0 0 0 0 19912.38 0 0 1015121053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 533.94 0 0 0 0 0 0 0 0 0 0 0 0 0 533.94 0 0 1015121088 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 1015121132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181.11 0 0 0 0 0 0 0 0 0 0 0 0 0 181.11 0 0 1015121189 92 Waiver 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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 1015123205 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 1015123713 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015123832 1457884108 10 Physicians MARSHALL ASTRID 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 7 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 309.99 0 2873.33 0 0 0 0 0 0 3183.32 0 0 1015124114 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 1330.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1330.89 0 0 1015124272 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 0 127.01 0 0 0 0 0 0 127.01 0 0 1015124703 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1978.02 0 0 0 0 0 0 0 0 0 0 0 0 0 1978.02 0 0 1015124966 1508396490 10 Physicians FRIDLINE ROMAN 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 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 2255.94 0 0 0 0 0 0 2255.94 0 0 1015125054 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 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 64 0 0 0 0 0 0 64 0 0 1015125252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3395.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3395.9 0 0 1015125262 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 10415.58 0 0 0 0 0 0 0 0 0 0 0 0 0 10415.58 0 0 1015125567 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564.2 0 0 0 0 0 0 0 0 0 0 0 0 0 564.2 0 0 1015125741 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298.88 298.88 0 0 1015125920 1720519754 10 Physicians POLEK JAMES S 999999999 24 Coles 0 0 0 0 0 17 0 0 0 0 0 0 5 0 32 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 552.67 0 0 0 0 0 0 11.25 0 1124.56 0 0 0 0 0 0 1688.48 0 0 1015126205 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1713.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1713.96 0 0 1015126587 10 Physicians 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015126719 1093240442 10 Physicians PARKER JOHN JAMES FISKE 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 274.78 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 430.96 0 0 1015126848 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1839.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1839.85 0 0 1015127626 1750986121 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDICAL WEST RESPIRATORY SERVI 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 419.95 0 0 0 0 0 0 419.95 0 0 1015127998 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2082.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2082.77 0 0 1015128233 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4736.56 0 0 0 0 0 0 0 0 0 0 0 0 0 4736.56 0 0 1015128680 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4481.07 0 0 0 0 0 0 0 0 0 0 0 0 0 4481.07 0 0 1015128718 1861006553 91 Waiver service provider--Adults (DHS/DDD) THORNTON AUBREY 999999999 91 Sangamon 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 1004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1004 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19484.46 0 0 0 0 0 0 0 0 0 0 0 0 0 19484.46 0 0 1015128732 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 58.27 0 0 0 0 0 0 58.27 0 0 1015128780 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14697.64 0 0 0 0 14697.64 0 0 1015129000 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 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 0 904.96 904.96 0 0 1015129023 1194306563 16 Nurse Practitioners READ ASHLEY 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 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 1558.6 0 0 0 0 0 0 1558.6 0 0 1015129468 1730543422 10 Physicians KRUM KRISTEN 999999999 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 23 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.59 0 0 0 0 0 0 0 0 210.59 0 0 1015129577 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13179.01 0 0 0 0 0 0 0 0 0 0 0 0 0 13179.01 0 0 1015129645 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 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 5115.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5115.77 0 0 1015130392 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.36 0 0 0 0 0 0 129.36 0 0 1015130472 1013376201 89 Physician Assistant Only(Encounter Only) NEWBURN VERONICA 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 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 0 119.62 0 0 0 0 0 0 119.62 0 0 1015130729 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11971.1 0 0 0 0 0 0 0 0 0 0 0 0 0 11971.1 0 0 1015130778 1235735598 91 Waiver service provider--Adults (DHS/DDD) JAQUES MADELINE 622081639 96 St Clair 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 0 266 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 15545.86 0 0 0 0 0 0 0 0 0 0 0 0 0 15545.86 0 0 1015130899 1932606084 10 Physicians WENTWORTH BAILEY 999999999 80 Peoria 0 0 Emergency 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 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 1620.2 0 0 0 0 0 0 1620.2 0 0 1015131170 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1503.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1503.81 0 0 1015131821 1386059400 10 Physicians RYAN DANIEL M 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 278 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7749.59 0 195.78 0 0 0 0 0 0 7945.37 0 0 1015131869 1972149649 16 Nurse Practitioners GARTZ JENNA 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 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 3189.07 0 0 0 0 0 0 3189.07 0 0 1015131998 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 1564.79 0 0 0 0 0 0 0 0 0 0 0 0 0 1564.79 0 0 1015132092 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.26 0 0 0 0 0 0 95.26 0 0 1015132764 1043697618 10 Physicians HOLOUBEK SIMON A 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 0 349.28 0 0 0 0 0 0 349.28 0 0 1015132909 1891462768 33 Nursing Facilities CARLYLE HEALTHCARE AND SR LIVI 999999999 23 Clinton 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 0 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82826.59 0 0 0 0 0 0 0 82826.59 0 0 1015133012 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2167.01 2167.01 0 0 1015133099 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6789.6 0 0 0 0 0 0 0 0 0 0 0 0 0 6789.6 0 0 1015133103 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 736.67 0 0 0 0 0 0 0 0 0 0 0 0 0 736.67 0 0 1015133218 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2546.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2546.74 0 0 1015133223 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 0 274.83 0 0 0 0 0 0 274.83 0 0 1015133511 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 33.6 0 0 0 0 0 0 33.6 0 0 1015133661 1417228560 86 Clinical Social Worker(Encounter Only) LANIER TRACY 60612 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 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 5031.06 0 0 0 0 0 0 5031.06 0 0 1015133767 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4749.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4749.69 0 0 1015133913 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015134089 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 3060.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3060.64 0 0 1015134324 10 Physicians 80 Peoria 0 0 Vascular 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 1015134391 1639673106 10 Physicians RAO ASHWIN 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 1015134421 1689223653 47 Local Education Agencies INTRINSIC SCHOOLS 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 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 3467.3 0 3467.3 0 0 1015135292 1043815624 16 Nurse Practitioners PATEL KHUSHBU 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 0 459.42 0 0 0 0 0 0 459.42 0 0 1015135455 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 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 0 210.6 210.6 0 0 1015135715 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 510.25 0 0 0 0 0 0 0 0 0 0 0 0 0 510.25 0 0 1015136163 1366049264 16 Nurse Practitioners BAUM MELANIE 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 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 2.73 0 0 0 0 0 0 2.73 0 0 1015136271 1902148158 10 Physicians MAGILL STEPHEN T 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 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 4598.25 0 0 0 0 0 0 4598.25 0 0 1015136293 1578940797 10 Physicians YOU CINDY 999999999 200 Cook 0 0 Internal Medicine 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 1008.94 0 0 0 0 0 0 1008.94 0 0 1015136387 1497172340 10 Physicians WANG BILLY C 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 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 17966.26 0 0 0 0 0 0 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1015138906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9847.58 0 0 0 0 0 0 0 0 0 0 0 0 0 9847.58 0 0 1015139345 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3069.84 0 0 0 0 0 0 0 0 0 0 0 0 0 3069.84 0 0 1015139358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821.94 0 0 0 0 0 0 0 0 0 0 0 0 0 821.94 0 0 1015139535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 711.65 0 0 0 0 0 0 0 0 0 0 0 0 0 711.65 0 0 1015139914 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 17.96 0 0 0 0 0 0 17.96 0 0 1015140012 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1015140225 1043603764 16 Nurse Practitioners REYNOLDS MITCHELL B 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 342.48 0 0 0 0 0 0 342.48 0 0 1015140408 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2952.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2952.53 0 0 1015140586 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 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0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1044.19 0 0 0 0 0 0 1044.19 0 0 1015141258 1932294980 10 Physicians SUSSMAN ERNEST 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.95 0 99.36 0 0 0 0 0 0 135.31 0 0 1015141381 1407218654 10 Physicians FU JOHN 999999999 200 Cook 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 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 0 140.36 0 0 0 0 0 0 0 0 140.36 0 0 1015141785 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 33.86 0 0 0 0 0 0 33.86 0 0 1015141980 1851319990 10 Physicians SCHWAB JOHN 999999999 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1116.3 0 0 0 0 0 0 1116.3 0 0 1015142049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1755.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1755.34 0 0 1015142171 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2048.48 0 0 0 0 0 0 0 0 0 0 0 0 0 2048.48 0 0 1015142305 10 Physicians 80 Peoria 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015142825 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 427.82 0 0 0 0 0 0 0 0 0 0 0 0 0 427.82 0 0 1015143130 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276.67 0 0 0 0 0 0 0 0 0 0 0 0 0 276.67 0 0 1015143196 1336721901 91 Waiver service provider--Adults (DHS/DDD) MORRIS JASMINE M 999999999 200 Cook 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 645 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33711.31 0 0 0 0 0 0 0 0 0 0 0 0 0 33711.31 0 0 1015143244 1962914135 16 Nurse Practitioners MIERS KRISTIN 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 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 0 907.12 0 0 0 0 0 0 907.12 0 0 1015143408 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4759.61 0 0 0 0 0 0 0 0 0 0 0 0 0 4759.61 0 0 1015143519 1912582339 16 Nurse Practitioners BALA STEPHEN 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 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 0 0 0 0 0 0 0 0 0 0 1015143921 1700438678 86 Clinical Social Worker(Encounter Only) BLYTHE JULIE A 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 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 0 730.66 0 0 0 0 0 0 730.66 0 0 1015144033 4015144033 90 Waiver service provider--Elderly (DOA) ALPHA HOME HEALTH CARE INC 999999999 200 Cook 0 0 0 0 0 0 0 8 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 34517.73 0 0 0 0 0 0 0 0 0 0 0 0 0 34517.73 0 0 1015144051 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18270.82 0 0 0 0 0 0 0 0 0 0 0 0 0 18270.82 0 0 1015144479 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 0 195.43 0 0 0 0 0 0 195.43 0 0 1015145084 1891395745 16 Nurse Practitioners PATEL VRUNDA 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 0 536.05 0 0 0 0 0 0 536.05 0 0 1015145088 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3357.88 0 0 0 0 0 0 0 0 0 0 0 0 0 3357.88 0 0 1015145155 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.85 0 0 0 0 0 0 168.85 0 0 1015145323 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4242.85 0 0 0 0 0 0 0 0 0 0 0 0 0 4242.85 0 0 1015145877 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15222.49 0 0 0 0 0 0 0 0 0 0 0 0 0 15222.49 0 0 1015146011 1346636479 10 Physicians SUAREZ DANIEL P 999999999 88 Richland 0 0 0 0 0 0 0 0 0 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 0 394.88 0 0 0 0 0 0 394.88 0 0 1015147240 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 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 2842.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2842.7 0 0 1015147576 1578057295 10 Physicians PHILSON RENEE Y 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 0 346.68 0 0 0 0 0 0 346.68 0 0 1015147958 1801396064 10 Physicians AL-ZAGHAL ZAID 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 154.23 0 0 0 0 0 0 154.23 0 0 1015148015 1891271904 10 Physicians ABBAS SYED 999999999 91 Sangamon 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 0 158 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 1624.67 0 0 0 0 0 0 1624.67 0 0 1015148304 16 Nurse Practitioners 106 Whiteside 0 0 0 0 0 0 0 0 0 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 79.72 0 0 0 0 0 0 79.72 0 0 1015148456 1336593300 10 Physicians MCVAY MATTHEW C 999999999 91 Sangamon 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 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 36.31 0 0 0 0 0 0 0 0 36.31 0 0 1015148782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 809.96 0 0 0 0 0 0 0 0 0 0 0 0 0 809.96 0 0 1015148830 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6894.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6894.77 0 0 1015148894 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 700.48 0 0 0 0 0 0 0 0 0 0 0 0 0 700.48 0 0 1015148896 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 1085 0 0 1015149279 1558546598 10 Physicians PETRICEK TRAVIS 999999999 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800.87 0 0 0 0 0 0 800.87 0 0 1015149348 1093301889 86 Clinical Social Worker(Encounter Only) LOEROP ELIZABETH 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 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 2940.52 0 0 0 0 0 0 2940.52 0 0 1015149434 1205429503 16 Nurse Practitioners NICHOLSON HALEIGH R 999999999 80 Peoria 0 0 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 0 107 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 32.15 0 0 0 0 0 0 0 0 2652.52 0 0 0 0 0 0 2684.67 0 0 1015149649 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2198.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2198.53 0 0 1015149829 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 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 0 182.12 182.12 0 0 1015149840 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1132.12 0 0 1015149924 1396394029 22 Physical Therapists YEUNG JUSTIN 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2458.81 2458.81 0 0 1015150409 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1847.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1847.03 0 0 1015150971 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 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 1400.08 0 0 0 0 0 0 0 0 0 0 0 0 0 1400.08 0 0 1015151089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1014.66 0 0 1015151381 1205333994 10 Physicians BADWAN HAMZEH 999999999 54 Kankakee 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 1 0 34 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 45 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 2.18 0 451.89 0 0 0 0 0 0 538.69 0 0 1015151404 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2083.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.2 0 0 1015151446 1861838260 10 Physicians KARAMANOS EFSTATHIOS 999999999 47 Jackson 0 0 Plastic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.37 0 0 0 0 0 0 186.37 0 0 1015151527 1023461506 10 Physicians AGARWAL DEEPAK 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 2 0 42 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 3533.73 0 0 0 0 0 0 3533.73 0 0 1015151788 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12242.56 0 0 0 0 0 0 0 0 0 0 0 0 0 12242.56 0 0 1015151820 1396817912 10 Physicians ZAJAC JACEK 999999999 30 DuPage 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1015152089 1609468891 16 Nurse Practitioners COOK AUSTIN 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 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 0 376.57 0 0 0 0 0 0 376.57 0 0 1015152607 16 Nurse Practitioners 80 Peoria 0 0 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 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 56.72 0 0 0 0 0 0 88.87 0 0 1015152758 1255926291 16 Nurse Practitioners FINN ALEXANDER 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 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 0 242.2 0 0 0 0 0 0 242.2 0 0 1015152919 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 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 23013.66 0 0 0 0 0 0 0 0 0 0 0 0 0 23013.66 0 0 1015152925 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8167.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8167.88 0 0 1015153202 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3585.09 0 0 0 0 0 0 0 0 0 0 0 0 0 3585.09 0 0 1015153370 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 299.51 0 0 0 0 0 0 0 0 0 0 0 0 0 299.51 0 0 1015153417 1285192112 16 Nurse Practitioners ODOOM KOBINA 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 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 0 556.87 0 0 0 0 0 0 556.87 0 0 1015153425 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8403.09 0 0 0 0 0 0 0 0 0 0 0 0 0 8403.09 0 0 1015153562 1679889026 10 Physicians RIEGLE BENJAMIN D 999999999 80 Peoria 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 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 1689.55 0 0 0 0 0 0 1689.55 0 0 1015153618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1296.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1296.04 0 0 1015154396 1659830057 16 Nurse Practitioners DEAN GINGER 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 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 0 0 0 0 0 0 0 0 0 0 1015154664 1134448087 10 Physicians QUINT JAMES D 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2771.9 0 0 0 0 0 0 2771.9 0 0 1015154667 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9515.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9515.45 0 0 1015154683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2083.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2083.72 0 0 1015154814 1093735722 16 Nurse Practitioners BAKER THOMAS 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 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 0 399.45 0 0 0 0 0 0 399.45 0 0 1015154823 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1001.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1001.14 0 0 1015155245 1982893608 10 Physicians MCCOOL PAMELA 999999999 200 Cook 0 0 Obstetric-Gynecology 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 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 19.58 0 0 0 0 0 0 0 0 563.1 0 0 0 0 0 0 582.68 0 0 1015155315 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 811.09 0 0 0 0 0 0 0 0 0 0 0 0 0 811.09 0 0 1015155547 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 1015155611 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.45 0 0 0 0 0 0 0 0 5.45 0 0 1015155717 1396034161 10 Physicians SILVER JEREMY M 999999999 200 Cook 0 0 Emergency 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 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 1725.89 0 0 0 0 0 0 1725.89 0 0 1015155936 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6738.21 0 0 0 0 0 0 0 0 0 0 0 0 0 6738.21 0 0 1015156163 86 Clinical Social Worker(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 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Physician Assistant Only(Encounter Only) BUSH SARAH 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 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 0 0 0 0 0 0 0 0 0 0 1015158145 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1608.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1608.76 0 0 1015158256 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1761.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1761.04 0 0 1015158681 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1384.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1384.81 0 0 1015158702 1417275256 10 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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 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 2690.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2690.8 0 0 1015178633 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1302.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1302.24 0 0 1015178702 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2126.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2126.6 0 0 1015178876 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4146.15 0 0 0 0 0 0 0 0 0 0 0 0 0 4146.15 0 0 1015179257 1720663024 16 Nurse Practitioners BRAIDA PATRICIA 999999999 107 Will 0 0 0 0 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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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 461.61 0 0 0 0 0 0 0 0 0 0 0 0 0 461.61 0 0 1015189044 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 1015189063 1720259476 10 Physicians HOTCHKISS JOHN 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 61 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2164.79 0 60.94 0 0 0 0 0 0 2225.73 0 0 1015189142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2894.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2894.98 0 0 1015189288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 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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Nursing Facilities 823 Michigan 0 0 0 0 0 0 0 0 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 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65790 0 0 0 0 0 0 0 65790 0 0 1015199476 1326277989 10 Physicians MA CHANGQING 999999999 10 Adams 0 0 0 0 0 0 0 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 0 157.96 0 0 0 0 0 0 0 0 157.96 0 0 1015199594 1861077299 16 Nurse Practitioners LI YIBO 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 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 0 188.34 0 0 0 0 0 0 188.34 0 0 1015199660 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 2359.87 0 0 0 0 0 0 0 0 0 0 0 0 0 2359.87 0 0 1015199899 16 Nurse Practitioners 30 DuPage 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 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.02 0 0 0 0 0 0 163.02 0 0 1015202594 1801561410 16 Nurse Practitioners BROWN KIRSTIE L 999999999 19 Champaign 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 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 85.65 0 0 0 0 0 0 0 0 309.28 0 0 0 0 0 0 394.93 0 0 1015202664 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.62 0 0 0 0 0 0 0 0 97.62 0 0 1015202765 1558954032 16 Nurse Practitioners AWADALLAH SALHAB 999999999 27 Dekalb 0 0 0 0 0 0 0 0 0 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 2927.79 0 0 0 0 0 0 2927.79 0 0 1015202944 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2012.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2012.67 0 0 1015203395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3576.59 0 0 0 0 0 0 0 0 0 0 0 0 0 3576.59 0 0 1015203751 1346601259 10 Physicians KAHLE KELLY 999999999 80 Peoria 0 0 0 0 0 3 0 0 0 0 0 0 15 0 34 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 18 0 41 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 18 0 41 0 0 0 0 0 0 0 0 0 239.73 0 0 0 0 0 0 578.3 0 846.88 0 0 0 0 0 0 1664.91 0 0 1015203954 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3451.03 0 0 0 0 0 0 0 0 0 0 0 0 0 3451.03 0 0 1015204007 86 Clinical Social Worker(Encounter Only) 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 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 0 747.25 0 0 0 0 0 0 747.25 0 0 1015204368 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 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 84.63 84.63 0 0 1015204440 1215920640 10 Physicians LEWIS KATHRYN M 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 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 0 790.32 0 0 0 0 0 0 790.32 0 0 1015204619 10 Physicians 63 Macon 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 22.27 0 0 0 0 0 0 22.27 0 0 1015204809 1407305824 16 Nurse Practitioners BAK NORA J 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 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 32.18 0 0 0 0 0 0 32.18 0 0 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 876.7 0 0 0 0 0 0 0 0 0 0 0 0 0 876.7 0 0 1015206157 1467815506 10 Physicians SETH ARJUN 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 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 0 193.16 0 0 0 0 0 0 193.16 0 0 1015206264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3851.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3851.75 0 0 1015206865 1023680972 16 Nurse Practitioners NICHTING JAMIE 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 0 233.48 0 0 0 0 0 0 233.48 0 0 1015207163 1720624356 16 Nurse Practitioners GONZALES JESSICA 999999999 75 Monroe 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.59 0 0 0 0 0 0 170.59 0 0 1015207240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1166.33 0 0 0 0 0 0 0 0 0 0 0 0 0 1166.33 0 0 1015207813 1043987977 33 Nursing Facilities AHVA CARE OF WINFIELD 999999999 30 DuPage 0 0 0 0 0 0 0 0 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 1861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240501.51 0 0 0 0 0 0 0 240501.51 0 0 1015207816 1881205938 16 Nurse Practitioners COVACIU LAVINIA 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 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 77.35 0 0 0 0 0 0 77.35 0 0 1015207872 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 11370.8 0 0 0 0 0 0 0 0 0 0 0 0 0 11370.8 0 0 1015208010 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 0 0 0 0 0 0 0 0 0 0 1015208555 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015208689 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015208819 1386242352 60 Pharmacies FAIRBURY PHARMACY 999999999 61 Livingston 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.79 0 0 0 0 0 0 20.79 0 0 1015210104 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1194.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1194.2 0 0 1015210599 10 Physicians 200 Cook 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 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 0 643.28 0 0 0 0 0 0 643.28 0 0 1015210644 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1435.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1435.14 0 0 1015210662 1063085447 11 Dentists ZAYYAD BANA A 999999999 200 Cook 0 0 General Dentistry 0 0 20 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 2889.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2889.71 0 0 1015210851 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 1015210918 1174194583 10 Physicians KIM JI YANG 999999999 66 Marion 0 0 0 0 0 0 0 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 17.69 0 0 0 0 0 0 0 0 17.69 0 0 1015211829 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 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 0 101.98 101.98 0 0 1015212325 1326298936 10 Physicians CARSON JOSHUA 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 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 2240.56 0 0 0 0 0 0 2240.56 0 0 1015212881 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13388.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13388.7 0 0 1015213065 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849.84 0 0 0 0 0 0 0 0 0 0 0 0 0 849.84 0 0 1015213335 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5881.39 0 0 0 0 0 0 0 0 0 0 0 0 0 5881.39 0 0 1015213717 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228.62 0 0 0 0 0 0 228.62 0 0 1015213788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1989.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1989.44 0 0 1015213961 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1101.74 0 0 0 0 0 0 0 0 0 0 0 0 0 1101.74 0 0 1015213993 16 Nurse Practitioners 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015214548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7589.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7589.19 0 0 1015214772 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 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 1936.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1936.72 0 0 1015214783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300.01 0 0 0 0 0 0 0 0 0 0 0 0 0 300.01 0 0 1015215072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015215083 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12450.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12450.6 0 0 1015215254 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 15 0 0 0 0 0 0 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0 331.41 0 0 1015216945 1164874244 22 Physical Therapists CALGARO LAURA 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 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 0 683.62 683.62 0 0 1015217370 86 Clinical Social Worker(Encounter Only) 58 La Salle 0 0 0 0 0 0 0 0 0 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 1179.27 0 0 0 0 0 0 1179.27 0 0 1015217589 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12171.8 0 0 0 0 0 0 0 0 0 0 0 0 0 12171.8 0 0 1015217890 1700462074 16 Nurse Practitioners CHEN 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 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 0 110.44 0 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3007.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3007.62 0 0 1015218563 13 Podiatrists 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 1015218913 1871932905 10 Physicians HAZANI HANI 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 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 1018.68 0 0 0 0 0 0 1018.68 0 0 1015218949 1962992883 10 Physicians GHASSAN JOHN 999999999 200 Cook 0 0 0 0 0 4 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 214.96 0 0 0 0 0 0 0 0 368.09 0 0 0 0 0 0 583.05 0 0 1015219148 1528635034 12 Optometrists PENDLETON JERESS 999999999 200 Cook 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 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 0 140.72 0 0 0 0 0 0 140.72 0 0 1015219624 1164849063 10 Physicians HAN ETHAN 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 0 0 0 0 0 0 0 0 0 0 1015219659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 566.06 0 0 0 0 0 0 0 0 0 0 0 0 0 566.06 0 0 1015219951 10 Physicians 65 Madison 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.1 0 0 0 0 0 0 22.1 0 0 1015219977 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 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 11754.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11754.62 0 0 1015220044 73 Other Transportation Providers ( Non-Registered) 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 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 0 277.09 0 0 0 0 0 0 277.09 0 0 1015220336 1760073530 16 Nurse Practitioners ZIMMERMAN JORY 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 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 1015220428 1427235233 10 Physicians HENRY MARION C 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 1637.03 0 0 0 0 0 0 1637.03 0 0 1015220799 1508436502 16 Nurse Practitioners BURON NATALIA 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 8006.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8006.65 0 0 1015222475 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 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 2555.96 0 0 0 0 0 0 0 0 0 0 0 0 0 2555.96 0 0 1015222736 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15176.76 0 0 0 0 0 0 0 0 0 0 0 0 0 15176.76 0 0 1015223392 1922419589 10 Physicians BARHAGHI KRYSTLE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 42 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1589.28 0 57.65 0 0 0 0 0 0 1646.93 0 0 1015223428 1215342449 10 Physicians LUDWIG JOHN 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 0 160 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 0 471.24 0 0 0 0 0 0 471.24 0 0 1015223530 1164439386 10 Physicians HAQQANI MOHAMMED 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 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 1227.22 0 0 0 0 0 0 1227.22 0 0 1015223568 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 147.6 0 0 0 0 0 0 0 0 0 0 0 0 0 147.6 0 0 1015223651 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 7.38 0 0 0 0 0 0 7.38 0 0 1015223819 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 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 8510.27 0 0 0 0 0 0 0 0 0 0 0 0 0 8510.27 0 0 1015224055 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 0 0 0 0 0 0 0 0 0 0 1015224117 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 0 329.67 0 0 0 0 0 0 0 0 0 0 0 0 0 329.67 0 0 1015224989 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 586.33 0 0 0 0 0 0 0 0 0 0 0 0 0 586.33 0 0 1015225329 1659665016 10 Physicians BRANDEL DAVID W 999999999 25 Crawford 0 0 0 0 0 0 0 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 0 224.46 0 0 0 0 0 0 0 0 224.46 0 0 1015225369 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 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 0 0 0 0 0 0 0 0 0 1015225549 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12434.5 0 0 0 0 0 0 0 0 0 0 0 0 0 12434.5 0 0 1015225889 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7667.88 0 0 0 0 0 0 0 0 0 0 0 0 0 7667.88 0 0 1015226079 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1481.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1481.7 0 0 1015226109 1245684737 10 Physicians HANNA SAMANTHA 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 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 1449 0 0 0 0 0 0 1449 0 0 1015226312 1225600554 16 Nurse Practitioners SAGOVAC BETTY 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 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 0 311.56 0 0 0 0 0 0 311.56 0 0 1015226374 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 5 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 0 0 0 0 1015226460 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10637.86 0 0 0 0 0 0 0 0 0 0 0 0 0 10637.86 0 0 1015226765 1962897108 10 Physicians POST DAVID J 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 14 0 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0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1015228218 10 Physicians 200 Cook 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 1015228587 1457880445 22 Physical Therapists MCWILLIAMS BRETT A 999999999 109 Winnebago 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 0 117 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 1410.99 1410.99 0 0 1015228681 1295400901 70 Ambulance Service Providers NORTH PARK FIRE PROTECTION DIS 999999999 109 Winnebago 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 0 116 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 12431.5 0 0 0 0 0 0 12431.5 0 0 1015228920 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 1015238090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15849.34 0 0 0 0 0 0 0 0 0 0 0 0 0 15849.34 0 0 1015238252 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7519.05 0 0 0 0 0 0 0 0 0 0 0 0 0 7519.05 0 0 1015238278 1295981280 10 Physicians NELSON AKSOY TAMASYN 999999999 200 Cook 0 0 0 0 0 24 0 0 0 0 0 0 5 0 16 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 5 0 19 0 0 0 0 0 0 0 0 0 1768.03 0 0 0 0 0 0 44.6 0 641.29 0 0 0 0 0 0 2453.92 0 0 1015238628 1942739396 10 Physicians DAVIS PATRICK L 999999999 53 Kane 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 0 0 0 0 0 0 0 5.17 0 0 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1015239296 4015239296 90 Waiver service provider--Elderly (DOA) "ALPHA IN-HOME SERVICES, LLC" 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 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40072.5 0 0 0 0 0 0 0 0 0 0 0 0 0 40072.5 0 0 1015239834 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21968.42 0 0 0 0 0 0 0 0 0 0 0 0 0 21968.42 0 0 1015239971 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 0 149 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 6223.03 0 0 0 0 0 0 0 0 0 0 0 0 0 6223.03 0 0 1015240440 1962996280 10 Physicians HADDEN KYLE R 999999999 91 Sangamon 0 0 Family Practice 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 3 0 0 0 0 0 0 0 0 0 0 0 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477.4 0 0 1015303450 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 0 0 0 0 0 0 0 0 0 0 1015304021 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 0 0 0 0 0 0 0 0 0 0 1015304037 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 440.49 0 0 0 0 0 0 0 0 0 0 0 0 0 440.49 0 0 1015304049 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10739.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10739.71 0 0 1015304080 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 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 7963.9 0 0 0 0 0 0 0 0 0 0 0 0 0 7963.9 0 0 1015304160 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4519.32 0 0 0 0 0 0 0 0 0 0 0 0 0 4519.32 0 0 1015304404 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 0 770.55 0 0 0 0 0 0 0 0 0 0 0 0 0 770.55 0 0 1015304668 1740812148 24 Speech Therapists MARMEL MIRIAM 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 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 2227.15 2227.15 0 0 1015304817 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11572.48 0 0 0 0 0 0 0 0 0 0 0 0 0 11572.48 0 0 1015304992 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2604.48 0 0 0 0 0 0 0 0 0 0 0 0 0 2604.48 0 0 1015305021 1124697719 16 Nurse Practitioners GIERCZYK SUSAN M 999999999 200 Cook 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 0 422 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 1319.38 0 0 0 0 0 0 1319.38 0 0 1015305097 1619237849 10 Physicians THURMAN JOHN R 999999999 30 DuPage 0 0 0 0 0 1 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 8 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 117.85 0 0 0 0 0 0 0 0 81.59 0 0 0 0 0 0 199.44 0 0 1015305647 10 Physicians 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.99 0 0 0 0 0 0 0 0 69.99 0 0 1015305675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2145.45 0 0 0 0 0 0 0 0 0 0 0 0 0 2145.45 0 0 1015305742 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4184.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4184.12 0 0 1015305829 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379.3 0 0 0 0 0 0 0 0 0 0 0 0 0 379.3 0 0 1015306058 1174919575 10 Physicians OSTERMEIER AUSTIN J 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 1410.55 0 0 0 0 0 0 1410.55 0 0 1015306305 1710332895 10 Physicians LIANG BURNS CHERYL 999999999 200 Cook 0 0 Family 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 0 213.8 0 0 0 0 0 0 213.8 0 0 1015306338 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 390.72 0 0 0 0 0 0 0 0 0 0 0 0 0 390.72 0 0 1015306358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2757.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2757.19 0 0 1015306518 1154600492 10 Physicians ENEZATE TARIQ 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 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 0 518.79 0 0 0 0 0 0 518.79 0 0 1015306888 1154854354 10 Physicians RAOUF SHERIEF 999999999 200 Cook 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 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44.6 0 704.16 0 0 0 0 0 0 748.76 0 0 1015307140 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6401.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6401.5 0 0 1015307181 1497142194 10 Physicians MILLS ANDREW 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 16 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 336.14 0 5583.69 0 0 0 0 0 0 5919.83 0 0 1015307646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1015308565 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5404.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5404.19 0 0 1015309189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1651.27 0 0 0 0 0 0 0 0 0 0 0 0 0 1651.27 0 0 1015309215 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8853.6 0 0 0 0 0 0 0 0 0 0 0 0 0 8853.6 0 0 1015309367 1619546447 16 Nurse Practitioners PERKINS MICHAEL PH 999999999 49 Jefferson 0 0 0 0 0 0 0 0 0 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 1775 0 0 0 0 0 0 1775 0 0 1015309783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.73 0 0 0 0 0 0 0 0 0 0 0 0 0 1509.73 0 0 1015310215 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 0 738.85 0 0 0 0 0 0 0 0 0 0 0 0 0 738.85 0 0 1015310452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1684.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1684.93 0 0 1015310650 1053842153 10 Physicians HURLEY MEGHAN 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 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 2555.41 0 0 0 0 0 0 2555.41 0 0 1015310956 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516.6 0 0 0 0 0 0 0 0 0 0 0 0 0 516.6 0 0 1015311103 94 Waiver service provider--Children's support (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 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 0 412.3 0 0 0 0 0 0 0 0 0 0 0 0 0 412.3 0 0 1015311291 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 2143.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2143.29 0 0 1015311943 1750958377 11 Dentists BUSOUL REEMA 999999999 200 Cook 0 0 General Dentistry 0 0 67 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 7254.68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7254.68 0 0 1015311960 1609379932 10 Physicians PATEL SAGAR 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 0 355.52 0 0 0 0 0 0 355.52 0 0 1015312143 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 632.78 0 0 0 0 0 0 0 0 0 0 0 0 0 632.78 0 0 1015312364 1164803292 10 Physicians THERRIAULT COLIN 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 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 0 848.58 0 0 0 0 0 0 848.58 0 0 1015313016 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.46 8.46 0 0 1015313017 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 0 890.3 0 0 0 0 0 0 890.3 0 0 1015313172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1064.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1064.55 0 0 1015313649 1265021919 16 Nurse Practitioners KENT RYAN 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 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 0 508.88 0 0 0 0 0 0 508.88 0 0 1015313798 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4042.36 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.36 0 0 1015314012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2026.82 0 0 0 0 0 0 0 0 0 0 0 0 0 2026.82 0 0 1015314790 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 337.65 0 0 0 0 0 0 0 0 0 0 0 0 0 337.65 0 0 1015314975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14852.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14852.21 0 0 1015315308 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2490.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2490.84 0 0 1015315372 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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1015345981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19789.65 0 0 0 0 0 0 0 0 0 0 0 0 0 19789.65 0 0 1015346131 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10838.81 0 0 0 0 0 0 0 0 0 0 0 0 0 10838.81 0 0 1015346529 1538651799 10 Physicians KUCERA MOLLY M 999999999 200 Cook 0 0 Family Practice 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 22 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 170.27 0 0 0 0 0 0 0 0 1767.01 0 0 0 0 0 0 1937.28 0 0 1015346553 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1187.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1187.19 0 0 1015346874 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 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 1298.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1298.29 0 0 1015346900 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.9 0 0 0 0 0 0 7.9 0 0 1015346989 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2709.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2709.18 0 0 1015347089 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3820.37 0 0 0 0 0 0 0 0 0 0 0 0 0 3820.37 0 0 1015347138 90 Waiver service provider--Elderly (DOA) 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 0 277 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 17768.37 0 0 0 0 0 0 0 0 0 0 0 0 0 17768.37 0 0 1015347230 89 Physician Assistant Only(Encounter Only) 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 4.4 0 0 0 0 0 0 4.4 0 0 1015347552 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4086.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4086.28 0 0 1015347882 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 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 27.78 0 0 0 0 0 0 27.78 0 0 1015348088 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10763.2 0 0 0 0 0 0 0 0 0 0 0 0 0 10763.2 0 0 1015348101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 812.43 0 0 0 0 0 0 0 0 0 0 0 0 0 812.43 0 0 1015348732 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2462.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2462.35 0 0 1015349520 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1482.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1482.78 0 0 1015349553 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10350.88 0 0 0 0 0 0 0 0 0 0 0 0 0 10350.88 0 0 1015349779 89 Physician Assistant Only(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 42.14 0 0 0 0 0 0 42.14 0 0 1015349831 1154766418 10 Physicians PARHAM JOHNATHON S 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 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 0 219.88 0 0 0 0 0 0 219.88 0 0 1015349971 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 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 1015350004 1174971337 12 Optometrists CLERMONT JOSHUA 999999999 53 Kane 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 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 0 110.71 0 0 0 0 0 0 110.71 0 0 1015350423 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1038.85 0 0 0 0 0 0 0 0 0 0 0 0 0 1038.85 0 0 1015350487 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4166.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4166.39 0 0 1015350811 1265929152 10 Physicians ALAVALAPADU APARNA 999999999 91 Sangamon 0 0 0 0 0 7 0 0 0 0 0 0 0 0 20 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 0 321.5 0 0 0 0 0 0 0 0 779.53 0 0 0 0 0 0 1101.03 0 0 1015351240 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 5963.34 0 0 0 0 0 0 0 0 0 0 0 0 0 5963.34 0 0 1015351511 1083673644 10 Physicians KAZEM FATIMA 999999999 200 Cook 0 0 Radiology Diagnosis 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 8 0 1 0 0 0 0 0 0 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 0 259.55 0 0 0 0 0 0 0 0 259.55 0 0 1015351566 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 94.27 0 0 0 0 0 0 0 0 0 0 0 0 0 94.27 0 0 1015351568 1518385335 10 Physicians WRIGHT HENRY C 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 4 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.65 0 1771.8 0 0 0 0 0 0 1780.45 0 0 1015351594 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 12969.42 0 0 0 0 0 0 0 0 0 0 0 0 0 12969.42 0 0 1015352003 1326487232 10 Physicians PATIL SHRUTI 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 54.73 0 0 0 0 0 0 54.73 0 0 1015352118 1306430699 16 Nurse Practitioners VAUGHAN JOSHUA R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 731.92 0 0 0 0 0 0 731.92 0 0 1015352130 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2753.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2753.69 0 0 1015352152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1197.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1197.54 0 0 1015352196 1659046266 16 Nurse Practitioners WINTERROWD SAUNDRA E 999999999 96 St Clair 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 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015353515 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1015353518 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 1015353550 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 315.76 0 0 0 0 0 0 0 0 0 0 0 0 0 315.76 0 0 1015354058 1528735149 16 Nurse Practitioners ALBRECHT KATIE 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 0 446.5 0 0 0 0 0 0 446.5 0 0 1015354560 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1580.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1580.48 0 0 1015354857 1346637485 10 Physicians ZHANG HAO 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 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 2771.47 0 0 0 0 0 0 2771.47 0 0 1015354993 1184657942 10 Physicians RASHID MICHAEL A 999999999 53 Kane 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 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.72 0 1404.38 0 0 0 0 0 0 1413.1 0 0 1015355039 23 Occupational Therapists 89 Rock Island 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 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 0 190.28 190.28 0 0 1015355096 1952693707 10 Physicians MCCONKEY ISHA 999999999 30 DuPage 0 0 Family Practice 0 0 0 0 0 0 0 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 43.73 0 0 0 0 0 0 43.73 0 0 1015355248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2087.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2087.55 0 0 1015355463 1811569049 16 Nurse Practitioners SESE KRYSTLE 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 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 1587.77 0 0 0 0 0 0 1587.77 0 0 1015355985 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 179.08 0 0 0 0 0 0 0 0 0 0 0 0 0 179.08 0 0 1015356412 1255900437 11 Dentists KHADEN MAHA S 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 0 180 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 5075.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5075.07 0 0 1015356426 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2050.02 0 0 0 0 0 0 0 0 0 0 0 0 0 2050.02 0 0 1015356540 1700364197 16 Nurse Practitioners KARCH BRYNN 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 58.53 0 0 0 0 0 0 58.53 0 0 1015356784 4015356784 90 Waiver service provider--Elderly (DOA) CENTRAL ILLINOIS CARE SERVICES 999999999 96 St Clair 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 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 762 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64584 0 0 0 0 0 0 0 0 0 0 0 0 0 64584 0 0 1015356889 1598262875 10 Physicians SINGH ANUJ K 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 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 0 742.48 0 0 0 0 0 0 742.48 0 0 1015356899 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 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 0 136.69 136.69 0 0 1015357002 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 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 0 947.2 0 0 0 0 0 0 0 0 0 0 0 0 0 947.2 0 0 1015357313 86 Clinical Social Worker(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 66.66 0 0 0 0 0 0 66.66 0 0 1015357509 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 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 75 0 0 0 0 0 0 75 0 0 1015357560 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2359.97 0 0 0 0 0 0 0 0 0 0 0 0 0 2359.97 0 0 1015357873 36 Community mental health provider 54 Kankakee 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 44.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284.88 0 0 329.16 0 0 1015358085 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 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 1542.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1542.09 0 0 1015358172 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11366.68 0 0 0 0 0 0 0 0 0 0 0 0 0 11366.68 0 0 1015358804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1390.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1390.76 0 0 1015359392 1982083887 10 Physicians CRESPO ALEXANDER 999999999 200 Cook 0 0 Orthopedic Surgery 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 19 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242.69 0 12739.03 0 0 0 0 0 0 12981.72 0 0 1015360445 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 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 2653.64 0 0 0 0 0 0 0 0 0 0 0 0 0 2653.64 0 0 1015360526 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 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 1660.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1660.47 0 0 1015360846 1669082988 91 Waiver service provider--Adults (DHS/DDD) LIBBRA KATHRYNE G 999999999 96 St Clair 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 0 213 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 28746 0 0 0 0 0 0 0 0 0 0 0 0 0 28746 0 0 1015360874 1407435241 16 Nurse Practitioners MORELOCK BENJAMIN A 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 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 0 115.27 0 0 0 0 0 0 115.27 0 0 1015361476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4020.76 0 0 0 0 0 0 0 0 0 0 0 0 0 4020.76 0 0 1015361507 10 Physicians 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 1015361559 1992291215 10 Physicians KHAN MUSA 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 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 0 0 0 0 0 0 0 0 0 0 1015361598 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 0 105.8 0 49.22 0 0 0 0 0 0 155.02 0 0 1015361646 1881291342 16 Nurse Practitioners DUNCAN ROBERT 999999999 57 Lake 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 0 218 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 3913.71 0 0 0 0 0 0 3913.71 0 0 1015361775 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1015361938 1134582497 10 Physicians FANG SHUYANG 999999999 91 Sangamon 0 0 Internal Medicine 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 42 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 0 0 276.83 0 0 0 0 0 0 296.41 0 0 1015362170 1407286651 91 Waiver service provider--Adults (DHS/DDD) WIBBENMEYER SARAH 624502028 88 Richland 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79656 0 0 0 0 0 0 0 0 0 0 0 0 0 79656 0 0 1015362243 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6862.02 0 0 0 0 0 0 0 0 0 0 0 0 0 6862.02 0 0 1015362617 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 1.2 0 0 0 0 0 0 1.2 0 0 1015363169 1952386476 10 Physicians FARRELL ROBERT 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 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 36 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 758.32 0 21.07 0 0 0 0 0 0 779.39 0 0 1015363365 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475.38 0 0 0 0 0 0 0 0 0 0 0 0 0 475.38 0 0 1015363709 1548604424 16 Nurse Practitioners FARQUHAR KATHERINE E 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 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 1691.77 0 0 0 0 0 0 1691.77 0 0 1015363779 70 Ambulance Service Providers 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 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 2976.92 0 0 0 0 0 0 2976.92 0 0 1015364168 1336454891 87 Psychologist(Encounter Only) WRIGHT KRISTEN A 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 0 144 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 0 0 0 0 0 0 0 0 0 0 1015364189 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1215.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.2 0 0 1015364417 1780097543 16 Nurse Practitioners DEL REAL ALEJANDRO 999999999 107 Will 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1015364610 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 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 1391.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1391.51 0 0 1015365202 63 Other Providers of Medical Equipment/Supplies (Non-registered) 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 105.03 0 0 0 0 105.03 0 0 1015365224 1851824999 10 Physicians PATEL MITALI 999999999 200 Cook 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 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 0 727.44 0 0 0 0 0 0 727.44 0 0 1015365524 1861084725 89 Physician Assistant Only(Encounter Only) OLSON KELSEY 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 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 2.73 0 0 0 0 0 0 2.73 0 0 1015365600 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 3.98 0 0 0 0 0 0 3.98 0 0 1015365649 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 23.46 0 0 0 0 0 0 23.46 0 0 1015365804 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62.12 0 0 0 0 0 0 62.12 0 0 1015365906 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 0 0 0 0 0 0 0 0 0 0 1015366326 1417619768 91 Waiver service provider--Adults (DHS/DDD) CAREY REAGAN 999999999 91 Sangamon 0 0 0 0 0 0 0 25 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 5254.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5254.47 0 0 1015366340 1922671924 16 Nurse Practitioners KAPOOR RUBY 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 0 344 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 1921.17 0 0 0 0 0 0 1921.17 0 0 1015366350 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8201.39 0 0 0 0 0 0 0 0 0 0 0 0 0 8201.39 0 0 1015366410 86 Clinical Social Worker(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 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 0 0 0 0 0 0 0 0 0 0 1015366723 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5114 0 0 0 0 0 0 0 0 0 0 0 0 0 5114 0 0 1015367071 89 Physician Assistant Only(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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015367345 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 0 594.79 0 0 0 0 0 0 0 0 0 0 0 0 0 594.79 0 0 1015367485 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 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 0 403.54 403.54 0 0 1015367518 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 0 104 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 12027.6 0 0 0 0 0 0 0 0 0 0 0 0 0 12027.6 0 0 1015367695 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 0 0 0 0 0 0 0 0 0 0 1015367822 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 1085 0 0 1015368033 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 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 4312.88 0 0 0 0 0 0 0 0 0 0 0 0 0 4312.88 0 0 1015368245 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12146.88 0 0 0 0 0 0 0 0 0 0 0 0 0 12146.88 0 0 1015368310 1285913129 16 Nurse Practitioners STILES BRANDIE M 999999999 100 Vermilion 0 0 0 0 0 0 0 0 0 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 0 742.77 0 0 0 0 0 0 742.77 0 0 1015368313 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.23 0 0 0 0 0 0 47.23 0 0 1015368606 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 5899.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5899.16 0 0 1015368904 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 253.05 0 0 0 0 0 0 0 0 0 0 0 0 0 253.05 0 0 1015369005 1023647443 16 Nurse Practitioners O'BRIEN SHARON S 999999999 200 Cook 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 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102536.09 0 0 0 0 0 0 102536.09 0 0 1015369184 1366609331 10 Physicians JIAMBOI GINA 999999999 109 Winnebago 0 0 Emergency 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 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 1048.56 0 0 0 0 0 0 1048.56 0 0 1015369203 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015369357 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3877.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3877.1 0 0 1015369655 1063901189 10 Physicians SEGREST BRANDON 999999999 30 DuPage 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 0 114 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 0 916.25 0 0 0 0 0 0 916.25 0 0 1015369870 1811419203 10 Physicians WAINWRIGHT SAMUEL 999999999 200 Cook 0 0 Internal Medicine 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 0 117 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 4524.1 0 0 0 0 0 0 4524.1 0 0 1015370000 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5163.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5163.2 0 0 1015370172 1396771077 70 Ambulance Service Providers COUNTY OF EDWARDS EMS 999999999 32 Edwards 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 0 125 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 9328.48 0 0 0 0 0 0 9328.48 0 0 1015370270 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32045.94 0 0 0 0 0 0 0 0 0 0 0 0 0 32045.94 0 0 1015370782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4011.92 0 0 0 0 0 0 0 0 0 0 0 0 0 4011.92 0 0 1015370964 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.69 0 0 0 0 0 0 0 0 0 0 0 0 0 16.69 0 0 1015371067 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 0 0 0 0 0 0 0 0 0 0 1015371141 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6984.65 0 0 0 0 0 0 0 0 0 0 0 0 0 6984.65 0 0 1015371457 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 0 101.06 0 0 0 0 0 0 101.06 0 0 1015371582 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 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 2580.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2580.38 0 0 1015371657 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 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Early Intervention Services 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 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 0 848.82 0 0 0 0 0 0 848.82 0 0 1015390633 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 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 2458.61 0 0 0 0 0 0 0 0 0 0 0 0 0 2458.61 0 0 1015390949 1073284907 16 Nurse Practitioners DRABYSHEUSKAYA IRENE V 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 0 100 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 0 163.02 0 0 0 0 0 0 163.02 0 0 1015391000 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4688.78 0 0 0 0 0 0 0 0 0 0 0 0 0 4688.78 0 0 1015391186 11 Dentists 30 DuPage 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 0 395.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 395.12 0 0 1015391621 1174052864 10 Physicians SALSTROM PHILIP L 999999999 60 Lee 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 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 0 143.8 0 464.13 0 0 0 0 0 0 607.93 0 0 1015391999 1346668019 10 Physicians BENCK LILLIAN ROCHELLE 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 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 55.39 0 0 0 0 0 0 55.39 0 0 1015392015 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2081.03 0 0 0 0 0 0 0 0 0 0 0 0 0 2081.03 0 0 1015392172 1417373044 89 Physician Assistant Only(Encounter Only) MELLAN LINDSAY 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 0 615.75 0 0 0 0 0 0 615.75 0 0 1015392265 1790390805 16 Nurse Practitioners KUPFERBERG KIMBERLY 606081732 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 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 0 727.15 0 0 0 0 0 0 727.15 0 0 1015392349 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 656.42 0 0 0 0 0 0 0 0 0 0 0 0 0 656.42 0 0 1015392395 1336436252 10 Physicians RAHEEM OMER 999999999 30 DuPage 0 0 Urology 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.89 0 0 0 0 0 0 129.89 0 0 1015392540 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1448.55 0 0 0 0 0 0 0 0 0 0 0 0 0 1448.55 0 0 1015392777 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.68 0 0 0 0 0 0 172.68 0 0 1015393434 1902336050 10 Physicians DISKINA MARIAM 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 9 0 14 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12 0 37 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12 0 37 0 0 0 0 0 0 0 0 0 19.58 0 0 0 0 0 0 307.11 0 1212.84 0 0 0 0 0 0 1539.53 0 0 1015394049 91 Waiver service provider--Adults (DHS/DDD) 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 0 332.01 0 0 0 0 0 0 0 0 0 0 0 0 0 332.01 0 0 1015394246 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1015394646 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 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 1870.26 0 0 0 0 0 0 0 0 0 0 0 0 0 1870.26 0 0 1015394666 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.34 0 0 0 0 0 0 78.34 0 0 1015394949 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 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 0 979.39 0 0 0 0 0 0 0 0 0 0 0 0 0 979.39 0 0 1015394971 23 Occupational Therapists 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.39 133.39 0 0 1015395060 1104443258 89 Physician Assistant Only(Encounter Only) CLARK KILMENY B 999999999 91 Sangamon 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 1378.7 0 0 0 0 0 0 1378.7 0 0 1015395185 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2447.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2447.3 0 0 1015395331 1841794971 10 Physicians PATEL RAMYA 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 0 105 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 68.48 0 0 0 0 0 0 68.48 0 0 1015395544 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14495.68 0 0 0 0 0 0 0 0 0 0 0 0 0 14495.68 0 0 1015395547 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 6689.01 0 0 0 0 0 0 0 0 0 0 0 0 0 6689.01 0 0 1015395604 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015395659 1285202887 11 Dentists ALSSAEAIDI DINA 999999999 107 Will 0 0 General Dentistry 0 0 6 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2398.1 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 3150.8 0 0 1015395702 1124640511 33 Nursing Facilities APERION CARE DEKALB 999999999 27 Dekalb 0 0 0 0 0 0 0 0 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 0 710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89446.62 0 0 0 0 0 0 0 89446.62 0 0 1015395800 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.31 0 0 0 0 0 0 0 0 0 0 0 0 0 98.31 0 0 1015395982 1942292503 10 Physicians MUNSON KEITH 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 0 110.33 0 0 0 0 0 0 110.33 0 0 1015396223 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 1862.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1862.5 0 0 1015396244 1699448928 91 Waiver service provider--Adults (DHS/DDD) HOOPER PATRICIA A 999999999 33 Effingham 0 0 0 0 0 0 0 23 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 13799.37 0 0 0 0 0 0 0 0 0 0 0 0 0 13799.37 0 0 1015396357 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1015396385 1437720695 11 Dentists DEFRIES SARAH 999999999 200 Cook 0 0 General Dentistry 0 0 99 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 11355.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11355.34 0 0 1015396496 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 791.07 0 0 0 0 0 0 0 0 0 0 0 0 0 791.07 0 0 1015396585 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 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 1080 0 0 0 0 0 0 0 0 0 0 0 0 0 1080 0 0 1015396868 1245785047 10 Physicians YEDLA NIHARIKA 999999999 10 Adams 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 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 0 342.1 0 0 0 0 0 0 342.1 0 0 1015397044 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11251.44 0 0 0 0 0 0 0 0 0 0 0 0 0 11251.44 0 0 1015397597 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858.65 0 0 0 0 0 0 0 0 0 0 0 0 0 858.65 0 0 1015397666 16 Nurse Practitioners 15 Bureau 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015397772 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2191.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2191.7 0 0 1015397855 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4471.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4471.25 0 0 1015397892 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 54.21 0 0 0 0 0 0 54.21 0 0 1015398209 1669060042 16 Nurse Practitioners ITHAL BRANDI 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 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 0 206.73 0 0 0 0 0 0 206.73 0 0 1015398671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1227.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1227.53 0 0 1015398696 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10953.7 0 0 0 0 0 0 0 0 0 0 0 0 0 10953.7 0 0 1015398748 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 19134.73 0 0 0 0 0 0 0 0 0 0 0 0 0 19134.73 0 0 1015398841 1396363156 11 Dentists MODI RIMA 999999999 53 Kane 0 0 0 0 25 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 2597.6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.6 0 0 1015398937 1861990731 10 Physicians LALONDE SEBASTIEN P 999999999 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 8 0 16 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 1.71 0 285.99 0 0 0 0 0 0 287.7 0 0 1015399053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6536.63 0 0 0 0 0 0 0 0 0 0 0 0 0 6536.63 0 0 1015399088 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5878.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5878.52 0 0 1015399421 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 406.94 0 0 0 0 0 0 406.94 0 0 1015400143 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7584.34 0 0 0 0 0 0 0 0 0 0 0 0 0 7584.34 0 0 1015400203 1952838179 10 Physicians PATEL UNNATI 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.22 0 50.4 0 0 0 0 0 0 55.62 0 0 1015400712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 27721.27 0 0 0 0 0 0 0 0 0 0 0 0 0 27721.27 0 0 1015400828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2877.29 0 0 0 0 0 0 0 0 0 0 0 0 0 2877.29 0 0 1015400981 1215324462 10 Physicians SHAH SHALIN 999999999 200 Cook 0 0 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 16 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149.18 0 4175.86 0 0 0 0 0 0 4325.04 0 0 1015400991 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 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 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 1085 0 0 1015401187 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8274.65 0 0 0 0 0 0 0 0 0 0 0 0 0 8274.65 0 0 1015401740 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1996.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1996.95 0 0 1015401950 1578154340 16 Nurse Practitioners AHRENS NICOLE 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 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 0 338.03 0 0 0 0 0 0 338.03 0 0 1015402130 97 Waiver service provider--Children's residential (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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.37 0 0 0 0 0 0 0 0 0 0 0 0 0 98.37 0 0 1015402323 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 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 0 245.44 0 0 0 0 0 0 245.44 0 0 1015402412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 677.26 0 0 0 0 0 0 0 0 0 0 0 0 0 677.26 0 0 1015402694 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2406.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2406.92 0 0 1015402856 57 Home Nursing Agency 200 Cook 0 0 0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9506.65 75.04 0 0 0 0 0 0 0 0 0 0 0 0 9581.69 0 0 1015402860 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 651.12 0 0 0 0 0 0 0 0 0 0 0 0 0 651.12 0 0 1015403019 1093766966 16 Nurse Practitioners NEUHOFF KIP 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 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 2073.7 0 0 0 0 0 0 2073.7 0 0 1015403533 10 Physicians 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947.82 0 0 0 0 0 0 947.82 0 0 1015403692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9404.85 0 0 0 0 0 0 0 0 0 0 0 0 0 9404.85 0 0 1015404171 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 387.44 0 0 0 0 0 0 0 0 0 0 0 0 0 387.44 0 0 1015404280 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 4 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 0 244.7 244.7 0 0 1015404388 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 705.64 0 0 0 0 0 0 0 0 0 0 0 0 0 705.64 0 0 1015404487 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5495.27 0 0 0 0 0 0 0 0 0 0 0 0 0 5495.27 0 0 1015404684 1497966634 91 Waiver service provider--Adults (DHS/DDD) SMILEY MONICA L 604463805 107 Will 0 0 0 0 0 0 0 11 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 30897.6 0 0 0 0 0 0 0 0 0 0 0 0 0 30897.6 0 0 1015405137 1205096070 10 Physicians WEINBERG RICHARD L 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 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 0 616.66 0 0 0 0 0 0 616.66 0 0 1015405166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9240.23 0 0 0 0 0 0 0 0 0 0 0 0 0 9240.23 0 0 1015405359 1922645910 40 Federally Qualified Health Centers WABASH COMMUNITY HEALTH CENTER 999999999 101 Wabash 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3601.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3601.89 0 0 1015405477 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3157.28 0 0 0 0 0 0 0 0 0 0 0 0 0 3157.28 0 0 1015405579 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 20.79 0 0 0 0 0 0 20.79 0 0 1015405598 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 18.59 0 0 0 0 0 0 18.59 0 0 1015406073 1780267526 16 Nurse Practitioners KRIPPEL SARAH 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 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 1015406133 1558384487 16 Nurse Practitioners DOUGHERTY ANNE 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 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 0 424.26 0 0 0 0 0 0 424.26 0 0 1015406360 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 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 1270.24 1270.24 0 0 1015406437 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6439.03 0 0 0 0 0 0 0 0 0 0 0 0 0 6439.03 0 0 1015406458 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 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 1122.94 0 0 0 0 0 0 0 0 0 0 0 0 0 1122.94 0 0 1015406659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1827.39 0 0 0 0 0 0 0 0 0 0 0 0 0 1827.39 0 0 1015407226 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11858.92 0 0 0 0 0 0 0 0 0 0 0 0 0 11858.92 0 0 1015407234 4015407234 90 Waiver service provider--Elderly (DOA) "AMAZON HOME CARE, INC." 999999999 200 Cook 0 0 0 0 0 0 0 7 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 7967.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7967.7 0 0 1015407401 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2446.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2446.14 0 0 1015407702 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 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 0 270.74 0 0 0 0 0 0 270.74 0 0 1015408051 1639543564 63 Other Providers of Medical Equipment/Supplies (Non-registered) APM MEDICAL SUPPLIES 999999999 845 Texas 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 7966.37 0 0 0 0 0 0 7966.37 0 0 1015408298 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3623.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3623.9 0 0 1015408513 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2187.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2187.84 0 0 1015408921 1386080760 10 Physicians SHUBECK SARAH P 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 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 0 180.61 0 0 0 0 0 0 180.61 0 0 1015409252 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3352.11 0 0 0 0 0 0 0 0 0 0 0 0 0 3352.11 0 0 1015409475 1124417357 61 Independent Laboratories AEGIS SCIENCES CORPORATION 999999999 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 2265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231210.59 0 0 0 0 0 0 0 0 231210.59 0 0 1015409580 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1840.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1840.34 0 0 1015409868 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2783.67 0 0 0 0 0 0 0 0 0 0 0 0 0 2783.67 0 0 1015409965 1275203051 16 Nurse Practitioners ARGO KELLY 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 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 0 149.95 0 0 0 0 0 0 149.95 0 0 1015410510 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6036.58 0 0 0 0 0 0 0 0 0 0 0 0 0 6036.58 0 0 1015410722 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 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 4999.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4999.69 0 0 1015411425 1871851154 10 Physicians DEJULIO PAUL A 999999999 200 Cook 0 0 Emergency 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 708.03 0 0 0 0 0 0 708.03 0 0 1015411511 1831498997 89 Physician Assistant Only(Encounter Only) BRIM KARRY 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 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 9.81 0 0 0 0 0 0 9.81 0 0 1015412171 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 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 2430.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2430.39 0 0 1015412419 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 0 260.95 0 0 0 0 0 0 260.95 0 0 1015412972 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 2530.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2530.62 0 0 1015413230 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 267.42 0 0 0 0 0 0 0 0 0 0 0 0 0 267.42 0 0 1015413642 94 Waiver service provider--Children's support (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2066.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2066.05 0 0 1015413819 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 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 0 594.52 594.52 0 0 1015413989 1548642580 10 Physicians BOWLES EDWARDS ALAN D 999999999 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.3 0 0 0 0 0 0 48.3 0 0 1015414864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 370.05 0 0 0 0 0 0 0 0 0 0 0 0 0 370.05 0 0 1015414932 1285694364 10 Physicians ALEXANDER RONALD D 999999999 24 Coles 0 0 0 0 0 0 0 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 0 217.9 0 0 0 0 0 0 0 0 217.9 0 0 1015415459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 783.99 0 0 0 0 0 0 0 0 0 0 0 0 0 783.99 0 0 1015415559 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5749.34 0 0 0 0 0 0 0 0 0 0 0 0 0 5749.34 0 0 1015415560 1417375791 10 Physicians HARTOG REBECCA R 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 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 0 428.83 0 0 0 0 0 0 428.83 0 0 1015415669 1932692746 10 Physicians RUSHDAN ADIB 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 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 4.2 0 0 0 0 0 0 4.2 0 0 1015415733 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4627.51 0 0 0 0 0 0 0 0 0 0 0 0 0 4627.51 0 0 1015415924 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3194.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3194.7 0 0 1015416253 10 Physicians 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 124.61 0 0 0 0 0 0 124.61 0 0 1015416486 1952377855 10 Physicians KOSZUTA JOHN 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 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 0 278.8 0 0 0 0 0 0 278.8 0 0 1015416586 91 Waiver service provider--Adults (DHS/DDD) 91 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015430281 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5944.3 0 0 0 0 0 0 0 0 0 0 0 0 0 5944.3 0 0 1015430525 1790147163 10 Physicians LABOY CARISSA 999999999 200 Cook 0 0 0 0 0 0 0 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 0 403.49 0 0 0 0 0 0 0 0 403.49 0 0 1015430577 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.53 0 0 0 0 0 0 0 0 0 0 0 0 0 172.53 0 0 1015430720 1730618133 10 Physicians ROSEN JOSHUA S 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 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 84.62 0 0 0 0 0 0 0 0 205.4 0 0 0 0 0 0 290.02 0 0 1015431104 22 Physical Therapists 35 Ford 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 32.66 32.66 0 0 1015431122 1386235133 16 Nurse Practitioners LI RUI Z 999999999 200 Cook 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 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 0 192.71 0 0 0 0 0 0 199.11 0 0 1015431166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3432.38 0 0 0 0 0 0 0 0 0 0 0 0 0 3432.38 0 0 1015431359 1609371384 10 Physicians LIN CHRISTINA 999999999 30 DuPage 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 0 143 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 2085.26 0 0 0 0 0 0 2085.26 0 0 1015431405 1164810255 70 Ambulance Service Providers NORTH BOONE FIRE DISTRICT 3 999999999 13 Boone 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 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 8209.35 0 0 0 0 0 0 8209.35 0 0 1015431531 1871164418 16 Nurse Practitioners WAGNER GRACE E 999999999 80 Peoria 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 36 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 48.22 0 0 0 0 0 0 0 0 779.32 0 0 0 0 0 0 827.54 0 0 1015431642 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1741.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1741.5 0 0 1015431887 10 Physicians 53 Kane 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 0 148.3 0 13.49 0 0 0 0 0 0 161.79 0 0 1015432169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6206.87 0 0 0 0 0 0 0 0 0 0 0 0 0 6206.87 0 0 1015432420 1053999599 10 Physicians GARASSINO MARINA C 999999999 30 DuPage 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1166.55 0 0 0 0 0 0 1166.55 0 0 1015432445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 705 0 0 0 0 0 0 0 0 0 0 0 0 0 705 0 0 1015433026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1514.57 0 0 0 0 0 0 0 0 0 0 0 0 0 1514.57 0 0 1015433341 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2400.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2400.69 0 0 1015433736 1386311371 23 Occupational Therapists MERCADO EDGAR 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 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 2208.21 2208.21 0 0 1015434574 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18.75 0 0 0 0 0 0 0 0 18.75 0 0 1015434648 1538750690 16 Nurse Practitioners MONTANA KELSEY 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 403.91 0 0 0 0 0 0 403.91 0 0 1015434653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9983.47 0 0 0 0 0 0 0 0 0 0 0 0 0 9983.47 0 0 1015435240 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2101.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2101.6 0 0 1015435531 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6132.01 0 0 0 0 0 0 0 0 0 0 0 0 0 6132.01 0 0 1015435676 1255644191 10 Physicians GHADBAN RUGHEED 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 685.48 0 0 0 0 0 0 685.48 0 0 1015435683 1164591616 10 Physicians PEEL AVANEE 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 22 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 0 464.46 0 0 0 0 0 0 0 0 464.46 0 0 1015435797 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3348.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3348.22 0 0 1015435866 1639796410 39 Hospice AMENITY HEALTH CARE INC 999999999 30 DuPage 0 0 0 0 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 0 494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99912.07 0 0 0 0 0 0 0 0 0 0 0 99912.07 0 0 1015436689 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8717.94 0 0 0 0 0 0 0 0 0 0 0 0 0 8717.94 0 0 1015436891 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 6141.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6141.09 0 0 1015437152 1952862104 16 Nurse Practitioners HILARIO RUBYLYN R 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 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 1015437325 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 1414.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1414.62 0 0 1015437542 1821679564 16 Nurse Practitioners SWANSON SAMANTHA K 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 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 1015438143 1639673569 10 Physicians KERL SPENCER D 999999999 200 Cook 0 0 Emergency 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 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 0 451.6 0 0 0 0 0 0 451.6 0 0 1015438264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1334.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1334.96 0 0 1015438426 1992332407 16 Nurse Practitioners RYCZEK LAUREN C 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 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 0 862.65 0 0 0 0 0 0 862.65 0 0 1015438626 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1948.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1948.23 0 0 1015438645 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 47.62 0 0 0 0 0 0 47.62 0 0 1015439008 1104336023 89 Physician Assistant Only(Encounter Only) POST TIFFANY R 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 361.87 0 0 0 0 0 0 361.87 0 0 1015439153 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6892.61 0 0 0 0 0 0 0 0 0 0 0 0 0 6892.61 0 0 1015439605 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1493.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1493.04 0 0 1015439849 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8864.44 0 0 0 0 0 0 0 0 0 0 0 0 0 8864.44 0 0 1015440145 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9116.8 0 0 0 0 0 0 0 0 0 0 0 0 0 9116.8 0 0 1015440938 39 Hospice 200 Cook 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 8035.62 0 0 0 0 0 0 0 0 0 0 0 8035.62 0 0 1015441040 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 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 0 461.95 0 0 0 0 0 0 461.95 0 0 1015441042 1598182412 10 Physicians SINHA RAHUL P 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 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 2748.82 0 0 0 0 0 0 2748.82 0 0 1015441508 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3619.81 0 0 0 0 0 0 0 0 0 0 0 0 0 3619.81 0 0 1015442073 1952921462 89 Physician Assistant Only(Encounter Only) JOHNSON ERIKA T 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 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 8.9 0 0 0 0 0 0 8.9 0 0 1015442294 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1403.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1403.6 0 0 1015443468 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 2669.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2669.92 0 0 1015443477 1285172239 10 Physicians AHMAD ZAKI 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 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 1692.83 0 0 0 0 0 0 1692.83 0 0 1015443509 1790219335 10 Physicians POOVATHUMKADAVIL ABDULJALEEL 999999999 80 Peoria 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 0 196 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 1806.57 0 0 0 0 0 0 0 0 1806.57 0 0 1015443670 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2951.26 0 0 0 0 0 0 0 0 0 0 0 0 0 2951.26 0 0 1015443938 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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1015458234 10 Physicians 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 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 86.75 0 0 0 0 0 0 0 0 86.75 0 0 1015458617 1366970212 13 Podiatrists RUNDELL JOESPH 999999999 71 McHenry 0 0 0 0 0 0 0 0 0 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 27.26 0 0 0 0 0 0 27.26 0 0 1015458767 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 16190.92 0 0 0 0 0 0 0 0 0 0 0 0 0 16190.92 0 0 1015459123 10 Physicians 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1015459129 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1131.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.46 0 0 1015459288 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5561.65 0 0 0 0 0 0 0 0 0 0 0 0 0 5561.65 0 0 1015459411 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4131.28 0 0 0 0 0 0 0 0 0 0 0 0 0 4131.28 0 0 1015459663 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1015460015 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2522.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2522.39 0 0 1015460804 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2130.77 0 0 0 0 0 0 0 0 0 0 0 0 0 2130.77 0 0 1015460879 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2597.49 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.49 0 0 1015461001 1700370988 10 Physicians THIPPARTHI MONICA 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 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 99.01 0 0 0 0 0 0 99.01 0 0 1015461233 16 Nurse Practitioners 200 Cook 0 0 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 6 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 32.15 0 0 0 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Physical 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 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 0 373.6 373.6 0 0 1015462589 1720647605 89 Physician Assistant Only(Encounter Only) MARTIN HALEY 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 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 0 373.1 0 0 0 0 0 0 373.1 0 0 1015462657 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 0 0 0 0 0 0 0 0 0 0 1015462733 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 820.62 0 0 0 0 0 0 0 0 0 0 0 0 0 820.62 0 0 1015463062 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 0 107.73 0 0 0 0 0 0 107.73 0 0 1015463278 1003583378 23 Occupational Therapists ROSE RACHEL A 999999999 91 Sangamon 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 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 2946.17 2946.17 0 0 1015463284 1245216860 65 Independent Diagnostic Testing Facility (IDTF) METRO MRI CENTER LIMITED PRTSH 999999999 89 Rock Island 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 0 174 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 8176.96 0 0 0 0 0 0 0 0 8176.96 0 0 1015463290 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 0 151 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 6171.48 0 0 0 0 0 0 0 0 0 0 0 0 0 6171.48 0 0 1015463448 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 475.04 0 0 0 0 0 0 0 0 0 0 0 0 0 475.04 0 0 1015463531 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 20.83 0 0 0 0 0 0 20.83 0 0 1015463782 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 39.86 0 0 0 0 0 0 39.86 0 0 1015464365 1396335048 63 Other Providers of Medical Equipment/Supplies (Non-registered) NEXT STEP FOOT AND ANKLE CENTE 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 2 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 0 402.79 0 84.05 0 0 0 0 486.84 0 0 1015464425 1497173900 10 Physicians KURLANDER DAVID E 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 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 2361.2 0 0 0 0 0 0 2361.2 0 0 1015464589 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 75 0 0 0 0 0 0 75 0 0 1015464631 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2676.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2676.05 0 0 1015464672 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2896.95 0 0 0 0 0 0 0 0 0 0 0 0 0 2896.95 0 0 1015464724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 126.31 0 0 0 0 0 0 0 0 0 0 0 0 0 126.31 0 0 1015464857 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 0 250.29 0 0 0 0 0 0 0 0 0 0 0 0 0 250.29 0 0 1015464941 57 Home Nursing Agency 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 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92780.25 0 0 0 0 0 0 0 0 0 0 0 0 0 92780.25 0 0 1015465058 1598983371 10 Physicians GLICKSTEIN JONATHAN 609361477 35 Ford 0 0 Otolaryngology 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 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 0 986.41 0 0 0 0 0 0 986.41 0 0 1015465171 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12905.63 0 0 0 0 0 0 0 0 0 0 0 0 0 12905.63 0 0 1015465203 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015465220 1801811187 10 Physicians SCHMIDT MICHAEL 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 14 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.08 0 0 0 0 0 0 0 0 11.08 0 0 1015465227 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 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 64.23 0 0 0 0 0 0 64.23 0 0 1015465650 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 83.7 0 0 0 0 0 0 83.7 0 0 1015465970 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 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 2227.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2227.81 0 0 1015466274 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10481.1 0 0 0 0 0 0 0 0 0 0 0 0 0 10481.1 0 0 1015466995 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 4405.12 0 0 0 0 0 0 0 0 0 0 0 0 0 4405.12 0 0 1015467024 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 119.23 0 104.64 0 0 0 0 0 0 223.87 0 0 1015467185 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 130.2 0 0 0 0 0 0 0 0 0 0 0 0 0 130.2 0 0 1015467319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4924.9 0 0 0 0 0 0 0 0 0 0 0 0 0 4924.9 0 0 1015467468 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3713.64 0 0 0 0 0 0 0 0 0 0 0 0 0 3713.64 0 0 1015467580 1659048320 11 Dentists PAI ADITYA N 999999999 58 La Salle 0 0 General Dentistry 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 1415.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1415.8 0 0 1015467933 10 Physicians 200 Cook 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 1015468023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271.64 0 0 0 0 0 0 0 0 0 0 0 0 0 271.64 0 0 1015468276 10 Physicians 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 0 200.33 0 0 0 0 0 0 200.33 0 0 1015468559 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104.7 0 0 0 0 0 0 104.7 0 0 1015468688 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 1015468883 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 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 0 217.72 0 0 0 0 0 0 217.72 0 0 1015468909 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015469105 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6 0 0 1015469366 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1855.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.92 0 0 1015469657 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1015469800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3311.29 0 0 0 0 0 0 0 0 0 0 0 0 0 3311.29 0 0 1015469818 1538692876 46 Ambulatory Surgical Treatment Centers CHICAGO VASCULAR SURGICAL CENT 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6717.34 0 0 0 0 0 6717.34 0 0 1015470045 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 4524.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4524.49 0 0 1015470349 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 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 0 101.99 101.99 0 0 1015470637 1154613933 10 Physicians MIRZA SOBIA 999999999 200 Cook 0 0 Radiology Diagnosis 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 30 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 295.43 0 8.81 0 0 0 0 0 0 304.24 0 0 1015470709 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1648.21 0 0 0 0 0 0 0 0 0 0 0 0 0 1648.21 0 0 1015471294 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.38 0 0 1015472033 1013413673 10 Physicians BURKE 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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 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 1849.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1849.09 0 0 1015505366 1255866448 10 Physicians AUBRY JONATHAN 999999999 19 Champaign 0 0 Family Practice 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 10 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.32 0 601.82 0 0 0 0 0 0 1270.14 0 0 1015505410 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 1015505490 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 923.17 0 0 0 0 0 0 0 0 0 0 0 0 0 923.17 0 0 1015505785 92 Waiver service 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provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6600.54 0 0 0 0 0 0 0 0 0 0 0 0 0 6600.54 0 0 1015507056 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 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 0 166.26 0 0 0 0 0 0 166.26 0 0 1015507074 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1882.66 0 0 0 0 0 0 0 0 0 0 0 0 0 1882.66 0 0 1015507153 89 Physician Assistant Only(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 0 270.5 0 0 0 0 0 0 270.5 0 0 1015507435 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4356.27 0 0 0 0 0 0 0 0 0 0 0 0 0 4356.27 0 0 1015507574 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5413.29 0 0 0 0 0 0 0 0 0 0 0 0 0 5413.29 0 0 1015508051 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 19.45 0 0 0 0 0 0 19.45 0 0 1015508134 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1562.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1562.62 0 0 1015508173 1144803396 89 Physician Assistant Only(Encounter Only) SCHLAGEL SCOTT A 999999999 91 Sangamon 0 0 0 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0 5534.48 0 0 0 0 0 0 0 0 0 0 0 0 0 5534.48 0 0 1015510829 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 301.33 0 0 0 0 0 0 0 0 0 0 0 0 0 301.33 0 0 1015511413 1700382371 10 Physicians FISHMAN LUCAS 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 0 145 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 2471.39 0 0 0 0 0 0 2471.39 0 0 1015511417 1861924490 10 Physicians DOCKRY ANDREA 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 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 1136.12 0 0 0 0 0 0 1136.12 0 0 1015511442 1376066860 11 Dentists PATEL SHILAM S 999999999 30 DuPage 0 0 General Dentistry 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 1397.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397.2 0 0 1015511861 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 1015512154 1245814128 16 Nurse Practitioners SANTIAGO RYMA 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 282.64 0 0 0 0 0 0 282.64 0 0 1015512451 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 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 0 401.45 0 0 0 0 0 0 0 0 0 0 0 0 0 401.45 0 0 1015512600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 84.76 0 0 0 0 0 0 0 0 0 0 0 0 0 84.76 0 0 1015512618 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 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 0 942.86 0 0 0 0 0 0 0 0 0 0 0 0 0 942.86 0 0 1015512839 1386135424 10 Physicians MUNAGALA ANISH RAO 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 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 87.08 0 0 0 0 0 0 87.08 0 0 1015513053 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8702.21 0 0 0 0 0 0 0 0 0 0 0 0 0 8702.21 0 0 1015513886 1790861714 10 Physicians MELLOW ALAN M 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 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 0 328.56 0 0 0 0 0 0 328.56 0 0 1015514501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12087.09 0 0 0 0 0 0 0 0 0 0 0 0 0 12087.09 0 0 1015514518 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015514526 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9274.4 0 0 0 0 0 0 0 0 0 0 0 0 0 9274.4 0 0 1015514922 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1578.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1578.48 0 0 1015514925 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194.74 0 0 0 0 0 0 0 0 0 0 0 0 0 194.74 0 0 1015514935 1447846902 60 Pharmacies BOND COUNTY PHARMACY LLC 999999999 12 Bond 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 0 451 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12973 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11518.92 0 0 0 11518.92 0 0 1015515031 1760088223 60 Pharmacies MEDWIZ OF ILLINOIS 999999999 30 DuPage 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 1942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40665.1 0 0 0 40665.1 0 0 1015515136 1457934747 33 Nursing Facilities BELLA TERRA SCHAUMBURG 999999999 200 Cook 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 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5164 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 765580.53 0 0 0 0 0 0 0 765580.53 0 0 1015515138 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8714.52 0 0 0 0 0 0 0 0 0 0 0 0 0 8714.52 0 0 1015515637 16 Nurse Practitioners 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015516011 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12330.53 0 0 0 0 0 0 0 0 0 0 0 0 0 12330.53 0 0 1015516122 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9965.86 0 0 0 0 0 0 0 0 0 0 0 0 0 9965.86 0 0 1015516497 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15429.4 0 0 0 0 0 0 0 0 0 0 0 0 0 15429.4 0 0 1015516599 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 25.81 0 0 0 0 0 0 25.81 0 0 1015516653 1467602821 89 Physician Assistant Only(Encounter Only) SHAFI AMERAH 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 745 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9683.87 0 0 0 0 0 0 9683.87 0 0 1015516797 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2968.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2968.14 0 0 1015516945 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 0 538.62 0 0 0 0 0 0 0 0 0 0 0 0 0 538.62 0 0 1015517179 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 0 155.98 155.98 0 0 1015517241 10 Physicians 70 McDonough 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 0 0 0 0 0 0 0 0 0 0 0 0 1015517653 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4312.87 0 0 0 0 0 0 0 0 0 0 0 0 0 4312.87 0 0 1015518301 60 Pharmacies 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 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 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1015519737 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 838.65 0 0 0 0 0 0 0 0 0 0 0 0 0 838.65 0 0 1015520069 86 Clinical Social Worker(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 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 0 218.52 0 0 0 0 0 0 218.52 0 0 1015520146 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4026.77 0 0 0 0 0 0 0 0 0 0 0 0 0 4026.77 0 0 1015520440 1790149862 10 Physicians KENNEDY PATRICK J 999999999 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 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 0 789.26 0 0 0 0 0 0 789.26 0 0 1015520509 1205357563 12 Optometrists REESE PAIGE A 999999999 94 Shelby 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 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 0 750.97 0 0 0 0 0 0 750.97 0 0 1015520515 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4497.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4497.89 0 0 1015520659 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7293.45 0 0 0 0 0 0 0 0 0 0 0 0 0 7293.45 0 0 1015520724 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 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 0 476.35 0 0 0 0 0 0 0 0 0 0 0 0 0 476.35 0 0 1015520877 55 Early Intervention Services 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 0 471.68 0 0 0 0 0 0 471.68 0 0 1015520965 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 32.56 0 0 0 0 0 0 0 0 0 0 0 0 0 32.56 0 0 1015521154 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 86.5 0 0 0 0 0 0 86.5 0 0 1015521405 65 Independent Diagnostic Testing Facility (IDTF) 91 Sangamon 0 0 0 0 0 0 0 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 0 177.62 0 0 0 0 0 0 0 0 177.62 0 0 1015521528 1326611393 16 Nurse Practitioners MEDICK SARAHBETH L 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 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 1830.22 0 0 0 0 0 0 1830.22 0 0 1015521592 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 519.63 0 0 0 0 0 0 0 0 0 0 0 0 0 519.63 0 0 1015521769 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1447.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1447.16 0 0 1015521985 1669628012 10 Physicians AQUINO ALEJANDRO 999999999 80 Peoria 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 0 144 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 0 593.28 0 0 0 0 0 0 593.28 0 0 1015522430 1851948889 89 Physician Assistant Only(Encounter Only) PLATT JACOB 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 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 43.54 0 0 0 0 0 0 43.54 0 0 1015522585 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 0 295.03 0 0 0 0 0 0 295.03 0 0 1015522624 1407451271 89 Physician Assistant Only(Encounter Only) NASH MADISON ELIZABETH 999999999 200 Cook 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 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5365.17 0 0 0 0 0 0 5365.17 0 0 1015522763 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 516.6 0 0 0 0 0 0 0 0 0 0 0 0 0 516.6 0 0 1015522767 1588722201 10 Physicians LAGATTA LORINE M 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 13 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24.94 0 421.92 0 0 0 0 0 0 446.86 0 0 1015522801 1356836043 25 Audiologists PARR KYLEE E 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 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 0 462.19 462.19 0 0 1015522914 1144665878 10 Physicians GRADIANU MARIUS 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 537.37 0 0 0 0 0 0 537.37 0 0 1015523168 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14737.92 0 0 0 0 0 0 0 0 0 0 0 0 0 14737.92 0 0 1015523291 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 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 0 716.32 0 0 0 0 0 0 0 0 0 0 0 0 0 716.32 0 0 1015523647 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 20.95 0 0 0 0 0 0 20.95 0 0 1015524275 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015524308 1083213037 16 Nurse Practitioners GORDON JOHANNA R 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 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 0 302.51 0 0 0 0 0 0 302.51 0 0 1015524380 1053905497 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES OF EFFINGHA 999999999 33 Effingham 0 0 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 0 469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45302.6 0 0 0 0 0 0 0 0 0 0 0 0 0 45302.6 0 0 1015524500 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 0 491.2 0 0 0 0 0 0 491.2 0 0 1015524512 10 Physicians 63 Macon 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 1015524807 91 Waiver service provider--Adults (DHS/DDD) 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 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 1881.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1881.4 0 0 1015524933 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 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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 11702.41 0 0 0 0 0 0 0 0 0 0 0 0 0 11702.41 0 0 1015525677 1295330868 10 Physicians YANKOL YUCEL 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 0 0 0 0 0 0 0 0 0 0 1015526069 1891038394 10 Physicians PEARL JOSHUA SIMON 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 11 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69.2 0 8174.58 0 0 0 0 0 0 8243.78 0 0 1015526286 12 Optometrists 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 191.2 0 0 0 0 0 0 191.2 0 0 1015526772 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 1015528020 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 79.72 0 0 0 0 0 0 79.72 0 0 1015528065 1598154163 10 Physicians CENICEROS ASHLEY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 1061 0 0 0 0 0 0 1061 0 0 1015528156 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4986.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4986.34 0 0 1015528546 1568036648 11 Dentists YOUSSEF MOUSTAFA ROSHDI 999999999 200 Cook 0 0 General Dentistry 0 0 50 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 204 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 6589.85 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 7342.55 0 0 1015528712 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015529008 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 1178.18 0 0 0 0 0 0 0 0 0 0 0 0 0 1178.18 0 0 1015529219 1639564115 10 Physicians JESSE JOHN N 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 137 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3035.2 0 95.81 0 0 0 0 0 0 3131.01 0 0 1015529319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 121.97 0 0 0 0 0 0 121.97 0 0 1015530237 1295255107 10 Physicians TEWARI ARTI D 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 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 0 427.67 0 0 0 0 0 0 427.67 0 0 1015530301 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7905.47 0 0 0 0 0 0 0 0 0 0 0 0 0 7905.47 0 0 1015530403 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10879.85 0 0 0 0 0 0 0 0 0 0 0 0 0 10879.85 0 0 1015530668 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 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 2417.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2417.28 0 0 1015530859 1215519194 23 Occupational Therapists JACKLIN KAYLA M 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 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 4762.16 4762.16 0 0 1015531106 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 4499.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4499.31 0 0 1015531328 94 Waiver service provider--Children's support (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 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 5670.21 0 0 0 0 0 0 0 0 0 0 0 0 0 5670.21 0 0 1015531463 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9011.34 0 0 0 0 0 0 0 0 0 0 0 0 0 9011.34 0 0 1015531560 1699194399 89 Physician Assistant Only(Encounter Only) WATSON ASHLEY E 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 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 0 191.99 0 0 0 0 0 0 191.99 0 0 1015531789 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1172.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1172.16 0 0 1015532450 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18009.13 0 0 0 0 0 0 0 0 0 0 0 0 0 18009.13 0 0 1015532501 1437579570 10 Physicians WAGNER HILLARY J 999999999 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 2 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.26 0 1267.33 0 0 0 0 0 0 1278.59 0 0 1015532506 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4047.63 0 0 0 0 0 0 0 0 0 0 0 0 0 4047.63 0 0 1015532580 1619463189 10 Physicians HONG WENTAO 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70.66 0 722.73 0 0 0 0 0 0 793.39 0 0 1015532609 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6756.2 0 0 0 0 0 0 0 0 0 0 0 0 0 6756.2 0 0 1015532660 1073185617 55 Early Intervention Services KLINGHOFER REBECCA 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 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 5444.14 0 0 0 0 0 0 5444.14 0 0 1015532910 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 162.75 0 0 0 0 0 0 0 0 0 0 0 0 0 162.75 0 0 1015533022 10 Physicians 826 Missouri 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 0 210.74 0 0 0 0 0 0 210.74 0 0 1015533099 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4144.25 0 0 0 0 0 0 0 0 0 0 0 0 0 4144.25 0 0 1015533494 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4585.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4585.89 0 0 1015533564 1427346444 10 Physicians ABUALSUOD AMJAD M 999999999 80 Peoria 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 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 0 778.16 0 0 0 0 0 0 778.16 0 0 1015533818 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5269.25 0 0 0 0 0 0 0 0 0 0 0 0 0 5269.25 0 0 1015533932 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 435.1 0 0 0 0 0 0 0 0 0 0 0 0 0 435.1 0 0 1015535143 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1600.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1600.67 0 0 1015535348 1669959706 10 Physicians GOTZEV SIMEON 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 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 0 284.99 0 0 0 0 0 0 284.99 0 0 1015535404 1225423791 10 Physicians BROCHIN ROBERT L 999999999 200 Cook 0 0 Orthopedic Surgery 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.5 0 234.22 0 0 0 0 0 0 255.72 0 0 1015536069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4189.76 0 0 0 0 0 0 0 0 0 0 0 0 0 4189.76 0 0 1015536202 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 0 103.18 0 0 0 0 0 0 103.18 0 0 1015536225 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 822.27 0 0 0 0 0 0 0 0 0 0 0 0 0 822.27 0 0 1015536556 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 5 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 0 531.93 531.93 0 0 1015536560 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5564.36 0 0 0 0 0 0 0 0 0 0 0 0 0 5564.36 0 0 1015536637 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 0 0 0 0 0 0 0 0 0 0 1015536905 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 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 5399.55 0 0 0 0 0 0 0 0 0 0 0 0 0 5399.55 0 0 1015537061 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 19182.8 0 0 0 0 0 0 0 0 0 0 0 0 0 19182.8 0 0 1015537156 1083119317 10 Physicians HEMP TIMOTHY R 999999999 24 Coles 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 0 126 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 0 884.45 0 0 0 0 0 0 884.45 0 0 1015537389 1255788022 10 Physicians SPRAGUE ROBERT M 999999999 47 Jackson 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 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 2617.46 0 0 0 0 0 0 2617.46 0 0 1015537681 1558955997 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES OF MATTOON 999999999 24 Coles 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115552.18 0 0 0 0 0 0 0 0 0 0 0 0 0 115552.18 0 0 1015537744 1174576490 10 Physicians GOKSEL MUSABERK 999999999 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.16 0 829.27 0 0 0 0 0 0 881.43 0 0 1015538058 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3717.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3717.25 0 0 1015538176 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 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 3171.72 0 0 0 0 0 0 0 0 0 0 0 0 0 3171.72 0 0 1015538294 1861749780 10 Physicians CHUDY-ONWUGAJE KENECHUKWU O 999999999 10 Adams 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 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 2092.92 0 0 0 0 0 0 2092.92 0 0 1015538459 1427646496 16 Nurse Practitioners GIBSON JOSHUA 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 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 0 258.77 0 0 0 0 0 0 258.77 0 0 1015538794 61 Independent Laboratories 811 Georgia 0 0 0 0 0 0 0 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 0 186.54 0 0 0 0 0 0 0 0 186.54 0 0 1015538796 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 24.25 0 0 0 0 0 0 24.25 0 0 1015539013 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 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 0 164.95 0 0 0 0 0 0 0 0 0 0 0 0 0 164.95 0 0 1015539054 1558968628 16 Nurse Practitioners NENOFF TIMOTHY 999999999 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.81 0 0 0 0 0 0 1335.81 0 0 1015539384 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3340.75 0 0 0 0 0 0 0 0 0 0 0 0 0 3340.75 0 0 1015539731 1255484283 10 Physicians BURNS JASON 999999999 30 DuPage 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 26 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1261.55 0 0 0 0 0 0 0 0 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1015540874 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2584.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2584.47 0 0 1015541095 16 Nurse Practitioners 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015541162 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015541204 1982041034 10 Physicians SCHOENEBERG LAURA 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 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 0 741.27 0 0 0 0 0 0 741.27 0 0 1015541299 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 21894.79 0 0 0 0 0 0 0 0 0 0 0 0 0 21894.79 0 0 1015541418 1629609706 89 Physician Assistant Only(Encounter Only) LUKOSE LIYA 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 85.69 0 0 0 0 0 0 85.69 0 0 1015541706 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1015541861 10 Physicians 31 Edgar 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 1015541868 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 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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 47.62 0 0 0 0 0 0 47.62 0 0 1015574912 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.66 19.66 0 0 1015575012 1639747629 33 Nursing Facilities CHICAGO RIDGE SNF 999999999 200 Cook 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 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 499304.79 0 0 0 0 0 0 0 499304.79 0 0 1015575156 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504.74 0 0 0 0 0 0 0 0 0 0 0 0 0 504.74 0 0 1015575164 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 1110.93 0 0 0 0 0 0 1110.93 0 0 1015575537 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 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 1068.6 1068.6 0 0 1015575545 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3423.25 0 0 0 0 0 0 0 0 0 0 0 0 0 3423.25 0 0 1015575735 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 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 0 321.3 0 0 0 0 0 0 321.3 0 0 1015576346 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 13596.06 0 0 0 0 0 0 0 0 0 0 0 0 0 13596.06 0 0 1015576377 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015576627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1300.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1300.15 0 0 1015576685 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 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 0 420.38 0 0 0 0 0 0 0 0 0 0 0 0 0 420.38 0 0 1015576724 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174.03 0 0 0 0 0 0 0 0 0 0 0 0 0 174.03 0 0 1015576749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10115.84 0 0 0 0 0 0 0 0 0 0 0 0 0 10115.84 0 0 1015576892 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2161.32 0 0 0 0 0 0 0 0 0 0 0 0 0 2161.32 0 0 1015577336 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2697.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2697.58 0 0 1015578291 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 1015578382 1760984983 10 Physicians TAYON MATTHEW 999999999 30 DuPage 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 0 144 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 2034.72 0 0 0 0 0 0 2034.72 0 0 1015578670 1437738747 33 Nursing Facilities APERION CARE LAKESHORE 999999999 200 Cook 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 0 193 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800200.44 0 0 0 0 0 0 0 800200.44 0 0 1015579365 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 771.2 0 0 0 0 0 0 0 0 0 0 0 0 0 771.2 0 0 1015579584 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.59 0 0 0 0 0 0 0 0 0 0 0 0 0 222.59 0 0 1015580700 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8899.87 0 0 0 0 0 0 0 0 0 0 0 0 0 8899.87 0 0 1015581292 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8453.66 0 0 0 0 0 0 0 0 0 0 0 0 0 8453.66 0 0 1015581367 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3125.76 0 0 0 0 0 0 0 0 0 0 0 0 0 3125.76 0 0 1015581501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2515.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2515.05 0 0 1015581562 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7550.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7550.91 0 0 1015581614 1558860940 91 Waiver service provider--Adults (DHS/DDD) ACHARYA SANJU 999999999 91 Sangamon 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26638.2 0 0 0 0 0 0 0 0 0 0 0 0 0 26638.2 0 0 1015581711 1407380405 10 Physicians MOOBERRY MATTHEW A 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 3 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4951.22 0 0 0 0 0 0 4951.22 0 0 1015581825 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4487.41 0 0 0 0 0 0 0 0 0 0 0 0 0 4487.41 0 0 1015581902 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 2865.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2865.28 0 0 1015582066 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 692.46 0 0 0 0 0 0 0 0 0 0 0 0 0 692.46 0 0 1015582228 1396306221 89 Physician Assistant Only(Encounter Only) CAIN KARALYN R 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 480.37 0 0 0 0 0 0 480.37 0 0 1015582410 1245694538 10 Physicians NEVILLE EVAN 999999999 80 Peoria 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 100 0 0 0 0 0 0 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 49.22 0 725.4 0 0 0 0 0 0 774.62 0 0 1015582442 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 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 0 252.25 0 0 0 0 0 0 252.25 0 0 1015582458 10 Physicians 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 161.51 0 0 0 0 0 0 0 0 161.51 0 0 1015582511 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3133.9 0 0 0 0 0 0 0 0 0 0 0 0 0 3133.9 0 0 1015582828 1346744489 10 Physicians HOUSER BLAKE A 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 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 23.75 0 0 0 0 0 0 23.75 0 0 1015582876 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14105 0 0 0 0 0 0 0 0 0 0 0 0 0 14105 0 0 1015583384 1497349955 60 Pharmacies MEDSCRIPT LTC PHARMACY 999999999 815 Indiana 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 0 835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20740 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8217.76 0 0 0 8217.76 0 0 1015583492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1215.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1215.89 0 0 1015583502 1881272946 10 Physicians KHOURY NABIL 999999999 53 Kane 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 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 0 111.3 0 0 0 0 0 0 0 0 111.3 0 0 1015583855 10 Physicians 24 Coles 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 1015583872 89 Physician Assistant Only(Encounter Only) 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015583931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17531.08 0 0 0 0 0 0 0 0 0 0 0 0 0 17531.08 0 0 1015584042 1023436805 10 Physicians ARGYELAN ALEX WILFRED 999999999 53 Kane 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 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 784.94 0 0 0 0 0 0 856.84 0 0 1015584101 1548270606 10 Physicians CHOU SHERRY H 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 0 380.72 0 0 0 0 0 0 380.72 0 0 1015584245 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2186.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2186.6 0 0 1015585054 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1137.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1137.95 0 0 1015585316 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 6694.27 0 0 0 0 0 0 0 0 0 0 0 0 0 6694.27 0 0 1015585411 1134609324 16 Nurse Practitioners ROBINSON MEGAN 999999999 36 Franklin 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 0 149 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 0 603.81 0 0 0 0 0 0 603.81 0 0 1015585565 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 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 0 739.27 0 0 0 0 0 0 0 0 0 0 0 0 0 739.27 0 0 1015585665 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 78.09 0 0 0 0 0 0 78.09 0 0 1015585855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2107.65 0 0 0 0 0 0 0 0 0 0 0 0 0 2107.65 0 0 1015585977 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 1015585981 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3700.34 0 0 0 0 0 0 0 0 0 0 0 0 0 3700.34 0 0 1015586823 1255903209 16 Nurse Practitioners STRAUBE JODI M 999999999 53 Kane 0 0 0 0 0 4 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 11 0 0 0 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 1015587341 1376906370 10 Physicians WITKOWSKI JULIE E 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 1250.4 0 0 0 0 0 0 1250.4 0 0 1015587370 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 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 0 121.46 0 0 0 0 0 0 121.46 0 0 1015587412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6133.19 0 0 0 0 0 0 0 0 0 0 0 0 0 6133.19 0 0 1015587452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8775.87 0 0 0 0 0 0 0 0 0 0 0 0 0 8775.87 0 0 1015587600 92 Waiver service provider--Disability (DHS/DRS) 84 Pope 0 0 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 36532.7 0 0 0 0 0 0 0 0 0 0 0 0 0 36532.7 0 0 1015588247 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 4378.33 0 0 0 0 0 0 0 0 0 0 0 0 0 4378.33 0 0 1015629792 1023609005 16 Nurse Practitioners KIM MICHAEL 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 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 46.75 0 0 0 0 0 0 0 0 117.23 0 0 0 0 0 0 163.98 0 0 1015629810 1164953295 10 Physicians KRAWITZ BRIAN 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 4 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.68 0 6077.95 0 0 0 0 0 0 6119.63 0 0 1015630014 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4577.07 0 0 0 0 0 0 0 0 0 0 0 0 0 4577.07 0 0 1015630084 1801162078 10 Physicians MOHAMMED ABDUS SAMI 999999999 80 Peoria 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 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 1075.32 0 0 0 0 0 0 1075.32 0 0 1015630459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20662.66 0 0 0 0 0 0 0 0 0 0 0 0 0 20662.66 0 0 1015630582 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 49.22 0 0 0 0 0 0 49.22 0 0 1015630703 1447670468 10 Physicians MALCOLM TENNISON L 999999999 30 DuPage 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 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 4266.58 0 0 0 0 0 0 4266.58 0 0 1015630789 1417311838 10 Physicians MARTIN SOOYOUNG S 999999999 109 Winnebago 0 0 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 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148.12 0 106.8 0 0 0 0 0 0 254.92 0 0 1015631033 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 0 113.66 0 0 0 0 0 0 0 0 113.66 0 0 1015631125 13 Podiatrists 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 0 0 0 0 0 0 0 0 0 0 1015631147 90 Waiver service provider--Elderly (DOA) 200 Cook 0 0 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 1159.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1159.53 0 0 1015631322 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6062.96 0 0 0 0 0 0 0 0 0 0 0 0 0 6062.96 0 0 1015631517 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 554.8 0 0 0 0 0 0 0 0 0 0 0 0 0 554.8 0 0 1015632342 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 72.18 0 0 0 0 0 0 0 0 0 0 0 0 0 72.18 0 0 1015632721 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5349.05 0 0 0 0 0 0 0 0 0 0 0 0 0 5349.05 0 0 1015632786 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 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 0 569.61 0 0 0 0 0 0 0 0 0 0 0 0 0 569.61 0 0 1015633292 1477543460 16 Nurse Practitioners HANSON CHARLES E 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 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 0 565.3 0 0 0 0 0 0 565.3 0 0 1015633475 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1430.7 0 0 0 0 0 0 0 0 0 0 0 0 0 1430.7 0 0 1015633493 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 1015633514 1881149078 10 Physicians HALASAN CAROL 999999999 200 Cook 0 0 Internal Medicine 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 0 268 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 0 187.84 0 0 0 0 0 0 187.84 0 0 1015633669 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 86.97 0 0 0 0 0 0 86.97 0 0 1015634549 1053988436 16 Nurse Practitioners NAGLAK CARYN 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911.41 0 0 0 0 0 0 911.41 0 0 1015634646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2805.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2805.55 0 0 1015634770 1003401498 16 Nurse Practitioners BROWN CARA R 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 0 144.09 0 0 0 0 0 0 144.09 0 0 1015634961 1053982942 11 Dentists QUINTANA PALOMA 999999999 200 Cook 0 0 General Dentistry 0 0 99 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 12324.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12324.44 0 0 1015635993 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 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.67 0 0 0 0 0 0 139.67 0 0 1015636028 72 Taxicabs and Livery Companies 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 87.62 0 0 0 0 0 0 87.62 0 0 1015636273 1982290276 70 Ambulance Service Providers HAMILTON COUNTY AMBULANCE SERV 999999999 41 Hamilton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 4.72 0 0 0 0 0 0 4.72 0 0 1015636454 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1015636882 10 Physicians 19 Champaign 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 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 16.1 0 741.48 0 0 0 0 0 0 757.58 0 0 1015637079 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 53.1 0 0 0 0 0 0 53.1 0 0 1015637183 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 1748.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1748.04 0 0 1015637276 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 0 194.85 194.85 0 0 1015637578 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 322.87 0 0 0 0 0 0 0 0 0 0 0 0 0 322.87 0 0 1015637698 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 7622.21 0 0 0 0 0 0 0 0 0 0 0 0 0 7622.21 0 0 1015638069 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 11.05 0 0 0 0 0 0 11.05 0 0 1015638140 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54.19 0 0 0 0 0 0 54.19 0 0 1015638209 22 Physical 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 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 62.76 62.76 0 0 1015638470 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 540.79 0 0 0 0 0 0 0 0 0 0 0 0 0 540.79 0 0 1015638741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2292.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2292.19 0 0 1015638870 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4747.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4747.64 0 0 1015638901 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17858.91 0 0 0 0 0 0 0 0 0 0 0 0 0 17858.91 0 0 1015639374 10 Physicians 30 DuPage 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015639472 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522.9 0 0 0 0 0 0 0 0 0 0 0 0 0 522.9 0 0 1015639557 10 Physicians 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015639708 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 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 0 716.1 0 0 0 0 0 0 0 0 0 0 0 0 0 716.1 0 0 1015639862 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12490.71 0 0 0 0 0 0 0 0 0 0 0 0 0 12490.71 0 0 1015639922 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 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 4954.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4954.34 0 0 1015640056 1043882590 16 Nurse Practitioners HOEHN KELSEY 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 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 1417.07 0 0 0 0 0 0 1417.07 0 0 1015640245 1427444884 10 Physicians HINTZ ADAM 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 0 617.12 0 0 0 0 0 0 617.12 0 0 1015640578 1699930834 16 Nurse Practitioners KELLEY LETICIA M 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.46 0 0 0 0 0 0 144.46 0 0 1015640766 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015640835 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5616.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5616.4 0 0 1015641078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 397.12 0 0 0 0 0 0 0 0 0 0 0 0 0 397.12 0 0 1015641262 10 Physicians 200 Cook 0 0 Internal Medicine 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 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60.84 0 0 0 0 0 0 60.84 0 0 1015641326 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 0 0 0 0 0 0 0 0 0 0 1015641355 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2180.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2180.84 0 0 1015641378 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 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 0 661.84 0 0 0 0 0 0 0 0 0 0 0 0 0 661.84 0 0 1015641666 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 1015641997 12 Optometrists 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 81.52 0 0 0 0 0 0 81.52 0 0 1015642207 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 1831.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1831.43 0 0 1015642208 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2645.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2645.36 0 0 1015642226 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1302.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1302.4 0 0 1015642675 1992736425 63 Other Providers of Medical Equipment/Supplies (Non-registered) TOTAL MEDICAL SUPPLY INC 999999999 845 Texas 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 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 2895.96 0 0 0 0 0 0 2895.96 0 0 1015642848 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8557.05 0 0 0 0 0 0 0 0 0 0 0 0 0 8557.05 0 0 1015643457 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2140.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2140.1 0 0 1015643686 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 1015643932 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5189.92 0 0 0 0 0 0 0 0 0 0 0 0 0 5189.92 0 0 1015644162 1528562972 10 Physicians BREWER MATTHEW 999999999 10 Adams 0 0 Emergency 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 0 114 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 2655.5 0 0 0 0 0 0 2655.5 0 0 1015644699 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015644749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9144.26 0 0 0 0 0 0 0 0 0 0 0 0 0 9144.26 0 0 1015644834 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.06 0 0 0 0 0 0 17.06 0 0 1015645355 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 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 0 365.73 365.73 0 0 1015645513 1508347725 10 Physicians BALSA GUERRERO JOSE 60612 200 Cook 0 0 Internal Medicine 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 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 0 0 0 0 0 0 0 0 0 0 1015645619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2943.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2943.12 0 0 1015645799 1043297401 30 General Hospitals INSIGHT HOSPITAL & MEDICAL CEN 606162315 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 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 0 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28539.7 0 0 0 0 0 0 0 0 0 28539.7 0 0 1015646178 10 Physicians 81 Perry 0 0 0 0 0 0 0 0 0 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 0 433.92 0 0 0 0 0 0 433.92 0 0 1015646683 1083895379 10 Physicians GARCIA-ROJAS XAVIER 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.89 0 0 0 0 0 0 0 0 75.89 0 0 1015646856 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 2564.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2564.1 0 0 1015646938 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015647042 1760052260 16 Nurse Practitioners KELLY 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 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 0 413.82 0 0 0 0 0 0 413.82 0 0 1015647056 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2440.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2440.3 0 0 1015647068 1437543766 10 Physicians MERCER RONALD W 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 103 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1807.09 0 211.4 0 0 0 0 0 0 2018.49 0 0 1015647401 1962074898 16 Nurse Practitioners MILLER MATTHEW J 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 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 0 810.1 0 0 0 0 0 0 810.1 0 0 1015647537 1952438137 10 Physicians KHAULI RAJA 999999999 19 Champaign 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.15 0 1777.33 0 0 0 0 0 0 1784.48 0 0 1015647605 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 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 0 169.98 169.98 0 0 1015647664 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 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 0 433.56 0 0 0 0 0 0 0 0 0 0 0 0 0 433.56 0 0 1015647761 1952807513 10 Physicians TRZCINSKI BRETT 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 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 0 300.51 0 0 0 0 0 0 300.51 0 0 1015648093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1531.42 0 0 0 0 0 0 0 0 0 0 0 0 0 1531.42 0 0 1015648483 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4380.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4380.03 0 0 1015648508 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1319.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1319.19 0 0 1015648538 1992755896 10 Physicians NAZARIO ILKA 999999999 200 Cook 0 0 Internal 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 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 0 367.53 0 0 0 0 0 0 367.53 0 0 1015648692 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015648822 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9779.16 0 0 0 0 0 0 0 0 0 0 0 0 0 9779.16 0 0 1015649412 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2493.93 0 0 0 0 0 0 0 0 0 0 0 0 0 2493.93 0 0 1015649500 1073278404 91 Waiver service provider--Adults (DHS/DDD) MOORE SCOTT A 999999999 36 Franklin 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5707.2 0 0 0 0 0 0 0 0 0 0 0 0 0 5707.2 0 0 1015649501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 117.13 0 0 0 0 0 0 0 0 0 0 0 0 0 117.13 0 0 1015650152 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 972.95 0 0 0 0 0 0 0 0 0 0 0 0 0 972.95 0 0 1015650169 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 667.48 0 0 0 0 0 0 0 0 0 0 0 0 0 667.48 0 0 1015650315 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 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 3183.28 3183.28 0 0 1015650487 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 46.45 0 0 0 0 0 0 46.45 0 0 1015650620 31 Psychiatric Hospitals 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 1015651153 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 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 21792.21 0 0 0 0 0 0 0 0 0 0 0 0 0 21792.21 0 0 1015651527 1588963375 10 Physicians WILLIAMS JOSHUA ADAM 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1015651604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2135.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2135.78 0 0 1015651654 1285075820 10 Physicians SHARAIN KOROSH 999999999 200 Cook 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 0 206 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 2301.05 0 0 0 0 0 0 2301.05 0 0 1015651709 1447826300 55 Early Intervention Services RAMIREZ STEPHANIE 999999999 91 Sangamon 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 0 349 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 20147 0 0 0 0 0 0 20147 0 0 1015651873 1508271149 10 Physicians ANAND NEIL 999999999 200 Cook 0 0 0 0 0 0 0 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 0 372.1 0 0 0 0 0 0 0 0 372.1 0 0 1015652027 1699269274 10 Physicians SCHIAZZA SARAH 999999999 40 Grundy 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 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 1426.58 0 0 0 0 0 0 1426.58 0 0 1015652132 89 Physician Assistant Only(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1015652167 1609412410 16 Nurse Practitioners FAPOHUNDA OLALEKAN M 999999999 30 DuPage 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 0 737.06 0 0 0 0 0 0 737.06 0 0 1015652188 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 0 341.06 0 0 0 0 0 0 341.06 0 0 1015652484 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 750.88 0 0 0 0 0 0 0 0 0 0 0 0 0 750.88 0 0 1015652507 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 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 1719.54 0 0 0 0 0 0 0 0 0 0 0 0 0 1719.54 0 0 1015653011 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1020.69 0 0 0 0 0 0 0 0 0 0 0 0 0 1020.69 0 0 1015653832 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9659.71 0 0 0 0 0 0 0 0 0 0 0 0 0 9659.71 0 0 1015653904 1972176212 16 Nurse Practitioners RILEY DARRYELLE 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 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 0 584.84 0 0 0 0 0 0 584.84 0 0 1015653906 10 Physicians 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 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 1015653956 1477179927 16 Nurse Practitioners BAIETTO REBECCA 999999999 91 Sangamon 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 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 32.15 0 0 0 0 0 0 0 0 483.81 0 0 0 0 0 0 515.96 0 0 1015654037 1417162819 10 Physicians GUGLIELMI ANDREW 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.93 0 0 0 0 0 0 0 0 108.93 0 0 1015655101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2162.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2162.3 0 0 1015655142 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7211.76 0 0 0 0 0 0 0 0 0 0 0 0 0 7211.76 0 0 1015655194 1144897547 16 Nurse Practitioners KUTHE MARGUERITE 999999999 57 Lake 0 0 0 0 0 0 0 0 0 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 0 400.69 0 0 0 0 0 0 400.69 0 0 1015655581 1588167977 30 General Hospitals RENPRO RENAL SERVICES 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 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 0 295 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1987 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37961.89 0 0 0 0 0 37961.89 0 0 1015655855 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 455.69 0 0 0 0 0 0 0 0 0 0 0 0 0 455.69 0 0 1015655868 1629050554 10 Physicians PAPA-RUGINO TOMMASINA 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 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 45.82 0 0 0 0 0 0 45.82 0 0 1015655962 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 0 273 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 20629.44 0 0 0 0 0 0 0 0 0 0 0 0 0 20629.44 0 0 1015656048 1699439752 16 Nurse Practitioners EDOIGIAWERIE OLUWAKEMI 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 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 0 240.69 0 0 0 0 0 0 240.69 0 0 1015656570 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7323.75 0 0 0 0 0 0 0 0 0 0 0 0 0 7323.75 0 0 1015656620 1962899690 10 Physicians CALDWELL JOHN P 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 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 1015656648 1548833197 16 Nurse Practitioners JOSLIN JACOB 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 113.42 0 0 0 0 0 0 113.42 0 0 1015657149 10 Physicians 91 Sangamon 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 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0 1015659263 91 Waiver service provider--Adults (DHS/DDD) 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 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 1110.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1110.12 0 0 1015659618 1285219758 16 Nurse Practitioners BROWN CURTIS T 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 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 0 232.32 0 0 0 0 0 0 232.32 0 0 1015659905 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 687.83 0 0 0 0 0 0 0 0 0 0 0 0 0 687.83 0 0 1015659980 28 Waiver service provider--Supportive living facility (HFS) 34 Fayette 0 0 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 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36696.99 0 0 0 0 0 0 0 0 0 0 0 0 0 36696.99 0 0 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0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1015660796 1538759832 63 Other Providers of Medical Equipment/Supplies (Non-registered) ILLINOIS SW ORTHOPEDICS 999999999 65 Madison 0 0 0 0 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 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 0 148.7 0 622.58 0 0 0 0 771.28 0 0 1015661142 1801440433 16 Nurse Practitioners KARONES YANG RITA 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 0 883.7 0 0 0 0 0 0 883.7 0 0 1015661909 10 Physicians 80 Peoria 0 0 Pediatrics 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 0 139.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.04 0 0 1015661964 1659979987 63 Other Providers of Medical Equipment/Supplies (Non-registered) ARCADIA CARE CLIFTON 999999999 46 Iroquois 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 181.87 0 0 1015663169 1003363979 65 Independent Diagnostic Testing Facility (IDTF) HEART MED LLC 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 86.04 0 0 0 0 0 0 0 0 86.04 0 0 1015663220 1992098735 10 Physicians DOLEHIDE CONOR 999999999 200 Cook 0 0 Dermatology 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 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109.31 0 0 0 0 0 0 109.31 0 0 1015663731 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015663827 1508284266 10 Physicians TSENG YU-SHAN 999999999 19 Champaign 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 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 3299.47 0 0 0 0 0 0 3299.47 0 0 1015663951 1447247671 16 Nurse Practitioners SAN PEDRO RICARDO A 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245.35 0 0 0 0 0 0 245.35 0 0 1015663999 1871947515 10 Physicians EL-ATOUM MOHAMMAD 999999999 10 Adams 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 0 160 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 0 324.94 0 0 0 0 0 0 324.94 0 0 1015664471 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.06 0 0 0 0 0 0 0 0 0 0 0 0 0 50.06 0 0 1015664796 1831589274 16 Nurse Practitioners KEVIN KRISTINA 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 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 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service provider--Elderly (DOA) CENTRAL ILLINOIS CARE SERVICES 999999999 33 Effingham 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35708.4 0 0 0 0 0 0 0 0 0 0 0 0 0 35708.4 0 0 1015666020 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 1015666048 1811579360 86 Clinical Social Worker(Encounter Only) PASHIA KRISTIN N 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 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 0 152.13 0 0 0 0 0 0 152.13 0 0 1015666053 1235719162 16 Nurse Practitioners FERSZT PETER A 999999999 24 Coles 0 0 0 0 0 0 0 0 0 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 1567.47 0 0 0 0 0 0 1567.47 0 0 1015666129 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1921.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.36 0 0 1015666432 1225490840 10 Physicians WANG JAMES 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 0 924.6 0 0 0 0 0 0 924.6 0 0 1015666460 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2143.93 0 0 0 0 0 0 0 0 0 0 0 0 0 2143.93 0 0 1015666846 1376905794 10 Physicians SIRAJEE SHAFAT 999999999 91 Sangamon 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 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 1430.94 0 0 0 0 0 0 1430.94 0 0 1015667233 1104310929 13 Podiatrists SORENSEN TYLER K 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 0 696.96 0 0 0 0 0 0 696.96 0 0 1015667330 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137.66 0 0 0 0 0 0 0 0 0 0 0 0 0 137.66 0 0 1015667352 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2075.7 0 0 0 0 0 0 0 0 0 0 0 0 0 2075.7 0 0 1015667505 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2170.4 0 0 0 0 0 0 0 0 0 0 0 0 0 2170.4 0 0 1015667647 11 Dentists 200 Cook 0 0 General Dentistry 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 0 206.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.9 0 0 1015667922 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 1015668494 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 72.13 0 0 0 0 0 0 72.13 0 0 1015668728 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13643.13 0 0 0 0 0 0 0 0 0 0 0 0 0 13643.13 0 0 1015669091 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 74 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 9312.25 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 10064.95 0 0 1015677400 1336670801 10 Physicians PATEL KEVIN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.97 0 565.53 0 0 0 0 0 0 676.5 0 0 1015677815 1811104961 10 Physicians TAYLOR SHERRI 999999999 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390.35 0 7.9 0 0 0 0 0 0 398.25 0 0 1015678062 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1269.44 0 0 0 0 0 0 0 0 0 0 0 0 0 1269.44 0 0 1015678185 1730166224 30 General Hospitals INSIGHT HOSPITAL & MEDICAL CEN 606162315 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 446 0 0 0 0 23 0 0 0 168 0 0 0 0 0 0 0 0 0 565 0 0 0 0 25 0 0 0 232 0 0 0 0 0 0 0 0 0 565 0 0 0 0 199 0 0 0 234 0 0 0 0 0 0 0 0 0 52903.09 0 0 0 0 47836.43 0 0 0 19253.33 0 0 0 0 0 119992.85 0 0 1015678289 1770873242 10 Physicians MCCONNELL PHILLIP D 999999999 200 Cook 0 0 Emergency 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 0 180.12 0 0 0 0 0 0 180.12 0 0 1015678391 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 72.22 0 0 0 0 0 0 72.22 0 0 1015678554 10 Physicians 109 Winnebago 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 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0 0 0 0 0 0 0 0 0 0 0 0 4523.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4523.03 0 0 1015679385 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4538.31 0 0 0 0 0 0 0 0 0 0 0 0 0 4538.31 0 0 1015679457 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 0 0 0 0 0 0 0 0 0 0 1015679517 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34.16 0 0 0 0 0 0 34.16 0 0 1015679629 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1212.68 0 0 0 0 0 0 0 0 0 0 0 0 0 1212.68 0 0 1015679670 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 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 0 618.41 0 0 0 0 0 0 0 0 0 0 0 0 0 618.41 0 0 1015679689 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119.35 0 0 0 0 0 0 0 0 0 0 0 0 0 119.35 0 0 1015680010 1962490201 10 Physicians SADIQ SMITHA 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 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 44.98 0 0 0 0 0 0 44.98 0 0 1015680043 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12211.79 0 0 0 0 0 0 0 0 0 0 0 0 0 12211.79 0 0 1015680109 1013588607 89 Physician Assistant Only(Encounter Only) PEDIAN AUSTINAH 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 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 0 245.56 0 0 0 0 0 0 245.56 0 0 1015680265 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 879.84 0 0 0 0 0 0 0 0 0 0 0 0 0 879.84 0 0 1015680665 1871163030 33 Nursing Facilities BEACON CARE AND REHABILITATION 999999999 200 Cook 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 0 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3037 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 426564.64 0 0 0 0 0 0 0 426564.64 0 0 1015681600 1386617223 10 Physicians CARLSON SIMON 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 27 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 0 186.14 0 45.29 0 0 0 0 0 0 231.43 0 0 1015681646 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2166.98 0 0 0 0 0 0 0 0 0 0 0 0 0 2166.98 0 0 1015681889 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 31.76 0 0 0 0 0 0 31.76 0 0 1015682068 1760900047 16 Nurse Practitioners STREICH VALERIE 999999999 91 Sangamon 0 0 0 0 0 1 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 12.8 0 0 0 0 0 0 0 0 378.15 0 0 0 0 0 0 390.95 0 0 1015682333 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 740.23 0 0 0 0 0 0 0 0 0 0 0 0 0 740.23 0 0 1015683241 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1362.76 0 0 0 0 0 0 0 0 0 0 0 0 0 1362.76 0 0 1015683355 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7696.46 0 0 0 0 0 0 0 0 0 0 0 0 0 7696.46 0 0 1015683442 1750900692 22 Physical Therapists DIETRICH CHRISTOPHER 999999999 10 Adams 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 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 0 635.31 635.31 0 0 1015683458 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 1015683492 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1837.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1837.49 0 0 1015683991 89 Physician Assistant Only(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 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 0 156.29 0 0 0 0 0 0 156.29 0 0 1015684064 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 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 0 781.59 0 0 0 0 0 0 781.59 0 0 1015684076 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015684090 1528416401 10 Physicians BRISCOE KRISTIN 999999999 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 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 2379.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2379.72 0 0 1015685390 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2882.13 0 0 0 0 0 0 0 0 0 0 0 0 0 2882.13 0 0 1015685887 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 1015686183 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 0 192.48 0 0 0 0 0 0 0 0 0 0 0 0 0 192.48 0 0 1015686238 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4486.99 0 0 0 0 0 0 0 0 0 0 0 0 0 4486.99 0 0 1015687097 1295120517 10 Physicians PELEG YONATAN 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 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 0 338.98 0 0 0 0 0 0 338.98 0 0 1015687719 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 1015687722 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.34 0 0 0 0 0 0 0 0 0 0 0 0 0 4042.34 0 0 1015687778 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 35.95 0 0 0 0 0 0 0 0 35.95 0 0 1015688094 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132.84 0 0 0 0 0 0 0 0 0 0 0 0 0 132.84 0 0 1015688219 1932587003 10 Physicians MCTABI OMAR 999999999 200 Cook 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 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 1332.37 0 0 0 0 0 0 1332.37 0 0 1015688297 1528615101 89 Physician Assistant Only(Encounter Only) LA MICHAEL 999999999 71 McHenry 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 0 402.67 0 0 0 0 0 0 402.67 0 0 1015688600 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14215.08 0 0 0 0 0 0 0 0 0 0 0 0 0 14215.08 0 0 1015689082 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 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 15523.62 0 0 0 0 0 0 0 0 0 0 0 0 0 15523.62 0 0 1015689220 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2417.58 0 0 0 0 0 0 0 0 0 0 0 0 0 2417.58 0 0 1015689275 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 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 1067.25 0 0 0 0 0 0 1067.25 0 0 1015689283 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 1015689517 10 Physicians 10 Adams 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015690501 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 856.32 0 0 0 0 0 0 0 0 0 0 0 0 0 856.32 0 0 1015690560 1457865669 24 Speech Therapists OLUWANDE OLUSOLA 999999999 53 Kane 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 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 3261.84 3261.84 0 0 1015690924 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 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 1015691003 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 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 2441.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2441.25 0 0 1015691027 1265674691 10 Physicians NAGENDRAN KRISHNA 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 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 37.01 0 0 0 0 0 0 37.01 0 0 1015691062 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 1015691838 1386318798 16 Nurse Practitioners DOUGLAS KERRI 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 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 93.72 0 0 0 0 0 0 93.72 0 0 1015691875 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 25.65 0 0 0 0 0 0 25.65 0 0 1015691929 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9300.49 0 0 0 0 0 0 0 0 0 0 0 0 0 9300.49 0 0 1015692015 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 62.74 0 0 0 0 0 0 62.74 0 0 1015692081 1447820824 55 Early Intervention Services DAVIS SARAH D 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 0 103 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 5615.93 0 0 0 0 0 0 5615.93 0 0 1015692122 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 303.85 0 0 0 0 0 0 0 0 0 0 0 0 0 303.85 0 0 1015692367 1992397467 16 Nurse Practitioners BROZEK CATHERINE A 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 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 4092 0 0 0 0 0 0 4092 0 0 1015692682 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.34 0 0 0 0 0 0 78.34 0 0 1015692777 1902985534 87 Psychologist(Encounter Only) HANSEN WILLIAM 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 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 0 375.48 0 0 0 0 0 0 375.48 0 0 1015693359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5626.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5626.72 0 0 1015693396 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 1015693809 1417395062 10 Physicians HELLER MICHAEL B 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.02 0 398.58 0 0 0 0 0 0 410.6 0 0 1015694260 10 Physicians 80 Peoria 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 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 0 205.2 0 0 0 0 0 0 205.2 0 0 1015694397 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2095.47 0 0 0 0 0 0 0 0 0 0 0 0 0 2095.47 0 0 1015694536 1396310645 16 Nurse Practitioners NNAJIEGO ACHEBE ANENE A 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 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 0 311.54 0 0 0 0 0 0 311.54 0 0 1015694652 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 2853.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2853.6 0 0 1015694720 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 0 0 0 0 0 0 0 0 0 0 1015694929 1386175313 10 Physicians KING PAIGE E 999999999 53 Kane 0 0 0 0 0 1 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 22 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 22 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 92.98 0 2005.56 0 0 0 0 0 0 2203.5 0 0 1015695144 94 Waiver service provider--Children's support (DHS/DDD) 94 Shelby 0 0 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 1101.93 0 0 0 0 0 0 0 0 0 0 0 0 0 1101.93 0 0 1015695157 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 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 1015695342 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 329.21 0 0 0 0 0 0 0 0 0 0 0 0 0 329.21 0 0 1015695708 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 0 220.2 0 0 0 0 0 0 220.2 0 0 1015695997 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 0 109.95 0 0 0 0 0 0 109.95 0 0 1015696066 1831867936 16 Nurse Practitioners EVANS PATRICE 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 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 0 924.75 0 0 0 0 0 0 924.75 0 0 1015696177 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.84 0 0 0 0 0 0 151.84 0 0 1015696232 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1015696241 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 0 135.38 0 0 0 0 0 0 135.38 0 0 1015696261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7266.48 0 0 0 0 0 0 0 0 0 0 0 0 0 7266.48 0 0 1015696294 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 1015696561 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37023.9 0 0 0 0 0 0 0 0 0 0 0 0 0 37023.9 0 0 1015696849 1417310384 10 Physicians KEATING BENJAMIN 999999999 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 726.16 0 0 0 0 0 0 726.16 0 0 1015696860 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1015697084 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3476.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3476.22 0 0 1015699717 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3775.99 0 0 0 0 0 0 0 0 0 0 0 0 0 3775.99 0 0 1015699936 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 921.31 0 0 0 0 0 0 0 0 0 0 0 0 0 921.31 0 0 1015700313 1427437706 10 Physicians HRAD VALERY 999999999 80 Peoria 0 0 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Cook 0 0 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 0 781.44 0 0 0 0 0 0 0 0 0 0 0 0 0 781.44 0 0 1015711342 1386148427 10 Physicians ALIHODZIC EDIN 999999999 80 Peoria 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 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 0 243.94 0 0 0 0 0 0 243.94 0 0 1015711812 1174048250 10 Physicians LOHSE AUSTIN J 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 3 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4198.23 0 0 0 0 0 0 4198.23 0 0 1015711885 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7712.06 0 0 0 0 0 0 0 0 0 0 0 0 0 7712.06 0 0 1015712402 1932798881 16 Nurse Practitioners MIRANDA GUADALUPE 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183.87 0 0 0 0 0 0 0 0 0 0 0 0 0 183.87 0 0 1015715803 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2360.26 0 0 0 0 0 0 0 0 0 0 0 0 0 2360.26 0 0 1015716131 1912503798 22 Physical Therapists MORAN IRENE 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 0 105 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 0 806.37 806.37 0 0 1015716287 1245822923 22 Physical Therapists CHAPMAN TRAVIS 999999999 108 Williamson 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 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 0 319.15 319.15 0 0 1015716359 10 Physicians 91 Sangamon 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 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 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137.73 0 0 1015717938 1194189217 10 Physicians HICKEY ERIN 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 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 0 506.48 0 0 0 0 0 0 506.48 0 0 1015718188 1013512243 16 Nurse Practitioners AJIDE JOAN C 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 759.95 0 0 0 0 0 0 759.95 0 0 1015718218 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 83.23 0 0 0 0 0 0 83.23 0 0 1015718409 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 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 1404.84 1404.84 0 0 1015718411 10 Physicians 30 DuPage 0 0 Obstetric-Gynecology 0 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0 0 0 0 0 0 0 0 0 0 0 2956.54 0 0 0 0 0 0 0 0 0 0 0 0 0 2956.54 0 0 1015727226 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 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 1009.05 0 0 0 0 0 0 0 0 0 0 0 0 0 1009.05 0 0 1015727744 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11110.4 0 0 0 0 0 0 0 0 0 0 0 0 0 11110.4 0 0 1015727871 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13150.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.2 0 0 1015728501 1972125201 12 Optometrists YOON HANNAH 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 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 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MICHAEL 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 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 6009.72 0 0 0 0 0 0 6009.72 0 0 1015735101 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7775.72 0 0 0 0 0 0 0 0 0 0 0 0 0 7775.72 0 0 1015735172 1124414859 10 Physicians SPAHO LIDIA 999999999 53 Kane 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 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 2082.63 0 0 0 0 0 0 2082.63 0 0 1015735280 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 47.62 0 0 0 0 0 0 47.62 0 0 1015735752 1447601059 10 Physicians ALSAYED ALHARETH 999999999 106 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0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.44 95.44 0 0 1015736520 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 15518.01 0 0 0 0 0 0 0 0 0 0 0 0 0 15518.01 0 0 1015736922 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 1015736988 1114489408 22 Physical Therapists IP CALVIN K 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 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 0 593.93 593.93 0 0 1015737024 11 Dentists 200 Cook 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 555.55 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 1367.1 0 0 1015737445 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 0 303.8 0 0 0 0 0 0 0 0 0 0 0 0 0 303.8 0 0 1015737517 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 614.91 0 0 0 0 0 0 0 0 0 0 0 0 0 614.91 0 0 1015737609 1730678665 10 Physicians O'BRIEN DANIEL T 999999999 24 Coles 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 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 1578.7 0 0 0 0 0 0 1578.7 0 0 1015737708 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 0 134.44 0 0 0 0 0 0 134.44 0 0 1015738051 92 Waiver service 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1730672619 10 Physicians LORING CAROLINE 999999999 200 Cook 0 0 0 0 0 16 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 1204.11 0 0 0 0 0 0 0 0 806.71 0 0 0 0 0 0 2010.82 0 0 1015740051 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015740054 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 83.61 0 0 0 0 0 0 83.61 0 0 1015740172 1437734001 16 Nurse Practitioners FARRELL LIAM B 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 0 126 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 0 420.48 0 0 0 0 0 0 420.48 0 0 1015740394 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 1015740423 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4059 0 0 0 0 0 0 0 0 0 0 0 0 0 4059 0 0 1015740585 1699145599 11 Dentists LEE WOOJIN 999999999 200 Cook 0 0 0 0 28 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 4407.02 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4407.02 0 0 1015740602 1225629447 16 Nurse Practitioners DIETRICH JAY 999999999 80 Peoria 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 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 96.45 0 0 0 0 0 0 0 0 1967.07 0 0 0 0 0 0 2063.52 0 0 1015740653 1609407329 16 Nurse Practitioners HAVILAND KELLI MARIE 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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 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 1015761474 16 Nurse Practitioners 88 Richland 0 0 0 0 0 0 0 0 0 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 0 835.54 0 0 0 0 0 0 835.54 0 0 1015761737 16 Nurse Practitioners 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 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 0 179.78 0 0 0 0 0 0 179.78 0 0 1015761767 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 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 1015762185 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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HEYMAN TARYN 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 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 2371.17 0 0 0 0 0 0 2371.17 0 0 1015764192 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6170.12 0 0 0 0 0 0 0 0 0 0 0 0 0 6170.12 0 0 1015764283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5405.81 0 0 0 0 0 0 0 0 0 0 0 0 0 5405.81 0 0 1015764604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 258.46 0 0 0 0 0 0 0 0 0 0 0 0 0 258.46 0 0 1015765273 1245720671 10 Physicians JOSEPH MELWIN 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 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 1836.12 0 0 0 0 0 0 1836.12 0 0 1015765928 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 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 27.25 0 0 0 0 0 0 27.25 0 0 1015766152 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 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 6612.81 0 0 0 0 0 0 0 0 0 0 0 0 0 6612.81 0 0 1015766226 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 0 195.87 0 0 0 0 0 0 0 0 0 0 0 0 0 195.87 0 0 1015766482 92 Waiver service provider--Disability (DHS/DRS) 91 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0 0 0 0 0 0 49.55 0 0 1015770136 1548725799 16 Nurse Practitioners WABOMNOR GRACE N 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 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 0 382.8 0 0 0 0 0 0 382.8 0 0 1015770210 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 0 219.56 0 0 0 0 0 0 219.56 0 0 1015770213 1659443810 16 Nurse Practitioners REYNOLDS CHRISTINE M 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 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 0 269.89 0 0 0 0 0 0 269.89 0 0 1015770304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 47.27 0 0 0 0 0 0 0 0 0 0 0 0 0 47.27 0 0 1015770669 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8803.13 0 0 0 0 0 0 0 0 0 0 0 0 0 8803.13 0 0 1015770812 1619547353 16 Nurse Practitioners GRAVES SHANNON N 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 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 0 275.28 0 0 0 0 0 0 275.28 0 0 1015771067 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1699.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1699.04 0 0 1015771069 10 Physicians 19 Champaign 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 1015771101 10 Physicians 200 Cook 0 0 0 0 0 0 0 0 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0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3617.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3617.94 0 0 1015773799 10 Physicians 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 55.71 0 0 0 0 0 0 55.71 0 0 1015773981 1033505367 10 Physicians WILLARD SARAH J 999999999 19 Champaign 0 0 0 0 0 6 0 0 0 0 0 0 9 0 27 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 17 0 42 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 17 0 42 0 0 0 0 0 0 0 0 0 545.76 0 0 0 0 0 0 62.76 0 1024.22 0 0 0 0 0 0 1632.74 0 0 1015774048 16 Nurse Practitioners 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.18 0 0 0 0 0 0 156.18 0 0 1015774398 1023689064 23 Occupational Therapists COOK CYNTHIA A 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 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 2668.05 2668.05 0 0 1015774829 1669521480 10 Physicians BLANKS RICHARD 999999999 19 Champaign 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 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 0 866.07 0 0 0 0 0 0 866.07 0 0 1015774953 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 14.88 0 0 0 0 0 0 14.88 0 0 1015775027 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7144.71 0 0 0 0 0 0 0 0 0 0 0 0 0 7144.71 0 0 1015775040 1902415797 22 Physical Therapists SMELSER MEGAN 999999999 83 Pike 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 0 190.28 190.28 0 0 1015775166 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11329.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11329.96 0 0 1015775208 22 Physical Therapists 55 Kendall 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 0 701.46 701.46 0 0 1015775461 1689348922 16 Nurse Practitioners MCKINNEY KATHLEEN 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 67.22 0 0 0 0 0 0 67.22 0 0 1015775805 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97.86 0 0 0 0 0 0 97.86 0 0 1015775980 1033597554 10 Physicians BUI DUAT 999999999 82 Piatt 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 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 2988.74 0 0 0 0 0 0 2988.74 0 0 1015776121 1548242738 89 Physician Assistant Only(Encounter Only) SOARE SEAN C 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 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 1015776445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1810.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1810.4 0 0 1015776710 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 0 238.7 0 0 0 0 0 0 0 0 0 0 0 0 0 238.7 0 0 1015777151 10 Physicians 53 Kane 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 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 0 362.38 0 0 0 0 0 0 362.38 0 0 1015777217 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 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 87.57 0 0 0 0 0 0 87.57 0 0 1015777275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.82 0 0 0 0 0 0 0 0 0 0 0 0 0 178.82 0 0 1015777465 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 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 0 801.85 0 0 0 0 0 0 801.85 0 0 1015777470 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51.35 0 0 0 0 0 0 0 0 0 0 0 0 0 51.35 0 0 1015777616 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 251.41 0 0 0 0 0 0 0 0 0 0 0 0 0 251.41 0 0 1015777927 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8384.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8384.88 0 0 1015778052 1093485948 16 Nurse Practitioners WILLIAMS ERIN D 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 0 537.95 0 0 0 0 0 0 537.95 0 0 1015778315 1871028423 10 Physicians SYED NAUSHEEN 999999999 200 Cook 0 0 Family Practice 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 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 0 775.27 0 0 0 0 0 0 775.27 0 0 1015778357 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 945.75 0 0 0 0 0 0 0 0 0 0 0 0 0 945.75 0 0 1015778509 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10187.13 0 0 0 0 0 0 0 0 0 0 0 0 0 10187.13 0 0 1015778558 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1231.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1231.47 0 0 1015778560 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1421.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1421.3 0 0 1015778626 10 Physicians 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 62.74 0 0 0 0 0 0 62.74 0 0 1015778990 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1888.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.48 0 0 1015778995 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10279.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10279.06 0 0 1015779289 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7082.97 0 0 0 0 0 0 0 0 0 0 0 0 0 7082.97 0 0 1015779413 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 12130.82 0 0 0 0 0 0 0 0 0 0 0 0 0 12130.82 0 0 1015779936 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 295.2 0 0 0 0 0 0 0 0 0 0 0 0 0 295.2 0 0 1015780063 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 34.22 0 0 0 0 0 0 0 0 34.22 0 0 1015780414 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 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 2167.83 0 0 0 0 0 0 0 0 0 0 0 0 0 2167.83 0 0 1015780778 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 867.32 0 0 0 0 0 0 0 0 0 0 0 0 0 867.32 0 0 1015780911 1194106575 10 Physicians KONCAREVIC ANGELLA E 999999999 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167.61 0 0 0 0 0 0 167.61 0 0 1015780931 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2235.39 0 0 0 0 0 0 0 0 0 0 0 0 0 2235.39 0 0 1015781054 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 1015781182 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 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 4675.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4675.02 0 0 1015781261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7572.84 0 0 0 0 0 0 0 0 0 0 0 0 0 7572.84 0 0 1015781327 1073102125 16 Nurse Practitioners AMLANI SANA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 1201.68 0 0 0 0 0 0 1201.68 0 0 1015781459 14 Chiropractors 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 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 51.95 0 0 0 0 0 0 51.95 0 0 1015781625 1447843172 16 Nurse Practitioners WALKER MORGAN 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 306.68 0 0 0 0 0 0 306.68 0 0 1015781699 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2246.4 0 0 0 0 0 0 0 0 0 0 0 0 0 2246.4 0 0 1015781852 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 0 245.02 0 0 0 0 0 0 245.02 0 0 1015782044 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 0 120.95 0 0 0 0 0 0 120.95 0 0 1015782081 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4049.65 0 0 0 0 0 0 0 0 0 0 0 0 0 4049.65 0 0 1015782305 1417153651 10 Physicians BISGROVE JOANNA T 999999999 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 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 47.77 0 0 0 0 0 0 47.77 0 0 1015782744 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5491.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5491.64 0 0 1015783081 1497027064 10 Physicians SINGH SWATI 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 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 83.45 0 0 0 0 0 0 83.45 0 0 1015783220 1538663455 25 Audiologists SHEHORN JAMES 999999999 200 Cook 0 0 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 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2077.29 2077.29 0 0 1015783647 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2308.88 0 0 0 0 0 0 0 0 0 0 0 0 0 2308.88 0 0 1015783701 10 Physicians 80 Peoria 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237.74 0 0 0 0 0 0 237.74 0 0 1015784431 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 0 258.4 0 0 0 0 0 0 258.4 0 0 1015784478 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 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 0 385.12 0 0 0 0 0 0 385.12 0 0 1015784658 1679169015 16 Nurse Practitioners ACOSTA JESSICA 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 1390.53 0 0 0 0 0 0 1390.53 0 0 1015784764 1386226413 11 Dentists RASHID FAKHRA 999999999 200 Cook 0 0 General Dentistry 0 0 28 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 3223.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3223.86 0 0 1015784774 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1093.3 0 0 0 0 0 0 0 0 0 0 0 0 0 1093.3 0 0 1015784814 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9157.36 0 0 0 0 0 0 0 0 0 0 0 0 0 9157.36 0 0 1015784849 16 Nurse Practitioners 106 Whiteside 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 0 303.63 0 0 0 0 0 0 310.03 0 0 1015784918 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5188.22 0 0 0 0 0 0 0 0 0 0 0 0 0 5188.22 0 0 1015785730 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6182.26 0 0 0 0 0 0 0 0 0 0 0 0 0 6182.26 0 0 1015786008 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 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 10877.1 0 0 0 0 0 0 0 0 0 0 0 0 0 10877.1 0 0 1015786532 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 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 1015786552 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10535.72 0 0 0 0 0 0 0 0 0 0 0 0 0 10535.72 0 0 1015786750 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.31 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.31 0 0 1015787240 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 47.62 0 0 0 0 0 0 47.62 0 0 1015787330 1922489327 10 Physicians LAMB BRYAN PATRICK 999999999 53 Kane 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 1032.3 0 0 0 0 0 0 1032.3 0 0 1015787353 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7194.7 0 0 0 0 0 0 0 0 0 0 0 0 0 7194.7 0 0 1015787489 1336644228 10 Physicians BHATT JENNY 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 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 0 408.35 0 0 0 0 0 0 408.35 0 0 1015787490 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1147.15 0 0 1015787997 1386031391 10 Physicians DHAR ABHISHEK 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 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 0 480.37 0 0 0 0 0 0 480.37 0 0 1015788282 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1196.84 0 0 0 0 0 0 0 0 0 0 0 0 0 1196.84 0 0 1015788668 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.4 0 0 0 0 0 0 100.4 0 0 1015788719 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1024.51 0 0 0 0 0 0 0 0 0 0 0 0 0 1024.51 0 0 1015788813 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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1932634763 10 Physicians AGUILA ELIZABETH 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 0 114 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 1600.15 0 0 0 0 0 0 1600.15 0 0 1015802080 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8334.1 0 0 0 0 0 0 0 0 0 0 0 0 0 8334.1 0 0 1015802791 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1015802844 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9238.4 0 0 0 0 0 0 0 0 0 0 0 0 0 9238.4 0 0 1015802915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1942.13 0 0 0 0 0 0 0 0 0 0 0 0 0 1942.13 0 0 1015803137 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 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280.52 0 0 0 0 0 0 280.52 0 0 1015803154 1881215622 61 Independent Laboratories BRIDGE DIAGNOSTICS 999999999 805 California 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1265.54 0 0 0 0 0 0 0 0 1265.54 0 0 1015803275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10931.43 0 0 0 0 0 0 0 0 0 0 0 0 0 10931.43 0 0 1015803306 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 905.7 0 0 0 0 0 0 0 0 0 0 0 0 0 905.7 0 0 1015803318 1295260735 10 Physicians AOUAD PASCALE J 999999999 200 Cook 0 0 Radiology Diagnosis 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 0 208 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 1866.68 0 0 0 0 0 0 0 0 1866.68 0 0 1015803358 1588156392 10 Physicians STIBITZ KRISTINA E 999999999 53 Kane 0 0 Pediatrics 0 0 0 30 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 3563.44 0 0 0 0 0 0 0 0 1953.67 0 0 0 0 0 0 5517.11 0 0 1015803594 1477570166 60 Pharmacies GIBSON FAMILY PHARMACY - A MEM 999999999 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1031 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1968.95 0 0 0 1968.95 0 0 1015803630 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20062.95 0 0 0 0 0 0 0 0 0 0 0 0 0 20062.95 0 0 1015803674 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 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 1015803691 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8825.88 0 0 0 0 0 0 0 0 0 0 0 0 0 8825.88 0 0 1015803711 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.9 0 0 0 0 0 0 0 0 0 0 0 0 0 151.9 0 0 1015803756 1871984823 10 Physicians HABIB ALI 999999999 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 45 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225.71 0 470.7 0 0 0 0 0 0 696.41 0 0 1015803773 1902292253 10 Physicians CHANDRAN ANJANA V 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 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 0 297.08 0 0 0 0 0 0 297.08 0 0 1015803942 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11835.56 0 0 0 0 0 0 0 0 0 0 0 0 0 11835.56 0 0 1015804008 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 6369.78 0 0 0 0 0 0 0 0 0 0 0 0 0 6369.78 0 0 1015804039 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2197.53 0 0 0 0 0 0 0 0 0 0 0 0 0 2197.53 0 0 1015804318 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 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 3284.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3284.1 0 0 1015804371 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 17.76 0 0 0 0 0 0 17.76 0 0 1015804375 10 Physicians 107 Will 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 1015804493 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3050.98 0 0 0 0 0 0 0 0 0 0 0 0 0 3050.98 0 0 1015804680 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5438.27 0 0 0 0 0 0 0 0 0 0 0 0 0 5438.27 0 0 1015804789 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11949.52 0 0 0 0 0 0 0 0 0 0 0 0 0 11949.52 0 0 1015804793 1770150179 33 Nursing Facilities LINCOLN VILLAGE HEALTHCARE 999999999 62 Logan 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 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 415790.06 0 0 0 0 0 0 0 415790.06 0 0 1015805443 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168.53 0 0 0 0 0 0 0 0 0 0 0 0 0 168.53 0 0 1015805524 1619500808 91 Waiver service provider--Adults (DHS/DDD) ANDRIUSIS DINA 999999999 30 DuPage 0 0 0 0 0 0 0 24 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 13499 0 0 0 0 0 0 0 0 0 0 0 0 0 13499 0 0 1015806106 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 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 7139.3 0 0 0 0 0 0 0 0 0 0 0 0 0 7139.3 0 0 1015806131 1740636398 10 Physicians EL-ARABI AHMAD 999999999 200 Cook 0 0 Urology 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 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 7.1 0 131.24 0 0 0 0 0 0 138.34 0 0 1015806324 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015806395 1396327037 16 Nurse Practitioners BROCKS-HUSSAIN MAUREEN 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 130 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 54430.65 0 0 0 0 0 0 54435.65 0 0 1015806621 16 Nurse Practitioners 97 Stephenson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015806682 1033793872 33 Nursing Facilities LOFT REHAB OF DECATUR 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229646.69 0 0 0 0 0 0 0 229646.69 0 0 1015806688 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.53 0 0 0 0 0 0 7.53 0 0 1015806905 16 Nurse Practitioners 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.3 0 0 0 0 0 0 12.3 0 0 1015807477 10 Physicians 80 Peoria 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 1015807611 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 981.79 0 0 0 0 0 0 0 0 0 0 0 0 0 981.79 0 0 1015807616 1184247165 89 Physician Assistant Only(Encounter Only) JACOBSON JENNA 999999999 109 Winnebago 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 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 0 124.44 0 0 0 0 0 0 124.44 0 0 1015807627 23 Occupational Therapists 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 324.75 324.75 0 0 1015807719 10 Physicians 89 Rock Island 0 0 Neurology 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 1015807939 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 3460.53 0 0 0 0 0 0 0 0 0 0 0 0 0 3460.53 0 0 1015808423 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539.45 0 0 0 0 0 0 0 0 0 0 0 0 0 539.45 0 0 1015808452 1083282107 11 Dentists BLACK WILLIAM M 999999999 200 Cook 0 0 General Dentistry 0 0 21 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 4344.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4344.95 0 0 1015808576 86 Clinical Social Worker(Encounter Only) 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015809078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 511.08 0 0 0 0 0 0 0 0 0 0 0 0 0 511.08 0 0 1015809812 1962489815 60 Pharmacies THE ATRIUM PHARMACY 617613558 72 McLean 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 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2167 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1934.73 0 0 0 1934.73 0 0 1015809832 10 Physicians 200 Cook 0 0 Emergency Medicine 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 3515.4 0 0 0 0 0 0 0 0 0 0 0 0 0 3515.4 0 0 1015810421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687.62 0 0 0 0 0 0 0 0 0 0 0 0 0 687.62 0 0 1015810717 23 Occupational Therapists 108 Williamson 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 32.76 32.76 0 0 1015810760 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 22.15 0 0 0 0 0 0 22.15 0 0 1015810856 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.17 0 0 0 0 0 0 1.17 0 0 1015810948 1518556786 16 Nurse Practitioners QAISAR ABDULMATEEN 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 1862.5 0 0 0 0 0 0 1862.5 0 0 1015811067 10 Physicians 98 Tazewell 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 94.91 0 0 0 0 0 0 0 0 94.91 0 0 1015811191 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 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 4179.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4179.89 0 0 1015811233 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 0 0 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 2952 0 0 0 0 0 0 0 0 0 0 0 0 0 2952 0 0 1015811591 91 Waiver service provider--Adults 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0 0 0 0 0 0 0 0 353.09 0 0 0 0 0 0 0 0 0 0 0 0 0 353.09 0 0 1015827988 1114518131 63 Other Providers of Medical Equipment/Supplies (Non-registered) APERION CARE WESTCHESTER 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 1655 0 0 0 0 0 0 1655 0 0 1015828023 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14227.94 0 0 0 0 0 0 0 0 0 0 0 0 0 14227.94 0 0 1015828125 1811538580 16 Nurse Practitioners COOPER EMILY 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 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 0 424.71 0 0 0 0 0 0 424.71 0 0 1015828274 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2226.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2226.55 0 0 1015829508 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015829560 1609396209 10 Physicians HAMAD SAMMY 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 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 0 428.48 0 0 0 0 0 0 428.48 0 0 1015829638 1659767259 10 Physicians KERTOWIDJOJO ELIZABETH C 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574.72 0 0 0 0 0 0 0 0 574.72 0 0 1015829655 1912490954 10 Physicians RICE BJAI R 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 23 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 5274.72 0 0 0 0 0 0 0 0 0 0 0 0 0 5274.72 0 0 1015831431 10 Physicians 91 Sangamon 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 0 177.94 0 0 0 0 0 0 0 0 177.94 0 0 1015831612 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2018.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2018.72 0 0 1015832041 1881239549 16 Nurse Practitioners BELL THERESE 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 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 0 303.63 0 0 0 0 0 0 303.63 0 0 1015832170 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1022.17 0 0 0 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0 0 0 0 0 0 0 0 2746.55 0 0 1015834111 1497314181 46 Ambulatory Surgical Treatment Centers OPHTHALMOLOGY SURGERY CENTER O 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4548.4 0 0 0 0 0 4548.4 0 0 1015834532 10 Physicians 89 Rock Island 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 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 4066.13 0 0 0 0 0 0 4066.13 0 0 1015834693 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 322.87 0 0 0 0 0 0 0 0 0 0 0 0 0 322.87 0 0 1015834809 1184248627 89 Physician Assistant Only(Encounter Only) MASLOVSKY SERHIY 999999999 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 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 0 584.06 0 0 0 0 0 0 584.06 0 0 1015834937 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14311.15 0 0 0 0 0 0 0 0 0 0 0 0 0 14311.15 0 0 1015835576 1336729672 33 Nursing Facilities HENRY REHAB AND NURSING 999999999 67 Marshall 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117080.38 0 0 0 0 0 0 0 117080.38 0 0 1015835776 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8408.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8408.38 0 0 1015836217 1457929754 11 Dentists ELBORNO LANA 999999999 200 Cook 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 220 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 8961.1 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 9713.8 0 0 1015836384 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 960.96 0 0 0 0 0 0 0 0 0 0 0 0 0 960.96 0 0 1015836577 10 Physicians 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015837115 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015837133 1225428857 10 Physicians JAIN UMANG 999999999 200 Cook 0 0 Emergency 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 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 3131.98 0 0 0 0 0 0 3131.98 0 0 1015837236 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5949.11 0 0 0 0 0 0 0 0 0 0 0 0 0 5949.11 0 0 1015838251 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11008.74 0 0 0 0 0 0 0 0 0 0 0 0 0 11008.74 0 0 1015838264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5046.18 0 0 0 0 0 0 0 0 0 0 0 0 0 5046.18 0 0 1015838290 1376128439 16 Nurse Practitioners GREEN TAYLOR 999999999 80 Peoria 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 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 252.46 0 0 0 0 0 0 284.61 0 0 1015838606 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 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 0 100.92 100.92 0 0 1015838620 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5427.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5427.47 0 0 1015838787 1790393155 89 Physician Assistant Only(Encounter Only) RICE PAIGE 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 420.42 0 0 0 0 0 0 420.42 0 0 1015838978 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 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 5382.33 0 0 0 0 0 0 0 0 0 0 0 0 0 5382.33 0 0 1015839502 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1728.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1728.01 0 0 1015839714 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 984.13 0 0 0 0 0 0 0 0 0 0 0 0 0 984.13 0 0 1015840386 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4981.68 0 0 0 0 0 0 0 0 0 0 0 0 0 4981.68 0 0 1015840435 30 General Hospitals 30 DuPage 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015840471 1902307390 10 Physicians LAL DIVYA 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 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 0 764.78 0 0 0 0 0 0 764.78 0 0 1015840573 4015840573 72 Taxicabs and Livery Companies AMAZING LLOYD MEDICAL TRANSPOR 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 0 168 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 1426.43 0 0 0 0 0 0 1426.43 0 0 1015840645 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1589.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1589.12 0 0 1015840885 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6971.1 0 0 0 0 0 0 0 0 0 0 0 0 0 6971.1 0 0 1015840904 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 0 125.31 0 0 0 0 0 0 125.31 0 0 1015840914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3770.47 0 0 0 0 0 0 0 0 0 0 0 0 0 3770.47 0 0 1015841261 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1617.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1617.03 0 0 1015841370 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2376.88 0 0 0 0 0 0 0 0 0 0 0 0 0 2376.88 0 0 1015841540 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 0 0 0 0 0 0 0 0 0 0 1015841560 1083381958 33 Nursing Facilities QUINCY HEALTHCARE AND SENIOR L 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 1166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123111.65 0 0 0 0 0 0 0 123111.65 0 0 1015841662 1114597275 33 Nursing Facilities UPTOWN CARE AND REHABILITATION 999999999 200 Cook 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 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 797884.42 0 0 0 0 0 0 0 797884.42 0 0 1015841667 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9600.08 0 0 0 0 0 0 0 0 0 0 0 0 0 9600.08 0 0 1015841670 1538763636 61 Independent Laboratories VISTALINK HEALTH LABORATORIES 999999999 848 Virginia 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 4163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161968.31 0 0 0 0 0 0 0 0 161968.31 0 0 1015841773 1477094654 10 Physicians HILDNER ZACHARY S 999999999 53 Kane 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 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 0 169.02 0 0 0 0 0 0 169.02 0 0 1015842158 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2411.84 0 0 0 0 0 0 0 0 0 0 0 0 0 2411.84 0 0 1015842248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1249.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1249.03 0 0 1015843037 1639743909 16 Nurse Practitioners SWANSON KAREN L 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 47.52 0 0 0 0 0 0 47.52 0 0 1015843670 1487328506 16 Nurse Practitioners FOSTER ANNE O 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 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 31.01 0 0 0 0 0 0 31.01 0 0 1015843889 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 24.56 0 0 0 0 0 0 24.56 0 0 1015843892 1942872171 11 Dentists TRIAND CHRISTIAN 999999999 200 Cook 0 0 General Dentistry 0 0 26 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 2824.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2824.95 0 0 1015844053 1407425283 16 Nurse Practitioners HUNNICUTT TRAMON 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 482.26 0 0 0 0 0 0 482.26 0 0 1015844262 1053908475 55 Early Intervention Services MILLER CHARLOTTE 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 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 2339.08 0 0 0 0 0 0 2339.08 0 0 1015844299 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7594.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7594.19 0 0 1015844492 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1439.58 0 0 0 0 0 0 0 0 0 0 0 0 0 1439.58 0 0 1015844708 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4502.98 0 0 0 0 0 0 0 0 0 0 0 0 0 4502.98 0 0 1015845093 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5789.54 0 0 0 0 0 0 0 0 0 0 0 0 0 5789.54 0 0 1015845372 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 1936.96 0 0 0 0 0 0 0 0 0 0 0 0 0 1936.96 0 0 1015845577 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14689.41 0 0 0 0 0 0 0 0 0 0 0 0 0 14689.41 0 0 1015845713 1124516794 10 Physicians THAKKAR KAVISH R 999999999 200 Cook 0 0 Emergency 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 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 2433.22 0 0 0 0 0 0 2433.22 0 0 1015845724 1730562950 10 Physicians NADIGER MEGHANA 999999999 80 Peoria 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 0 124 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 33959.4 0 0 0 0 0 0 33959.4 0 0 1015846405 1902917909 10 Physicians FINK KATHLEEN 999999999 200 Cook 0 0 Radiology Diagnosis 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 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 0 119.89 0 0 0 0 0 0 0 0 119.89 0 0 1015847024 1518636679 57 Home Nursing Agency SHILOH HEALTHCARE SERVICES INC 999999999 200 Cook 0 0 0 0 0 0 0 11 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151387.5 16 0 0 0 0 0 0 0 0 0 0 0 0 151403.5 0 0 1015847026 1578133211 12 Optometrists ISMOND JONATHAN 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 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 0 265.07 0 0 0 0 0 0 265.07 0 0 1015847087 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1960.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1960.4 0 0 1015847132 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 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 1036.6 0 0 0 0 0 0 0 0 0 0 0 0 0 1036.6 0 0 1015847678 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2384.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2384.56 0 0 1015848072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11350.9 0 0 0 0 0 0 0 0 0 0 0 0 0 11350.9 0 0 1015848509 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 0 189.56 0 0 0 0 0 0 189.56 0 0 1015848627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696.46 0 0 0 0 0 0 0 0 0 0 0 0 0 696.46 0 0 1015848680 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015848687 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14475.19 0 0 0 0 0 0 0 0 0 0 0 0 0 14475.19 0 0 1015848898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2206.69 0 0 0 0 0 0 0 0 0 0 0 0 0 2206.69 0 0 1015849459 1629323167 57 Home Nursing Agency VINTAGE HOME NURSING 604611011 200 Cook 0 0 0 0 0 0 0 8 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209037.59 10698.61 0 0 0 0 0 0 0 0 0 0 0 0 219736.2 0 0 1015849477 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 0 0 0 0 0 0 0 0 0 0 1015849609 1558776781 10 Physicians SINGH GURMEET 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 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 0 327.4 0 0 0 0 0 0 327.4 0 0 1015849619 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 329.71 0 0 0 0 0 0 0 0 0 0 0 0 0 329.71 0 0 1015849789 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 1929.04 0 0 0 0 0 0 0 0 0 0 0 0 0 1929.04 0 0 1015849851 10 Physicians 200 Cook 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015850358 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3206.17 0 0 0 0 0 0 0 0 0 0 0 0 0 3206.17 0 0 1015850499 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 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 8533.57 0 0 0 0 0 0 0 0 0 0 0 0 0 8533.57 0 0 1015850759 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1774.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1774.52 0 0 1015851015 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 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 2183.55 0 0 0 0 0 0 0 0 0 0 0 0 0 2183.55 0 0 1015851032 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 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 5318.46 0 0 0 0 0 0 0 0 0 0 0 0 0 5318.46 0 0 1015851084 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5885.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5885.4 0 0 1015851368 1023451267 10 Physicians KAPADIA SHIVIKA T 999999999 30 DuPage 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.01 0 449.3 0 0 0 0 0 0 459.31 0 0 1015851434 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 0 0 0 0 0 0 0 0 0 0 1015851439 10 Physicians 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015852476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4354.82 0 0 0 0 0 0 0 0 0 0 0 0 0 4354.82 0 0 1015852579 1528553419 10 Physicians AKUNNE UGOCHINYEREM 999999999 80 Peoria 0 0 Internal Medicine 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 6 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 446.32 0 0 0 0 0 0 446.32 0 0 1015852638 1528294089 10 Physicians KLOCEK PATRICK 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 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 0 566.75 0 0 0 0 0 0 566.75 0 0 1015852639 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 1015853001 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3082.02 0 0 0 0 0 0 0 0 0 0 0 0 0 3082.02 0 0 1015853117 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2710.42 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.42 0 0 1015853273 1639436199 10 Physicians TANAKA SHOICHIRO 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 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 0 785.05 0 0 0 0 0 0 785.05 0 0 1015853282 1154783777 10 Physicians OBEIDIN FARRES 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 683.75 0 0 0 0 0 0 0 0 683.75 0 0 1015853427 1295323137 16 Nurse Practitioners KORPUS OLIVIA 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 0 129 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 1824.83 0 0 0 0 0 0 1824.83 0 0 1015854278 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4137.07 0 0 0 0 0 0 0 0 0 0 0 0 0 4137.07 0 0 1015854321 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2015.71 0 0 0 0 0 0 0 0 0 0 0 0 0 2015.71 0 0 1015854441 63 Other Providers of Medical Equipment/Supplies (Non-registered) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 440.46 0 0 0 0 0 0 440.46 0 0 1015854503 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 22.15 0 0 0 0 0 0 22.15 0 0 1015854540 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 623.22 0 0 0 0 0 0 0 0 0 0 0 0 0 623.22 0 0 1015854566 1639750920 28 Waiver service provider--Supportive living facility (HFS) "POINTE AT EASTGATE, THE" 999999999 71 McHenry 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 267126.91 0 0 0 0 0 0 0 0 0 0 0 0 0 267126.91 0 0 1015854573 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1018.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1018.67 0 0 1015854623 1841818663 55 Early Intervention Services LANSDALE LAUREN 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7825.41 0 0 0 0 0 0 7825.41 0 0 1015854673 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11685.45 0 0 0 0 0 0 0 0 0 0 0 0 0 11685.45 0 0 1015854843 10 Physicians 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 80 0 0 1015855045 10 Physicians 200 Cook 0 0 Urology 0 0 0 0 0 0 0 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 2.24 0 0 0 0 0 0 2.24 0 0 1015855168 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1015855662 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 0 0 0 0 0 0 0 0 0 0 1015855966 1972009900 10 Physicians PAZON LEO JC G 999999999 53 Kane 0 0 Family 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 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 0 672.49 0 0 0 0 0 0 672.49 0 0 1015856035 1467038265 16 Nurse Practitioners MCGILL ERIN 999999999 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 593.73 0 0 0 0 0 0 625.88 0 0 1015856084 1942884937 33 Nursing Facilities "LOFT REHAB OF ROCK SPRINGS, TH" 999999999 63 Macon 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 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2717 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190978.08 0 0 0 0 0 0 0 190978.08 0 0 1015856127 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6376.74 0 0 0 0 0 0 0 0 0 0 0 0 0 6376.74 0 0 1015856412 1225561335 10 Physicians NIENHOUSE VANESSA L 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 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 3207.24 0 0 0 0 0 0 3207.24 0 0 1015856562 1861804841 10 Physicians BABU JACOB 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 2 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015856614 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1551.47 0 0 0 0 0 0 0 0 0 0 0 0 0 1551.47 0 0 1015856849 1508936907 10 Physicians AMIRKHAN MOJGAN MICHELLE 999999999 92 Schuyler 0 0 0 0 0 0 0 0 0 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 0 231.81 0 0 0 0 0 0 231.81 0 0 1015856887 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 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 0 164.07 164.07 0 0 1015857069 86 Clinical Social Worker(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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015857138 1205411204 16 Nurse Practitioners BONIFIELD MCKENZIE 999999999 108 Williamson 0 0 0 0 0 0 0 0 0 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 1554.63 0 0 0 0 0 0 1554.63 0 0 1015857311 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 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 5442.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5442.75 0 0 1015857389 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015857452 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 937.41 0 0 0 0 0 0 0 0 0 0 0 0 0 937.41 0 0 1015857454 1649701962 10 Physicians ROBINSON CHRISTOPHER L 999999999 53 Kane 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 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 2887.93 0 0 0 0 0 0 2887.93 0 0 1015857672 1992244164 10 Physicians SHAH SHUCHI 999999999 91 Sangamon 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 0 136 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 1220.84 0 0 0 0 0 0 1220.84 0 0 1015857823 1962070417 11 Dentists OMARI MUHAMMAD 999999999 200 Cook 0 0 General Dentistry 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 218 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 7178.44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7178.44 0 0 1015858314 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 1015858474 1124577036 12 Optometrists SANDERS CLAIRE 999999999 54 Kankakee 0 0 0 0 0 0 0 0 0 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 0 107.76 0 0 0 0 0 0 107.76 0 0 1015858884 4015858884 71 Medicar Provider ADVANCED MEDICAL TRANSPORTATIO 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 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6100.68 0 0 0 0 0 0 6100.68 0 0 1015859036 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 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 24.43 0 0 0 0 0 0 24.43 0 0 1015859237 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2675.56 0 0 0 0 0 0 0 0 0 0 0 0 0 2675.56 0 0 1015859386 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6968.38 0 0 0 0 0 0 0 0 0 0 0 0 0 6968.38 0 0 1015859829 1043976061 70 Ambulance Service Providers NOKOMIS WITT AREA AMBULANCE SE 999999999 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 6112.03 0 0 0 0 0 0 6112.03 0 0 1015859849 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 0 0 0 0 1015859919 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2156.88 0 0 0 0 0 0 0 0 0 0 0 0 0 2156.88 0 0 1015860205 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206.94 0 0 0 0 0 0 206.94 0 0 1015860422 1235584053 16 Nurse Practitioners KING DANIEL D 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 0 123.74 0 0 0 0 0 0 123.74 0 0 1015860816 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1307.36 0 0 0 0 0 0 0 0 0 0 0 0 0 1307.36 0 0 1015860839 91 Waiver service provider--Adults (DHS/DDD) 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 0 131 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 12793.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12793.9 0 0 1015861018 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 0 220.92 0 0 0 0 0 0 0 0 0 0 0 0 0 220.92 0 0 1015861038 1730317702 10 Physicians BHOOMA VINAY K 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 238.43 0 0 0 0 0 0 238.43 0 0 1015861349 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 10965.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10965.93 0 0 1015861513 1811585912 61 Independent Laboratories NEELYX LABS INC 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 17 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 1787.94 0 0 0 0 0 0 0 0 1787.94 0 0 1015861678 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4144.69 0 0 0 0 0 0 0 0 0 0 0 0 0 4144.69 0 0 1015861761 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 710.33 0 0 0 0 0 0 0 0 0 0 0 0 0 710.33 0 0 1015861942 1033747654 89 Physician Assistant Only(Encounter Only) STAMPS HANNAH 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 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 0 299.92 0 0 0 0 0 0 299.92 0 0 1015861984 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8544.07 0 0 0 0 0 0 0 0 0 0 0 0 0 8544.07 0 0 1015862013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9421.93 0 0 0 0 0 0 0 0 0 0 0 0 0 9421.93 0 0 1015862143 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2703.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2703.75 0 0 1015862538 1427644210 16 Nurse Practitioners O'HANLON VICTORIA A 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 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525.84 0 0 0 0 0 0 525.84 0 0 1015862685 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 327.88 0 0 0 0 0 0 0 0 0 0 0 0 0 327.88 0 0 1015863248 1285208926 89 Physician Assistant Only(Encounter Only) COOK ERIC 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 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 0 981.11 0 0 0 0 0 0 981.11 0 0 1015863997 1144640673 10 Physicians RAUSCH ANDREW C 999999999 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 6 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.35 0 1107.9 0 0 0 0 0 0 1395.25 0 0 1015864013 1982910527 10 Physicians ASAD MOHAMMAD FAHAD 999999999 80 Peoria 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 12 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.1 0 14935.46 0 0 0 0 0 0 15038.56 0 0 1015864084 10 Physicians 80 Peoria 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015864102 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1012.98 0 0 0 0 0 0 0 0 0 0 0 0 0 1012.98 0 0 1015864386 1518386911 10 Physicians SONG SHEN 999999999 30 DuPage 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 0 274 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 1605.63 0 0 0 0 0 0 1605.63 0 0 1015865137 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 0 600.69 0 0 0 0 0 0 0 0 0 0 0 0 0 600.69 0 0 1015865894 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 50.47 0 0 0 0 0 0 50.47 0 0 1015867072 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 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 6119.18 0 0 0 0 0 0 0 0 0 0 0 0 0 6119.18 0 0 1015867894 10 Physicians 80 Peoria 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 0 445.15 0 0 0 0 0 0 445.15 0 0 1015867950 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 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 0 976.68 0 0 0 0 0 0 0 0 0 0 0 0 0 976.68 0 0 1015868320 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015868800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 801.59 0 0 0 0 0 0 0 0 0 0 0 0 0 801.59 0 0 1015869047 1033872957 11 Dentists AYO-OKUWOBI OLUWATOSIN H 999999999 200 Cook 0 0 0 0 43 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 4996.73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4996.73 0 0 1015869221 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5056.08 0 0 0 0 0 0 0 0 0 0 0 0 0 5056.08 0 0 1015869328 10 Physicians 70 McDonough 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 7.65 0 0 0 0 0 0 7.65 0 0 1015869666 1770900185 10 Physicians ESPOSITO ANTHONY J 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 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 0 646.36 0 0 0 0 0 0 646.36 0 0 1015869708 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2197.09 0 0 0 0 0 0 0 0 0 0 0 0 0 2197.09 0 0 1015870548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 186.21 0 0 0 0 0 0 0 0 0 0 0 0 0 186.21 0 0 1015870642 1740695980 10 Physicians BEHR IAN 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 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 0 877.25 0 0 0 0 0 0 877.25 0 0 1015870979 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 23.8 0 0 0 0 0 0 23.8 0 0 1015871159 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6487.23 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.23 0 0 1015871161 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 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 0 236.98 236.98 0 0 1015871324 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1012.12 0 0 0 0 0 0 0 0 0 0 0 0 0 1012.12 0 0 1015871383 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13003.63 0 0 0 0 0 0 0 0 0 0 0 0 0 13003.63 0 0 1015871450 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1248.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1248.59 0 0 1015871497 10 Physicians 200 Cook 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 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 1015871511 1538587035 10 Physicians BHATTI NAVDEEP K 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 21.95 0 0 0 0 0 0 21.95 0 0 1015871966 1750562799 10 Physicians GEDALIA URI 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 0 173 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 0 788.6 0 0 0 0 0 0 788.6 0 0 1015871999 1336752799 10 Physicians ASSMUS MARK A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 4.29 0 2537.33 0 0 0 0 0 0 2541.62 0 0 1015872218 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2710.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2710.62 0 0 1015872443 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 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 2540.48 2540.48 0 0 1015872666 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 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 4468.65 0 0 0 0 0 0 0 0 0 0 0 0 0 4468.65 0 0 1015873051 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 5001.17 0 0 0 0 0 0 0 0 0 0 0 0 0 5001.17 0 0 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1015874369 10 Physicians 200 Cook 0 0 0 0 0 0 0 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 0 197.38 0 0 0 0 0 0 0 0 197.38 0 0 1015874765 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8918.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8918.68 0 0 1015874799 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1507.22 0 0 0 0 0 0 0 0 0 0 0 0 0 1507.22 0 0 1015874901 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 0 121.97 0 0 0 0 0 0 121.97 0 0 1015874992 10 Physicians 30 DuPage 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 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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 2767.6 0 0 0 0 0 0 0 0 0 0 0 0 0 2767.6 0 0 1015875719 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 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 0 520.96 0 0 0 0 0 0 0 0 0 0 0 0 0 520.96 0 0 1015876269 22 Physical Therapists 96 St Clair 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 56.08 56.08 0 0 1015876293 89 Physician Assistant Only(Encounter Only) 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 0 0 0 0 0 0 0 0 0 0 1015876579 1528173325 10 Physicians HACKETT RAYMOND A 999999999 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 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 0 439.94 0 0 0 0 0 0 439.94 0 0 1015876645 1770168874 16 Nurse Practitioners DYE 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 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 0 784.07 0 0 0 0 0 0 784.07 0 0 1015876945 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 0 174.84 0 0 0 0 0 0 174.84 0 0 1015877078 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1415.45 0 0 0 0 0 0 0 0 0 0 0 0 0 1415.45 0 0 1015877084 10 Physicians 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 2981.65 0 0 0 0 0 0 2981.65 0 0 1015877312 16 Nurse Practitioners 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 74.95 0 0 0 0 0 0 74.95 0 0 1015877350 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2299.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2299.44 0 0 1015877560 1609455591 16 Nurse Practitioners THILTGEN LISA R 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 858.78 0 0 0 0 0 0 858.78 0 0 1015877650 1073926846 10 Physicians BELAY ABEL 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 23.24 0 156.03 0 0 0 0 0 0 179.27 0 0 1015877883 1427268283 10 Physicians ROBINSON ELISABETH C 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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 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 3479.67 0 0 0 0 0 0 0 0 0 0 0 0 0 3479.67 0 0 1015878272 1770159378 11 Dentists PATEL PARAGKUMAR S 999999999 200 Cook 0 0 0 0 116 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 477 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 19885.87 0 0 0 0 0 0 0 0 0 0 0 4516.2 0 0 0 0 24402.07 0 0 1015878440 1962073213 16 Nurse Practitioners KORN KELLY E 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 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 0 284.12 0 0 0 0 0 0 284.12 0 0 1015878889 10 Physicians 30 DuPage 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 96.6 0 0 0 0 0 0 0 0 78.09 0 0 0 0 0 0 174.69 0 0 1015879134 1891308748 16 Nurse Practitioners WILKINS ROBERT 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 663.34 0 0 0 0 0 0 663.34 0 0 1015879486 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 28.17 0 0 0 0 0 0 28.17 0 0 1015879577 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 83.7 0 0 0 0 0 0 83.7 0 0 1015879672 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15067.98 0 0 0 0 0 0 0 0 0 0 0 0 0 15067.98 0 0 1015879787 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 1050.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1050.72 0 0 1015879838 1285074104 10 Physicians DESAI SHAMIT 999999999 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 29 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 186.71 0 1243.43 0 0 0 0 0 0 1430.14 0 0 1015879880 16 Nurse Practitioners 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 1015879933 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6306.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6306.76 0 0 1015880525 1649542846 89 Physician Assistant Only(Encounter Only) SCHAEFER KRISTINA 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 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 0 177.67 0 0 0 0 0 0 177.67 0 0 1015880728 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 17.4 0 0 0 0 0 0 17.4 0 0 1015880783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 584.45 0 0 0 0 0 0 0 0 0 0 0 0 0 584.45 0 0 1015880882 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2871.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2871.44 0 0 1015881036 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5453.8 0 0 0 0 0 0 0 0 0 0 0 0 0 5453.8 0 0 1015881148 10 Physicians 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 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 13.7 0 0 0 0 0 0 13.7 0 0 1015881440 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 81.79 0 0 0 0 0 0 81.79 0 0 1015881557 1447923172 16 Nurse Practitioners JENSEN JENNIFER B 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 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 62.02 0 0 0 0 0 0 62.02 0 0 1015881627 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3539.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3539.22 0 0 1015881679 1518522408 63 Other Providers of Medical Equipment/Supplies (Non-registered) BEST MEDICAL SUPPLY INC 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 0 146 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 1688.05 0 0 0 0 0 0 1688.05 0 0 1015881947 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1855.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1855.34 0 0 1015882257 1417451618 10 Physicians OTAISHAN DIMA 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 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 1430.92 0 0 0 0 0 0 1430.92 0 0 1015882451 1588059265 10 Physicians PATEL RAVI 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 8 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107.24 0 387.84 0 0 0 0 0 0 495.08 0 0 1015882497 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5219.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5219.64 0 0 1015882597 36 Community mental health provider 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2087.84 0 0 2087.84 0 0 1015882919 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2228.05 0 0 0 0 0 0 0 0 0 0 0 0 0 2228.05 0 0 1015883009 1659922649 89 Physician Assistant Only(Encounter Only) FOES MEGAN 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 31.01 0 0 0 0 0 0 31.01 0 0 1015883330 1649682543 10 Physicians DAKAY KATARINA BODNAR 999999999 200 Cook 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 4 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.86 0 1860.06 0 0 0 0 0 0 1860.92 0 0 1015883403 1932638111 10 Physicians PORTIN ELIZABETH 999999999 200 Cook 0 0 0 0 0 27 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 80 0 0 0 0 0 0 1 0 13 0 0 0 0 0 0 0 0 0 2318.94 0 0 0 0 0 0 5.22 0 554.28 0 0 0 0 0 0 2878.44 0 0 1015883808 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3405.92 0 0 0 0 0 0 0 0 0 0 0 0 0 3405.92 0 0 1015884028 1548858707 89 Physician Assistant Only(Encounter Only) DELVO EMILY 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 518.12 0 0 0 0 0 0 518.12 0 0 1015884423 1639608680 10 Physicians MAHAJAN ANKITA 999999999 200 Cook 0 0 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 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.86 0 625.61 0 0 0 0 0 0 721.47 0 0 1015884734 1023512795 10 Physicians RASMUSSEN ZACHARY 999999999 89 Rock Island 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 1782.7 0 0 0 0 0 0 1782.7 0 0 1015885076 1073968525 64 Imaging Services HARMONYCARES MEDICAL GRP 605270849 200 Cook 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 0 157 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 0 158.62 0 0 0 0 0 0 0 0 158.62 0 0 1015885381 1407171853 10 Physicians SAOUR BASIL 999999999 200 Cook 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 94 0 0 0 0 0 0 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 0 0 1914.01 0 0 0 0 0 0 1914.01 0 0 1015885595 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 217.04 0 0 0 0 0 0 0 0 0 0 0 0 0 217.04 0 0 1015885883 1407312564 16 Nurse Practitioners SOEDER JEREMY 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 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 0 582.5 0 0 0 0 0 0 582.5 0 0 1015886477 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1864.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1864.63 0 0 1015886797 16 Nurse Practitioners 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 47.62 0 0 0 0 0 0 47.62 0 0 1015886934 91 Waiver service 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1962885293 10 Physicians SONI SUMEET 999999999 47 Jackson 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 1453.76 0 0 0 0 0 0 1453.76 0 0 1015887254 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 438.27 0 0 0 0 0 0 0 0 0 0 0 0 0 438.27 0 0 1015887444 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4019.26 0 0 0 0 0 0 0 0 0 0 0 0 0 4019.26 0 0 1015887448 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 1015887556 1043985443 91 Waiver service provider--Adults (DHS/DDD) HAMILTON STEPHANIE 999999999 91 Sangamon 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 0 414 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 28016.8 0 0 0 0 0 0 0 0 0 0 0 0 0 28016.8 0 0 1015887591 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 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 2469.6 2469.6 0 0 1015888157 1033792304 16 Nurse Practitioners JONES ALEXIS 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 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 0 456.84 0 0 0 0 0 0 456.84 0 0 1015888198 1740778216 10 Physicians SHETH PRANALI P 999999999 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 29.48 0 1605.45 0 0 0 0 0 0 1634.93 0 0 1015888201 1720676760 16 Nurse Practitioners RAYSON-HENRY TANISHA 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 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 1253.46 0 0 0 0 0 0 1253.46 0 0 1015888247 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 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 0 429.76 429.76 0 0 1015888441 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 0 239.15 0 0 0 0 0 0 239.15 0 0 1015888789 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3040.81 0 0 0 0 0 0 0 0 0 0 0 0 0 3040.81 0 0 1015888853 1558951731 16 Nurse Practitioners SHAH POOJA 999999999 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 38.38 0 0 1015898403 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3179.05 0 0 0 0 0 0 0 0 0 0 0 0 0 3179.05 0 0 1015898772 1699256644 21 Licensed Practical Nurses PALMER CHRISTY L 999999999 96 St Clair 0 0 0 0 0 0 0 0 0 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 0 304.29 0 0 0 0 0 0 304.29 0 0 1015898938 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 1211.06 0 0 0 0 0 0 0 0 0 0 0 0 0 1211.06 0 0 1015899128 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3244.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3244.62 0 0 1015899425 1720585029 10 Physicians HAYNES ANDREA 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 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 0 920.43 0 0 0 0 0 0 920.43 0 0 1015899741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16051.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16051.67 0 0 1015900035 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 0 0 0 0 0 0 0 0 0 0 1015900549 22 Physical Therapists 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 20.95 20.95 0 0 1015900672 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4268.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4268.39 0 0 1015900727 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 162.8 0 0 0 0 0 0 0 0 0 0 0 0 0 162.8 0 0 1015901042 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 0 0 0 0 0 0 0 0 0 0 1015901527 1851986624 16 Nurse Practitioners KOZIEL ANNA 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 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 1831.79 0 0 0 0 0 0 1831.79 0 0 1015901713 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 903.2 0 0 0 0 0 0 0 0 0 0 0 0 0 903.2 0 0 1015901970 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1432.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1432.2 0 0 1015902116 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 13039.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13039.35 0 0 1015902752 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6336.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6336.4 0 0 1015902759 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153.48 0 0 0 0 0 0 153.48 0 0 1015902842 4015902842 72 Taxicabs and Livery Companies "LADY BOSS ENTERPRISE,LLC" 999999999 107 Will 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 1619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1619 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13953.58 0 0 0 0 0 0 13953.58 0 0 1015902875 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 43.54 0 0 0 0 0 0 43.54 0 0 1015902972 1972173698 16 Nurse Practitioners SMITH KYLE 999999999 101 Wabash 0 0 0 0 0 0 0 0 0 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 0 492.95 0 0 0 0 0 0 492.95 0 0 1015903233 1235558297 10 Physicians NUFFER ZACHARY 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 6 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.3 0 0 0 0 0 0 0 0 48.3 0 0 1015903297 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10466.27 0 0 0 0 0 0 0 0 0 0 0 0 0 10466.27 0 0 1015903388 1295182459 10 Physicians KALAPURAYIL MATHEW 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 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 0 184.71 0 0 0 0 0 0 184.71 0 0 1015903557 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 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 0 214.29 214.29 0 0 1015904046 1326493271 10 Physicians DUNFORD GERRIT 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 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 0 691.79 0 0 0 0 0 0 691.79 0 0 1015904289 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5614.76 0 0 0 0 0 0 0 0 0 0 0 0 0 5614.76 0 0 1015904548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2844.25 0 0 0 0 0 0 0 0 0 0 0 0 0 2844.25 0 0 1015904652 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1229.9 0 0 0 0 0 0 0 0 0 0 0 0 0 1229.9 0 0 1015905087 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3089.13 0 0 0 0 0 0 0 0 0 0 0 0 0 3089.13 0 0 1015905125 1669979456 10 Physicians GILBERT MOLLY ETLING 999999999 91 Sangamon 0 0 0 0 0 2 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 4 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 296.47 0 0 0 0 0 0 0 0 47.77 0 0 0 0 0 0 344.24 0 0 1015905365 1649790627 10 Physicians KHOSRAVI HASAN 999999999 200 Cook 0 0 Dermatology 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 0 116 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 6040.98 0 0 0 0 0 0 6040.98 0 0 1015906096 89 Physician Assistant Only(Encounter Only) 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 48.22 0 0 0 0 0 0 0 0 82.95 0 0 0 0 0 0 131.17 0 0 1015906344 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.75 0 0 0 0 0 0 76.75 0 0 1015907001 1750648044 10 Physicians DEINES DANIELLE A 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 0 133 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 31511.97 0 0 0 0 0 0 31511.97 0 0 1015907301 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 43.54 0 0 0 0 0 0 43.54 0 0 1015907434 1003072646 10 Physicians BANUELOS POLO A 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 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 0 436.8 0 0 0 0 0 0 436.8 0 0 1015907556 91 Waiver service provider--Adults (DHS/DDD) 89 Rock Island 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 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 8404.38 0 0 0 0 0 0 0 0 0 0 0 0 0 8404.38 0 0 1015907631 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1309.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.67 0 0 1015907834 1902457310 89 Physician Assistant Only(Encounter Only) HARIPRASAD SRUTHI 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 0 189 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 2633.09 0 0 0 0 0 0 2633.09 0 0 1015907927 1710358270 86 Clinical Social Worker(Encounter Only) HENTRICH JESSICA 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 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 0 0 0 0 0 0 0 0 0 0 1015908035 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 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 4306.33 0 0 0 0 0 0 0 0 0 0 0 0 0 4306.33 0 0 1015908104 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 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 0 177.55 0 0 0 0 0 0 0 0 177.55 0 0 1015908169 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733.82 0 0 0 0 0 0 0 0 0 0 0 0 0 733.82 0 0 1015908222 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 601.35 0 0 0 0 0 0 0 0 0 0 0 0 0 601.35 0 0 1015908249 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12651.1 0 0 0 0 0 0 0 0 0 0 0 0 0 12651.1 0 0 1015908377 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 434 0 0 0 0 0 0 0 0 0 0 0 0 0 434 0 0 1015908843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 282.49 0 0 0 0 0 0 0 0 0 0 0 0 0 282.49 0 0 1015908850 10 Physicians 10 Adams 0 0 Pediatrics 0 0 0 0 0 0 0 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 0 512.01 0 0 0 0 0 0 512.01 0 0 1015909081 10 Physicians 91 Sangamon 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1015909285 10 Physicians 24 Coles 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 199.84 0 0 0 0 0 0 199.84 0 0 1015909448 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5425 0 0 0 0 0 0 0 0 0 0 0 0 0 5425 0 0 1015909761 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 1015910198 1639589948 10 Physicians TARHUNI ALAEDDIN 999999999 91 Sangamon 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 4 0 69 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 12.02 0 5286.29 0 0 0 0 0 0 5298.31 0 0 1015910414 10 Physicians 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 44.28 0 0 0 0 0 0 44.28 0 0 1015910590 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3271.26 0 0 0 0 0 0 0 0 0 0 0 0 0 3271.26 0 0 1015910618 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 563.63 0 0 0 0 0 0 0 0 0 0 0 0 0 563.63 0 0 1015910689 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.07 0 0 0 0 0 0 0 0 0 0 0 0 0 210.07 0 0 1015911054 10 Physicians 88 Richland 0 0 0 0 0 0 0 0 0 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 0 208.05 0 0 0 0 0 0 208.05 0 0 1015911211 10 Physicians 35 Ford 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 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 3.25 0 0 0 0 0 0 3.25 0 0 1015911268 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015911368 1245865906 16 Nurse Practitioners DELIVA CHRISTINE 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 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 544 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6332.14 0 0 0 0 0 0 6332.14 0 0 1015911457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635.39 0 0 0 0 0 0 0 0 0 0 0 0 0 635.39 0 0 1015911664 22 Physical Therapists 109 Winnebago 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 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 0 454.96 454.96 0 0 1015911894 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 302.85 0 0 0 0 0 0 0 0 0 0 0 0 0 302.85 0 0 1015912168 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1339.03 0 0 0 0 0 0 0 0 0 0 0 0 0 1339.03 0 0 1015912206 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13931.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13931.4 0 0 1015912217 1043766314 10 Physicians JOUAN AHMED A 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 76.83 0 0 0 0 0 0 76.83 0 0 1015912290 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 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 1390.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1390.97 0 0 1015912297 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1005.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1005.81 0 0 1015912585 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 16040.41 0 0 0 0 0 0 0 0 0 0 0 0 0 16040.41 0 0 1015912658 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 3594.2 0 0 0 0 0 0 0 0 0 0 0 0 0 3594.2 0 0 1015912950 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 495.56 0 0 0 0 0 0 0 0 0 0 0 0 0 495.56 0 0 1015913264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1302.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1302.62 0 0 1015913505 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 0 750.69 0 0 0 0 0 0 750.69 0 0 1015913657 1215425079 10 Physicians ANGELL ERIN 999999999 65 Madison 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 1414.82 0 0 0 0 0 0 1414.82 0 0 1015913698 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 215.91 0 0 0 0 0 0 0 0 0 0 0 0 0 215.91 0 0 1015913836 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015914414 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 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 98.76 0 0 0 0 0 0 98.76 0 0 1015914445 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 331.37 0 0 0 0 0 0 0 0 0 0 0 0 0 331.37 0 0 1015914700 1598127458 10 Physicians ATWI NOAH E 999999999 200 Cook 0 0 0 0 0 0 0 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 27.09 0 0 0 0 0 0 0 0 27.09 0 0 1015914771 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 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 1001.3 1001.3 0 0 1015914792 16 Nurse Practitioners 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 0 0 0 0 0 0 0 0 0 0 1015914863 1679894661 10 Physicians YESHWANT SRINATH 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 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 0 656.29 0 0 0 0 0 0 656.29 0 0 1015915300 1265109409 16 Nurse Practitioners GREER KELLY 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 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 37.31 0 0 0 0 0 0 37.31 0 0 1015915746 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 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 0 629.2 0 0 0 0 0 0 0 0 0 0 0 0 0 629.2 0 0 1015915764 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 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 0 653.8 653.8 0 0 1015915849 1992167043 10 Physicians SALARI REZA 999999999 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 11 0 1 0 0 0 0 0 0 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 18 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 230 0 0 1015915891 1558963900 23 Occupational Therapists VICE EMILY 999999999 10 Adams 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.26 0 0 0 0 0 0 0 0 0 0 0 0 0 73.26 0 0 1015917428 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 2344.99 0 0 0 0 0 0 0 0 0 0 0 0 0 2344.99 0 0 1015917671 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2091.3 0 0 0 0 0 0 0 0 0 0 0 0 0 2091.3 0 0 1015918887 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5341.98 0 0 0 0 0 0 0 0 0 0 0 0 0 5341.98 0 0 1015919449 87 Psychologist(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 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 0 712.69 0 0 0 0 0 0 712.69 0 0 1015919496 1811564859 11 Dentists NIEMZYK JENNIFER E 999999999 200 Cook 0 0 General Dentistry 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9580.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9580.88 0 0 1015919631 1831730084 89 Physician Assistant Only(Encounter Only) BUTLER KENDAL 999999999 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 965.17 0 0 0 0 0 0 965.17 0 0 1015919751 1154999746 16 Nurse Practitioners LOFTUS BRITTANY I 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 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 0 408.79 0 0 0 0 0 0 408.79 0 0 1015919857 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4549.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4549.2 0 0 1015920305 1588256150 89 Physician Assistant Only(Encounter Only) LONG KATHERINE MARY 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 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 0 117.7 0 0 0 0 0 0 117.7 0 0 1015920313 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 733.26 0 0 0 0 0 0 0 0 0 0 0 0 0 733.26 0 0 1015920602 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1033.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1033.63 0 0 1015920725 89 Physician Assistant Only(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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015920758 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 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 0 936.49 0 0 0 0 0 0 0 0 0 0 0 0 0 936.49 0 0 1015920992 1205930484 10 Physicians STEWART DAVID B 999999999 91 Sangamon 0 0 Colon - Rectal Surgery 0 0 0 0 0 0 0 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 0 664.54 0 0 0 0 0 0 664.54 0 0 1015921115 1033792437 11 Dentists SOLTANISHIRAZI VIDA 999999999 200 Cook 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 274 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 9615.4 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 9991.75 0 0 1015921330 1619325446 10 Physicians BAJAJ VINAY V 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 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 1030.37 0 0 0 0 0 0 1030.37 0 0 1015921428 1619460292 13 Podiatrists ADMAD MAHEEN 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 58.1 0 0 0 0 0 0 58.1 0 0 1015921841 10 Physicians 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015921883 1740876648 16 Nurse Practitioners JULIAN CAITLIN 999999999 200 Cook 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 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 0 414.84 0 0 0 0 0 0 414.84 0 0 1015922772 1669060091 16 Nurse Practitioners SANTO SHELLY R 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 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 0 433.65 0 0 0 0 0 0 433.65 0 0 1015923037 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5500.95 0 0 0 0 0 0 0 0 0 0 0 0 0 5500.95 0 0 1015923140 1558757724 10 Physicians BLAKE LEAH J 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 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 0 462.54 0 0 0 0 0 0 462.54 0 0 1015923333 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 4380.71 0 0 0 0 0 0 0 0 0 0 0 0 0 4380.71 0 0 1015923361 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5442.47 0 0 0 0 0 0 0 0 0 0 0 0 0 5442.47 0 0 1015923782 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5656.05 0 0 0 0 0 0 0 0 0 0 0 0 0 5656.05 0 0 1015924268 1114513306 16 Nurse Practitioners PATEL SHAHEEN 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1015924382 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6405.34 0 0 0 0 0 0 0 0 0 0 0 0 0 6405.34 0 0 1015924414 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4383.4 0 0 0 0 0 0 0 0 0 0 0 0 0 4383.4 0 0 1015924838 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 83.23 0 0 0 0 0 0 83.23 0 0 1015925069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 923.89 0 0 0 0 0 0 0 0 0 0 0 0 0 923.89 0 0 1015925089 1518540871 33 Nursing Facilities AVANTARA CHICAGO RIDGE 999999999 200 Cook 0 0 1 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 193 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 4304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562275.3 0 0 0 0 0 0 0 562275.3 0 0 1015925128 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 4046.13 0 0 0 0 0 0 0 0 0 0 0 0 0 4046.13 0 0 1015925342 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4764.11 0 0 0 0 0 0 0 0 0 0 0 0 0 4764.11 0 0 1015925545 1346813508 23 Occupational Therapists MOSS EMILY R 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 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 5200.59 5200.59 0 0 1015925764 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2035.49 0 0 0 0 0 0 0 0 0 0 0 0 0 2035.49 0 0 1015925823 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11922.78 0 0 0 0 0 0 0 0 0 0 0 0 0 11922.78 0 0 1015926098 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 1703.72 1703.72 0 0 1015926127 10 Physicians 87 Randolph 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 1015926289 1588631212 10 Physicians HARJAI KISHORE 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 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 0 216.77 0 0 0 0 0 0 216.77 0 0 1015926521 1073048625 10 Physicians NOOR NABEEL 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 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 0 415.62 0 0 0 0 0 0 415.62 0 0 1015926568 1407329246 89 Physician Assistant Only(Encounter Only) WAGNER MARIAH 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 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 0 255.71 0 0 0 0 0 0 255.71 0 0 1015926688 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6644.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6644.11 0 0 1015926822 86 Clinical Social Worker(Encounter Only) 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015927211 1891399432 48 Rural Health Clinics OSF HEALTHCARE - STREATOR MEDI 999999999 58 La Salle 0 0 0 440 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1095 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1095 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26234.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26234.1 0 0 1015927219 1144710385 10 Physicians HEDROUG YOUSSEF A 999999999 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1627.19 0 0 0 0 0 0 1627.19 0 0 1015927257 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 0 0 0 0 0 0 0 0 0 0 1015927625 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 13437.7 0 0 0 0 0 0 0 0 0 0 0 0 0 13437.7 0 0 1015927641 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6749.45 0 0 0 0 0 0 0 0 0 0 0 0 0 6749.45 0 0 1015927936 1073006672 89 Physician Assistant Only(Encounter Only) BEADLE MOLLY 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 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 74.95 0 0 0 0 0 0 74.95 0 0 1015928618 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 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 1015928784 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 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 6392.75 0 0 0 0 0 0 0 0 0 0 0 0 0 6392.75 0 0 1015928907 89 Physician Assistant Only(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 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 0 480.06 0 0 0 0 0 0 480.06 0 0 1015929358 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7706.32 0 0 0 0 0 0 0 0 0 0 0 0 0 7706.32 0 0 1015929565 1154842169 10 Physicians ADEYOOYE ADEWALE 999999999 200 Cook 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 2870.33 0 0 0 0 0 0 2870.33 0 0 1015930481 98 Waiver service provider--TBI (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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 719.49 0 0 0 0 0 0 0 0 0 0 0 0 0 719.49 0 0 1015930776 1851481824 89 Physician Assistant Only(Encounter Only) BUCKETT WILLIAM E 999999999 49 Jefferson 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 0 187 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 0 603.81 0 0 0 0 0 0 603.81 0 0 1015930804 1902471444 16 Nurse Practitioners HALL JENNIFER L 999999999 63 Macon 0 0 0 0 0 0 0 0 0 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 0 395.96 0 0 0 0 0 0 395.96 0 0 1015930845 86 Clinical Social Worker(Encounter Only) 822 Massachusetts 0 0 0 0 0 0 0 0 0 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 2563.05 0 0 0 0 0 0 2563.05 0 0 1015930983 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.27 0 0 0 0 0 0 102.27 0 0 1015931124 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 20.83 0 0 0 0 0 0 20.83 0 0 1015931230 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4774.38 0 0 0 0 0 0 0 0 0 0 0 0 0 4774.38 0 0 1015931400 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 844.01 0 0 0 0 0 0 0 0 0 0 0 0 0 844.01 0 0 1015931929 1043745151 10 Physicians HU KAREN 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.69 0 5038.05 0 0 0 0 0 0 5067.74 0 0 1015931956 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 1935.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1935.75 0 0 1015932025 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2405.24 0 0 0 0 0 0 0 0 0 0 0 0 0 2405.24 0 0 1015933086 71 Medicar Provider 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 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 0 513.81 0 0 0 0 0 0 513.81 0 0 1015933097 1841640190 10 Physicians NAFE AHMAD 999999999 200 Cook 0 0 Family 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 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 0 276.46 0 0 0 0 0 0 276.46 0 0 1015933132 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 257.29 0 0 0 0 0 0 0 0 0 0 0 0 0 257.29 0 0 1015933149 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 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 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3275.45 0 0 0 0 0 0 0 0 3275.45 0 0 1015933948 1881198026 10 Physicians RASHID SHAHNAZ 999999999 200 Cook 0 0 Emergency Medicine 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 3308.27 0 0 0 0 0 0 3308.27 0 0 1015933959 1467849513 10 Physicians LEACH MATTHEW R 999999999 200 Cook 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 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 53.8 0 0 0 0 0 0 53.8 0 0 1015934266 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7180.12 0 0 0 0 0 0 0 0 0 0 0 0 0 7180.12 0 0 1015934391 1467023713 16 Nurse Practitioners KINGERY AMBER L 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1015934921 1689019598 10 Physicians ALSOMALI KHADRAH M 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 207 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2881.02 0 34.56 0 0 0 0 0 0 2915.58 0 0 1015934955 60 Pharmacies 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 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 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340.93 0 0 0 340.93 0 0 1015934967 1194493080 11 Dentists ABDULMAJEED ALI 999999999 200 Cook 0 0 0 0 30 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 4802.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4802.16 0 0 1015935085 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 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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 6768.42 0 0 0 0 0 0 0 0 0 0 0 0 0 6768.42 0 0 1015938903 10 Physicians 53 Kane 0 0 Thoracic 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.67 0 0 0 0 0 0 113.67 0 0 1015939783 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4577.87 0 0 0 0 0 0 0 0 0 0 0 0 0 4577.87 0 0 1015939951 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1337.91 0 0 0 0 0 0 0 0 0 0 0 0 0 1337.91 0 0 1015940225 10 Physicians 10 Adams 0 0 0 0 0 0 0 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 29 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 0 678.49 0 0 0 0 0 0 678.49 0 0 1015940841 1669051975 16 Nurse Practitioners GOOD HEATHER 999999999 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 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 0 178.24 0 0 0 0 0 0 178.24 0 0 1015940962 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 0 139.66 0 0 0 0 0 0 0 0 0 0 0 0 0 139.66 0 0 1015941163 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13365.21 0 0 0 0 0 0 0 0 0 0 0 0 0 13365.21 0 0 1015941504 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 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 3257.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3257.6 0 0 1015941541 10 Physicians 70 McDonough 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35.2 0 0 0 0 0 0 35.2 0 0 1015941656 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 1015942244 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 1008.73 0 0 0 0 0 0 1008.73 0 0 1015942711 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7106.22 0 0 0 0 0 0 0 0 0 0 0 0 0 7106.22 0 0 1015942961 1629746706 22 Physical Therapists KONTOS DENA 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 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 4757.61 4757.61 0 0 1015944258 1275780470 12 Optometrists PIANT JASON 999999999 200 Cook 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 0 198 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 1607.98 0 0 0 0 0 0 1607.98 0 0 1015944500 1720608763 89 Physician Assistant Only(Encounter Only) OLSON ALEXA 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 0 511.71 0 0 0 0 0 0 511.71 0 0 1015944711 1558896613 86 Clinical Social Worker(Encounter Only) WEILAND LEAH 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 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 0 104.97 0 0 0 0 0 0 104.97 0 0 1015944942 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 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 3215.01 0 0 0 0 0 0 0 0 0 0 0 0 0 3215.01 0 0 1015945228 10 Physicians 54 Kankakee 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 0 0 0 0 0 0 0 0 0 0 1015945303 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4298.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4298.66 0 0 1015945329 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 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 0 149.44 149.44 0 0 1015945498 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 450.03 0 0 0 0 0 0 0 0 0 0 0 0 0 450.03 0 0 1015945683 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 1015945717 1639103302 10 Physicians PATEL VIMAL 999999999 30 DuPage 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 0 144 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 1431.8 0 0 0 0 0 0 1431.8 0 0 1015946369 89 Physician Assistant Only(Encounter Only) 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 15.53 0 0 0 0 0 0 15.53 0 0 1015946667 1538510300 10 Physicians BOOTH ADAM L 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 342.65 0 0 0 0 0 0 0 0 342.65 0 0 1015946752 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1537.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1537.43 0 0 1015946781 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 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1823.22 1823.22 0 0 1015946970 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 0 232.84 0 0 0 0 0 0 232.84 0 0 1015946987 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 5 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4692.03 0 0 0 0 0 0 0 0 0 0 0 0 0 4692.03 0 0 1015948146 1760050744 11 Dentists OWAIS AHSAN 999999999 200 Cook 0 0 0 0 76 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 9746.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9746.15 0 0 1015948382 1447663539 10 Physicians WIELE ANDREW J 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 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 0 940.33 0 0 0 0 0 0 940.33 0 0 1015948685 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 2372.81 0 0 0 0 0 0 0 0 0 0 0 0 0 2372.81 0 0 1015948907 1326536921 10 Physicians SKIADOPOULOS LEONIDAS 999999999 24 Coles 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 1539.08 0 0 0 0 0 0 1539.08 0 0 1015948983 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5458.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5458.91 0 0 1015949100 10 Physicians 96 St Clair 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.78 0 0 0 0 0 0 0 0 11.78 0 0 1015949147 16 Nurse Practitioners 107 Will 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 0 174.35 0 0 0 0 0 0 174.35 0 0 1015949879 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 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 8710.69 0 0 0 0 0 0 0 0 0 0 0 0 0 8710.69 0 0 1015950280 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14445.92 0 0 0 0 0 0 0 0 0 0 0 0 0 14445.92 0 0 1015950501 10 Physicians 200 Cook 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 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 0 735.17 0 0 0 0 0 0 735.17 0 0 1015950818 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6505.52 0 0 0 0 0 0 0 0 0 0 0 0 0 6505.52 0 0 1015950968 1881282523 89 Physician Assistant Only(Encounter Only) SULLIVAN CONNOR J 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 364.65 0 0 0 0 0 0 364.65 0 0 1015951230 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 402.79 0 0 0 0 0 0 0 0 0 0 0 0 0 402.79 0 0 1015951252 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 78.34 0 0 0 0 0 0 78.34 0 0 1015951343 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 1875.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1875.01 0 0 1015951571 1851778633 10 Physicians CHELALA LYDIA 999999999 30 DuPage 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 0 788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5522.16 0 0 0 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0 0 12271.05 0 0 1015952299 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6802.77 0 0 0 0 0 0 0 0 0 0 0 0 0 6802.77 0 0 1015952421 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 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 4253.2 0 0 0 0 0 0 0 0 0 0 0 0 0 4253.2 0 0 1015952510 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015952578 1831680438 16 Nurse Practitioners MAY TRACEY 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 0 150.68 0 0 0 0 0 0 150.68 0 0 1015953250 10 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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 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 3873.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3873.33 0 0 1015953969 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 520.1 0 0 0 0 0 0 0 0 0 0 0 0 0 520.1 0 0 1015954447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5021.4 0 0 0 0 0 0 0 0 0 0 0 0 0 5021.4 0 0 1015954796 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 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 3435.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3435.08 0 0 1015954834 1457936437 24 Speech Therapists CONLON KATELYN R 999999999 53 Kane 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0 0 0 0 0 0 1172.67 0 0 0 0 0 0 0 0 0 0 0 0 0 1172.67 0 0 1015980447 1700477262 89 Physician Assistant Only(Encounter Only) RADO JAMES E 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 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 0 526.35 0 0 0 0 0 0 526.35 0 0 1015980497 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 199.73 0 0 0 0 0 0 0 0 0 0 0 0 0 199.73 0 0 1015980591 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.01 9.01 0 0 1015980717 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 47.77 0 0 0 0 0 0 47.77 0 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0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2967.46 0 0 0 0 0 0 0 0 0 0 0 0 0 2967.46 0 0 1015983146 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11900.25 0 0 0 0 0 0 0 0 0 0 0 0 0 11900.25 0 0 1015983326 1194119339 10 Physicians LEE RAMON 999999999 200 Cook 0 0 Ophthalmology 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 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.4 0 2763.84 0 0 0 0 0 0 2774.24 0 0 1015983442 1841896644 16 Nurse Practitioners COTTINI HEATHER 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 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 0 735.66 0 0 0 0 0 0 735.66 0 0 1015983568 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 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1015985552 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 0 210.7 0 0 0 0 0 0 210.7 0 0 1015985688 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 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 4686.3 0 0 0 0 0 0 0 0 0 0 0 0 0 4686.3 0 0 1015985743 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 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 0 924.42 0 0 0 0 0 0 0 0 0 0 0 0 0 924.42 0 0 1015985807 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 5952.37 0 0 0 0 0 0 0 0 0 0 0 0 0 5952.37 0 0 1015985935 91 Waiver service 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0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67.82 0 0 0 0 0 0 0 0 0 0 0 0 0 67.82 0 0 1015987106 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10411.92 0 0 0 0 0 0 0 0 0 0 0 0 0 10411.92 0 0 1015987120 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.24 0 0 0 0 0 0 17.24 0 0 1015987181 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5704.66 0 0 0 0 0 0 0 0 0 0 0 0 0 5704.66 0 0 1015987652 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1874.48 0 0 0 0 0 0 0 0 0 0 0 0 0 1874.48 0 0 1015987694 1851979280 33 Nursing Facilities NATURE TRAIL HEALTH AND REHAB 999999999 49 Jefferson 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 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 155619.05 0 0 0 0 0 0 0 155619.05 0 0 1015988022 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 31.01 0 0 0 0 0 0 31.01 0 0 1015988580 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 0 619.53 0 0 0 0 0 0 0 0 0 0 0 0 0 619.53 0 0 1015988873 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1042.92 0 0 0 0 0 0 0 0 0 0 0 0 0 1042.92 0 0 1015988883 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 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 2442.79 0 0 0 0 0 0 0 0 0 0 0 0 0 2442.79 0 0 1015989119 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8574.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8574.76 0 0 1015989327 1710482039 10 Physicians SQUIERS KATHRYN E 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 652.26 0 0 0 0 0 0 652.26 0 0 1015989465 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.24 0 0 0 0 0 0 0 0 0 0 0 0 0 219.24 0 0 1015989498 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1773.86 0 0 0 0 0 0 0 0 0 0 0 0 0 1773.86 0 0 1015989542 10 Physicians 53 Kane 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 2.01 0 0 0 0 0 0 2.01 0 0 1015989698 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3435.08 0 0 0 0 0 0 0 0 0 0 0 0 0 3435.08 0 0 1015990084 10 Physicians 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015990309 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 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 1015990415 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 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 1666.34 0 0 0 0 0 0 0 0 0 0 0 0 0 1666.34 0 0 1015990492 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7260.82 0 0 0 0 0 0 0 0 0 0 0 0 0 7260.82 0 0 1015990566 1659630192 10 Physicians GOEL AKASH 999999999 15 Bureau 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 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 1151.92 0 0 0 0 0 0 1151.92 0 0 1015991366 1629573241 10 Physicians ANALYTIS STEPHANIE P 999999999 53 Kane 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 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 0 0 0 0 0 0 0 0 0 0 1015991372 1851969976 16 Nurse Practitioners PARA KATARZYNA 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 0 107 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 3451.09 0 0 0 0 0 0 3451.09 0 0 1015991421 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.68 17.68 0 0 1015991455 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 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 0 846.3 0 0 0 0 0 0 0 0 0 0 0 0 0 846.3 0 0 1015991915 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4791.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4791.39 0 0 1015992037 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 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 2.73 0 0 0 0 0 0 2.73 0 0 1015992074 1558687939 10 Physicians HAIDER HIBA A 999999999 30 DuPage 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 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 0 160.73 0 0 0 0 0 0 160.73 0 0 1015992143 1053938332 16 Nurse Practitioners RODRIGUEZ PAULA 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 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 0 610 0 0 0 0 0 0 610 0 0 1015992316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3338.33 0 0 0 0 0 0 0 0 0 0 0 0 0 3338.33 0 0 1015992700 1003498965 30 General Hospitals DIALYSIS CARE CENTER ROCKFORD 611032158 109 Winnebago DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015993192 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.01 0 0 0 0 0 0 12.01 0 0 1015993932 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11529.21 0 0 0 0 0 0 0 0 0 0 0 0 0 11529.21 0 0 1015994228 1861072530 91 Waiver service provider--Adults (DHS/DDD) RENFROW MARIAH 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 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31003.47 0 0 0 0 0 0 0 0 0 0 0 0 0 31003.47 0 0 1015994263 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9101.91 0 0 0 0 0 0 0 0 0 0 0 0 0 9101.91 0 0 1015994451 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 1015994756 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 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 1939.69 0 0 0 0 0 0 0 0 0 0 0 0 0 1939.69 0 0 1015995125 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1015995202 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 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 0 208.56 0 0 0 0 0 0 208.56 0 0 1015995376 1891389508 89 Physician Assistant Only(Encounter Only) POLK KRISTEN E 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 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 0 361.68 0 0 0 0 0 0 361.68 0 0 1015995755 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8595.84 0 0 0 0 0 0 0 0 0 0 0 0 0 8595.84 0 0 1015995931 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 0 497.9 0 0 0 0 0 0 0 0 0 0 0 0 0 497.9 0 0 1015995996 10 Physicians 53 Kane 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 7.26 0 0 0 0 0 0 7.26 0 0 1015996058 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7349.07 0 0 0 0 0 0 0 0 0 0 0 0 0 7349.07 0 0 1015996731 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 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 0 210.7 0 0 0 0 0 0 210.7 0 0 1015996951 1134518087 10 Physicians COHEN LIZA M 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 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 0 713.36 0 0 0 0 0 0 713.36 0 0 1015997062 1174044077 10 Physicians OWEN JOSHUA M 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 54.04 0 0 0 0 0 0 54.04 0 0 1015997999 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2711.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2711.1 0 0 1015998675 1366974578 10 Physicians SZPARA TAYLOR 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 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 0 654.15 0 0 0 0 0 0 654.15 0 0 1015998970 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 73.46 0 0 0 0 0 0 73.46 0 0 1015999064 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 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 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 1015999646 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 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 3169.71 0 0 0 0 0 0 0 0 0 0 0 0 0 3169.71 0 0 1016000043 1639521669 16 Nurse Practitioners KALVODA NATALIE 999999999 107 Will 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 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 0 130.62 0 0 0 0 0 0 130.62 0 0 1016000053 1962638494 10 Physicians NAJERA LARRY V 999999999 80 Peoria 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 226.24 0 0 0 0 0 0 226.24 0 0 1016000411 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9503.45 0 0 0 0 0 0 0 0 0 0 0 0 0 9503.45 0 0 1016000471 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.86 0 0 0 0 0 0 39.86 0 0 1016000603 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 0 0 0 0 0 0 0 0 0 0 1016000952 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1440.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1440.88 0 0 1016001019 1114518834 16 Nurse Practitioners REYNOLDS MEGAN R 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 193.44 0 0 0 0 0 0 193.44 0 0 1016001332 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1936.38 0 0 0 0 0 0 0 0 0 0 0 0 0 1936.38 0 0 1016001418 1275159428 89 Physician Assistant Only(Encounter Only) EVERT BREANNA 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 0 114.86 0 0 0 0 0 0 114.86 0 0 1016001496 1962024109 89 Physician Assistant Only(Encounter Only) CAMPBELL BRITTANY 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 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 0 508.77 0 0 0 0 0 0 508.77 0 0 1016001525 1124672142 12 Optometrists KWAN KATIE K 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 287.53 0 0 0 0 0 0 287.53 0 0 1016001664 1326590274 91 Waiver service provider--Adults (DHS/DDD) WYSOGLAD CAITLYN 999999999 91 Sangamon 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7486 0 0 0 0 0 0 0 0 0 0 0 0 0 7486 0 0 1016001844 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4553.37 0 0 0 0 0 0 0 0 0 0 0 0 0 4553.37 0 0 1016002762 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3984.12 0 0 0 0 0 0 0 0 0 0 0 0 0 3984.12 0 0 1016002856 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 1603.75 0 0 0 0 0 0 0 0 0 0 0 0 0 1603.75 0 0 1016002935 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23292.61 0 0 0 0 0 0 0 0 0 0 0 0 0 23292.61 0 0 1016003017 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4118.65 0 0 0 0 0 0 0 0 0 0 0 0 0 4118.65 0 0 1016003027 1033592340 10 Physicians LIGHTER MELANI 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 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 0 850.57 0 0 0 0 0 0 850.57 0 0 1016003588 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 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 0 355.9 355.9 0 0 1016003619 1821678764 63 Other Providers of Medical Equipment/Supplies (Non-registered) A-1 MEDICAL EQUIPMENTS & SUPPL 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 1503.46 0 0 0 0 0 0 1503.46 0 0 1016003837 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 0 258.63 0 0 0 0 0 0 0 0 0 0 0 0 0 258.63 0 0 1016003922 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 2279.14 0 0 0 0 0 0 0 0 0 0 0 0 0 2279.14 0 0 1016004404 1831767938 28 Waiver service provider--Supportive living facility (HFS) RAVENSWOOD SENIOR LIVING 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 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135890.61 0 0 0 0 0 0 0 0 0 0 0 0 0 135890.61 0 0 1016005186 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 298.22 0 0 0 0 0 0 0 0 0 0 0 0 0 298.22 0 0 1016005322 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1530.14 0 0 0 0 0 0 0 0 0 0 0 0 0 1530.14 0 0 1016005685 55 Early Intervention Services 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 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 1523.81 0 0 0 0 0 0 1523.81 0 0 1016006449 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 46.45 0 0 0 0 0 0 46.45 0 0 1016006682 1922502467 10 Physicians JOHNSON JUSTINA 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 0 133.82 0 0 0 0 0 0 133.82 0 0 1016006934 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 24.25 0 0 0 0 0 0 24.25 0 0 1016007260 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 1016007739 25 Audiologists 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 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 228.91 228.91 0 0 1016009009 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260.95 0 0 0 0 0 0 260.95 0 0 1016009178 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3124.8 0 0 0 0 0 0 0 0 0 0 0 0 0 3124.8 0 0 1016009729 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 845.4 0 0 0 0 0 0 0 0 0 0 0 0 0 845.4 0 0 1016009760 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5173.94 0 0 0 0 0 0 0 0 0 0 0 0 0 5173.94 0 0 1016010344 1982126074 25 Audiologists MAXIM HILARY A 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 206 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 1121.36 1121.36 0 0 1016010517 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 0 245.2 0 0 0 0 0 0 245.2 0 0 1016011533 1134735962 10 Physicians LUNG KALVIN CH 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 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 4931.28 0 0 0 0 0 0 4931.28 0 0 1016011689 1932725801 16 Nurse Practitioners WATKINS HILLARY 999999999 200 Cook 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 82 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1581.48 0 0 0 0 0 0 1613.63 0 0 1016011768 1538836200 11 Dentists AGRAWAL KARTIKI 999999999 58 La Salle 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 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 0 886.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 886.9 0 0 1016011898 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 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 18806.7 0 0 0 0 0 0 0 0 0 0 0 0 0 18806.7 0 0 1016011923 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 2021.35 0 0 0 0 0 0 0 0 0 0 0 0 0 2021.35 0 0 1016011967 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.84 0 0 0 0 0 0 0 0 0 0 0 0 0 151.84 0 0 1016012039 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 14.26 0 0 0 0 0 0 14.26 0 0 1016012224 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593.74 0 0 0 0 0 0 0 0 0 0 0 0 0 593.74 0 0 1016012700 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 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 0 301.87 0 0 0 0 0 0 0 0 0 0 0 0 0 301.87 0 0 1016012753 1588076285 10 Physicians RAMIREZ GOMEZ JOSE M 999999999 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3820.39 0 0 0 0 0 0 3820.39 0 0 1016013026 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15003.77 0 0 0 0 0 0 0 0 0 0 0 0 0 15003.77 0 0 1016013054 1831430941 60 Pharmacies OKAWVILLE MEDICENTER PHARMACY 622711799 103 Washington 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 1474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3518.36 0 0 0 3518.36 0 0 1016013347 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 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 6463.16 0 0 0 0 0 0 0 0 0 0 0 0 0 6463.16 0 0 1016013624 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4539.64 0 0 0 0 0 0 0 0 0 0 0 0 0 4539.64 0 0 1016013812 1972098457 10 Physicians PATEL CHARMI 999999999 200 Cook 0 0 Internal Medicine 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 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 1049.78 0 0 0 0 0 0 1049.78 0 0 1016013939 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1343.2 0 0 0 0 0 0 0 0 0 0 0 0 0 1343.2 0 0 1016013954 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 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 3548.76 0 0 0 0 0 0 0 0 0 0 0 0 0 3548.76 0 0 1016014872 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2929.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2929.36 0 0 1016014906 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1122.97 0 0 0 0 0 0 0 0 0 0 0 0 0 1122.97 0 0 1016015013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 10455.38 0 0 0 0 0 0 0 0 0 0 0 0 0 10455.38 0 0 1016015519 1871110254 60 Pharmacies RIDGEWOOD PHARMACY 999999999 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 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 0 711 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 430.84 0 0 0 430.84 0 0 1016015567 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016015599 1356721930 10 Physicians ARNOLD JENNIFER 999999999 91 Sangamon 0 0 Neurology 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 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 0 721.03 0 0 0 0 0 0 721.03 0 0 1016015827 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 747.02 0 0 0 0 0 0 0 0 0 0 0 0 0 747.02 0 0 1016016538 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5412.87 0 0 0 0 0 0 0 0 0 0 0 0 0 5412.87 0 0 1016016646 1891280624 10 Physicians LEI CHI MAN 999999999 19 Champaign 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 0 117 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 1582.15 0 0 0 0 0 0 1582.15 0 0 1016017828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1559.78 0 0 0 0 0 0 0 0 0 0 0 0 0 1559.78 0 0 1016018226 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1703.52 0 0 0 0 0 0 0 0 0 0 0 0 0 1703.52 0 0 1016018416 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 804.09 0 0 0 0 0 0 0 0 0 0 0 0 0 804.09 0 0 1016018795 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016019059 1356835284 10 Physicians ROOT MATTHEW 999999999 200 Cook 0 0 0 0 0 3 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 223.66 0 0 0 0 0 0 273.1 0 747.28 0 0 0 0 0 0 1244.04 0 0 1016019327 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4905.08 0 0 0 0 0 0 0 0 0 0 0 0 0 4905.08 0 0 1016019350 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2958.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2958.8 0 0 1016019361 4016019361 90 Waiver service provider--Elderly (DOA) "ALPHA IN-HOME SERVICES, LLC" 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 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53410.5 0 0 0 0 0 0 0 0 0 0 0 0 0 53410.5 0 0 1016019617 1811564743 16 Nurse Practitioners BRANDS THERESA 999999999 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 456.57 0 0 0 0 0 0 456.57 0 0 1016020096 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 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 0 331.9 0 0 0 0 0 0 0 0 0 0 0 0 0 331.9 0 0 1016020144 10 Physicians 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 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 0 190.9 0 0 0 0 0 0 190.9 0 0 1016020431 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 1016020444 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 4177.18 0 0 0 0 0 0 0 0 0 0 0 0 0 4177.18 0 0 1016020720 1376122408 23 Occupational Therapists MELVILLE LAURA 999999999 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 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 1337.97 1337.97 0 0 1016021019 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 37.69 37.69 0 0 1016021079 1386310605 16 Nurse Practitioners GAZDZIAK LISA 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 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 0 363.3 0 0 0 0 0 0 363.3 0 0 1016021432 1255934378 16 Nurse Practitioners ANDAL WHITNEY R 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 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 1016021870 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 1011.49 0 0 0 0 0 0 0 0 0 0 0 0 0 1011.49 0 0 1016021987 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 1016021996 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016022380 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6907.93 0 0 0 0 0 0 0 0 0 0 0 0 0 6907.93 0 0 1016022674 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 6290.86 0 0 0 0 0 0 0 0 0 0 0 0 0 6290.86 0 0 1016023188 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 4059 0 0 0 0 0 0 0 0 0 0 0 0 0 4059 0 0 1016023325 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 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 0 900.54 0 0 0 0 0 0 0 0 0 0 0 0 0 900.54 0 0 1016023697 10 Physicians 109 Winnebago 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 12.02 0 106.8 0 0 0 0 0 0 118.82 0 0 1016024950 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2196.68 0 0 0 0 0 0 0 0 0 0 0 0 0 2196.68 0 0 1016025100 1295128049 23 Occupational Therapists ESPINOSA ANETA M 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 920 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66061.04 66061.04 0 0 1016025343 1487110540 16 Nurse Practitioners HAGGER KARRIE 999999999 79 Ogle 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 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 860.89 0 0 0 0 0 0 860.89 0 0 1016025454 1023460086 22 Physical Therapists CYGAN JACK 999999999 200 Cook 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 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2823.02 2823.02 0 0 1016025519 1790139269 10 Physicians RAY JOCELYN 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 0 302.67 0 0 0 0 0 0 302.67 0 0 1016026054 1568054096 16 Nurse Practitioners HYDE MATTHEW 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 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 0 587.02 0 0 0 0 0 0 587.02 0 0 1016026825 1760099337 16 Nurse Practitioners PISAREVSKAYA TATYANA 999999999 57 Lake 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 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 54.34 0 0 0 0 0 0 54.34 0 0 1016026946 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 3657.3 0 0 0 0 0 0 0 0 0 0 0 0 0 3657.3 0 0 1016027059 1225487663 10 Physicians ROBERTS JARED R 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 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 0 706.05 0 0 0 0 0 0 706.05 0 0 1016027123 25 Audiologists 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 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 0 167.83 167.83 0 0 1016027368 63 Other Providers of Medical Equipment/Supplies (Non-registered) 810 Florida 0 0 0 0 0 0 0 0 0 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 0 108.16 0 0 0 0 0 0 108.16 0 0 1016027469 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 663.09 0 0 0 0 0 0 0 0 0 0 0 0 0 663.09 0 0 1016027936 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 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 2698.41 0 0 0 0 0 0 0 0 0 0 0 0 0 2698.41 0 0 1016028024 1861653958 10 Physicians HAERIAN HAFEZ 999999999 82 Piatt 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 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7685.05 0 0 0 0 0 0 0 0 7685.05 0 0 1016028055 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16779.89 0 0 0 0 0 0 0 0 0 0 0 0 0 16779.89 0 0 1016028236 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 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 1534.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1534.19 0 0 1016028639 10 Physicians 30 DuPage 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 0 106.28 0 0 0 0 0 0 106.28 0 0 1016028745 1568065514 16 Nurse Practitioners AREGBESOLA OLUWAKEMI 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 0 120 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 0 332.62 0 0 0 0 0 0 332.62 0 0 1016028788 1396038188 10 Physicians WU XIAOPING 999999999 200 Cook 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 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 0 659.52 0 0 0 0 0 0 659.52 0 0 1016028835 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7900.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7900.51 0 0 1016028930 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2604.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2604.8 0 0 1016029100 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9447.58 0 0 0 0 0 0 0 0 0 0 0 0 0 9447.58 0 0 1016029416 4016029416 90 Waiver service provider--Elderly (DOA) LOVED ONES HOME HEALTH 999999999 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 0 396 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 44436.6 0 0 0 0 0 0 0 0 0 0 0 0 0 44436.6 0 0 1016029585 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12169.3 0 0 0 0 0 0 0 0 0 0 0 0 0 12169.3 0 0 1016029723 1790379147 28 Waiver service provider--Supportive living facility (HFS) BROOKSTONE ESTATES OF ROBINSON 999999999 25 Crawford 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43661.42 0 0 0 0 0 0 0 0 0 0 0 0 0 43661.42 0 0 1016029759 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 1085 0 0 1016029911 1245902915 55 Early Intervention Services VILLANUEVA JEANETTE 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 4063.14 0 0 0 0 0 0 4063.14 0 0 1016030126 1437595469 10 Physicians IMAOKA RESTEN T 999999999 53 Kane 0 0 0 0 0 0 0 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 69.81 0 0 0 0 0 0 0 0 69.81 0 0 1016030331 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.09 0 0 0 0 0 0 0 0 0 0 0 0 0 75.09 0 0 1016030466 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 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 0 493.48 493.48 0 0 1016030800 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 73.4 0 0 0 0 0 0 73.4 0 0 1016030907 1275975682 10 Physicians DAS LAKSHMI 999999999 19 Champaign 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 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 95.08 0 0 0 0 0 0 95.08 0 0 1016031012 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172.36 0 0 0 0 0 0 0 0 0 0 0 0 0 172.36 0 0 1016031384 1366028318 16 Nurse Practitioners ABUKAR MUHIDIN 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 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 0 837.81 0 0 0 0 0 0 837.81 0 0 1016031423 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11961.73 0 0 0 0 0 0 0 0 0 0 0 0 0 11961.73 0 0 1016031540 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 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 4 0 0 0 0 0 0 4 0 0 1016031721 1386215937 11 Dentists CONTI MICA FRANK 999999999 71 McHenry 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1309.32 0 0 1016032044 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 482.25 0 0 0 0 0 0 0 0 0 0 0 0 0 482.25 0 0 1016032161 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5198.11 0 0 0 0 0 0 0 0 0 0 0 0 0 5198.11 0 0 1016032216 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6010.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6010.9 0 0 1016032556 1366772287 11 Dentists RAKSTANG JONATHAN K 999999999 200 Cook 0 0 0 0 53 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 12513.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12513.35 0 0 1016032960 1770786972 10 Physicians TRAN TIN 999999999 53 Kane 0 0 Anesthesiology 0 0 0 0 0 0 0 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 0 579.53 0 0 0 0 0 0 579.53 0 0 1016033020 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6810.83 0 0 0 0 0 0 0 0 0 0 0 0 0 6810.83 0 0 1016033069 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 613.53 0 0 0 0 0 0 0 0 0 0 0 0 0 613.53 0 0 1016033211 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7708.91 0 0 0 0 0 0 0 0 0 0 0 0 0 7708.91 0 0 1016033687 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6585.95 0 0 0 0 0 0 0 0 0 0 0 0 0 6585.95 0 0 1016033860 1831772912 16 Nurse Practitioners WLODEK AMY C 999999999 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016034134 1467035881 16 Nurse Practitioners CONOBOY KAREN 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 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 0 145.71 0 0 0 0 0 0 145.71 0 0 1016035307 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 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 30968.36 0 0 0 0 0 0 0 0 0 0 0 0 0 30968.36 0 0 1016035534 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4997.57 0 0 0 0 0 0 0 0 0 0 0 0 0 4997.57 0 0 1016035856 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12231.58 0 0 0 0 0 0 0 0 0 0 0 0 0 12231.58 0 0 1016035908 1922687938 16 Nurse Practitioners ADAMS ANGELA N 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 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 0 312.79 0 0 0 0 0 0 312.79 0 0 1016036097 1184986093 12 Optometrists SABO SNEZHANA B 999999999 200 Cook 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 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 0 252.35 0 0 0 0 0 0 252.35 0 0 1016037320 1013440221 10 Physicians CHOI ALEXANDER J 999999999 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 0 111.56 0 0 0 0 0 0 111.56 0 0 1016037486 1396332300 16 Nurse Practitioners MACKIN HILARY 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 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340.62 0 0 0 0 0 0 340.62 0 0 1016037645 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 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 1538.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1538.46 0 0 1016037828 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8490.55 0 0 0 0 0 0 0 0 0 0 0 0 0 8490.55 0 0 1016037862 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 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 0 657.64 657.64 0 0 1016038205 1477933497 10 Physicians LEE SIMON 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 7 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387.83 0 2418.44 0 0 0 0 0 0 2806.27 0 0 1016038797 1689036758 10 Physicians STEWART LINDSEY 999999999 109 Winnebago 0 0 Psychiatry 0 0 0 0 0 0 0 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 2178.2 0 0 0 0 0 0 2178.2 0 0 1016039205 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7275.5 0 0 0 0 0 0 0 0 0 0 0 0 0 7275.5 0 0 1016039450 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9615.35 0 0 0 0 0 0 0 0 0 0 0 0 0 9615.35 0 0 1016039649 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 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 4859.14 0 0 0 0 0 0 4859.14 0 0 1016039711 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 629.68 0 0 0 0 0 0 0 0 0 0 0 0 0 629.68 0 0 1016039864 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4194.75 0 0 0 0 0 0 0 0 0 0 0 0 0 4194.75 0 0 1016041298 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.7 0 0 0 0 0 0 0 0 0 0 0 0 0 21.7 0 0 1016041448 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 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 2555.16 0 0 0 0 0 0 0 0 0 0 0 0 0 2555.16 0 0 1016041700 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 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 0 111.82 111.82 0 0 1016041762 1184827172 10 Physicians REISENBICHLER EMILY 999999999 89 Rock Island 0 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 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 1016077878 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6021.31 0 0 0 0 0 0 0 0 0 0 0 0 0 6021.31 0 0 1016077884 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667.6 0 0 0 0 0 0 0 0 0 0 0 0 0 667.6 0 0 1016077938 1831653401 16 Nurse Practitioners ABRAHAM JOSEPH J 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 0 285.46 0 0 0 0 0 0 285.46 0 0 1016078837 24 Speech Therapists 91 Sangamon 0 0 0 0 0 0 0 0 0 0 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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 74.95 0 0 0 0 0 0 74.95 0 0 1016087353 1306287396 10 Physicians SULEIMAN AYUB 999999999 91 Sangamon 0 0 Radiology Diagnosis 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 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.31 0 189.29 0 0 0 0 0 0 196.6 0 0 1016087380 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 93.95 0 0 0 0 0 0 93.95 0 0 1016087496 1104316058 10 Physicians SOUTHERLAND DANIELLE 999999999 53 Kane 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 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 0 623.52 0 0 0 0 0 0 623.52 0 0 1016087532 1114583481 11 Dentists SAHLOUL JAMAL 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 0 232 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 10958.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10958.48 0 0 1016087599 1063047371 16 Nurse Practitioners RAYA KRISTYN A 999999999 10 Adams 0 0 0 0 0 0 0 0 0 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 0 207.83 0 0 0 0 0 0 207.83 0 0 1016087618 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21.32 0 0 0 0 0 0 0 0 0 0 0 0 0 21.32 0 0 1016087631 1760890313 16 Nurse Practitioners BAUKERT LINDSAY 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 0 402 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 57964.63 0 0 0 0 0 0 57964.63 0 0 1016087925 10 Physicians 60 Lee 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.4 0 0 1016088391 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 1.6 0 0 0 0 0 0 1.6 0 0 1016088600 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7963.9 0 0 0 0 0 0 0 0 0 0 0 0 0 7963.9 0 0 1016088611 1245524404 10 Physicians HAZEGHAZAM MARYAM HELEN 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 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 0 236.9 0 0 0 0 0 0 236.9 0 0 1016088705 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 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0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5635.7 0 0 0 0 0 0 0 0 0 0 0 0 0 5635.7 0 0 1016089665 1518562982 75 Department of Alcohol and Substance Abuse Provider "MUTUAL GROUND, INC." 999999999 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 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 7677.43 0 0 7677.43 0 0 1016090038 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2079.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2079.38 0 0 1016090111 1619561594 16 Nurse Practitioners WHITE TARA M 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 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 0 599.08 0 0 0 0 0 0 599.08 0 0 1016090168 1134899818 89 Physician Assistant Only(Encounter Only) NGUYEN AN THUY HONG 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 0 179.12 0 0 0 0 0 0 179.12 0 0 1016090283 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016090401 60 Pharmacies 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 9.2 0 0 0 9.2 0 0 1016090521 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 1016090779 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 256.63 0 0 0 0 0 0 0 0 0 0 0 0 0 256.63 0 0 1016090860 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4837.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4837.8 0 0 1016090867 10 Physicians 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 0 238.25 0 0 0 0 0 0 238.25 0 0 1016090917 1457823544 16 Nurse Practitioners SCHEERENBERGER THERESA K 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 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 0 492.42 0 0 0 0 0 0 492.42 0 0 1016091116 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020.77 0 0 0 0 0 0 1020.77 0 0 1016091671 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 455.2 0 0 0 0 0 0 0 0 0 0 0 0 0 455.2 0 0 1016091999 1487919502 10 Physicians PATEL PRASAD 999999999 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 255 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 453 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4968.79 0 0 0 0 0 0 0 0 4968.79 0 0 1016092025 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2177.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2177.18 0 0 1016092421 10 Physicians 80 Peoria 0 0 Urology 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 1 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 125.96 0 0 0 0 0 0 128.14 0 0 1016092519 1427438704 16 Nurse Practitioners CURRY LISA 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 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 1016092592 1679017529 16 Nurse Practitioners EVANS IRINA S 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 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 0 240.43 0 0 0 0 0 0 240.43 0 0 1016092673 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 1016092714 1679193460 89 Physician Assistant Only(Encounter Only) ZASTROW THOMAS J 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 0 281.03 0 0 0 0 0 0 281.03 0 0 1016093334 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6293.45 0 0 0 0 0 0 0 0 0 0 0 0 0 6293.45 0 0 1016093492 1194257576 10 Physicians PATEL JIGAR J 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 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 0 365.69 0 0 0 0 0 0 365.69 0 0 1016093512 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016093630 11 Dentists 200 Cook 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 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 378 0 0 1016093675 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12602.25 0 0 0 0 0 0 0 0 0 0 0 0 0 12602.25 0 0 1016093685 1407458946 40 Federally Qualified Health Centers ESPERANZA AT VIDA PEDIATRICS 999999999 200 Cook 0 0 0 139 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 0 282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37814.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37814.72 0 0 1016093768 10 Physicians 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 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 1016093780 10 Physicians 107 Will 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016093912 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3655.51 0 0 0 0 0 0 0 0 0 0 0 0 0 3655.51 0 0 1016094093 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 15.88 0 0 0 0 0 0 15.88 0 0 1016094523 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 1019.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1019.83 0 0 1016094683 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3675.7 0 0 0 0 0 0 0 0 0 0 0 0 0 3675.7 0 0 1016094838 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 0 109.81 0 0 0 0 0 0 109.81 0 0 1016094863 1447414420 89 Physician Assistant Only(Encounter Only) KREWSON CLINTON 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 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 0 988.36 0 0 0 0 0 0 988.36 0 0 1016095061 10 Physicians 200 Cook 0 0 Plastic Surgery 0 0 0 0 0 0 0 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 0 250.31 0 0 0 0 0 0 250.31 0 0 1016095267 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 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 1296.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1296.8 0 0 1016095319 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11236.35 0 0 0 0 0 0 0 0 0 0 0 0 0 11236.35 0 0 1016095581 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1104.43 0 0 0 0 0 0 0 0 0 0 0 0 0 1104.43 0 0 1016095621 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1079.4 0 0 1016095687 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4265.77 0 0 0 0 0 0 0 0 0 0 0 0 0 4265.77 0 0 1016095875 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1373.41 0 0 0 0 0 0 0 0 0 0 0 0 0 1373.41 0 0 1016095908 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 408.39 0 0 0 0 0 0 0 0 0 0 0 0 0 408.39 0 0 1016096129 1598262503 10 Physicians HORNBECK JUSTIN D 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 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 39.86 0 0 0 0 0 0 39.86 0 0 1016096357 1710576715 11 Dentists LEE KA HI 999999999 19 Champaign 0 0 General Dentistry 0 0 163 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 812 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 812 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 32411.03 0 0 0 0 0 0 0 0 0 0 0 4516.2 0 0 0 0 36927.23 0 0 1016096535 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016096784 1124550926 10 Physicians NAPIAL JOSHUA 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 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 0 994.68 0 0 0 0 0 0 994.68 0 0 1016096788 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12471.11 0 0 0 0 0 0 0 0 0 0 0 0 0 12471.11 0 0 1016096898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1827.09 0 0 0 0 0 0 0 0 0 0 0 0 0 1827.09 0 0 1016097039 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 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 11927.58 0 0 0 0 0 0 0 0 0 0 0 0 0 11927.58 0 0 1016097163 1508460635 16 Nurse Practitioners WOODARD JANET 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.2 0 0 0 0 0 0 12.2 0 0 1016097232 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18804.65 0 0 0 0 0 0 0 0 0 0 0 0 0 18804.65 0 0 1016097647 1881200178 30 General Hospitals KINDRED HOSPITAL - SYCAMORE 601782137 27 Dekalb ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 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 0 382 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43868.54 0 0 0 0 0 0 0 0 0 43868.54 0 0 1016097662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 941.08 0 0 0 0 0 0 0 0 0 0 0 0 0 941.08 0 0 1016097771 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 0 0 0 0 0 0 0 0 0 0 1016097834 1417308511 10 Physicians SINGH SONAL 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 2 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 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 11.52 0 762.09 0 0 0 0 0 0 773.61 0 0 1016097949 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7638.79 0 0 0 0 0 0 0 0 0 0 0 0 0 7638.79 0 0 1016098417 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 0 188.2 0 0 0 0 0 0 188.2 0 0 1016098844 1215316484 10 Physicians BEHERY OMAR 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 7 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.3 0 4466.68 0 0 0 0 0 0 4525.98 0 0 1016098851 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5242.16 0 0 0 0 0 0 0 0 0 0 0 0 0 5242.16 0 0 1016099257 1073181574 12 Optometrists PURRIER NICOLE 999999999 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 7 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180.85 0 146.4 0 0 0 0 327.25 0 0 1016099848 86 Clinical Social Worker(Encounter Only) 63 Macon 0 0 0 0 0 0 0 0 0 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 0 100.1 0 0 0 0 0 0 100.1 0 0 1016100162 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 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 1016100465 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4444.44 0 0 0 0 0 0 0 0 0 0 0 0 0 4444.44 0 0 1016100784 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2968.85 0 0 0 0 0 0 0 0 0 0 0 0 0 2968.85 0 0 1016101343 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 898.87 0 0 0 0 0 0 0 0 0 0 0 0 0 898.87 0 0 1016101732 1134735343 16 Nurse Practitioners FITZ MICHAEL B 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 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 2191.16 0 0 0 0 0 0 2191.16 0 0 1016102062 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 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 16289.44 0 0 0 0 0 0 0 0 0 0 0 0 0 16289.44 0 0 1016102323 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 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 13714.4 0 0 0 0 0 0 0 0 0 0 0 0 0 13714.4 0 0 1016102707 1730855537 12 Optometrists DAVIS SARAH R 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 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 0 429.32 0 0 0 0 0 0 429.32 0 0 1016102794 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 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 25.96 0 0 0 0 0 0 25.96 0 0 1016102843 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 919.05 0 0 0 0 0 0 0 0 0 0 0 0 0 919.05 0 0 1016102865 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2188.74 0 0 0 0 0 0 0 0 0 0 0 0 0 2188.74 0 0 1016102949 1194349191 91 Waiver service provider--Adults (DHS/DDD) MYERS KESHYRA 627621000 91 Sangamon 0 0 0 0 0 0 0 16 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 36517 0 0 0 0 0 0 0 0 0 0 0 0 0 36517 0 0 1016103643 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366.92 0 0 0 0 0 0 0 0 0 0 0 0 0 366.92 0 0 1016103720 1023034196 10 Physicians ALVAREZ VANESSA 999999999 91 Sangamon 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 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 0 545.46 0 0 0 0 0 0 545.46 0 0 1016103870 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 266.27 0 0 0 0 0 0 0 0 0 0 0 0 0 266.27 0 0 1016104029 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8504.14 0 0 0 0 0 0 0 0 0 0 0 0 0 8504.14 0 0 1016104201 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133.49 0 0 0 0 0 0 0 0 0 0 0 0 0 133.49 0 0 1016104783 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.21 0 0 0 0 0 0 0 0 0 0 0 0 0 39.21 0 0 1016104914 1780175612 10 Physicians IOFFE TARA C 999999999 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 25.76 0 0 0 0 0 0 0 0 266.81 0 0 0 0 0 0 292.57 0 0 1016104949 1609165356 10 Physicians YAMAMOTO SHOTA 999999999 57 Lake 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 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 1528.32 0 0 0 0 0 0 0 0 1528.32 0 0 1016105083 1073038519 11 Dentists MA RUIDAN 999999999 200 Cook 0 0 0 0 12 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 1057.12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1057.12 0 0 1016105158 1255759700 10 Physicians LAROSSA PETER D 999999999 80 Peoria 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 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2024.35 0 0 0 0 0 0 2024.35 0 0 1016105313 1063186237 25 Audiologists KIRCHNER ABBIGAIL 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121.74 121.74 0 0 1016105321 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 353.05 0 0 0 0 0 0 353.05 0 0 1016105550 1629670237 25 Audiologists SHEERAN KATHLEEN ALEXANDRA 999999999 200 Cook 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 0 101 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 0 570.49 570.49 0 0 1016105689 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 1162.95 0 0 0 0 0 0 0 0 0 0 0 0 0 1162.95 0 0 1016105989 10 Physicians 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016106099 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016106906 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 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 1754.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1754.01 0 0 1016107024 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1020.82 0 0 0 0 0 0 0 0 0 0 0 0 0 1020.82 0 0 1016107235 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016107257 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 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 7676.02 0 0 0 0 0 0 0 0 0 0 0 0 0 7676.02 0 0 1016107645 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 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 16946.74 0 0 0 0 0 0 0 0 0 0 0 0 0 16946.74 0 0 1016107741 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6862.18 0 0 0 0 0 0 0 0 0 0 0 0 0 6862.18 0 0 1016107868 4016107868 91 Waiver service provider--Adults (DHS/DDD) MCFIELD ROBERT 999999999 23 Clinton 0 0 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 2755.2 0 0 0 0 0 0 0 0 0 0 0 0 0 2755.2 0 0 1016108093 12 Optometrists 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 0 0 0 0 0 0 0 0 0 0 1016108364 1487209045 16 Nurse Practitioners KAY CHRISTY A 999999999 60 Lee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 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 67.3 0 0 0 0 0 0 67.3 0 0 1016108376 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 6770.4 0 0 0 0 0 0 0 0 0 0 0 0 0 6770.4 0 0 1016108424 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10317.45 0 0 0 0 0 0 0 0 0 0 0 0 0 10317.45 0 0 1016108496 1336554716 10 Physicians HAGHSHENAS JAFAR 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 0 117 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 16739.07 0 0 0 0 0 0 16739.07 0 0 1016108590 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 47.08 0 0 0 0 0 0 47.08 0 0 1016108695 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 511.09 0 0 0 0 0 0 0 0 0 0 0 0 0 511.09 0 0 1016109187 1760987929 16 Nurse Practitioners GABRIEL LEANNE C 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 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 6.55 0 0 0 0 0 0 6.55 0 0 1016109190 1750960092 91 Waiver service provider--Adults (DHS/DDD) MAFTEI NADIA 999999999 91 Sangamon 0 0 0 0 0 0 0 25 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 0 682 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75126.24 0 0 0 0 0 0 0 0 0 0 0 0 0 75126.24 0 0 1016109224 1194327866 38 Specialized Mental Health Rehabilitation Facilities (SMHRF) LYDIA CARE CENTER 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 375353.72 0 0 0 0 0 0 0 375353.72 0 0 1016109241 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 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 9924.68 0 0 0 0 0 0 0 0 0 0 0 0 0 9924.68 0 0 1016110351 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 976.5 0 0 0 0 0 0 0 0 0 0 0 0 0 976.5 0 0 1016110675 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176.54 0 0 0 0 0 0 0 0 0 0 0 0 0 176.54 0 0 1016110820 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 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 0 777.14 777.14 0 0 1016111140 1376937722 10 Physicians MORNEAU LEONARD 999999999 30 DuPage 0 0 0 0 0 0 0 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 0 318.91 0 0 0 0 0 0 0 0 318.91 0 0 1016111452 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 64.08 0 0 0 0 0 0 64.08 0 0 1016111676 1528630837 33 Nursing Facilities WARREN BARR LIEBERMAN 999999999 200 Cook 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 0 318 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7901 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1390285.43 0 0 0 0 0 0 0 1390285.43 0 0 1016111874 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 812.6 0 0 0 0 0 0 0 0 0 0 0 0 0 812.6 0 0 1016112121 89 Physician Assistant Only(Encounter Only) 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 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 0 187 0 0 0 0 0 0 187 0 0 1016112295 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 757.36 0 0 0 0 0 0 0 0 0 0 0 0 0 757.36 0 0 1016112377 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 1545.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1545.61 0 0 1016112839 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 2868.63 0 0 1016113890 89 Physician Assistant Only(Encounter Only) 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 1016114010 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 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 0 0 0 0 1016114604 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9539.4 0 0 0 0 0 0 0 0 0 0 0 0 0 9539.4 0 0 1016114693 1003493958 16 Nurse Practitioners OMOROGIEVA TRACY 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 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 82.54 0 0 0 0 0 0 82.54 0 0 1016115033 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4882.01 0 0 0 0 0 0 0 0 0 0 0 0 0 4882.01 0 0 1016115433 1922633452 89 Physician Assistant Only(Encounter Only) HOUGSTED KRISTINA 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 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 0 387.18 0 0 0 0 0 0 387.18 0 0 1016115816 1558723239 10 Physicians ESCOBAR CARRASQUERO LUIS A 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 1318.43 0 0 0 0 0 0 1318.43 0 0 1016115829 1043605926 10 Physicians JIA JENNY 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 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 1.44 0 0 0 0 0 0 1.44 0 0 1016116544 1790377125 91 Waiver service provider--Adults (DHS/DDD) SMITH BENJI 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 0 172 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 11845.06 0 0 0 0 0 0 0 0 0 0 0 0 0 11845.06 0 0 1016116643 1598439846 16 Nurse Practitioners MILLER NOELLE H 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 47.62 0 0 0 0 0 0 47.62 0 0 1016116914 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2441.13 0 0 0 0 0 0 0 0 0 0 0 0 0 2441.13 0 0 1016117486 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113.29 0 0 0 0 0 0 113.29 0 0 1016117809 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1507.56 0 0 0 0 0 0 0 0 0 0 0 0 0 1507.56 0 0 1016118087 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2995.75 0 0 0 0 0 0 0 0 0 0 0 0 0 2995.75 0 0 1016118164 1467738039 23 Occupational Therapists BECKER BRITTANY 999999999 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 167 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 12595.33 12595.33 0 0 1016118186 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8220.36 0 0 0 0 0 0 0 0 0 0 0 0 0 8220.36 0 0 1016118306 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 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 14090.95 0 0 0 0 0 0 0 0 0 0 0 0 0 14090.95 0 0 1016118612 1750874749 10 Physicians SINCLAIR JARED 999999999 91 Sangamon 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 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 2381.92 0 0 0 0 0 0 2381.92 0 0 1016118780 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30.92 0 0 0 0 0 0 0 0 0 0 0 0 0 30.92 0 0 1016119766 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 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 2754.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2754.36 0 0 1016119960 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4864.89 0 0 0 0 0 0 0 0 0 0 0 0 0 4864.89 0 0 1016120042 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 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 2518.54 0 0 0 0 0 0 2518.54 0 0 1016120050 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15612.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15612.52 0 0 1016120418 1588975346 10 Physicians PAPAKOSTAS ATHANASIOS 999999999 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.73 0 4666.82 0 0 0 0 0 0 4676.55 0 0 1016120597 1467847962 10 Physicians WERKMEISTER LINDSAY 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 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 2322.37 0 0 0 0 0 0 2322.37 0 0 1016120751 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 0 456.02 0 0 0 0 0 0 0 0 0 0 0 0 0 456.02 0 0 1016120886 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2126.61 0 0 0 0 0 0 0 0 0 0 0 0 0 2126.61 0 0 1016120898 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5936.64 0 0 0 0 0 0 0 0 0 0 0 0 0 5936.64 0 0 1016120988 1295318863 22 Physical Therapists PHILIP PHEBE 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 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 0 173.35 173.35 0 0 1016121184 1710268412 10 Physicians JIMINIAN WILMOT AMIN H 999999999 52 Johnson 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.2 0 0 0 0 0 0 219.2 0 0 1016121235 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.57 0 0 0 0 0 0 7.57 0 0 1016121389 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14284 0 0 0 0 0 0 0 0 0 0 0 0 0 14284 0 0 1016121545 1023514833 10 Physicians HOLSAPPLE TYLER C 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 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 0 504.79 0 0 0 0 0 0 504.79 0 0 1016121714 1205420809 16 Nurse Practitioners GALLAGHER AMANDA M 999999999 80 Peoria 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 89 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 89 0 0 0 0 0 0 0 0 0 32.15 0 0 0 0 0 0 0 0 1694.57 0 0 0 0 0 0 1726.72 0 0 1016121917 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.37 0 0 0 0 0 0 0 0 0 0 0 0 0 33.37 0 0 1016121947 1649864828 16 Nurse Practitioners CHA MARK 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 0 988.06 0 0 0 0 0 0 988.06 0 0 1016122201 1356933790 16 Nurse Practitioners LONG EMILY R 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 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 27.82 0 0 0 0 0 0 27.82 0 0 1016122325 55 Early Intervention Services 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 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 0 589.6 0 0 0 0 0 0 589.6 0 0 1016122691 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5440.81 0 0 0 0 0 0 0 0 0 0 0 0 0 5440.81 0 0 1016123288 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 328.04 0 0 0 0 0 0 0 0 0 0 0 0 0 328.04 0 0 1016123498 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 38302.71 0 0 0 0 0 0 0 0 0 0 0 0 0 38302.71 0 0 1016123804 1851734354 10 Physicians DESILVA SEAN 999999999 19 Champaign 0 0 0 0 0 0 0 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 0 401.73 0 0 0 0 0 0 0 0 401.73 0 0 1016123920 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 53.91 0 0 0 0 0 0 53.91 0 0 1016123923 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1810.83 0 0 0 0 0 0 0 0 0 0 0 0 0 1810.83 0 0 1016123983 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 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Emergency 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 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 0 991.26 0 0 0 0 0 0 991.26 0 0 1016124575 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 0 0 0 0 0 0 0 0 0 0 1016124596 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1743.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1743.16 0 0 1016124600 1073077608 16 Nurse Practitioners MUNIZ KATHERINE E 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 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 1071 0 0 0 0 0 0 1071 0 0 1016124886 1750776175 10 Physicians HAAS MATTHEW T 999999999 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 13 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 2221.58 0 0 0 0 0 0 2221.58 0 0 1016124926 1689263444 16 Nurse Practitioners ZENK JENNIFER M 999999999 53 Kane 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1016125233 1871989483 10 Physicians JACKSON KAREN E 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 0 251 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 3173 0 0 0 0 0 0 3173 0 0 1016125661 24 Speech Therapists 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016125797 1861978025 10 Physicians MOHAMED ABDELNASIR 999999999 200 Cook 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 0 147 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 1044.49 0 0 0 0 0 0 1044.49 0 0 1016126090 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5567.76 0 0 0 0 0 0 0 0 0 0 0 0 0 5567.76 0 0 1016126568 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20279.25 0 0 0 0 0 0 0 0 0 0 0 0 0 20279.25 0 0 1016126575 94 Waiver service provider--Children's support (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 0 117 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 10744.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10744.8 0 0 1016126789 1598051104 10 Physicians EATON JENNIFER 999999999 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 82 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 857.53 0 157.05 0 0 0 0 0 0 1014.58 0 0 1016126979 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 5454.97 0 0 0 0 0 0 0 0 0 0 0 0 0 5454.97 0 0 1016127442 1952835787 10 Physicians EKRAM SAHRISH 999999999 53 Kane 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 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 1067.85 0 0 0 0 0 0 1067.85 0 0 1016127476 10 Physicians 200 Cook 0 0 Urology 0 0 0 0 0 0 0 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 0 379.1 0 0 0 0 0 0 379.1 0 0 1016127535 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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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 0 139.99 0 0 0 0 0 0 0 0 0 0 0 0 0 139.99 0 0 1016131072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17696.34 0 0 0 0 0 0 0 0 0 0 0 0 0 17696.34 0 0 1016131177 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4434.39 0 0 0 0 0 0 0 0 0 0 0 0 0 4434.39 0 0 1016131348 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 399.62 0 0 0 0 0 0 0 0 0 0 0 0 0 399.62 0 0 1016131592 92 Waiver service 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0 0 0 0 6488.2 0 0 1016131960 1689945792 10 Physicians CHOUSSAL-GONZALEZ RODOLFO 999999999 200 Cook 0 0 Internal Medicine 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 0 164 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 2648.16 0 0 0 0 0 0 2648.16 0 0 1016132091 1023230802 13 Podiatrists BERG CHRYSTAL 999999999 200 Cook 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 1082 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1082 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 926.38 0 0 0 0 0 0 926.38 0 0 1016132203 1548898026 89 Physician Assistant Only(Encounter Only) STIMAC HOLLY 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 0 165 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 0 761.72 0 0 0 0 0 0 761.72 0 0 1016132529 1467036186 16 Nurse Practitioners HOLDENER ANNA K 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 9 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 62.24 0 0 0 0 0 0 0 0 0 0 0 0 0 62.24 0 0 1016133776 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 528.84 0 0 0 0 0 0 0 0 0 0 0 0 0 528.84 0 0 1016133926 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 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 1016133986 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 0 414.45 0 0 0 0 0 0 414.45 0 0 1016134164 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103.92 103.92 0 0 1016134438 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 716.27 0 0 0 0 0 0 0 0 0 0 0 0 0 716.27 0 0 1016134543 1124660311 23 Occupational Therapists LOPEZ ALMA I 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 662 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48565.9 48565.9 0 0 1016134755 1285212431 16 Nurse Practitioners MEHTA SHARVI 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 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 1016134945 1316309537 10 Physicians NELLAMATTATHIL MICHAEL G 999999999 200 Cook 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 0 191 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 0 474.98 0 0 0 0 0 0 0 0 474.98 0 0 1016135256 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15675.12 0 0 0 0 0 0 0 0 0 0 0 0 0 15675.12 0 0 1016135373 1124406145 10 Physicians EMBREE LEAH 999999999 80 Peoria 0 0 Family Practice 0 0 0 0 0 0 0 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 0 940.26 0 0 0 0 0 0 940.26 0 0 1016136113 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2329.5 0 0 0 0 0 0 0 0 0 0 0 0 0 2329.5 0 0 1016136240 1326014879 10 Physicians TYLKE JAMES E 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 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 3554.31 0 0 0 0 0 0 3554.31 0 0 1016136302 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 0 180 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 18518.5 0 0 0 0 0 0 0 0 0 0 0 0 0 18518.5 0 0 1016136613 22 Physical Therapists 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10.12 10.12 0 0 1016136712 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2058.18 0 0 0 0 0 0 0 0 0 0 0 0 0 2058.18 0 0 1016137122 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 814 0 0 0 0 0 0 0 0 0 0 0 0 0 814 0 0 1016137530 1255907283 16 Nurse Practitioners COLEMAN-BRADLEY BETTY 999999999 200 Cook 0 0 0 0 0 3 0 0 0 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0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150.21 0 0 0 0 0 0 150.21 0 0 1016140028 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 13150.2 0 0 0 0 0 0 0 0 0 0 0 0 0 13150.2 0 0 1016140073 4016140073 71 Medicar Provider "KEVLAR EXPRESS TRANSIT, LLC" 606203832 200 Cook 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 4770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4770 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45783.24 0 0 0 0 0 0 45783.24 0 0 1016140319 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 0 142 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 7354.64 0 0 0 0 0 0 0 0 0 0 0 0 0 7354.64 0 0 1016140433 1215306360 16 Nurse Practitioners KEC GABRIELLE 999999999 71 McHenry 0 0 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 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 10 0 0 0 0 0 0 0 0 0 64.3 0 0 0 0 0 0 0 0 168.75 0 0 0 0 0 0 233.05 0 0 1016140767 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 80.09 0 0 0 0 0 0 0 0 0 0 0 0 0 80.09 0 0 1016140792 1245828839 55 Early Intervention Services IBARRA ISABELLA 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 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 3484.21 0 0 0 0 0 0 3484.21 0 0 1016140836 16 Nurse Practitioners 64 Macoupin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1016140933 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 8918.68 0 0 0 0 0 0 0 0 0 0 0 0 0 8918.68 0 0 1016140974 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 573.49 0 0 0 0 0 0 0 0 0 0 0 0 0 573.49 0 0 1016141092 1013193705 10 Physicians FLIPPIN KELLIE E 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 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 0 0 0 0 0 0 0 0 0 0 1016141221 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3056.18 0 0 0 0 0 0 0 0 0 0 0 0 0 3056.18 0 0 1016141405 1467028605 10 Physicians HABER ROGER 999999999 200 Cook 0 0 Dermatology 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 0 265 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 12419.17 0 0 0 0 0 0 12419.17 0 0 1016141442 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 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 0 216.16 0 0 0 0 0 0 216.16 0 0 1016141713 1962175562 16 Nurse Practitioners LEMUS MARCELA R 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 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 0 372.88 0 0 0 0 0 0 372.88 0 0 1016142197 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 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 5004.75 0 0 0 0 0 0 0 0 0 0 0 0 0 5004.75 0 0 1016142282 1770820292 10 Physicians PATEL MONALIBEN 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 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 0 326.11 0 0 0 0 0 0 326.11 0 0 1016142421 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2673.1 0 0 0 0 0 0 0 0 0 0 0 0 0 2673.1 0 0 1016142690 10 Physicians 30 DuPage 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 1079.45 0 0 0 0 0 0 1079.45 0 0 1016142938 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 4317.02 0 0 0 0 0 0 0 0 0 0 0 0 0 4317.02 0 0 1016143013 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4779.8 0 0 0 0 0 0 0 0 0 0 0 0 0 4779.8 0 0 1016143054 1508495847 89 Physician Assistant Only(Encounter Only) HAKMAN EVAN 999999999 24 Coles 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 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 0 374.31 0 0 0 0 0 0 374.31 0 0 1016143546 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.02 0 0 0 0 0 0 0 0 11.02 0 0 1016143629 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 73.4 0 0 0 0 0 0 73.4 0 0 1016143798 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1430.15 0 0 0 0 0 0 0 0 0 0 0 0 0 1430.15 0 0 1016143850 1225603673 33 Nursing Facilities CRESCENT CARE OF ELGIN 999999999 53 Kane 0 0 0 0 0 0 0 0 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 1381 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136179.98 0 0 0 0 0 0 0 136179.98 0 0 1016144034 22 Physical Therapists 109 Winnebago 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 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 0 388.92 388.92 0 0 1016145324 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 773.16 0 0 0 0 0 0 0 0 0 0 0 0 0 773.16 0 0 1016145621 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177.54 0 0 0 0 0 0 0 0 0 0 0 0 0 177.54 0 0 1016145820 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2206.19 0 0 0 0 0 0 0 0 0 0 0 0 0 2206.19 0 0 1016145904 1396327847 16 Nurse Practitioners SHEARIN-SIMS VERONICA 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 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 1203.05 0 0 0 0 0 0 1203.05 0 0 1016146395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1125.64 0 0 0 0 0 0 0 0 0 0 0 0 0 1125.64 0 0 1016146668 1710658919 16 Nurse Practitioners DILGER MELANIE Y 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 388.97 0 0 0 0 0 0 388.97 0 0 1016146777 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 0 253.7 0 0 0 0 0 0 253.7 0 0 1016147256 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 2224.62 0 0 0 0 0 0 0 0 0 0 0 0 0 2224.62 0 0 1016147611 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 0 945.42 0 0 0 0 0 0 0 0 0 0 0 0 0 945.42 0 0 1016147672 1992004600 10 Physicians YU ROBERT 999999999 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.51 0 3149.38 0 0 0 0 0 0 3155.89 0 0 1016148029 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 0 144.05 0 0 0 0 0 0 144.05 0 0 1016148237 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 47.71 0 0 0 0 0 0 47.71 0 0 1016148355 1164901203 11 Dentists CHERUVILLIL ANISHA 999999999 200 Cook 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11078.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11078.96 0 0 1016148360 1164403648 10 Physicians MONTGOMERY MICHAEL D 999999999 80 Peoria 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 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 0 201.98 0 0 0 0 0 0 0 0 201.98 0 0 1016148404 1447822705 16 Nurse Practitioners SCHARF MAIA 999999999 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374.56 0 0 0 0 0 0 374.56 0 0 1016159419 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2858.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2858.78 0 0 1016181245 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 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 1656.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1656.53 0 0 1016199418 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8422.17 0 0 0 0 0 0 0 0 0 0 0 0 0 8422.17 0 0 1016211590 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2444.33 0 0 0 0 0 0 0 0 0 0 0 0 0 2444.33 0 0 1016218530 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2323.72 0 0 0 0 0 0 0 0 0 0 0 0 0 2323.72 0 0 1016237978 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 599.12 0 0 0 0 0 0 0 0 0 0 0 0 0 599.12 0 0 1016246730 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 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 16093.44 0 0 0 0 0 0 0 0 0 0 0 0 0 16093.44 0 0 1016280022 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2597.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2597.78 0 0 1016297863 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1657.23 0 0 0 0 0 0 0 0 0 0 0 0 0 1657.23 0 0 1016298487 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6065.93 0 0 0 0 0 0 0 0 0 0 0 0 0 6065.93 0 0 1016305237 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9174.57 0 0 0 0 0 0 0 0 0 0 0 0 0 9174.57 0 0 1016306407 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 919.72 0 0 0 0 0 0 0 0 0 0 0 0 0 919.72 0 0 1016341050 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 335.22 0 0 0 0 0 0 0 0 0 0 0 0 0 335.22 0 0 1016341559 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2109.57 0 0 0 0 0 0 0 0 0 0 0 0 0 2109.57 0 0 1016348548 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17617.64 0 0 0 0 0 0 0 0 0 0 0 0 0 17617.64 0 0 1016350083 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6111.91 0 0 0 0 0 0 0 0 0 0 0 0 0 6111.91 0 0 1016354145 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3084.52 0 0 0 0 0 0 0 0 0 0 0 0 0 3084.52 0 0 1016368867 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1403.16 0 0 0 0 0 0 0 0 0 0 0 0 0 1403.16 0 0 1016372463 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36782.11 0 0 0 0 0 0 0 0 0 0 0 0 0 36782.11 0 0 1016384248 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1529.59 0 0 0 0 0 0 0 0 0 0 0 0 0 1529.59 0 0 1016390256 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14604.98 0 0 0 0 0 0 0 0 0 0 0 0 0 14604.98 0 0 1016390441 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 8437.79 0 0 0 0 0 0 0 0 0 0 0 0 0 8437.79 0 0 1016411072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 448.74 0 0 0 0 0 0 0 0 0 0 0 0 0 448.74 0 0 1016437707 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21216.61 0 0 0 0 0 0 0 0 0 0 0 0 0 21216.61 0 0 1016449332 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12068.98 0 0 0 0 0 0 0 0 0 0 0 0 0 12068.98 0 0 1016453695 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460.53 0 0 0 0 0 0 0 0 0 0 0 0 0 460.53 0 0 1016460545 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 0 819.02 0 0 0 0 0 0 0 0 0 0 0 0 0 819.02 0 0 1016466975 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1491.53 0 0 0 0 0 0 0 0 0 0 0 0 0 1491.53 0 0 1016468035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3643.19 0 0 0 0 0 0 0 0 0 0 0 0 0 3643.19 0 0 1016469725 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1571.8 0 0 0 0 0 0 0 0 0 0 0 0 0 1571.8 0 0 1016480123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5760.26 0 0 0 0 0 0 0 0 0 0 0 0 0 5760.26 0 0 1016480503 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 9868.78 0 0 0 0 0 0 0 0 0 0 0 0 0 9868.78 0 0 1016498957 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1577.81 0 0 0 0 0 0 0 0 0 0 0 0 0 1577.81 0 0 1016523670 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4471.78 0 0 0 0 0 0 0 0 0 0 0 0 0 4471.78 0 0 1016528609 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 508.16 0 0 0 0 0 0 0 0 0 0 0 0 0 508.16 0 0 1016533944 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 32872.17 0 0 0 0 0 0 0 0 0 0 0 0 0 32872.17 0 0 1016538392 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 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 19952.59 0 0 0 0 0 0 0 0 0 0 0 0 0 19952.59 0 0 1016585800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2519.66 0 0 0 0 0 0 0 0 0 0 0 0 0 2519.66 0 0 1016592055 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7444.42 0 0 0 0 0 0 0 0 0 0 0 0 0 7444.42 0 0 1016615800 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1436.63 0 0 0 0 0 0 0 0 0 0 0 0 0 1436.63 0 0 1016632887 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 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 2871 0 0 0 0 0 0 0 0 0 0 0 0 0 2871 0 0 1016633968 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2826.31 0 0 0 0 0 0 0 0 0 0 0 0 0 2826.31 0 0 1016654239 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2606.15 0 0 0 0 0 0 0 0 0 0 0 0 0 2606.15 0 0 1016666188 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4115.87 0 0 0 0 0 0 0 0 0 0 0 0 0 4115.87 0 0 1016670402 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5393.58 0 0 0 0 0 0 0 0 0 0 0 0 0 5393.58 0 0 1016675267 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36774.58 0 0 0 0 0 0 0 0 0 0 0 0 0 36774.58 0 0 1016676706 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 18796.81 0 0 0 0 0 0 0 0 0 0 0 0 0 18796.81 0 0 1016680704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7167.2 0 0 0 0 0 0 0 0 0 0 0 0 0 7167.2 0 0 1016710231 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23380.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23380.85 0 0 1016712928 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 31080.23 0 0 0 0 0 0 0 0 0 0 0 0 0 31080.23 0 0 1016719155 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23401.66 0 0 0 0 0 0 0 0 0 0 0 0 0 23401.66 0 0 1016720704 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 49573.92 0 0 0 0 0 0 0 0 0 0 0 0 0 49573.92 0 0 1016749101 1053083006 61 Independent Laboratories ZENIX LABS LLC 999999999 200 Cook 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 0 312 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 12406.7 0 0 0 0 0 0 0 0 12406.7 0 0 1016760480 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 3579.1 0 0 0 0 0 0 0 0 0 0 0 0 0 3579.1 0 0 1016788114 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 4458.59 0 0 0 0 0 0 0 0 0 0 0 0 0 4458.59 0 0 1016799137 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1566.29 0 0 0 0 0 0 0 0 0 0 0 0 0 1566.29 0 0 1016822476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 20418.18 0 0 0 0 0 0 0 0 0 0 0 0 0 20418.18 0 0 1016837812 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6078.11 0 0 0 0 0 0 0 0 0 0 0 0 0 6078.11 0 0 1016841777 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373.65 0 0 0 0 0 0 0 0 0 0 0 0 0 373.65 0 0 1016846072 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 872.5 0 0 0 0 0 0 0 0 0 0 0 0 0 872.5 0 0 1016878399 10 Physicians 200 Cook 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 33.27 0 21.07 0 0 0 0 0 0 54.34 0 0 1016879197 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9408.77 0 0 0 0 0 0 0 0 0 0 0 0 0 9408.77 0 0 1016892750 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 41144.1 0 0 0 0 0 0 0 0 0 0 0 0 0 41144.1 0 0 1016918850 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 0 335.38 0 0 0 0 0 0 0 0 0 0 0 0 0 335.38 0 0 1016919507 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36799.37 0 0 0 0 0 0 0 0 0 0 0 0 0 36799.37 0 0 1016980290 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 9086.31 0 0 0 0 0 0 0 0 0 0 0 0 0 9086.31 0 0 1016985340 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 118.79 0 0 0 0 0 0 0 0 0 0 0 0 0 118.79 0 0 1016998563 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22633.66 0 0 0 0 0 0 0 0 0 0 0 0 0 22633.66 0 0 1017001247 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6344.84 0 0 0 0 0 0 0 0 0 0 0 0 0 6344.84 0 0 1017011395 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7395.79 0 0 0 0 0 0 0 0 0 0 0 0 0 7395.79 0 0 1017019554 55 Early Intervention Services 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 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 0 589.52 0 0 0 0 0 0 589.52 0 0 1017026221 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6054.64 0 0 0 0 0 0 0 0 0 0 0 0 0 6054.64 0 0 1017027271 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11918.47 0 0 0 0 0 0 0 0 0 0 0 0 0 11918.47 0 0 1017030123 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4446.93 0 0 0 0 0 0 0 0 0 0 0 0 0 4446.93 0 0 1017030556 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 39877.97 0 0 0 0 0 0 0 0 0 0 0 0 0 39877.97 0 0 1017033846 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4324.45 0 0 0 0 0 0 0 0 0 0 0 0 0 4324.45 0 0 1017034927 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16607.58 0 0 0 0 0 0 0 0 0 0 0 0 0 16607.58 0 0 1017035886 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 97.61 0 0 0 0 0 0 0 0 0 0 0 0 0 97.61 0 0 1017068648 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21194.49 0 0 0 0 0 0 0 0 0 0 0 0 0 21194.49 0 0 1017080857 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 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 59653.34 0 0 0 0 0 0 0 0 0 0 0 0 0 59653.34 0 0 1017091260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 17769.69 0 0 0 0 0 0 0 0 0 0 0 0 0 17769.69 0 0 1017097098 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 0 910.82 0 0 0 0 0 0 0 0 0 0 0 0 0 910.82 0 0 1017102991 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13239.97 0 0 0 0 0 0 0 0 0 0 0 0 0 13239.97 0 0 1017114207 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8942.35 0 0 0 0 0 0 0 0 0 0 0 0 0 8942.35 0 0 1017124439 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 4408.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4408.96 0 0 1017131751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7747.83 0 0 0 0 0 0 0 0 0 0 0 0 0 7747.83 0 0 1017152275 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8206.67 0 0 0 0 0 0 0 0 0 0 0 0 0 8206.67 0 0 1017156429 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65.91 0 0 0 0 0 0 0 0 0 0 0 0 0 65.91 0 0 1017160630 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.07 0 0 0 0 0 0 0 0 0 0 0 0 0 58.07 0 0 1017162898 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369.29 0 0 0 0 0 0 0 0 0 0 0 0 0 369.29 0 0 1017170343 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 0 167.03 0 0 0 0 0 0 0 0 0 0 0 0 0 167.03 0 0 1017187207 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 32783.09 0 0 0 0 0 0 0 0 0 0 0 0 0 32783.09 0 0 1017187316 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 13728.54 0 0 0 0 0 0 0 0 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0 1101013937 1346410453 10 Physicians SIDDIQI AHEED J 480381125 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 377 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 701 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9998.3 0 249.16 0 0 0 0 0 0 10247.46 0 0 1101013940 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 7506.33 0 0 0 0 0 0 0 0 0 0 0 0 0 7506.33 0 0 1101013946 1235144486 60 Pharmacies BOND DRUG CO OF ILLINOIS 02288 604772287 200 Cook 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 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17344.27 0 0 0 17344.27 0 0 1101013948 1376521575 30 General Hospitals FOSTER G MCGAW HOSPITAL 601533328 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 20 0 0 0 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1101014234 1861741860 22 Physical Therapists PEACH DARCY 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 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 3041.65 3041.65 0 0 1101014250 2100004668 91 Waiver service provider--Adults (DHS/DDD) "WILLOWGLEN ACADEMY-ILLINOIS, I" 610325921 97 Stephenson 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 29746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4921398.54 0 0 0 0 0 0 0 0 0 0 0 0 0 4921398.54 0 0 1101014257 1316912561 16 Nurse Practitioners SIGLE KATHLEEN 627083428 91 Sangamon 0 0 0 0 0 8 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 144 0 0 0 0 0 0 0 0 0 290.03 0 0 0 0 0 0 0 0 1895.28 0 0 0 0 0 0 2185.31 0 0 1101014270 63 Other Providers of Medical Equipment/Supplies (Non-registered) 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28.14 0 0 0 0 28.14 0 0 1101014281 1073710208 10 Physicians HACHEM CHRISTINE 628321230 81 Perry 0 0 Gastroenterology 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 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 1379.36 0 0 0 0 0 0 1379.36 0 0 1101014323 1891787040 10 Physicians TREDWAY DORRIE 62269 96 St Clair 0 0 Family Practice 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 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 15.7 0 510.85 0 0 0 0 0 0 526.55 0 0 1101014324 1396731329 10 Physicians NAGPAL RAJEEV 604532600 200 Cook 0 0 Pediatrics 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 0 204 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 14355.11 0 0 0 0 0 0 14355.11 0 0 1101014331 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7126.76 0 0 0 0 0 0 0 0 0 0 0 0 0 7126.76 0 0 1101014334 10 Physicians 815 Indiana 0 0 Nephrology 0 0 0 0 0 0 0 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 31.01 0 0 0 0 0 0 31.01 0 0 1101014337 1063525160 10 Physicians BASLER JOSEPH 622072326 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 322 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8895.95 0 189.96 0 0 0 0 0 0 9085.91 0 0 1101014355 91 Waiver service provider--Adults (DHS/DDD) 65 Madison 0 0 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 3736.22 0 0 0 0 0 0 0 0 0 0 0 0 0 3736.22 0 0 1101014359 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 9743.04 0 0 0 0 0 0 0 0 0 0 0 0 0 9743.04 0 0 1101014365 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 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 1625.46 0 0 0 0 0 0 0 0 0 0 0 0 0 1625.46 0 0 1101014376 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 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 16447.91 0 0 0 0 0 0 0 0 0 0 0 0 0 16447.91 0 0 1101014390 1053427344 10 Physicians BRINKMAN MARK J 604353460 30 DuPage 0 1 Pediatrics 0 0 0 124 0 0 0 0 0 0 8 0 103 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 8 0 121 0 0 0 0 0 0 0 0 0 246 0 0 0 0 0 0 8 0 121 0 0 0 0 0 0 0 0 0 11155.9 0 0 0 0 0 0 19.12 0 5610.93 0 0 0 0 0 0 16785.95 0 0 1101014402 1316055023 10 Physicians OPAL PUNEET 606118709 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 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 0 274.06 0 0 0 0 0 0 274.06 0 0 1101014404 1427037209 10 Physicians TEVERBAUGH LORI 616157835 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 6 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347.18 0 3508.62 0 0 0 0 0 0 3855.8 0 0 1101014419 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 0 160 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 22229.42 0 0 0 0 0 0 0 0 0 0 0 0 0 22229.42 0 0 1101014421 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 0 258.68 0 0 0 0 0 0 0 0 0 0 0 0 0 258.68 0 0 1101014430 1427296920 55 Early Intervention Services SCOTT SHONTE 606066921 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 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 3070.47 0 0 0 0 0 0 3070.47 0 0 1101014448 1891905600 10 Physicians GEHLBACH THOMAS 610210737 60 Lee 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1870.35 0 0 0 0 0 0 1870.35 0 0 1101014463 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 0 319 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 21851.83 0 0 0 0 0 0 0 0 0 0 0 0 0 21851.83 0 0 1101014504 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 0 307 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 24390.8 0 0 0 0 0 0 0 0 0 0 0 0 0 24390.8 0 0 1101014512 1093733800 10 Physicians CARR DAVID B 631600352 200 Cook 0 0 Geriatrics 0 0 0 0 0 0 0 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 98 0 0 0 0 0 0 98 0 0 1101014527 1093802001 10 Physicians FULFER JAMIE 618012500 19 Champaign 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 2600.83 0 0 0 0 0 0 2600.83 0 0 1101014531 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 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 21490.02 0 0 0 0 0 0 0 0 0 0 0 0 0 21490.02 0 0 1101014566 10 Physicians 53 Kane 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 53.74 0 0 0 0 0 0 53.74 0 0 1101014569 1790722577 70 Ambulance Service Providers PLEASANTVIEW FIRE PROT 605253709 200 Cook 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 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 766 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829312.05 0 0 0 0 0 0 829312.05 0 0 1101014578 10 Physicians 30 DuPage 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275.8 0 0 0 0 0 0 275.8 0 0 1101014579 61 Independent Laboratories 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.91 0 0 0 0 0 0 0 0 50.91 0 0 1101014587 1669697744 24 Speech Therapists SCHULZ CYNTHIA 627621000 91 Sangamon 0 0 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 0 194 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 25204.09 25204.09 0 0 1101014593 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 23638.56 0 0 0 0 0 0 0 0 0 0 0 0 0 23638.56 0 0 1101014600 1932128014 33 Nursing Facilities BIG MEADOWS 610741640 17 Carroll 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524040.07 0 0 0 0 0 0 0 524040.07 0 0 1101014614 1750567442 46 Ambulatory Surgical Treatment Centers IRELAND GROVE CNTR FOR SURGERY 617045297 72 McLean ASTC Ambulatory Surgical Treatment Center. 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 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 4018.24 0 0 0 0 0 4018.24 0 0 1101014627 1033101092 10 Physicians GUMAPAS EDWIN 483771600 109 Winnebago 0 0 Psychiatry 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 1737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1737 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3446.6 0 0 0 0 0 0 3446.6 0 0 1101014628 1730140187 10 Physicians HAYDEN MARY 606123714 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166.88 0 0 0 0 0 0 166.88 0 0 1101014646 1063668994 10 Physicians PENDLETON DIONNA 605481100 27 Dekalb 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 894.93 0 0 0 0 0 0 894.93 0 0 1101014668 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12059.41 0 0 0 0 0 0 0 0 0 0 0 0 0 12059.41 0 0 1101014672 1235160433 10 Physicians NOVAS JEANNE 600103175 57 Lake 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 215.7 0 262.45 0 0 0 0 0 0 478.15 0 0 1101014679 1598719213 10 Physicians BUKHALO YURIY 600052368 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 11 0 110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 679 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 134.03 0 2291.73 0 0 0 0 0 0 2425.76 0 0 1101014698 1689669293 10 Physicians BELLUCCI JACKSON JENNIFER 600846037 57 Lake 0 1 Family Practice 0 0 0 204 0 0 0 0 0 0 8 0 850 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 12 0 2650 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 12 0 2650 0 0 0 0 0 0 0 0 0 15974.26 0 0 0 0 0 0 72.79 0 74581.59 0 0 0 0 0 0 90628.64 0 0 1101014699 1427043546 30 General Hospitals KATH SHAW BETHEA HOSP 610213116 60 Lee DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 866 0 0 0 0 205 0 0 0 1845 0 0 0 0 0 0 0 0 0 1258 0 0 0 0 234 0 0 0 8051 0 0 0 0 0 0 0 0 0 1258 0 0 0 0 951 0 0 0 8051 0 0 0 0 0 0 0 0 0 164103.26 0 0 0 0 463358.68 0 0 0 431003.2 0 0 0 0 0 1058465.14 0 0 1101014717 93 Waiver service provider--HIV/AIDS (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12850.66 0 0 0 0 0 0 0 0 0 0 0 0 0 12850.66 0 0 1101014718 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.52 0 31.01 0 0 0 0 0 0 132.53 0 0 1101014720 10 Physicians 79 Ogle 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124.31 0 0 0 0 0 0 124.31 0 0 1101014736 1871729988 60 Pharmacies CVS PHARMACY 08926 600021453 57 Lake 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 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6789.66 0 0 0 6789.66 0 0 1101014805 1124138318 10 Physicians ITTMANN PATRICIA 611033655 109 Winnebago 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5119.23 0 0 0 0 0 0 5119.23 0 0 1101014812 1417940917 10 Physicians NICOLAS JOHN 606118709 200 Cook 0 0 Internal Medicine 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 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 0 489.56 0 0 0 0 0 0 489.56 0 0 1101014815 1538148093 10 Physicians DINIOTIS ATHANASIOS 607073717 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 0 174 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 9167.01 0 0 0 0 0 0 9167.01 0 0 1101014831 1336209055 12 Optometrists CLARKE SCOTT 619202017 24 Coles 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 58 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1362.83 0 1643.13 0 0 0 0 3005.96 0 0 1101014838 1174740872 60 Pharmacies WALGREENS #10558 606065885 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.6 0 0 0 159.6 0 0 1101014844 1801959226 52 Certified local public health department STEPHENSON CO HEALTH DEPT 610323310 97 Stephenson 0 0 Family Practice 0 46 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 668.68 0 1351.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2019.92 0 0 1101014875 1275515827 10 Physicians BAYANG MARIA 604413265 107 Will 0 1 Pediatrics 0 0 0 67 0 0 0 0 0 0 5 0 80 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 6 0 119 0 0 0 0 0 0 0 0 0 227 0 0 0 0 0 0 6 0 119 0 0 0 0 0 0 0 0 0 7127.14 0 0 0 0 0 0 68.64 0 5500.35 0 0 0 0 0 0 12696.13 0 0 1101014888 10 Physicians 91 Sangamon 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 1.23 0 0 0 0 0 0 1.23 0 0 1101014890 1407086515 10 Physicians ABIONA TITILAYO 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 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 0 540.49 0 0 0 0 0 0 540.49 0 0 1101014924 30 General Hospitals 852 Wisconsin 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 88.23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88.23 0 0 1101014935 1104969211 23 Occupational Therapists GASSIRARO DIANE M 627621000 91 Sangamon 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 0 602 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 46668.03 46668.03 0 0 1101014941 1790714202 10 Physicians SUN AMY R 606313222 200 Cook 0 0 Pediatrics 0 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0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23.76 0 0 0 0 0 0 23.76 0 0 1101015079 1528090164 10 Physicians DILORENZO RICHARD ROBERT R 616151941 80 Peoria 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 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 3233.05 0 0 0 0 0 0 3233.05 0 0 1101015095 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2646.9 0 0 0 0 0 0 0 0 0 0 0 0 0 2646.9 0 0 1101015096 1427193531 47 Local Education Agencies ALSIP HAZELGREEN OAKLAWN DIST 608032307 200 Cook 0 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 4092 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 86772.57 0 86772.57 0 0 1101015115 10 Physicians 91 Sangamon 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 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Pathology 0 0 0 0 0 0 0 0 0 0 101 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1376 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5240.23 0 930 0 0 0 0 0 0 6170.23 0 0 1101015261 1306984216 10 Physicians SANKARI SUSAN 605406791 30 DuPage 0 1 Pediatrics 0 0 0 58 0 0 0 0 0 0 14 0 56 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 19 0 174 0 0 0 0 0 0 0 0 0 222 0 0 0 0 0 0 19 0 174 0 0 0 0 0 0 0 0 0 6386 0 0 0 0 0 0 98.72 0 7712.39 0 0 0 0 0 0 14197.11 0 0 1101015265 1336201888 10 Physicians COHEN RUSSELL 605615314 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 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 0 772.41 0 0 0 0 0 0 772.41 0 0 1101015269 1578561767 10 Physicians TANNA SHITAL 601234717 53 Kane 0 1 Family Practice 0 0 0 3 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 248.76 0 0 0 0 0 0 15.7 0 574.55 0 0 0 0 0 0 839.01 0 0 1101015278 10 Physicians 815 Indiana 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 0 322.35 0 0 0 0 0 0 322.35 0 0 1101015282 1609135789 63 Other Providers of Medical Equipment/Supplies (Non-registered) TOWER HILL HEALTHCARE CENTER 601771418 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 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 3608.4 0 0 0 0 0 0 3608.4 0 0 1101015286 1003055179 10 Physicians NUYLES MICHAEL 605066222 53 Kane 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 8 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101.87 0 2484.54 0 0 0 0 0 0 2586.41 0 0 1101015294 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 0 128 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 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Physicians FAKOURI FARAH 601901295 30 DuPage 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 0 179 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 1296.35 0 0 0 0 0 0 1296.35 0 0 1101015498 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 26717.93 0 0 0 0 0 0 0 0 0 0 0 0 0 26717.93 0 0 1101015506 1164865408 10 Physicians QUAGGIN SUSAN 606118709 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 0 220.61 0 0 0 0 0 0 220.61 0 0 1101015514 1417167354 10 Physicians GORELICK ALISSA 600073361 200 Cook 0 0 Emergency 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 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 1453.55 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 163.08 0 0 0 0 0 0 163.08 0 0 1101016488 1073569463 60 Pharmacies OSCO DRUG 3394 601428039 71 McHenry 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 0 109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2359 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7092.61 0 0 0 7092.61 0 0 1101016491 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 0 468 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 40948.8 0 0 0 0 0 0 0 0 0 0 0 0 0 40948.8 0 0 1101016493 1124069455 10 Physicians POLAND TIM 600601438 57 Lake 0 1 Emergency Medicine 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 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 76.84 0 0 0 0 0 0 0 0 147.26 0 0 0 0 0 0 224.1 0 0 1101016518 1821010349 10 Physicians PIPITONE ANTHONY 601228942 53 Kane 0 1 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 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1101016597 1588751598 70 Ambulance Service Providers GREATER ROUND LAKE FIRE PROT 600733223 57 Lake 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 1472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1232292.38 0 0 0 0 0 0 1232292.38 0 0 1101016628 91 Waiver service provider--Adults (DHS/DDD) 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 0 151 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 12254.77 0 0 0 0 0 0 0 0 0 0 0 0 0 12254.77 0 0 1101016634 1073576922 10 Physicians KUMAR PANKAJ 616157822 80 Peoria 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 22 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 1553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109 0 1553 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1002.16 0 334698.14 0 0 0 0 0 0 335700.3 0 0 1101016683 1679604151 70 Ambulance Service Providers KIRKLAND FIRE PROT DIST 601468635 27 Dekalb 0 0 0 0 0 0 0 0 0 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 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0 0 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8962.1 0 0 0 0 0 0 0 0 0 0 0 0 0 8962.1 0 0 1101018462 1104114701 24 Speech Therapists SYED NARGESS 604905039 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 427 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38370.02 38370.02 0 0 1101018475 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 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 7257.98 0 0 0 0 0 0 0 0 0 0 0 0 0 7257.98 0 0 1101018513 1528164076 10 Physicians SCHAIBLE KEITH 608052243 200 Cook 0 0 Neurology Surgery 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 0 165 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 27717.44 0 0 0 0 0 0 27717.44 0 0 1101018517 1790958064 10 Physicians LIPNIK ANDREW 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 66 0 115 0 0 0 0 0 0 0 0 0 0 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104 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 4283.81 0 0 0 0 0 0 4283.81 0 0 1101018625 1326392747 40 Federally Qualified Health Centers SIHF MCKINLEY HEALTH CTR 620404700 65 Madison 0 1 0 1118 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4055 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4055 0 455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246811.51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246811.51 0 0 1101018651 1750591475 10 Physicians SCHILSKY ANGELA 627949248 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 493 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 635 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7372.95 0 63.44 0 0 0 0 0 0 7436.39 0 0 1101018654 1598789521 10 Physicians GLASER MITCHELL 606573000 200 Cook 0 0 Psychiatry 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 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16617.99 0 0 0 0 0 0 16617.99 0 0 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Nurse Practitioners DECKER SUZANNE M 616151941 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 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 0 122.44 0 0 0 0 0 0 122.44 0 0 1101018775 1932121860 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALVERNO HOME MEDICAL EQUIP 604265908 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7580.2 0 88.51 0 0 0 0 7668.71 0 0 1101018782 1326216300 47 Local Education Agencies SCHOOL DISTRICT U 46 601206543 53 Kane 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 2081 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 57240 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 57240 0 0 0 0 330.4 0 0 0 0 0 0 0 0 0 0 0 0 0 1111501.85 0 1111832.25 0 0 1101018784 1265698542 10 Physicians SALZMAN DAVID 606118709 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3150.98 0 0 0 0 0 0 3150.98 0 0 1101018803 1316069099 28 Waiver service provider--Supportive living facility (HFS) EAGLE RIDGE OF DECATUR 625263287 63 Macon 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 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4788 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 434823.39 0 0 0 0 0 0 0 0 0 0 0 0 0 434823.39 0 0 1101018815 1912992561 10 Physicians LAMBIASE ELYSE 606253500 200 Cook 0 0 Oncology 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 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4639.49 0 0 0 0 0 0 4639.49 0 0 1101018833 1184640310 10 Physicians CHAR DOUGLAS 631600352 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 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 0 883.39 0 0 0 0 0 0 883.39 0 0 1101018849 1306806518 10 Physicians MULLETT CHRISTOPHER T. 618012529 19 Champaign 0 0 Pediatrics 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 0 134 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 8596.02 0 0 0 0 0 0 8596.02 0 0 1101018880 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 0 208 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 13758.83 0 0 0 0 0 0 0 0 0 0 0 0 0 13758.83 0 0 1101018881 1275831273 16 Nurse Practitioners BAECHT LEAH 999999999 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 0 0 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 3703.28 0 0 0 0 0 0 3703.28 0 0 1101018886 1407981392 40 Federally Qualified Health Centers HEARTLAND INTERNATIONAL HEALTH 606576710 200 Cook 0 0 0 2474 0 485 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 12627 0 2032 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 12627 0 2032 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 903453.09 0 0 0 0 0 0 0 163.65 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 0 600.52 0 0 0 0 0 0 600.52 0 0 1101018949 1770648271 70 Ambulance Service Providers CENTRAL STICKNEY FIRE PROT DIS 606438495 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 0 139 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 239605.98 0 0 0 0 0 0 239605.98 0 0 1101018957 1356397749 60 Pharmacies OSCO DRUG #3481 600683252 200 Cook 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 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3648 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1922.36 0 0 0 1922.36 0 0 1101018966 1548363765 10 Physicians BENEJAM RALPH 616151941 80 Peoria 0 0 Urology 0 0 0 0 0 0 0 0 0 0 1 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.3 0 2566.26 0 0 0 0 0 0 2655.56 0 0 1101018967 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 0 137 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1459.36 0 0 0 0 0 0 1459.36 0 0 1101019049 1578513362 10 Physicians KESANI MOHAN 463201942 815 Indiana 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790.63 0 0 0 0 0 0 790.63 0 0 1101019106 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 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 0 879.12 0 0 0 0 0 0 0 0 0 0 0 0 0 879.12 0 0 1101019113 1497956981 10 Physicians AYALA JUANBOSCO 604632389 200 Cook 0 0 Pulmonary Diseases 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 0 998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15374.25 0 0 0 0 0 0 15374.25 0 0 1101019115 1629154356 10 Physicians MULDOON JOSEPH P. 602011700 200 Cook 0 0 Colon - Rectal Surgery 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 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 1295.57 0 0 0 0 0 0 1295.57 0 0 1101019124 1124210646 10 Physicians ESTACIO DAVID A 605638669 30 DuPage 0 0 Anesthesiology 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 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 3907.39 0 0 0 0 0 0 3907.39 0 0 1101019164 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 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 28465.57 0 0 0 0 0 0 0 0 0 0 0 0 0 28465.57 0 0 1101019181 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 0 320 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 23488.91 0 0 0 0 0 0 0 0 0 0 0 0 0 23488.91 0 0 1101019186 1497889554 33 Nursing Facilities "CLAYBERG, THE" 614275109 37 Fulton 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 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3841 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 440346.36 0 0 0 0 0 0 0 440346.36 0 0 1101019193 1417140757 16 Nurse Practitioners MITCHELL VALERIE 618012530 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 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 0 158.9 0 0 0 0 0 0 158.9 0 0 1101019194 1770565525 10 Physicians MULLER NANCY 633012844 826 Missouri 0 0 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 0 103 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 0 911.01 0 0 0 0 0 0 0 0 911.01 0 0 1101019227 1538258603 10 Physicians MCGLONE THOMAS 610811252 106 Whiteside 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 0 148 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 0 844.12 0 0 0 0 0 0 844.12 0 0 1101019251 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373.86 0 0 0 0 0 0 373.86 0 0 1101019272 1174552038 10 Physicians LUTHRINGSHAUSEN MICHELLE 600051929 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 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 0 0 165.12 0 0 0 0 0 0 165.12 0 0 1101019276 1659349074 10 Physicians MORGAN ELAINE 606116649 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 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 3505.77 0 0 0 0 0 0 3505.77 0 0 1101019278 1154579597 63 Other Providers of Medical Equipment/Supplies (Non-registered) CROSSROADS ORTHOTICS AND CONSU 479333546 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.96 0 829.7 0 0 0 0 886.66 0 0 1101019280 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 335.07 0 0 1101019291 1932125168 16 Nurse Practitioners MOON CYNTHIA 631600352 57 Lake 0 0 0 0 0 0 0 0 0 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 0 417.89 0 0 0 0 0 0 417.89 0 0 1101019305 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 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 0 910.69 0 0 0 0 0 0 0 0 0 0 0 0 0 910.69 0 0 1101019313 1164586616 10 Physicians LEIDERMAN YANNEK I 606127232 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 11 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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"JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 274 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 765 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 765 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156476.21 0 4727.79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161204 0 0 1101022620 10 Physicians 826 Missouri 0 0 Rheumatology 0 0 0 0 0 0 0 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 0 201 0 0 0 0 0 0 201 0 0 1101022621 1841247277 10 Physicians PEEK MONICA 605275965 30 DuPage 0 1 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 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 0 328.97 0 0 0 0 0 0 328.97 0 0 1101022623 1952381865 10 Physicians HO ERLING 605462082 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 32 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 520 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 2495 0 0 2495 0 0 1101022700 1255633012 33 Nursing Facilities PARK VILLA NURSING REHAB CTR 604631859 200 Cook 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 0 222 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5055 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 733725.5 0 0 0 0 0 0 0 733725.5 0 0 1101022701 1669401287 10 Physicians HAMMOND NANCY 606118709 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 197 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2931.53 0 17.49 0 0 0 0 0 0 2949.02 0 0 1101022719 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 24115.93 0 0 0 0 0 0 0 0 0 0 0 0 0 24115.93 0 0 1101022762 1962427161 10 Physicians SHAH DINESHCHANDRA 609701644 46 Iroquois 0 0 Internal 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1101022967 1396701942 10 Physicians SAMANT SANDEEP 381053678 844 Tennessee 0 0 Otolaryngology 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 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 2130.11 0 0 0 0 0 0 2198.11 0 0 1101022984 55 Early Intervention Services 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 0 106 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 5500.55 0 0 0 0 0 0 5500.55 0 0 1101023034 1720297591 10 Physicians SHEPHERD BENJAMIN 611042231 200 Cook 0 0 Family Practice 0 0 0 12 0 0 0 0 0 0 3 0 109 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 3 0 189 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 3 0 189 0 0 0 0 0 0 0 0 0 396.67 0 0 0 0 0 0 26.92 0 10089.09 0 0 0 0 0 0 10512.68 0 0 1101023039 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 14.26 0 0 0 0 0 0 14.26 0 0 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0 0 0 0 0 0 0 5 0 0 0 0 0 0 854.3 0 0 0 0 0 0 0 0 0 0 0 1881.75 0 0 0 0 2736.05 0 0 1101023097 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 18448.2 0 0 0 0 0 0 0 0 0 0 0 0 0 18448.2 0 0 1101023106 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 0 111.24 0 0 0 0 0 0 111.24 0 0 1101023113 1548426745 10 Physicians HASSAN AHMED 606781034 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10860.05 0 0 0 0 0 0 10860.05 0 0 1101023132 1538109228 13 Podiatrists SOLWAY DOUGLAS 600162359 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 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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 11450.42 0 0 0 0 0 0 0 0 0 0 0 0 0 11450.42 0 0 1101023383 1346251543 30 General Hospitals ST LUKES HOSPITAL WEST 630173406 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 10 0 0 0 0 7 0 0 0 49 0 0 0 0 0 0 0 0 0 10 0 0 0 0 8 0 0 0 81 0 0 0 0 0 0 0 0 0 10 0 0 0 0 120 0 0 0 81 0 0 0 0 0 0 0 0 0 303.27 0 0 0 0 699.34 0 0 0 3609.56 0 0 0 0 0 4612.17 0 0 1101023389 91 Waiver service provider--Adults (DHS/DDD) 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 2248.04 0 0 0 0 0 0 0 0 0 0 0 0 0 2248.04 0 0 1101023412 1083786917 10 Physicians POLASANI VENUGOPAL R 618562116 82 Piatt 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2306.12 0 0 0 0 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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 21583.39 0 0 0 0 0 0 0 0 0 0 0 0 0 21583.39 0 0 1101026246 30 General Hospitals 836 Ohio ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101026249 1689649071 10 Physicians SWINGLE CHRISTOPHER 631417129 826 Missouri 0 0 Nuclear 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 65.4 0 0 0 0 0 0 65.4 0 0 1101026271 1548365026 10 Physicians PORURI KALYANA 601344200 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 259 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 396 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6126.3 0 73.56 0 0 0 0 0 0 6199.86 0 0 1101026273 1477597805 10 Physicians BRAVERMAN ALAN C 631600352 200 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0 0 0 5396.27 0 0 1101026333 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 20905.86 0 0 0 0 0 0 0 0 0 0 0 0 0 20905.86 0 0 1101026338 10 Physicians 200 Cook 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 1101026346 1851536296 48 Rural Health Clinics HIGHLAND PRIORITY CARE 622491285 65 Madison 0 0 0 390 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1434 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1434 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33954.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33954.85 0 0 1101026355 1003891987 10 Physicians ROSENBAUM MICHAEL 600771057 200 Cook 0 0 Pediatrics 0 0 0 3 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 507.84 0 0 0 0 0 0 0 0 287.89 0 0 0 0 0 0 795.73 0 0 1101026357 1164403598 10 Physicians CULLEN MICHAEL 612656867 89 Rock Island 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 20 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 38399.44 0 0 0 0 0 0 38399.44 0 0 1101026359 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 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 6508.84 6508.84 0 0 1101026371 10 Physicians 30 DuPage 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 0 159.68 0 0 0 0 0 0 159.68 0 0 1101026374 1245395466 10 Physicians GLICK DAVID 605276686 30 DuPage 0 0 Anesthesiology 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 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 9929.05 0 0 0 0 0 0 9929.05 0 0 1101026389 10 Physicians 200 Cook 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 0 312.05 0 0 0 0 0 0 312.05 0 0 1101026402 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22392.88 0 0 0 0 0 0 0 0 0 0 0 0 0 22392.88 0 0 1101026411 1235408725 16 Nurse Practitioners BARSZCZAK AGNIESZKA 333232815 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 0 215.95 0 0 0 0 0 0 215.95 0 0 1101026420 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 23931.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23931.6 0 0 1101026431 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21002.44 0 0 0 0 0 0 0 0 0 0 0 0 0 21002.44 0 0 1101026432 10 Physicians 53 Kane 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 156.47 0 0 0 0 0 0 156.47 0 0 1101026444 1114025541 70 Ambulance Service Providers CITY OF HURST AMBULANCE DEPT 629490146 108 Williamson 0 0 0 0 0 0 0 0 0 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 6014.28 0 0 0 0 0 0 6014.28 0 0 1101026454 30 General Hospitals 823 Michigan NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 339 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24444.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24444.42 0 0 1101026523 1548227606 10 Physicians COULTER RUSSELL 622861867 87 Randolph 0 0 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 0 170 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 1401.14 0 0 0 0 0 0 1401.14 0 0 1101026550 1619103280 10 Physicians WIESE KRISTIN M. 606740018 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 0 194 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 4452 0 0 0 0 0 0 4452 0 0 1101026551 1477867372 60 Pharmacies WALGREENS 13004 629012120 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 811 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 21152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.62 0 0 47427.96 0 0 0 47466.58 0 0 1101026570 1356542864 10 Physicians VAZQUEZ MELENDEZ ELSA 616052576 80 Peoria 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 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 2353.14 0 0 0 0 0 0 2353.14 0 0 1101026572 1912040429 10 Physicians LANSKY ANAT ASZODI 602011718 200 Cook 0 1 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 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 0 305.82 0 0 0 0 0 0 305.82 0 0 1101026599 92 Waiver service provider--Disability (DHS/DRS) 108 Williamson 0 0 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 0 495.33 0 0 0 0 0 0 0 0 0 0 0 0 0 495.33 0 0 1101026602 1073557369 16 Nurse Practitioners HEENAN DANIEL 601181416 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129.73 0 0 0 0 0 0 129.73 0 0 1101026638 1841499902 10 Physicians CHARLES DAVID 999999999 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 671 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7789.68 0 0 0 0 0 0 7789.68 0 0 1101026641 91 Waiver service provider--Adults (DHS/DDD) 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 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 3885.35 0 0 0 0 0 0 0 0 0 0 0 0 0 3885.35 0 0 1101026658 1881686244 16 Nurse Practitioners WAGNER ALAN 629023988 47 Jackson 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 0 553.72 0 0 0 0 0 0 553.72 0 0 1101026678 1861419145 60 Pharmacies WAL MART PHARMACY 10 1897 600073073 200 Cook 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 0 378 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8623.89 0 0 0 8623.89 0 0 1101026700 1922271287 10 Physicians OLSON ERIN 606112991 200 Cook 0 0 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WHITING JEFFREY 631102515 200 Cook 0 0 Orthopedic Surgery 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 2293.27 0 0 0 0 0 0 2293.27 0 0 1101026774 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 19158.22 0 0 0 0 0 0 0 0 0 0 0 0 0 19158.22 0 0 1101026812 10 Physicians 10 Adams 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 1101026831 1356357529 10 Physicians SCHWARTZ DAVID 606123714 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 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 93.03 0 0 0 0 0 0 93.03 0 0 1101026857 1295863983 40 Federally Qualified 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1735.72 0 0 0 0 0 0 0 0 0 0 0 0 0 1735.72 0 0 1101031735 1740458462 36 Community mental health provider COMMUNITY RESOURCE CENTER 628013002 66 Marion 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 1039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 1039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1209 0 0 41807.52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67713.35 0 0 109520.87 0 0 1101031748 1609876424 10 Physicians SYED ZAINULABUDDIN 605152266 30 DuPage 0 1 Internal Medicine 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.65 0 1486.14 0 0 0 0 0 0 1584.79 0 0 1101031787 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 0 233 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 22572.22 0 0 0 0 0 0 0 0 0 0 0 0 0 22572.22 0 0 1101031815 1629137161 10 Physicians CHMURA STEVEN J 606777007 200 Cook 0 0 Radiation Oncology 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 0 481 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 4836.79 0 0 0 0 0 0 4836.79 0 0 1101031821 1265660237 12 Optometrists DESAI ACHYUT 606164201 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 32 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1319.9 0 146.4 0 0 0 0 1466.3 0 0 1101031833 1891733507 10 Physicians SETIA SUMAN 608051901 200 Cook 0 1 Family Practice 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 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2420.92 0 0 0 0 0 0 2420.92 0 0 1101031852 1639356017 73 Other Transportation Providers ( Non-Registered) MOULTRIE COUNTY BEACON INC 619511883 78 Moultrie 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1036.61 0 0 0 0 0 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2 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 192.54 0 0 0 0 0 0 4.7 0 439.38 0 0 0 0 0 0 636.62 0 0 1101032077 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 4417.66 0 0 0 0 0 0 0 0 0 0 0 0 0 4417.66 0 0 1101032101 1144301227 10 Physicians AKBARNIA HALLEH 600774302 200 Cook 0 0 Emergency Medicine 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 0 114 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 4679.08 0 0 0 0 0 0 4679.08 0 0 1101032106 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 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 0 448.32 448.32 0 0 1101032125 1720112162 22 Physical Therapists OWENS HEIDI KAY 627621000 200 Cook 0 0 0 0 0 0 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1101034776 1639174006 70 Ambulance Service Providers LINCOLNWOOD FIRE DEPT 607122606 200 Cook 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 0 382 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 219988.27 0 0 0 0 0 0 219988.27 0 0 1101034791 63 Other Providers of Medical Equipment/Supplies (Non-registered) 76 Montgomery 0 0 0 0 0 0 0 0 0 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 0 249.2 0 0 0 0 0 0 249.2 0 0 1101034793 1942402409 47 Local Education Agencies SALEM SCH DIST 111 628814274 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2923 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137224.16 0 137224.16 0 0 1101034833 1184724866 10 Physicians PETERSON RANDAL 627949248 91 Sangamon 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 21 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 186 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2174.94 0 0 0 0 0 0 2174.94 0 0 1101035135 1194789479 10 Physicians OBERT HONG JOHN 604062426 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 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 88.64 0 0 0 0 0 0 88.64 0 0 1101035141 1013980945 63 Other Providers of Medical Equipment/Supplies (Non-registered) "NATIONAL SEATING & MOBILITY," 537143124 852 Wisconsin 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 0 614 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 33542.39 0 0 0 0 0 0 33542.39 0 0 1101035156 1205049046 10 Physicians GAUTAM SAGUN 601604100 200 Cook 0 0 Family Practice 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 1282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1282 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15346.11 0 0 0 0 0 0 15346.11 0 0 1101035178 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 565.45 0 0 0 0 0 0 0 0 0 0 0 0 0 565.45 0 0 1101035210 1306930466 63 Other Providers of Medical Equipment/Supplies (Non-registered) PAIN REHAB PRODUCTS INC 631463207 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.43 0 2994.58 0 0 0 0 3010.01 0 0 1101035214 10 Physicians 815 Indiana 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 0 116.44 0 0 0 0 0 0 116.44 0 0 1101035225 1295920387 30 General Hospitals WAYNE COUNTY DIALYSIS 628371203 104 Wayne DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2214 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2291.68 0 0 0 0 0 2291.68 0 0 1101035227 1063534592 55 Early Intervention Services POWERS ANNE 606544510 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 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 9118.2 0 0 0 0 0 0 9118.2 0 0 1101035231 2100025649 73 Other Transportation Providers ( Non-Registered) SHELTERED VILLAGE 600982137 71 McHenry 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 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2702.73 0 0 0 0 0 0 2702.73 0 0 1101035241 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 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 2841.92 0 0 0 0 0 0 0 0 0 0 0 0 0 2841.92 0 0 1101035249 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 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 14181.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14181.39 0 0 1101035250 1629025663 10 Physicians HERSONSKEY TAMIR 604358119 107 Will 0 0 Neurology Surgery 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 1316.31 0 0 0 0 0 0 1316.31 0 0 1101035255 1740371400 63 Other Providers of Medical Equipment/Supplies (Non-registered) FITZSIMMONS SURG SUPPLY INC 605028005 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1050 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 286553.17 0 0 0 0 0 0 286553.17 0 0 1101035262 1528168523 10 Physicians BOLER NICOLE 604405125 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1837.83 0 0 0 0 0 0 1837.83 0 0 1101035301 1730353186 16 Nurse Practitioners STEPHENS DANA 616142868 80 Peoria 0 0 0 0 0 6 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 257.39 0 0 0 0 0 0 0 0 4989.26 0 0 0 0 0 0 5246.65 0 0 1101035316 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 0 160 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 21782.2 0 0 0 0 0 0 0 0 0 0 0 0 0 21782.2 0 0 1101035318 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25069.2 0 0 0 0 0 0 0 0 0 0 0 0 0 25069.2 0 0 1101035342 1023121167 10 Physicians GOODE MARK 605214875 107 Will 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 628 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5062.46 0 0 0 0 0 0 5062.46 0 0 1101035364 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1101035545 1063572683 10 Physicians BOYD LAURA 601912020 30 DuPage 0 1 Family Practice 0 0 0 5 0 0 0 0 0 0 1 0 53 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 513.72 0 0 0 0 0 0 6.3 0 1619.94 0 0 0 0 0 0 2139.96 0 0 1101035567 1508837758 10 Physicians LAPKE JALAYNE 616561649 80 Peoria 0 1 Pediatrics 0 0 0 14 0 0 0 0 0 0 5 0 17 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 5 0 27 0 0 0 0 0 0 0 0 0 989.64 0 0 0 0 0 0 32.94 0 1296.49 0 0 0 0 0 0 2319.07 0 0 1101035572 1942296231 10 Physicians TAYUI EBENEZER 606163395 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.4 0 0 0 0 0 0 197.4 0 0 1101035579 1427145440 10 Physicians PATEL RAJESH 604151367 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 6 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 265 0 0 0 0 0 0 0 0 0 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0 0 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 2937.62 0 0 0 0 0 0 2937.62 0 0 1101035801 1194784470 11 Dentists MAHAIRI AMJAD 601205620 53 Kane 0 0 General Dentistry 0 0 255 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52535.06 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52535.06 0 0 1101035810 1679749725 55 Early Intervention Services SHWATAL ELLEN 601855147 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 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27557.53 0 0 0 0 0 0 27557.53 0 0 1101035814 1457448508 70 Ambulance Service Providers WARRENVILLE FIRE PROT DIST 605553301 30 DuPage 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 0 277 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 230830.4 0 0 0 0 0 0 230830.4 0 0 1101035815 10 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0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 0 44 0 0 0 0 0 0 0 0 0 363.73 0 0 0 0 0 0 16.54 0 1618.02 0 0 0 0 0 0 1998.29 0 0 1101037127 10 Physicians 89 Rock Island 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300.12 0 0 0 0 0 0 0 0 300.12 0 0 1101037149 1790798593 10 Physicians WELLENDORF LARRY 607144501 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 19 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.92 0 263.17 0 0 0 0 0 0 403.09 0 0 1101037158 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 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 1367.61 1367.61 0 0 1101037193 1710905138 16 Nurse Practitioners ELLIS CHRISTINE 631600352 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 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0 0 0 0 7 0 0 0 0 0 0 274 0 473 0 0 0 0 0 0 0 0 0 102.2 0 0 0 0 0 0 17716.31 0 35293.13 0 0 0 0 0 0 53111.64 0 0 1101038562 1396962791 47 Local Education Agencies FAIRMONT SCHOOL DISTRICT 89 604414935 107 Will 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 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20943.83 0 20943.83 0 0 1101038565 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 0 168 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 18179.64 0 0 0 0 0 0 0 0 0 0 0 0 0 18179.64 0 0 1101038570 1528218179 36 Community mental health provider SHELBY CO COMMUNITY SERVICES 625650650 94 Shelby 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 772.28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3703.86 0 0 4476.14 0 0 1101038582 92 Waiver service provider--Disability (DHS/DRS) 72 McLean 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 2635.11 0 0 0 0 0 0 2640.28 0 0 1101050413 1558439315 10 Physicians GAROFOLI ERIN M. 602011718 200 Cook 0 1 Pediatrics 0 0 0 7 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 513.15 0 0 0 0 0 0 0 0 196.88 0 0 0 0 0 0 710.03 0 0 1101050443 1669436457 63 Other Providers of Medical Equipment/Supplies (Non-registered) SCHECK AND SIRESS PROSTHETICS 601812987 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6616.73 0 77890.84 0 0 0 0 84507.57 0 0 1101050459 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 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 0 660.25 0 0 0 0 0 0 660.25 0 0 1101050465 1871510156 60 Pharmacies WAL MART PHARMACY 10 1734 618221251 19 Champaign 0 0 0 0 0 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Physicians HAVALAD VINOD 49155500 200 Cook 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 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 6699.96 0 0 0 0 0 0 6699.96 0 0 1101050990 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 1983.01 0 0 0 0 0 0 0 0 0 0 0 0 0 1983.01 0 0 1101050993 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 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 21598.9 0 0 0 0 0 0 0 0 0 0 0 0 0 21598.9 0 0 1101051003 1619950060 10 Physicians KUREISHY FARRUKH 617272199 28 De Witt 0 1 Internal Medicine 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 0 299.95 0 0 0 0 0 0 299.95 0 0 1101051016 30 General Hospitals 816 Iowa ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 445.61 0 0 0 0 0 0 0 0 19.15 0 0 0 0 0 464.76 0 0 1101051020 1487612370 10 Physicians OGBEVOEN JUSTIN 622032048 96 St Clair 0 1 Pediatrics 0 0 0 26 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 2669.41 0 0 0 0 0 0 0 0 394.1 0 0 0 0 0 0 3063.51 0 0 1101051035 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 6940.25 0 0 0 0 0 0 0 0 0 0 0 0 0 6940.25 0 0 1101051039 10 Physicians 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 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Practitioners SHEPHARD REBEKAH 606123714 200 Cook 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 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 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 2106.99 0 0 0 0 0 0 2106.99 0 0 1101051100 1124280383 10 Physicians LAFIKES MARLA 628371219 104 Wayne 0 0 Family Practice 0 0 0 0 0 0 0 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 0 381.37 0 0 0 0 0 0 381.37 0 0 1101051109 1134388770 10 Physicians SHAH SAUMIL 619202413 24 Coles 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 133 0 147 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 1101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123.12 0 2139.22 0 0 0 0 0 0 2262.34 0 0 1101051142 1679684674 47 Local Education Agencies EFFINGHAM COMMUNITY UNIT 40 624012978 33 Effingham 0 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 8187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8187 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 132363.22 0 132363.22 0 0 1101051170 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 0 176 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 23969.44 0 0 0 0 0 0 0 0 0 0 0 0 0 23969.44 0 0 1101051173 1588640650 10 Physicians CLARK JAMES 600184110 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 76 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3557.16 0 0 0 0 0 0 3557.16 0 0 1101051181 1629092226 10 Physicians CONNER-GARCIA THEMBI A 606544342 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 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 1101051186 60 Pharmacies 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 826.23 0 0 11.47 0 0 0 837.7 0 0 1101051192 1821057027 30 General Hospitals TAYLORVILLE DIALYSIS 625681831 20 Christian DIALYSIS Outpatient dialysis centers. 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 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 830.44 0 0 0 0 0 830.44 0 0 1101051234 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 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 97.21 0 0 0 0 0 0 0 0 0 0 0 0 0 97.21 0 0 1101051236 1316946338 12 Optometrists STOLLER BRYAN 617641612 61 Livingston 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 45 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1405.23 0 1441.76 0 0 0 0 2846.99 0 0 1101051250 1477561553 13 Podiatrists SALEM ATIYEH A 604631069 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 0 296 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 1124.75 0 0 0 0 0 0 1124.75 0 0 1101051278 1124284401 10 Physicians SAMET JONATHAN 606118709 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 310 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9886.57 0 793.5 0 0 0 0 0 0 10680.07 0 0 1101051289 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 0 106.72 0 0 0 0 0 0 106.72 0 0 1101051300 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120.64 0 0 0 0 0 0 0 0 0 0 0 0 0 120.64 0 0 1101051302 63 Other Providers of Medical Equipment/Supplies 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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 24 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 124.54 0 0 0 0 0 0 0 0 418.79 0 0 0 0 0 0 543.33 0 0 1101065436 1134334022 10 Physicians KAKUMANI SEETAL 627949248 91 Sangamon 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 19 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 2310.61 0 0 0 0 0 0 2310.61 0 0 1101065440 1790790012 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604112143 200 Cook 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 1141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35602 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47165.96 0 0 0 47165.96 0 0 1101065444 1861463101 10 Physicians CULLEN JEFFREY 627044183 91 Sangamon 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 841 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1074 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6778.14 0 130.22 0 0 0 0 0 0 6908.36 0 0 1101065447 1114975216 10 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Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 7 0 0 0 1 0 0 0 0 0 0 0 0 0 100.43 0 0 0 0 4540.98 0 0 0 185.97 0 0 0 0 0 4827.38 0 0 1101065816 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 13265.85 0 0 0 0 0 0 0 0 0 0 0 0 0 13265.85 0 0 1101065822 1285829572 16 Nurse Practitioners KLOSTERMANN KIRBY L 631418512 91 Sangamon 0 0 0 0 0 0 0 0 0 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 0 336.8 0 0 0 0 0 0 336.8 0 0 1101065827 1134161805 40 Federally Qualified Health Centers MT VERNON COMMUNITY HEALTH CTR 628645924 49 Jefferson 0 1 0 696 0 315 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2752 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2752 0 787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150278.43 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 29602.06 0 0 0 0 0 0 0 0 0 0 0 0 0 29602.06 0 0 1101069419 1689720377 23 Occupational Therapists SCHRANZ CAREN M 604172110 815 Indiana 0 0 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 0 468 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 36943.7 36943.7 0 0 1101069425 1679569347 10 Physicians TOURK KARIM 604355403 107 Will 0 0 Internal Medicine 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 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 31.23 0 0 0 0 0 0 31.23 0 0 1101069435 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 14992.88 0 0 0 0 0 0 0 0 0 0 0 0 0 14992.88 0 0 1101069446 1881691665 70 Ambulance Service Providers SCHUYLER COUNTY AMBULANCE 626811344 92 Schuyler 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 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48907.33 0 0 0 0 0 0 48907.33 0 0 1101069477 1679746317 33 Nursing Facilities AMBASSADOR NURSING REHAB CTR 606255146 200 Cook 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 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1200668.68 0 0 0 0 0 0 0 1200668.68 0 0 1101069478 2100059896 10 Physicians LIANG TEHMING 604402565 107 Will 0 0 Dermatology 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 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 2013.24 0 0 0 0 0 0 2013.24 0 0 1101069490 1124077326 10 Physicians YALAMANCHILI SAROJA 609012940 54 Kankakee 0 0 Obstetric-Gynecology 0 0 0 10 0 0 0 0 0 0 8 0 124 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 9 0 272 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 9 0 272 0 0 0 0 0 0 0 0 0 607.72 0 0 0 0 0 0 41.36 0 22952.29 0 0 0 0 0 0 23601.37 0 0 1101069503 1427039197 10 Physicians STEWART PATRICK 624012191 33 Effingham 0 0 Surgery Hand 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 673.54 0 0 0 0 0 0 673.54 0 0 1101069516 1558593582 10 Physicians PATEL PINALKUMAR 520016389 816 Iowa 0 0 Internal 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 0 308 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 4135.81 0 0 0 0 0 0 4135.81 0 0 1101069518 1700994381 47 Local Education Agencies PAWNEE COMM UNIT SCH DIST 11 625589680 91 Sangamon 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 1037 0 0 0 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 1037 0 0 0 0 775.47 0 0 0 0 0 0 0 0 0 0 0 0 0 18432.79 0 19208.26 0 0 1101069523 1922069160 10 Physicians TAJUDDIN ALKARIM 600077335 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 10 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 577 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169.67 0 82873.21 0 0 0 0 0 0 83042.88 0 0 1101069533 1316051097 10 Physicians SPENCER LESLIE 606740018 200 Cook 0 0 Obstetric-Gynecology 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 6 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160.54 0 340.69 0 0 0 0 0 0 501.23 0 0 1101069544 1912175126 36 Community mental health provider BRIDGEWAY INC 614016498 56 Knox 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1318 0 0 1067.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43809.94 0 0 44877.58 0 0 1101069554 1083668560 10 Physicians CAMBA NOEL 604641508 200 Cook 0 0 Cardiology 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 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5046.71 0 0 0 0 0 0 5046.71 0 0 1101069566 1497734396 10 Physicians POTHULA ASWARTHA 527613433 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 8 0 475 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 1028 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 1028 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808.26 0 11752.47 0 0 0 0 0 0 12560.73 0 0 1101069575 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 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 32704.19 0 0 0 0 0 0 0 0 0 0 0 0 0 32704.19 0 0 1101069583 1386832855 10 Physicians KEFALAS JOHN C 625264276 63 Macon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 65 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 470.62 0 9147.42 0 0 0 0 0 0 9618.04 0 0 1101069586 1467445361 10 Physicians FRITSCH MARK A 463603301 53 Kane 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 0 248 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 1245.08 0 0 0 0 0 0 0 0 1245.08 0 0 1101069589 1154449544 10 Physicians BADNER JUDITH 606751611 200 Cook 0 0 Psychiatry 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 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17362.12 0 0 0 0 0 0 17362.12 0 0 1101069598 1720173354 16 Nurse Practitioners HARRIS RACHEL 625264163 63 Macon 0 0 0 0 0 0 0 0 0 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 0 188.53 0 0 0 0 0 0 188.53 0 0 1101069602 1891749081 10 Physicians RASSOULI MAJID 604353103 107 Will 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13495.19 0 0 0 0 0 0 13495.19 0 0 1101069627 10 Physicians 826 Missouri 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 0 130.64 0 0 0 0 0 0 130.64 0 0 1101069628 1891893913 12 Optometrists CHAWLA NEETU 605855412 107 Will 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1068.49 0 0 0 0 0 0 1068.49 0 0 1101069629 1437151693 10 Physicians YASEEN MOHAMMAD 612656138 89 Rock Island 0 0 Gastroenterology 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 0 234 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 17447.73 0 0 0 0 0 0 17447.73 0 0 1101069652 1679660229 10 Physicians AGUIAR DAVID 601751065 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527.26 0 3613.2 0 0 0 0 0 0 4140.46 0 0 1101069666 1851417562 16 Nurse Practitioners TRUSNER SARAH K 625214665 50 Jersey 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 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 1004.88 0 0 0 0 0 0 1090.53 0 0 1101069677 1932177433 10 Physicians SCHREIBER ANNE 601082227 30 DuPage 0 0 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 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 0 239.83 0 0 0 0 0 0 239.83 0 0 1101069695 1730306523 47 Local Education Agencies MURPHYSBORO CU SCH DIST 186 629664267 47 Jackson 0 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 3119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38827.28 0 38827.28 0 0 1101069699 1902941628 30 General Hospitals ALEXIAN BROTHERS MED CTR 600073311 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 2 0 0 0 1151 0 0 0 0 722 0 0 0 1810 0 0 0 0 0 2 0 0 0 1595 0 0 0 0 796 0 0 0 4395 0 0 0 0 0 13 0 0 0 1734 0 0 0 0 4240 0 0 0 5113 0 0 0 0 0 1064.16 0 0 0 245661.13 0 0 0 0 2966368.58 0 0 0 560176.77 0 0 0 0 0 3773270.64 0 0 1101069708 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 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 16152.67 0 0 0 0 0 0 0 0 0 0 0 0 0 16152.67 0 0 1101069710 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 4 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 5937.96 5937.96 0 0 1101069711 1528005154 10 Physicians DOERHOFF FAYE 606116649 200 Cook 0 0 Pediatrics 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 5148.8 0 0 0 0 0 0 5148.8 0 0 1101069718 1376677021 70 Ambulance Service Providers CITY OF CARTERVILLE AMBULANCE 629181358 108 Williamson 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 0 773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 773 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88234.54 0 0 0 0 0 0 88234.54 0 0 1101069743 1205879095 32 Rehabilitation Hospitals REHABILITATION INSTITUTE 606113015 200 Cook REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 3 1552 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 4 8155 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 4 8271 0 0 0 0 0 0 0 4006 0 0 0 0 0 0 0 0 0 427.41 1070000.06 0 0 0 0 0 0 0 2370151.1 0 0 0 0 0 0 0 0 0 3440578.57 0 0 1101069747 2100060165 89 Physician Assistant Only(Encounter Only) SCARDINO JENNIFER LYNNE 612656152 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 332.03 0 0 0 0 0 0 332.03 0 0 1101069750 1902076128 10 Physicians AREF MICHAEL 618012500 815 Indiana 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 0 104 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 0 879.56 0 0 0 0 0 0 879.56 0 0 1101069759 16 Nurse Practitioners 49 Jefferson 0 0 0 0 0 0 0 0 0 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 42.14 0 0 0 0 0 0 42.14 0 0 1101069775 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 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 7586.32 0 0 0 0 0 0 0 0 0 0 0 0 0 7586.32 0 0 1101069777 1568698918 10 Physicians NAWAB HINA 601783185 27 Dekalb 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 7 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12980.14 0 0 0 0 0 0 12980.14 0 0 1101069779 1710046859 10 Physicians LUGTHART PAUL K 605638669 30 DuPage 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 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 1456.54 0 0 0 0 0 0 1456.54 0 0 1101069791 1134390313 47 Local Education Agencies BUNCOMBE ELEM SCH DIST 43 629122296 52 Johnson 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 297.85 0 0 1101069793 1740479989 16 Nurse Practitioners SHIELDS BART R 333232815 35 Ford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 436.84 0 0 0 0 0 0 436.84 0 0 1101069798 1487736799 10 Physicians KHURSHID NAILA 605151548 30 DuPage 0 1 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 0 200 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 2554.19 0 0 0 0 0 0 2554.19 0 0 1101069805 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 24330.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24330.2 0 0 1101069815 1659524619 22 Physical Therapists STEWART MONICA 615231246 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 449 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 36877.24 36877.24 0 0 1101069817 1487630513 10 Physicians SIDDIQUI MOHAMMAD 600761266 200 Cook 0 1 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 0 248 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 0 889.18 0 0 0 0 0 0 889.18 0 0 1101069833 1023299799 10 Physicians TAN KELLY 600475292 57 Lake 0 0 Internal Medicine 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 0 411 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 4248.57 0 0 0 0 0 0 4248.57 0 0 1101069839 1568620276 10 Physicians MAMDANI SALMAN 611082425 109 Winnebago 0 0 Emergency Medicine 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 0 263 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 5762.52 0 0 0 0 0 0 5762.52 0 0 1101069851 1205040698 10 Physicians DOSHI DEVANG 463212901 815 Indiana 0 0 Radiology Diagnosis 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 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 0 637.77 0 0 0 0 0 0 0 0 637.77 0 0 1101069877 1386822591 36 Community mental health provider ECKER CENTER FOR MENTAL HEALTH 601232040 53 Kane 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3271 0 0 2205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3271 0 0 97525.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97963.12 0 0 195489.08 0 0 1101069886 1144201674 10 Physicians RHEE YOUN 606211394 200 Cook 0 1 Pediatrics 0 0 0 23 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 2715.5 0 0 0 0 0 0 0 0 225.75 0 0 0 0 0 0 2941.25 0 0 1101069915 1629025051 70 Ambulance Service Providers LIFESTAR AMBULANCE SERVICE INC 627025122 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1802 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 843994.33 0 0 0 0 0 0 843994.33 0 0 1101069918 1609842434 10 Physicians SINGH INDERJIT 631366149 25 Crawford 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 0 298 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 2372.53 0 0 0 0 0 0 2372.53 0 0 1101069919 1467426676 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEADOWBROOK MANOR OF LAGRANGE 605256429 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 0 113 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 18701.5 0 0 0 0 0 0 18701.5 0 0 1101069930 1689648537 10 Physicians NAIR SHANTI 601545716 200 Cook 0 0 Pediatrics 0 0 0 129 0 0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 173 0 0 0 0 0 0 0 0 133 0 0 0 0 0 0 0 0 0 13506.25 0 0 0 0 0 0 0 0 5936.54 0 0 0 0 0 0 19442.79 0 0 1101069944 1013923689 10 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SCHOOL DISTRICT 154 604761254 200 Cook 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 0 430 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 5505.01 0 5505.01 0 0 1101076116 1588624290 10 Physicians RICHARDS JON 600681270 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 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 1311.91 0 0 0 0 0 0 1311.91 0 0 1101076119 1225027873 10 Physicians ZAHID MOHAMMAD 601237879 53 Kane 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 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 623 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6269.16 0 0 0 0 0 0 6269.16 0 0 1101076142 1457314130 63 Other Providers of Medical Equipment/Supplies (Non-registered) PRISM HEALTHCARE SERVICES INC 601730000 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1040 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 164405.58 0 0 0 0 0 0 164405.58 0 0 1101076146 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 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 12409.93 0 0 0 0 0 0 0 0 0 0 0 0 0 12409.93 0 0 1101076149 1083836928 10 Physicians CRAIG CAROL 611011214 109 Winnebago 0 0 Child 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 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 2141.16 0 0 0 0 0 0 2141.16 0 0 1101076154 2100066572 47 Local Education Agencies ROCKDALE SCHOOL DIST 84 604362405 107 Will 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 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9060.7 0 9060.7 0 0 1101076160 1912961558 10 Physicians GUPTA ANIL 622362462 75 Monroe 0 1 Family 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 75 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0 0 0 0 0 0 0 0 0 0 0 0 691.11 0 0 0 0 0 0 0 0 0 0 0 0 0 691.11 0 0 1101078360 1174725634 47 Local Education Agencies CARBON CLIFF BARSTOW SCH DIST 612821779 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19247.4 0 19247.4 0 0 1101078362 2100068780 90 Waiver service provider--Elderly (DOA) URHAI COMMUNITY SERVICE CENTER 606593811 200 Cook 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 21230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2167700.38 0 0 0 0 0 0 0 0 0 0 0 0 0 2167700.38 0 0 1101078371 1033462643 16 Nurse Practitioners CUCA AMANDA 606751611 200 Cook 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 0 171 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 171 0 0 0 0 0 0 0 0 0 228.76 0 0 0 0 0 0 0 0 3294.02 0 0 0 0 0 0 3522.78 0 0 1101078398 1699910455 16 Nurse Practitioners CHAMPION MARGOT C 605638113 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 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 0 458.42 0 0 0 0 0 0 458.42 0 0 1101078408 1801862461 10 Physicians SADIQ SHAMIM 618012334 19 Champaign 0 0 Internal Medicine 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 0 309 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 3379.4 0 0 0 0 0 0 3379.4 0 0 1101078409 1639252737 10 Physicians HORAN MARY 604023429 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 368.48 0 0 0 0 0 0 368.48 0 0 1101078412 30 General Hospitals 826 Missouri 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 9 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 0 0 0 0 0 0 0 0 0 1101078423 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 24546.53 0 0 0 0 0 0 0 0 0 0 0 0 0 24546.53 0 0 1101078428 1194838789 10 Physicians ZIMMERMAN JERRAD 618027431 19 Champaign 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 1 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 122 0 0 0 0 0 0 0 0 0 69.52 0 0 0 0 0 0 0 0 3042.84 0 0 0 0 0 0 3112.36 0 0 1101078434 1023239043 24 Speech Therapists ZIEMBA SARAH 627621000 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7775.37 7775.37 0 0 1101078453 1659324465 10 Physicians POLACK DONOVAN C 631366166 30 DuPage 0 0 Radiology Diagnosis 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 0 128 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 2195.03 0 0 0 0 0 0 2195.03 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 196 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.32 0 4189.48 0 0 0 0 0 0 4198.8 0 0 1101084118 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.08 0 0 0 0 0 0 210.08 0 0 1101084126 10 Physicians 200 Cook 0 0 Pedodontics 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.52 0 0 0 0 0 0 125.52 0 0 1101084135 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18145.24 0 0 0 0 0 0 0 0 0 0 0 0 0 18145.24 0 0 1101084159 1235140674 10 Physicians SETHI ROMI 606733039 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 52 0 0 0 0 0 0 0 0 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23408.32 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.32 0 0 1101084520 1124155841 52 Certified local public health department MCDONOUGH COUNTY HLTH DEPT 614552310 70 McDonough 0 0 0 13 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.78 0 294.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 506.18 0 0 1101084524 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 0 126.99 0 0 0 0 0 0 126.99 0 0 1101084544 2100074962 91 Waiver service provider--Adults (DHS/DDD) LUTHERAN SOCIAL SERVICES OF IL 618213061 19 Champaign 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 16506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2227629.12 0 0 0 0 0 0 0 0 0 0 0 0 0 2227629.12 0 0 1101084563 47 Local Education Agencies 42 Hancock 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 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0 0 2482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2482 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 404935.35 0 0 0 0 0 0 0 0 0 0 0 0 0 404935.35 0 0 1101085528 1891827721 47 Local Education Agencies NORTH SHORE SCH DIST 112 600353112 57 Lake 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 115 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 4582 0 0 0 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 4582 0 0 0 0 796.85 0 0 0 0 0 0 0 0 0 0 0 0 0 108828.4 0 109625.25 0 0 1101085536 1508061136 10 Physicians CULP ERIC 606222743 200 Cook 0 0 Neonatology 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 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 2006.66 0 0 0 0 0 0 2006.66 0 0 1101085540 1336281575 10 Physicians SANI SEPEHR 606751611 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 24 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 2309.05 0 0 0 0 0 0 2309.05 0 0 1101085561 1588866099 47 Local Education Agencies BREESE SCH DIST 12 622301376 23 Clinton 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 0 163 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 7559.63 0 7559.63 0 0 1101085572 1326034448 10 Physicians NEUMEISTER MICHAEL 627949639 91 Sangamon 0 0 Plastic Surgery 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 0 313 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 61545.35 0 0 0 0 0 0 61545.35 0 0 1101085586 10 Physicians 10 Adams 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 1101085594 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 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 5489.77 0 0 0 0 0 0 0 0 0 0 0 0 0 5489.77 0 0 1101085623 1760562177 10 Physicians LEONARD RONALD K 614621007 102 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0 0 0 0 0 0 1080.95 0 0 1101085933 1215965652 10 Physicians KEATING KRISTINA 600451688 57 Lake 0 1 Pediatrics 0 0 0 3 0 0 0 0 0 0 2 0 14 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 2 0 17 0 0 0 0 0 0 0 0 0 183.49 0 0 0 0 0 0 15.7 0 695.38 0 0 0 0 0 0 894.57 0 0 1101085965 1992782122 10 Physicians KENNEDY JACOB 477470001 815 Indiana 0 0 Emergency 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 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 0 561.81 0 0 0 0 0 0 561.81 0 0 1101085977 1508851114 10 Physicians SHERMAN EDWARD 601484932 30 DuPage 0 0 Infectious Diseases 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 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 343 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2894.62 0 0 0 0 0 0 2894.62 0 0 1101086000 2100076418 47 Local Education Agencies PROVISO AREA EXCEPTIONAL CHILD 601531970 200 Cook 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 450 0 0 0 0 370 0 0 0 0 0 0 0 0 0 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Providers of Medical Equipment/Supplies (Non-registered) MEDENVIOS HEALTHCARE INC 331261204 810 Florida 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11647 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27813.66 0 0 0 0 0 0 27813.66 0 0 1101086056 1225046253 10 Physicians PADGETT WILLIAM 624502499 88 Richland 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 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 2605.04 0 0 0 0 0 0 2605.04 0 0 1101086067 1578739124 16 Nurse Practitioners COOPER DYAN R 631600352 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 502.35 0 0 0 0 0 0 502.35 0 0 1101086069 1316950496 10 Physicians OOSTMAN BRIAN 605064356 53 Kane 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 21 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 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 210.6 0 0 0 0 0 0 210.6 0 0 1101086103 1154376572 10 Physicians MERCHANT ZARINA 606255009 200 Cook 0 1 Pediatrics 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 0 224 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 4692.29 0 0 0 0 0 0 4692.29 0 0 1101086138 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 1668.62 0 0 0 0 0 0 0 0 0 0 0 0 0 1668.62 0 0 1101086148 1306846670 10 Physicians PATEL MANOJ R 606118709 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 32 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 368 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311.72 0 2584.29 0 0 0 0 0 0 2896.01 0 0 1101086155 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 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 23407.79 0 0 0 0 0 0 0 0 0 0 0 0 0 23407.79 0 0 1101086188 10 Physicians 200 Cook 0 1 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 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 84.59 0 0 0 0 0 0 84.59 0 0 1101086190 1720355142 16 Nurse Practitioners SPAL KATHERINE R 191787642 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 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 90.22 0 0 0 0 0 0 90.22 0 0 1101086206 1487783650 47 Local Education Agencies WHEELING CC SCHOOL DIST 21 600903986 200 Cook 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 316 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 11015 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 11015 0 0 0 0 335.48 0 0 0 0 0 0 0 0 0 0 0 0 0 367567.4 0 367902.88 0 0 1101086216 1306015383 47 Local Education Agencies ALLEN OTTER CREEK CCSD 65 604708087 58 La Salle 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 8397.03 0 0 0 0 0 0 0 0 0 0 0 0 0 8397.03 0 0 1101088348 1811976665 10 Physicians THOMPSON DANA 606112605 200 Cook 0 0 Otolaryngology 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 0 194 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 22583.01 0 0 0 0 0 0 22583.01 0 0 1101088350 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 0 159 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 19640.18 0 0 0 0 0 0 0 0 0 0 0 0 0 19640.18 0 0 1101088361 1235277393 23 Occupational Therapists MEDER-JENDERSAK KIMBERLY L 604488132 107 Will 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 0 136 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 10011.24 10011.24 0 0 1101088371 2100078789 10 Physicians CONSTANTINOU COSTAS 528041853 816 Iowa 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 64 0 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service provider--Elderly (DOA) RELIABLE HOME CARE PROVIDERS 600693015 57 Lake 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 5094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5094 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 578169.19 0 0 0 0 0 0 0 0 0 0 0 0 0 578169.19 0 0 1101097884 16 Nurse Practitioners 815 Indiana 0 0 0 0 0 0 0 0 0 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 0 316.85 0 0 0 0 0 0 316.85 0 0 1101097899 1316117765 48 Rural Health Clinics ELMER HUGH TAYLOR CLINIC 999999999 18 Cass 0 0 0 255 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 875 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25990.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25990.72 0 0 1101097906 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 8929.03 0 0 0 0 0 0 0 0 0 0 0 0 0 8929.03 0 0 1101097923 1164511580 10 Physicians WAHEED HARRIS 609142437 54 Kankakee 0 1 Family Practice 0 0 0 16 0 0 0 0 0 0 32 0 169 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 52 0 480 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 52 0 480 0 0 0 0 0 0 0 0 0 1297.56 0 0 0 0 0 0 487.68 0 12051.86 0 0 0 0 0 0 13837.1 0 0 1101097930 1386842557 10 Physicians CHIANG LO KU 600044823 200 Cook 0 0 Nephrology 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 0 382 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 6472.53 0 0 0 0 0 0 6472.53 0 0 1101097944 1689640005 10 Physicians JELINEK CHRISTOPHER 610326942 97 Stephenson 0 1 Family Practice 0 0 0 7 0 0 0 0 0 0 6 0 64 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 7 0 141 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 7 0 141 0 0 0 0 0 0 0 0 0 374.23 0 0 0 0 0 0 83.11 0 2550.47 0 0 0 0 0 0 3007.81 0 0 1101097945 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 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 1216.28 0 0 0 0 0 0 1216.28 0 0 1101097962 1639266646 47 Local Education Agencies COWDEN HERRICK CUSD 3A 624224104 94 Shelby 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 433 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2332.01 0 2332.01 0 0 1101097963 1154481588 60 Pharmacies LAGRANGE ROAD PHARMACY 604877581 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 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 2219 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478.66 0 0 0 478.66 0 0 1101097978 1366492357 12 Optometrists DAVIS JAMES 625262861 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 561.09 0 497.76 0 0 0 0 1058.85 0 0 1101097982 1942574769 16 Nurse Practitioners CLISBY TRACIE E 606151503 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 1631.6 0 0 0 0 0 0 1631.6 0 0 1101098001 1912117912 10 Physicians RODRIGUEZ FRIAS EDMUNDO 622861820 87 Randolph 0 0 Internal Medicine 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 0 281 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 7514.63 0 0 0 0 0 0 7514.63 0 0 1101098002 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48.12 0 0 0 0 0 0 48.12 0 0 1101098003 92 Waiver service provider--Disability (DHS/DRS) 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 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 42409.82 0 0 0 0 0 0 0 0 0 0 0 0 0 42409.82 0 0 1101098029 1497889661 11 Dentists PUDIK BETHELEN O 616043457 80 Peoria 0 0 General Dentistry 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1072.61 0 0 1101098048 1508871732 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 616041360 80 Peoria 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 0 506 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16077 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24227.18 0 0 0 24227.18 0 0 1101098078 10 Physicians 200 Cook 0 1 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 0 167.45 0 0 0 0 0 0 167.45 0 0 1101098099 10 Physicians 826 Missouri 0 0 Orthopedic Surgery 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 16.3 0 101.5 0 0 0 0 0 0 117.8 0 0 1101098106 1487974424 10 Physicians VINCENT ANDREW 616021320 80 Peoria 0 0 Emergency 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 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 3004.64 0 0 0 0 0 0 3004.64 0 0 1101098121 1447257316 10 Physicians KIVISTO ERIC 613429012 58 La Salle 0 0 Surgery General 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 0 128 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 3546.06 0 0 0 0 0 0 3546.06 0 0 1101098136 1316176308 25 Audiologists KITNER BLYTHE 601159621 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 162 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 15608.33 15608.33 0 0 1101098144 1689650814 10 Physicians LERNER CYNTHIA 606116649 200 Cook 0 0 Allergy 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 604.7 0 0 0 0 0 0 604.7 0 0 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0 43 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 1101098194 1619914496 10 Physicians NAZIR SAIF A 731279742 80 Peoria 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3051.27 0 0 0 0 0 0 3051.27 0 0 1101098204 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 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 10847.75 0 0 0 0 0 0 0 0 0 0 0 0 0 10847.75 0 0 1101098209 1932377652 36 Community mental health provider COMMUNITY RESOURCE CENTER 628812004 66 Marion 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195 0 0 2023.53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13674.26 0 0 15697.79 0 0 1101098215 1073564175 10 Physicians DONVITO MARK T. 622743342 81 Perry 0 0 Emergency 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 1520.92 0 0 0 0 0 0 1520.92 0 0 1101098220 1841249000 16 Nurse Practitioners YOUNG KISHA N 605275965 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 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 0 750.05 0 0 0 0 0 0 750.05 0 0 1101098227 1902069412 13 Podiatrists GOLDKIND ADAM 600073260 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 0 114 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 0 832.38 0 0 0 0 0 0 832.38 0 0 1101098229 1306863683 60 Pharmacies WALMART PHARMACY 10-0302 629665202 47 Jackson 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 1054 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59947.64 0 0 0 59947.64 0 0 1101098232 1558389973 60 Pharmacies SAMS PHARMACY 10 8285 622691615 96 St Clair 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 0 322 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10981.18 0 0 0 10981.18 0 0 1101098253 1538395793 36 Community mental health provider COMMUNITY RESOURCE CENTER 622311803 23 Clinton 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 374 0 0 6802.94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30493.39 0 0 37296.33 0 0 1101098261 1982806279 10 Physicians WANG EDWARD H 402324098 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 3 0 27 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 24.15 0 427.49 0 0 0 0 0 0 451.64 0 0 1101098267 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23978.5 0 0 0 0 0 0 0 0 0 0 0 0 0 23978.5 0 0 1101098273 1467745208 16 Nurse Practitioners MEINHART ELIZABETH 624010665 33 Effingham 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 0 189 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 3339.76 0 0 0 0 0 0 3339.76 0 0 1101098278 1639186315 11 Dentists WINTERSTEEN BRUCE C 618561641 82 Piatt 0 0 General Dentistry 0 0 90 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 396 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 12780.92 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 13533.62 0 0 1101098284 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 24082.79 0 0 0 0 0 0 0 0 0 0 0 0 0 24082.79 0 0 1101098312 1447385257 70 Ambulance Service Providers NORTHBROOK FIRE DEPT 600622704 200 Cook 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 0 556 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 60950.79 0 0 0 0 0 0 60950.79 0 0 1101098317 1245350040 43 Encounter rate clinic FANTUS HEALTH CENTER 606123701 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 7072 0 206 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 41950 0 453 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 41950 0 453 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 8464971.39 0 57153.85 0 0 0 0 0 15399.5 0 0 0 0 0 0 0 0 0 8537524.74 0 0 1101098325 1215986062 10 Physicians MAXOURIS KATE LYNN 606253500 200 Cook 0 1 Family Practice 0 0 0 17 0 0 0 0 0 0 0 0 178 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 255 0 0 0 0 0 0 0 0 0 1882.08 0 0 0 0 0 0 0 0 9362.17 0 0 0 0 0 0 11244.25 0 0 1101098335 1740291939 10 Physicians PINSKY JONATHAN 605639791 30 DuPage 0 0 Infectious Diseases 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 0 665 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 8038.52 0 0 0 0 0 0 8038.52 0 0 1101098344 1992931661 10 Physicians FRAZIER MATTHEW 999999999 200 Cook 0 0 0 0 0 8 0 0 0 0 0 0 3 0 21 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 3 0 70 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 3 0 70 0 0 0 0 0 0 0 0 0 563.51 0 0 0 0 0 0 4.5 0 772.76 0 0 0 0 0 0 1340.77 0 0 1101098345 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 556.47 0 0 0 0 0 0 0 0 0 0 0 0 0 556.47 0 0 1101098356 1609874015 13 Podiatrists AKERELE PETER 606495016 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 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 3860.87 0 0 0 0 0 0 3860.87 0 0 1101098377 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 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 25775.91 0 0 0 0 0 0 0 0 0 0 0 0 0 25775.91 0 0 1101098384 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 0 137 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 10059.81 0 0 0 0 0 0 0 0 0 0 0 0 0 10059.81 0 0 1101098392 1487826517 29 ICF/MR MAPLE TERRACE 623011652 10 Adams 0 0 0 0 0 0 0 0 0 0 16 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 11165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849053.16 0 0 0 0 0 0 0 0 0 0 849053.16 0 0 1101098395 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 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 20200.67 0 0 0 0 0 0 0 0 0 0 0 0 0 20200.67 0 0 1101098417 1679606073 48 Rural Health Clinics OSF HOLY FAMILY CLINICS 614621007 102 Warren 0 1 0 669 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2716 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2716 0 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52853.71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52853.71 0 0 1101098420 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 0 0 0 0 0 0 0 0 0 0 1101098424 91 Waiver service provider--Adults (DHS/DDD) 96 St Clair 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44210.76 0 0 0 0 0 0 0 0 0 0 0 0 0 44210.76 0 0 1101098474 1043574544 55 Early Intervention Services THRASHER JENNIFER L 605151774 30 DuPage 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 0 829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 829 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50905.21 0 0 0 0 0 0 50905.21 0 0 1101098475 1962793687 48 Rural Health Clinics SOUTHERN OBSTETRICS GYNY ASSOC 622491255 65 Madison 0 0 0 37 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 5320.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5320.18 0 0 1101098485 10 Physicians 53 Kane 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101098487 1528042686 52 Certified local public health department SHELBY COUNTY HEALTH DEPT 625659510 94 Shelby 0 0 0 46 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1845.72 0 616.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2462.61 0 0 1101098492 1043224470 63 Other Providers of Medical Equipment/Supplies (Non-registered) EASE E MEDICAL INC 812124905 806 Colorado 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 1039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1039 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75300.6 0 0 0 0 0 0 75300.6 0 0 1101098510 12 Optometrists 200 Cook 0 0 Diagnostic 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 46.45 0 0 0 0 0 0 46.45 0 0 1101098526 1750526471 10 Physicians SUNGHAY SHWETHA 604030928 107 Will 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 148 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 347.51 0 0 0 0 0 0 347.51 0 0 1101098531 1447216239 10 Physicians APOSTOL FERDINAND 628646293 49 Jefferson 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 18 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 286 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.05 0 2687.43 0 0 0 0 0 0 2896.48 0 0 1101098536 1720394307 11 Dentists GUADIZ MICHAEL 604031881 107 Will 0 0 General Dentistry 0 0 62 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 6898 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6898 0 0 1101098565 1700220043 11 Dentists ATSAWASUWAN PHIMON 606017524 200 Cook 0 0 Orthodontist 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 2558.25 0 0 0 0 0 0 0 0 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1831263110 63 Other Providers of Medical Equipment/Supplies (Non-registered) TOBII DYNAVOX LLC 152031942 839 Pennsylvania 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 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 107960.52 0 0 0 0 0 0 107960.52 0 0 1101102023 1629293386 10 Physicians SCHREIBER GARY 602023328 200 Cook 0 0 Oncology 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 0 206 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 3021.95 0 0 0 0 0 0 3021.95 0 0 1101102028 92 Waiver service provider--Disability (DHS/DRS) 85 Pulaski 0 0 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 3997.42 0 0 0 0 0 0 0 0 0 0 0 0 0 3997.42 0 0 1101102031 1104072362 10 Physicians SANTHIRAJ YAVEEN 606123714 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 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 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0 0 0 0 11292.34 0 0 0 0 0 0 0 0 0 0 0 0 0 11292.34 0 0 1101102411 1134397649 47 Local Education Agencies CENTRAL CUSD 301 601247879 53 Kane 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 117 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 3990 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 3990 0 0 0 0 1605.77 0 0 0 0 0 0 0 0 0 0 0 0 0 81544.88 0 83150.65 0 0 1101102413 1558410886 10 Physicians MILLER CELINA 600508409 200 Cook 0 1 Pediatrics 0 0 0 44 0 0 0 0 0 0 14 0 17 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 14 0 22 0 0 0 0 0 0 0 0 0 140 0 0 0 0 0 0 14 0 22 0 0 0 0 0 0 0 0 0 5186.93 0 0 0 0 0 0 30.5 0 988.09 0 0 0 0 0 0 6205.52 0 0 1101102436 1922287663 13 Podiatrists MENDOZA LUIS 608042219 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 849 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1643.52 0 0 0 0 0 0 1643.52 0 0 1101102445 1033196001 61 Independent Laboratories LABORATORY CORPORATION AMERICA 277090150 834 North Carolina 0 0 0 0 0 0 0 0 0 0 0 0 41 0 0 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53 Kane 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 0 962 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 962 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13822.35 0 0 0 0 0 0 0 0 0 0 0 0 0 13822.35 0 0 1101112703 1356358238 60 Pharmacies WALGREEN CO 531424951 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 666 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1336.35 0 0 0 1336.35 0 0 1101112711 1659392850 70 Ambulance Service Providers GLENCOE DEPT OF PUBLIC SAFETY 600221609 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 4399.98 0 0 0 0 0 0 4399.98 0 0 1101112753 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 0 186 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 15038.02 0 0 0 0 0 0 0 0 0 0 0 0 0 15038.02 0 0 1101112775 63 Other Providers of 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1101112883 10 Physicians 109 Winnebago 0 0 Ophthalmology 0 0 0 0 0 0 0 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 0 236.98 0 0 0 0 0 0 236.98 0 0 1101112888 2100103306 92 Waiver service provider--Disability (DHS/DRS) NEW ERA SUPPORT SERVICES INC 605437150 55 Kendall 0 0 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 46948.57 0 0 0 0 0 0 0 0 0 0 0 0 0 46948.57 0 0 1101112889 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30577.72 0 0 0 0 0 0 0 0 0 0 0 0 0 30577.72 0 0 1101112901 10 Physicians 852 Wisconsin 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4406.34 0 0 0 0 0 0 4406.34 0 0 1101112907 1235140732 60 Pharmacies DEV PHARMACY 605053083 53 Kane 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 0 347 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6801 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4378.99 0 0 0 4378.99 0 0 1101112912 1891786372 10 Physicians LITOFF DANIEL 606022001 200 Cook 0 1 Internal Medicine 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 2 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.27 0 1420.12 0 0 0 0 0 0 1428.39 0 0 1101112937 1104815562 11 Dentists MAYER CARL ERIC 600719253 71 McHenry 0 0 General Dentistry 0 0 13 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 3310.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3310.07 0 0 1101112939 1942227640 10 Physicians BALAGANI RADHA K 606313222 200 Cook 0 1 Family Practice 0 0 0 5 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 86 0 0 0 0 0 0 0 0 0 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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 2239.44 0 0 0 0 0 0 2239.44 0 0 1101113131 1326013004 63 Other Providers of Medical Equipment/Supplies (Non-registered) HAYAT HOME MEDICAL EQUIPMENT 608052105 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 472 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 130980.07 0 0 0 0 0 0 130980.07 0 0 1101113149 55 Early Intervention Services 47 Jackson 0 0 0 0 0 0 0 0 0 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 0 824.93 0 0 0 0 0 0 824.93 0 0 1101113150 1790808657 10 Physicians YUNUS SAADIA 606740018 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.86 0 2034.81 0 0 0 0 0 0 2049.67 0 0 1101113166 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 8093.16 0 859.76 0 0 0 0 0 0 8952.92 0 0 1101122393 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 0 0 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 1899.5 0 0 0 0 0 0 0 0 0 0 0 0 0 1899.5 0 0 1101122408 1932365277 10 Physicians VALAITIS JOSEPH S 753120288 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.48 0 5728.68 0 0 0 0 0 0 5758.16 0 0 1101122412 1235238973 10 Physicians SHAPIRO MICHAEL 600165320 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.16 0 20804.11 0 0 0 0 0 0 20882.27 0 0 1101122414 60 Pharmacies 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 11.64 0 0 0 11.64 0 0 1101122416 1811084452 10 Physicians LEW JENNIFER L 601228942 53 Kane 0 0 Obstetric-Gynecology 0 0 0 3 0 0 0 0 0 0 13 0 57 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 14 0 114 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 14 0 114 0 0 0 0 0 0 0 0 0 111.63 0 0 0 0 0 0 355.45 0 5330.64 0 0 0 0 0 0 5797.72 0 0 1101122448 10 Physicians 852 Wisconsin 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 7.7 0 0 0 0 0 0 7.7 0 0 1101122459 1629247465 10 Physicians SHETTY ANISHA 605066222 53 Kane 0 0 Pediatrics 0 0 0 9 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 711.65 0 0 0 0 0 0 0 0 815.96 0 0 0 0 0 0 1527.61 0 0 1101122461 1629090972 10 Physicians TOMCHIK KENNETH 600420190 57 Lake 0 1 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 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0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1005.51 0 0 0 0 0 0 1005.51 0 0 1101123840 1285843011 10 Physicians FLETCHALL WILLIAM 616148280 80 Peoria 0 0 Emergency Medicine 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 0 109 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 6576.11 0 0 0 0 0 0 6576.11 0 0 1101123847 10 Physicians 816 Iowa 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101123874 1972662658 40 Federally Qualified Health Centers EAGLE VIEW COMMUNITY HEALTH SY 614805033 44 Henderson 0 1 0 208 0 2 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 1330 0 3 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 1330 0 3 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 56173.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56173.14 0 0 1101123876 1619953486 10 Physicians KLAUSS SVEN 617013552 72 McLean 0 1 Internal Medicine 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 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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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.83 0 0 0 0 0 0 0 0 0 0 0 0 0 580.83 0 0 1101123918 1265482640 10 Physicians SHAH MAIMOONA 603041095 200 Cook 0 1 Pediatrics 0 0 0 24 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 2252.35 0 0 0 0 0 0 0 0 1340.14 0 0 0 0 0 0 3592.49 0 0 1101123945 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 0 176 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 19508.3 0 0 0 0 0 0 0 0 0 0 0 0 0 19508.3 0 0 1101123969 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 24565.42 0 0 0 0 0 0 0 0 0 0 0 0 0 24565.42 0 0 1101123982 1184759136 10 Physicians CACIOPPO PHILLIP L 600073372 200 Cook 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10136.95 0 0 0 0 0 0 10136.95 0 0 1101123996 1053398933 10 Physicians FORD DONALD R 612541091 45 Henry 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 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 0 325.5 0 0 0 0 0 0 325.5 0 0 1101124008 1295743383 10 Physicians THAPPA VIVEK 611081673 109 Winnebago 0 0 Pulmonary Diseases 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 0 260 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 6156.07 0 0 0 0 0 0 6156.07 0 0 1101124016 92 Waiver service provider--Disability (DHS/DRS) 16 Calhoun 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28286.65 0 0 0 0 0 0 0 0 0 0 0 0 0 28286.65 0 0 1101124033 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0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.43 0 0 0 0 0 0 454.43 0 0 1101124130 1144476631 23 Occupational Therapists MOORE ROBIN L 627023207 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 398 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32452.55 32452.55 0 0 1101124159 1851558001 10 Physicians ROMANTSEVA LUBOV 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 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 4513.25 0 0 0 0 0 0 4513.25 0 0 1101124185 1740220664 10 Physicians BECHTEL WILLIAM C 462063272 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1092 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1759 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1759 0 182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12036.21 0 1151.38 0 0 0 0 0 0 13187.59 0 0 1101124218 1699881227 10 Physicians MAURER GREGORY 619389388 24 Coles 0 0 Urological Surgery 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 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4535.38 0 0 0 0 0 0 0 0 0 0 0 0 0 4535.38 0 0 1101135813 1023118692 10 Physicians CHEN EDWARD 303285834 53 Kane 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 0 170 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 5015.78 0 0 0 0 0 0 5015.78 0 0 1101135828 1578599098 60 Pharmacies SCHNUCKS PHARMACY 750 611083008 109 Winnebago 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 0 137 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3344 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6144.43 0 0 0 6144.43 0 0 1101135863 10 Physicians 852 Wisconsin 0 1 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 48.68 0 0 0 0 0 0 48.68 0 0 1101135946 1528173374 30 General Hospitals RCG CENTRAL ILLINOIS-PEKIN 615549300 98 Tazewell DIALYSIS Outpatient dialysis centers. 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0 0 0 14223.63 0 0 1101136006 1912973512 50 Home Health Agencies - In Home HOME STAFF INC 606564751 200 Cook 0 0 0 0 0 0 0 19 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2545 1293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2545 1293 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1115579.9 85624.45 0 0 0 0 0 0 0 0 0 0 0 0 1201204.35 0 0 1101136009 1215031919 10 Physicians HAHN EUGENIA 607145611 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 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 0 116.67 0 0 0 0 0 0 116.67 0 0 1101136017 1174519219 10 Physicians MULVEY THOMAS 616143294 80 Peoria 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 12 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118.87 0 2832.63 0 0 0 0 0 0 2951.5 0 0 1101136027 1104852177 10 Physicians HAHN LAURA 601262966 65 Madison 0 0 Anesthesiology 0 0 0 0 0 0 0 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 1179.81 0 0 0 0 0 0 1179.81 0 0 1101136038 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 73.4 0 0 0 0 0 0 73.4 0 0 1101136041 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 22287.32 0 0 0 0 0 0 0 0 0 0 0 0 0 22287.32 0 0 1101136044 1003962697 10 Physicians ZEHNDER NICHOLE 800455701 806 Colorado 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 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 0 262.08 0 0 0 0 0 0 262.08 0 0 1101136046 92 Waiver service provider--Disability (DHS/DRS) 47 Jackson 0 0 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 18157.99 0 0 0 0 0 0 0 0 0 0 0 0 0 18157.99 0 0 1101136047 91 Waiver service provider--Adults (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 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 517 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10328.86 0 0 0 0 0 0 0 0 0 0 0 0 0 10328.86 0 0 1101136065 10 Physicians 19 Champaign 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.8 0 0 0 0 0 0 235.8 0 0 1101136079 1952453037 60 Pharmacies WALGREENS 10498 605609851 55 Kendall 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 332 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 8201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.62 0 0 11213.17 0 0 0 11251.79 0 0 1101136083 1508935701 10 Physicians KIM PAUL 616111853 98 Tazewell 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 520 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 821 0 61 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 1255 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1255 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39116.85 0 385.83 0 0 0 0 39502.68 0 0 1101144825 1720050982 10 Physicians GOOTEE MICHAEL J 616151941 80 Peoria 0 0 Otolaryngology 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 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 5133.09 0 0 0 0 0 0 5133.09 0 0 1101144844 1821035106 10 Physicians THAMEEM DANISH 618203909 19 Champaign 0 0 Pulmonary Diseases 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 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 283 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4228.51 0 0 0 0 0 0 4228.51 0 0 1101144846 1992791271 70 Ambulance Service Providers NORTH WAYNE AMBULANCE 628230133 104 Wayne 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 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 2329.55 0 0 0 0 0 0 2329.55 0 0 1101144874 1255399242 10 Physicians PYATT STUART L. 311936436 54 Kankakee 0 0 Emergency 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 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 1745.4 0 0 0 0 0 0 1745.4 0 0 1101144877 1164694022 60 Pharmacies OSCO DRUG 2481 605435015 55 Kendall 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 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2917.69 0 0 0 2917.69 0 0 1101144882 2100135300 28 Waiver service provider--Supportive living facility (HFS) KNOLLWOOD ST CLAIR RETIRE COMM 622321808 96 St Clair 0 0 0 0 0 0 0 22 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 2967 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 284508.2 0 0 0 0 0 0 0 0 0 0 0 0 0 284508.2 0 0 1101144934 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 0 225 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 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0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20826.34 0 0 0 0 0 0 0 0 0 0 0 0 0 20826.34 0 0 1101145461 1043296734 10 Physicians NUDELMAN MARC 49155500 200 Cook 0 0 Pediatrics 0 0 0 4 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 472.55 0 0 0 0 0 0 0 0 323.52 0 0 0 0 0 0 796.07 0 0 1101145493 1740436856 10 Physicians PARKES MEGAN 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 0 115 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 1270.31 0 0 0 0 0 0 1270.31 0 0 1101145539 1558642314 33 Nursing Facilities LAKEVIEW REHAB NURSING CENTER 999999999 200 Cook 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 0 251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899881.89 0 0 0 0 0 0 0 899881.89 0 0 1101145553 1346399029 16 Nurse Practitioners SAMSON SHERWIN 606603968 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 105 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2503.45 0 380.64 0 0 0 0 2884.09 0 0 1101148196 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 17484.4 0 0 0 0 0 0 0 0 0 0 0 0 0 17484.4 0 0 1101148200 16 Nurse Practitioners 62 Logan 0 0 0 0 0 0 0 0 0 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 1.32 0 0 0 0 0 0 1.32 0 0 1101148207 1225018153 10 Physicians WINKLEMAN MATTHEW C 629023988 47 Jackson 0 0 Family Practice 0 0 0 0 0 0 0 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 21.86 0 0 0 0 0 0 21.86 0 0 1101148208 1740213495 10 Physicians PATIL RAKHI 600164029 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 9 0 83 0 0 0 0 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 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0 0 2136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64806 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8267087.7 0 0 0 0 0 0 0 0 0 0 8267087.7 0 0 1101148245 1841373156 10 Physicians MCDAID DAWN 622461161 12 Bond 0 0 Gynecology 0 0 0 1 0 0 0 0 0 0 1 0 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 2659.64 0 0 0 0 0 0 2744.26 0 0 1101148248 1689841314 10 Physicians SIEMIONOW KRZYSZTOF 606930623 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 915.94 0 0 0 0 0 0 915.94 0 0 1101148252 1730243015 10 Physicians CHEN XUEGUANG 627118300 91 Sangamon 0 0 Nephrology 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 0 835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8059.87 0 0 0 0 0 0 8059.87 0 0 1101148264 1194982488 11 Dentists HERMANN SZILARD 606131113 200 Cook 0 0 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SETHI AMAN 605066222 53 Kane 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 0 190 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 9080.2 0 0 0 0 0 0 9080.2 0 0 1101148449 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2145.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2145.78 0 0 1101148466 1174524136 10 Physicians JACOBS JEFFREY 601220021 53 Kane 0 0 Gastroenterology 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 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 0 531.35 0 0 0 0 0 0 531.35 0 0 1101148479 10 Physicians 852 Wisconsin 0 0 Radiology 0 0 0 0 0 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 17 0 0 0 0 0 0 0 0 17 0 0 1101148482 1417984105 16 Nurse Practitioners AULDS JULIE 624012006 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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 20653.94 0 0 0 0 0 0 0 0 0 0 0 0 0 20653.94 0 0 1101148693 1255386538 10 Physicians WARSI SYED M 605423059 53 Kane 0 1 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 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 1171.82 0 0 0 0 0 0 1171.82 0 0 1101148707 1285660530 60 Pharmacies SCHNUCKS PHARMACY 229 620252582 65 Madison 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10289.5 0 0 0 10289.5 0 0 1101148723 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 27743.65 0 0 0 0 0 0 0 0 0 0 0 0 0 27743.65 0 0 1101148747 1427164243 47 Local Education Agencies WINDSOR CUSD 1 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0 1101152886 1386842029 55 Early Intervention Services PAULSBERG CHRISTINA 600845006 57 Lake 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 0 118 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 13472.36 0 0 0 0 0 0 13472.36 0 0 1101152897 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 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 3935.69 0 0 0 0 0 0 0 0 0 0 0 0 0 3935.69 0 0 1101152906 1629151352 10 Physicians BOLER LEO 606242334 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 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 3186.05 0 0 0 0 0 0 3186.05 0 0 1101152917 1851333819 16 Nurse Practitioners WHITE TINA 616370001 80 Peoria 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 0 124 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 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0 0 0 0 0 0 0 1 0 98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2998.5 0 0 0 0 0 0 2998.5 0 0 1101153849 1114179702 10 Physicians SEKHADIA LIPI 604355487 107 Will 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 0 227 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 0 998.72 0 0 0 0 0 0 998.72 0 0 1101153852 30 General Hospitals 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580.97 0 0 1101153853 91 Waiver service provider--Adults (DHS/DDD) 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 0 248 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 26157.76 0 0 0 0 0 0 0 0 0 0 0 0 0 26157.76 0 0 1101153856 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600073443 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431768.63 0 431768.63 0 0 1101158067 1932311883 10 Physicians MAHAJAN RENU 601604138 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 132 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 9.3 0 0 0 0 0 0 9.3 0 0 1101158097 1023371143 40 Federally Qualified Health Centers SIHF MATTOON MEDICAL CENTER 999999999 24 Coles 0 0 0 132 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 624 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 624 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26596.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26596.86 0 0 1101158102 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 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 11808 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 9531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 806084.12 0 0 0 0 0 0 0 0 0 0 806084.12 0 0 1101164442 1912985540 11 Dentists SAMBORSKI MICHAEL 604592115 200 Cook 0 0 General Dentistry 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 686.32 0 0 1101164449 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 21294.24 0 0 0 0 0 0 0 0 0 0 0 0 0 21294.24 0 0 1101164450 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24742.32 0 0 0 0 0 0 0 0 0 0 0 0 0 24742.32 0 0 1101164504 1558316117 10 Physicians NISIPEANU OANA 606313222 200 Cook 0 0 Emergency Medicine 0 0 0 17 0 0 0 0 0 0 5 0 144 0 0 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2927.13 0 0 1101164578 1356676431 10 Physicians RAMAS CARLA V 618012529 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 99 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 121 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1335.26 0 34.56 0 0 0 0 0 0 1369.82 0 0 1101164607 1316087059 23 Occupational Therapists LENKE MAUREEN 600563425 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5120.85 5120.85 0 0 1101164609 1801806054 10 Physicians SCALZO ANTHONY 631032236 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 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 0 700.44 0 0 0 0 0 0 700.44 0 0 1101164619 1225202492 16 Nurse Practitioners BAUER SHELLY A 600508409 71 McHenry 0 0 0 0 0 8 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 741.28 0 0 0 0 0 0 0 0 1560.33 0 0 0 0 0 0 2301.61 0 0 1101164639 92 Waiver service provider--Disability (DHS/DRS) 60 Lee 0 0 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 5178.19 0 0 0 0 0 0 0 0 0 0 0 0 0 5178.19 0 0 1101164669 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23620.45 0 0 0 0 0 0 0 0 0 0 0 0 0 23620.45 0 0 1101164686 1275520132 10 Physicians KIM JAMES H 601431249 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 40 0 59 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 72 0 115 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 72 0 115 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 2038.52 0 12111.33 0 0 0 0 0 0 14164.45 0 0 1101164692 1710971288 33 Nursing Facilities HICKORY NURSING PAVILION 604572066 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 29 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 3096 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418649.83 0 0 0 0 0 0 0 418649.83 0 0 1101164703 1720073067 10 Physicians KNUTH SANDRA 619200770 24 Coles 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 121 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4368.32 0 443.93 0 0 0 0 0 0 4812.25 0 0 1101164718 1336315761 10 Physicians STROTKAMP JON PETER 999999999 200 Cook 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 0 206 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 9185.99 0 0 0 0 0 0 9185.99 0 0 1101164722 1902069875 10 Physicians IMBOREK KATHERINE 522421009 816 Iowa 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 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 0 237.71 0 0 0 0 0 0 237.71 0 0 1101164737 1235399304 10 Physicians MCHALE SARA A 946081844 200 Cook 0 0 Family Practice 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 0 357 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 4133.59 0 0 0 0 0 0 4133.59 0 0 1101164741 1376530766 33 Nursing Facilities ALDEN PARK STRATHMOOR 611075110 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 55 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 6366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1115912.6 0 0 0 0 0 0 0 1115912.6 0 0 1101164757 1467749085 55 Early Intervention Services BAULT KELLY 613504304 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 371 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18127.11 0 0 0 0 0 0 18127.11 0 0 1101164773 1316178064 60 Pharmacies CVS PHARMACY 07017 617047117 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 182 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 49098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68556.08 0 0 0 68556.08 0 0 1101164780 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 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 4258.24 0 0 0 0 0 0 0 0 0 0 0 0 0 4258.24 0 0 1101164785 1386932028 16 Nurse Practitioners WHITAKER KELLY 622697287 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 911 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5869.91 0 0 0 0 0 0 5869.91 0 0 1101164811 1699978791 10 Physicians MURTHY AMISHI 602012475 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1168.44 0 0 0 0 0 0 1168.44 0 0 1101164824 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 12440.61 0 0 0 0 0 0 0 0 0 0 0 0 0 12440.61 0 0 1101164828 10 Physicians 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 0 670.4 0 0 0 0 0 0 670.4 0 0 1101164835 1578793170 10 Physicians WHYTE SARAH 731191026 200 Cook 0 0 Emergency Medicine 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 0 102 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 3609.9 0 0 0 0 0 0 3609.9 0 0 1101164857 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 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 3945.45 3945.45 0 0 1101164862 1538129275 10 Physicians LESLIE WILLIAM 606751611 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 79 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 1623.44 0 0 0 0 0 0 1623.44 0 0 1101164873 2100155291 91 Waiver service provider--Adults (DHS/DDD) ROCK RIVER VALLEY SELF HELP EN 610817703 106 Whiteside 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9178 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803669.77 0 0 0 0 0 0 0 0 0 0 0 0 0 803669.77 0 0 1101164877 11 Dentists 200 Cook 0 0 General Dentistry 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76.15 0 0 1101164883 1457364903 10 Physicians BENNETT DAVID 606253642 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 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 0 888.24 0 0 0 0 0 0 888.24 0 0 1101164891 1902832397 10 Physicians FASEHUN TAIWO M 600505434 71 McHenry 0 1 Pediatrics 0 0 0 2 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 166.48 0 0 0 0 0 0 0 0 858.99 0 0 0 0 0 0 1025.47 0 0 1101164894 1376677187 16 Nurse Practitioners FELT TRACEY R. 602011718 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 263.36 0 0 0 0 0 0 263.36 0 0 1101164896 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 23355.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23355.29 0 0 1101164923 1427064708 16 Nurse Practitioners BAGGE MARLA J 610320268 97 Stephenson 0 0 0 0 0 4 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 160 0 0 0 0 0 0 0 0 0 331.73 0 0 0 0 0 0 0 0 3354.15 0 0 0 0 0 0 3685.88 0 0 1101164924 1912002882 10 Physicians DELOSO DAVID 628645924 49 Jefferson 0 1 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5817.05 0 0 0 0 0 0 5817.05 0 0 1101164991 1629024013 60 Pharmacies OSCO DRUG #3721 606382743 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 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 7574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8047.4 0 0 0 8047.4 0 0 1101165023 10 Physicians 53 Kane 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 0 245.34 0 0 0 0 0 0 0 0 245.34 0 0 1101165058 1720203086 10 Physicians AHMAD TANVEER 600983713 71 McHenry 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 5 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.6 0 2909.07 0 0 0 0 0 0 3011.67 0 0 1101165068 1912936600 63 Other Providers of Medical Equipment/Supplies (Non-registered) HEALTHCARE EQUIP AND SUPPLY 637751837 826 Missouri 0 0 0 0 0 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0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 188.09 0 0 0 0 0 0 0 0 1354.58 0 0 0 0 0 0 1542.67 0 0 1101165968 1518241017 11 Dentists SHARMA VINEET 601852315 30 DuPage 0 0 General Dentistry 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11495.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11495.35 0 0 1101165982 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11664.62 0 0 0 0 0 0 0 0 0 0 0 0 0 11664.62 0 0 1101165997 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 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 0 905.3 0 0 0 0 0 0 905.3 0 0 1101166002 12 Optometrists 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 0 0 0 0 0 0 0 0 0 0 1101166011 1669608394 16 Nurse Practitioners KOBLER JASON 616159506 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 708.29 0 0 0 0 0 0 708.29 0 0 1101166028 1023072394 10 Physicians SHIMONY JOSHUA 633101076 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 76 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3744.16 0 15.57 0 0 0 0 0 0 3759.73 0 0 1101166034 1932304789 28 Waiver service provider--Supportive living facility (HFS) CAMBRIDGE HOUSE OF O'FALLON 622691976 96 St Clair 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 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3341 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260808.69 0 0 0 0 0 0 0 0 0 0 0 0 0 260808.69 0 0 1101166044 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 0 137.66 0 0 0 0 0 0 137.66 0 0 1101166064 1275799785 10 Physicians NAUMANN SHANNON 622265360 96 St Clair 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 98.41 0 177.48 0 0 0 0 0 0 275.89 0 0 1101166075 92 Waiver service provider--Disability (DHS/DRS) 38 Gallatin 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10455.71 0 0 0 0 0 0 0 0 0 0 0 0 0 10455.71 0 0 1101166101 1386914372 33 Nursing Facilities PERSHING GARDENS HC CENTER 604024168 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 30 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 2851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261221.69 0 0 0 0 0 0 0 261221.69 0 0 1101166105 1831263797 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 627044194 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 257 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4371.17 0 46421.81 0 0 0 0 50792.98 0 0 1101166143 1134211956 10 Physicians BHATIA MOTILAL 604292056 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1119.98 0 0 0 0 0 0 1119.98 0 0 1101166165 1770608903 11 Dentists RAMADORAI THIRUNINDRAVUR 601063342 30 DuPage 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 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 1020.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1020.32 0 0 1101166199 1386605061 10 Physicians IYENGAR NEHA 605214013 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 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 0 168.05 0 0 0 0 0 0 168.05 0 0 1101166202 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 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 0 340.62 0 0 0 0 0 0 340.62 0 0 1101166213 80 Prepaid health plan--Health maintenance organization HUMANA HEALTH PLAN INC MMP 60661 200 Cook 0 0 "7,765" 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60584799.06 0 1101166215 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25084.65 0 0 0 0 0 0 0 0 0 0 0 0 0 25084.65 0 0 1101166238 1952333585 23 Occupational Therapists LENZ SHARI 606561724 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 9067.48 9067.48 0 0 1101166239 1194921924 10 Physicians DUYKA LANDON J 606118709 200 Cook 0 0 Otolaryngology 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 0 128 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 2567.61 0 0 0 0 0 0 2567.61 0 0 1101166264 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8405.76 0 0 0 0 0 0 0 0 0 0 0 0 0 8405.76 0 0 1101166277 1750481263 16 Nurse Practitioners FINCH RODNEY 629595884 108 Williamson 0 0 0 0 0 0 0 0 0 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 0 490.87 0 0 0 0 0 0 490.87 0 0 1101166279 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 0 181 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 23085.04 0 0 0 0 0 0 0 0 0 0 0 0 0 23085.04 0 0 1101166280 1760423552 10 Physicians EZIKE CHUKWUEMEKA 606123714 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 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 0 497.4 0 0 0 0 0 0 497.4 0 0 1101166295 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 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 27.02 0 0 0 0 0 27.02 0 0 1101166311 1104056449 10 Physicians KISHKURNO SERGUEI 604532600 200 Cook 0 0 Pediatrics 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 38679.49 0 0 0 0 0 0 38679.49 0 0 1101166339 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 21396.47 0 0 0 0 0 0 0 0 0 0 0 0 0 21396.47 0 0 1101166350 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3924.83 0 0 0 0 0 0 0 0 0 0 0 0 0 3924.83 0 0 1101166360 1427001445 30 General Hospitals MERCY HARVARD HOSPITAL INC 600331821 71 McHenry DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 217 0 0 0 0 24 0 0 0 253 0 0 0 0 0 0 0 0 0 340 0 0 0 0 25 0 0 0 464 0 0 0 0 0 0 0 0 0 340 0 0 0 0 93 0 0 0 464 0 0 0 0 0 0 0 0 0 128253.48 0 0 0 0 20824.42 0 0 0 184463.79 0 0 0 0 0 333541.69 0 0 1101166365 1437260528 70 Ambulance Service Providers JACKSON COUNTY AMBULANCE 629030328 47 Jackson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1902696.31 0 0 0 0 0 0 1902696.31 0 0 1101166393 1992861918 10 Physicians SMITH GREGORY 606173905 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 4 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 1163.42 0 0 0 0 0 0 1169.72 0 0 1101166398 1740315472 13 Podiatrists KOSIVZOFF LORA 606105278 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 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 249.58 0 0 0 0 0 0 249.58 0 0 1101166408 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 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 82.25 0 0 0 0 0 0 0 0 82.25 0 0 1101166413 1649342064 11 Dentists CHACON JOSE 999999999 30 DuPage 0 0 0 0 56 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 18792.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18792.75 0 0 1101166428 1194767772 10 Physicians SAMBANDAM ALARMELU 627949639 91 Sangamon 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 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.15 0 48.06 0 0 0 0 0 0 87.21 0 0 1101166429 1861408510 10 Physicians DORODI SHERVIN 600161252 200 Cook 0 1 Family Practice 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 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2536.81 0 0 0 0 0 0 2536.81 0 0 1101166439 1619125317 10 Physicians LOPEZ CASSANDRA 601523107 71 McHenry 0 1 Family Practice 0 0 0 14 0 0 0 0 0 0 9 0 38 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 11 0 64 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 11 0 64 0 0 0 0 0 0 0 0 0 1405.97 0 0 0 0 0 0 89.43 0 2228.94 0 0 0 0 0 0 3724.34 0 0 1101166457 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 0 199.55 0 0 0 0 0 0 199.55 0 0 1101166459 1275686446 11 Dentists RICHARDS BRIAN J 612654878 89 Rock Island 0 0 Pedodontics 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15855.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15855.95 0 0 1101166484 1164648614 10 Physicians WALSH JEAN 601220021 53 Kane 0 0 Family Practice 0 0 0 8 0 0 0 0 0 0 13 0 174 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 31 0 319 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 31 0 319 0 0 0 0 0 0 0 0 0 688.15 0 0 0 0 0 0 252.88 0 3956.49 0 0 0 0 0 0 4897.52 0 0 1101166523 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14738.12 0 0 0 0 0 0 0 0 0 0 0 0 0 14738.12 0 0 1101166547 1942292412 10 Physicians JONES DAVID 625213836 63 Macon 0 1 Family Practice 0 0 0 4 0 0 0 0 0 0 7 0 49 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 8 0 101 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 8 0 101 0 0 0 0 0 0 0 0 0 153.68 0 0 0 0 0 0 30.92 0 3050.76 0 0 0 0 0 0 3235.36 0 0 1101166559 1992735526 10 Physicians PATEL BHARAT K 629602461 69 Massac 0 1 Cardiovascular Diseases 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 1396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1396 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4856.8 0 0 0 0 0 0 4856.8 0 0 1101166568 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 0 109 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 25974.85 0 0 0 0 0 0 0 0 0 0 0 0 0 25974.85 0 0 1101166584 1538187349 10 Physicians BAILEY THOMAS 631082259 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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 0 250.24 0 0 0 0 0 0 250.24 0 0 1101166586 1790780013 10 Physicians OLMSTED ADAM K 452132664 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 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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 1018.22 0 0 0 0 0 0 1018.22 0 0 1101166619 1548340060 16 Nurse Practitioners SUHAYDA LAUREN 601901295 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 392.45 0 0 0 0 0 0 392.45 0 0 1101166635 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 20221.4 0 0 0 0 0 0 0 0 0 0 0 0 0 20221.4 0 0 1101166638 1114920824 10 Physicians ASIMACOPOULOS VOULA 606930623 200 Cook 0 1 Internal Medicine 0 0 0 1 0 0 0 0 0 0 1 0 14 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 94.65 0 0 0 0 0 0 2.6 0 539.47 0 0 0 0 0 0 636.72 0 0 1101166646 2100157064 71 Medicar Provider SOUTH CENTRAL ILL MASS TRANSIT 628013149 66 Marion 0 0 0 0 0 0 0 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(Non-registered) HOVEROUND CORPORATION 342326060 810 Florida 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 2835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2835 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97934.22 0 0 0 0 0 0 97934.22 0 0 1101171869 1225340078 16 Nurse Practitioners MESKIMEN SCOTT 612654856 89 Rock Island 0 0 0 0 0 28 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 75 0 0 0 0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 1456.99 0 0 0 0 0 0 0 0 6066.85 0 0 0 0 0 0 7523.84 0 0 1101171881 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101171882 30 General Hospitals 852 Wisconsin ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2594.85 0 0 0 0 0 0 0 0 0 2594.85 0 0 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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 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 0 674.05 0 0 0 0 0 0 674.05 0 0 1101174454 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 17067.42 0 0 0 0 0 0 0 0 0 0 0 0 0 17067.42 0 0 1101174458 1881676997 10 Physicians SHAPIRO ALAN 600761260 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 42 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 0 963.54 0 0 0 0 0 0 963.54 0 0 1101174472 1538177423 30 General Hospitals CHRISTIAN HOSPITAL NE NW 631366163 826 Missouri DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 166 0 0 0 0 221 0 0 0 541 0 0 0 0 0 0 0 0 0 206 0 0 0 0 110 0 0 0 941 0 0 0 0 0 0 0 0 0 206 0 0 0 0 684 0 0 0 1083 0 0 0 0 0 0 0 0 0 22793.71 0 0 0 0 775294.88 0 0 0 77341.75 0 0 0 0 0 875430.34 0 3903.7 1101174480 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 0 192 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 22043.12 0 0 0 0 0 0 0 0 0 0 0 0 0 22043.12 0 0 1101174499 1407845985 11 Dentists KIM YOONJUNG 601335257 200 Cook 0 0 General Dentistry 0 0 34 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 5558.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5558.42 0 0 1101174507 1225296858 28 Waiver service provider--Supportive living facility (HFS) HAWTHORNE INN OF FREEPORT 610327803 97 Stephenson 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99174.81 0 0 0 0 0 0 0 0 0 0 0 0 0 99174.81 0 0 1101174517 1922025451 10 Physicians CORNELIUS LYNN A 631600352 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 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 0 123.62 0 0 0 0 0 0 123.62 0 0 1101174540 1851349831 16 Nurse Practitioners POWERS MICHELLE 601159602 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 760.67 0 0 0 0 0 0 760.67 0 0 1101174542 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18827.11 0 0 0 0 0 0 0 0 0 0 0 0 0 18827.11 0 0 1101174544 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 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 31.12 0 0 0 0 0 0 31.12 0 0 1101174545 1528032430 12 Optometrists WILLIAMS ROBERT TRACY 601533304 53 Kane 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 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 0 127.5 0 0 0 0 0 0 127.5 0 0 1101174551 1659300796 10 Physicians SINGLA ABHIN 604355683 107 Will 0 0 Internal Medicine 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 0 524 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 3882.75 0 0 0 0 0 0 3882.75 0 0 1101174563 1033297023 10 Physicians GREENSPAN AARON 606133077 200 Cook 0 1 Family Practice 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 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2121.95 0 0 0 0 0 0 2121.95 0 0 1101174568 1619153780 47 Local Education Agencies SKOKIE ELEMENTARY DIST 69 600772578 200 Cook 0 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 2705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45017.51 0 45017.51 0 0 1101174576 1114149770 10 Physicians WHEATLEY BRIAN 618223741 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 11 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.03 0 7345.42 0 0 0 0 0 0 7378.45 0 0 1101174586 1568459030 13 Podiatrists GASTWIRTH BART 600891134 57 Lake 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 0 299 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 3146.32 0 0 0 0 0 0 3146.32 0 0 1101174600 1992079388 55 Early Intervention Services JOHNSON ANGELITA D 606205753 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 0 232 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 15285.79 0 0 0 0 0 0 15285.79 0 0 1101174601 1417067695 10 Physicians BULLOCK ERIC 601220021 53 Kane 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 0 241 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 2324.97 0 0 0 0 0 0 2324.97 0 0 1101174608 1003899428 10 Physicians GULATI ANIL 605234655 30 DuPage 0 0 Ophthalmology 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 1316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1316 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5452.88 0 0 0 0 0 0 5452.88 0 0 1101174615 1346566445 36 Community mental health provider CHESTNUT HEALTH SYSTEMS INC 622342023 65 Madison 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 1076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 0 1076 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 0 34068.64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31653.31 0 0 65721.95 0 0 1101174623 1922149418 10 Physicians MACDONALD KATHRYN K 761165707 71 McHenry 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 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 1306.73 0 0 0 0 0 0 1306.73 0 0 1101174635 10 Physicians 815 Indiana 0 0 Pediatric Hematology Oncology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101174649 1295904282 47 Local Education Agencies WASHINGTON SCHOOL DISTRICT 52 615711473 98 Tazewell 0 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 0 385 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 5705.86 0 5705.86 0 0 1101174681 1508924267 10 Physicians KAGAN TATYANA 600073713 200 Cook 0 1 Pediatrics 0 0 0 118 0 0 0 0 0 0 27 0 113 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 38 0 207 0 0 0 0 0 0 0 0 0 632 0 0 0 0 0 0 38 0 207 0 0 0 0 0 0 0 0 0 15513.12 0 0 0 0 0 0 587.54 0 10691.69 0 0 0 0 0 0 26792.35 0 0 1101174683 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 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 70.25 0 0 0 0 0 0 70.25 0 0 1101174695 1053312694 10 Physicians PATEL PRANAV 612656180 89 Rock Island 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 333 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 390 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5391.65 0 375.55 0 0 0 0 0 0 5767.2 0 0 1101174703 23 Occupational Therapists 67 Marshall 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 1101174710 63 Other Providers of Medical Equipment/Supplies (Non-registered) 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.4 0 0 0 0 0 0 141.4 0 0 1101174721 10 Physicians 96 St Clair 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 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 11.85 0 0 0 0 0 0 11.85 0 0 1101174730 1013017797 10 Physicians RICHARDS JENNIFER 627949248 91 Sangamon 0 1 Internal Medicine 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 0 142 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 76.84 0 0 0 0 0 0 0 0 1319.81 0 0 0 0 0 0 1396.65 0 0 1101174772 1053560987 22 Physical Therapists ISAACS ELIZABETH 999999999 57 Lake 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 0 188 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 0 972.12 972.12 0 0 1101174778 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 11.1 0 0 0 0 0 0 0 0 11.1 0 0 1101174809 1629036983 10 Physicians OLEARY PATRICIA 600162335 200 Cook 0 0 Obstetric-Gynecology 0 0 0 2 0 0 0 0 0 0 2 0 29 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 49 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 49 0 0 0 0 0 0 0 0 0 67.5 0 0 0 0 0 0 74.5 0 1712.69 0 0 0 0 0 0 1854.69 0 0 1101174813 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22785 0 0 0 0 0 0 0 0 0 0 0 0 0 22785 0 0 1101174858 1679779912 10 Physicians RAJAGOPAL RITHWICK 631600352 200 Cook 0 0 Ophthalmology 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 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 84.99 0 2053.86 0 0 0 0 0 0 2138.85 0 0 1101174862 1326026543 10 Physicians KUNST RONALD D 463212901 200 Cook 0 0 Radiology Diagnosis 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 0 218 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 2786.31 0 0 0 0 0 0 0 0 2786.31 0 0 1101174865 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 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 7140.66 0 0 0 0 0 0 0 0 0 0 0 0 0 7140.66 0 0 1101174871 1336154517 60 Pharmacies BOND DRUG COMPANY OF IL 05193 604691438 200 Cook 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 1739 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54936 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133614.49 0 0 0 133614.49 0 0 1101174878 1114931375 10 Physicians CARROLL META 606116649 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 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 2727.69 0 0 0 0 0 0 2727.69 0 0 1101174892 1245262906 10 Physicians KULIK LAURA 606118709 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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 1010.67 0 0 0 0 0 0 1010.67 0 0 1101174900 10 Physicians 80 Peoria 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101174902 1568478816 23 Occupational Therapists HANK KARA 616370001 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 14858.21 14858.21 0 0 1101174933 10 Physicians 844 Tennessee 0 0 Ophthalmology 0 0 0 0 0 0 0 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 62.15 0 0 0 0 0 0 62.15 0 0 1101174971 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 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 14025.58 0 0 0 0 0 0 0 0 0 0 0 0 0 14025.58 0 0 1101174974 94 Waiver service provider--Children's support (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 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 6960.09 0 0 0 0 0 0 0 0 0 0 0 0 0 6960.09 0 0 1101174981 1699085381 10 Physicians VALLEJO DAVID 296072101 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 117.55 0 4483.84 0 0 0 0 0 0 4601.39 0 0 1101175004 92 Waiver service provider--Disability (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8651.24 0 0 0 0 0 0 0 0 0 0 0 0 0 8651.24 0 0 1101175018 1235163049 60 Pharmacies KROGER PHARMACY 629463327 90 Saline 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 0 596 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16694 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18503.61 0 0 0 18503.61 0 0 1101175023 1437105178 10 Physicians TURNER ARNOLD 606127323 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 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 0 309.88 0 0 0 0 0 0 309.88 0 0 1101175032 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 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 7325.19 0 0 0 0 0 0 0 0 0 0 0 0 0 7325.19 0 0 1101175034 1871591941 52 Certified local public health department BOND CO HEALTH DEPT 622461847 12 Bond 0 0 0 27 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1016.52 0 1620.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2636.87 0 0 1101175049 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 17180.95 0 0 0 0 0 0 0 0 0 0 0 0 0 17180.95 0 0 1101175054 1336305051 10 Physicians ZERTH HERBERT 617613558 72 McLean 0 0 Emergency 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 0 122 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 5703.51 0 0 0 0 0 0 5703.51 0 0 1101175078 1881974541 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(Non-registered) LINCARE INC 613502209 58 La Salle 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 3896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3896 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85040.54 0 0 0 0 0 0 85040.54 0 0 1101185919 1457692931 16 Nurse Practitioners PITCHFORD SARA 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 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 0 383.75 0 0 0 0 0 0 383.75 0 0 1101185924 1073622957 10 Physicians EDOIGIAWERIE CHARLES 606233501 200 Cook 0 0 Psychiatry 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 0 107 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 2254.04 0 0 0 0 0 0 2254.04 0 0 1101185927 1538105523 48 Rural Health Clinics CMH RURAL HEALTH PALESTINE 624511254 25 Crawford 0 1 0 119 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6741.81 0 0 0 0 0 0 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0 0 1349 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31642.45 0 31642.45 0 0 1101193038 1467478693 10 Physicians BENZINGER GEORGE R 631600352 24 Coles 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 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 1165.56 0 0 0 0 0 0 1165.56 0 0 1101193040 1396844189 10 Physicians KOLB JEAN 617043750 72 McLean 0 1 Pediatrics 0 0 0 18 0 0 0 0 0 0 4 0 23 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 4 0 34 0 0 0 0 0 0 0 0 0 1539.66 0 0 0 0 0 0 346.07 0 1015.26 0 0 0 0 0 0 2900.99 0 0 1101193048 1871587691 13 Podiatrists WALTERS LORNA V 606196107 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 407 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1682.98 0 0 0 0 0 0 1682.98 0 0 1101193062 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 0 234 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 25532.22 0 0 0 0 0 0 0 0 0 0 0 0 0 25532.22 0 0 1101193065 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17890.46 0 0 0 0 0 0 0 0 0 0 0 0 0 17890.46 0 0 1101193078 1245245414 60 Pharmacies BOND DRUG COMPANY OF IL 4148 604625038 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 1155 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 30622 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386.2 0 0 55649.3 0 0 0 56035.5 0 0 1101193082 1194729517 10 Physicians PROBST JAMES E 628320192 81 Perry 0 0 Anesthesiology 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 0 145 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 3375.2 0 0 0 0 0 0 3375.2 0 0 1101193106 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 0 234 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 24238.2 0 0 0 0 0 0 0 0 0 0 0 0 0 24238.2 0 0 1101193112 1831291145 70 Ambulance Service Providers WINNEBAGO CO FPD 1 610249565 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 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 2542.91 0 0 0 0 0 0 2542.91 0 0 1101193122 1730103201 10 Physicians BELLAFIORE FRANK J 624502553 88 Richland 0 0 Clinical Pathology 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 0 263 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 3114.06 0 0 0 0 0 0 0 0 3114.06 0 0 1101193129 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23812.29 0 0 0 0 0 0 0 0 0 0 0 0 0 23812.29 0 0 1101193139 1417088931 11 Dentists ARNOUS AMNEH 606255009 200 Cook 0 0 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1730251042 10 Physicians ALEXANDER FREDERICK S 604352812 107 Will 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 0 505 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 3280.33 0 0 0 0 0 0 3280.33 0 0 1101193329 1629080742 13 Podiatrists WILLIAMS EVELEIGH 604292184 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 0 159 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 0 386.48 0 0 0 0 0 0 386.48 0 0 1101193349 1326082140 16 Nurse Practitioners ANGYALOSY ALINA S 117474300 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 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 1221.56 0 0 0 0 0 0 1221.56 0 0 1101193371 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 0 116 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 13519.1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 5.17 0 1574.52 0 0 0 0 0 0 1789.61 0 0 1101193407 1619079282 10 Physicians HASLER SCOTT 606123806 200 Cook 0 1 Internal Medicine 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 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 0 707.06 0 0 0 0 0 0 707.06 0 0 1101193421 10 Physicians 818 Kentucky 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.08 0 0 0 0 0 0 0 0 56.08 0 0 1101193431 1790899979 13 Podiatrists KIRCHNER PAUL B. 604511871 107 Will 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 0 198 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 7374.93 0 0 0 0 0 0 7374.93 0 0 1101193453 1730397720 11 Dentists YOUNG TONNIE 603024408 200 Cook 0 0 General Dentistry 0 0 6 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 617.52 0 0 0 0 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0 1101194478 1043304389 10 Physicians JAMES WILLIAM 631600352 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 43 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 456.71 0 0 0 0 0 0 0 0 456.71 0 0 1101194492 1689902355 91 Waiver service provider--Adults (DHS/DDD) BRUK VLADA 606144946 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 1711 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 94776.54 0 0 0 0 0 0 0 0 0 0 0 0 0 94776.54 0 0 1101194502 1861704199 12 Optometrists SEATON LINDSAEY 605553274 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1872.26 0 0 0 0 0 0 1872.26 0 0 1101194529 1457459570 10 Physicians GREATTING MARK 627949248 91 Sangamon 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 18 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.57 0 5535.19 0 0 0 0 0 0 5598.76 0 0 1101194552 1801844063 10 Physicians BANDY JOHN R 617043514 72 McLean 0 1 Pediatrics 0 0 0 28 0 0 0 0 0 0 24 0 41 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 47 0 100 0 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 47 0 100 0 0 0 0 0 0 0 0 0 3394.62 0 0 0 0 0 0 745.89 0 5922.07 0 0 0 0 0 0 10062.58 0 0 1101194567 1346278017 10 Physicians SOKOLOWSKI MARK 607074305 200 Cook 0 0 Orthopedic Surgery 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 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 0 333.59 0 0 0 0 0 0 333.59 0 0 1101194576 1104868165 10 Physicians LEE STEPHEN 605595554 30 DuPage 0 0 Internal Medicine 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 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 1630.44 0 0 0 0 0 0 1630.44 0 0 1101194608 1740461698 56 School Based / Linked Health Clinics SCHOOL HEALTH LINK INC 612015419 89 Rock Island 0 1 0 35 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1089.07 0 4175.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5264.15 0 0 1101194629 1295703510 10 Physicians AWENDER ERICH 610324864 97 Stephenson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1388.37 0 0 0 0 0 0 1388.37 0 0 1101194632 1407049703 16 Nurse Practitioners GIGLIOTTI GABRIEL 622461154 12 Bond 0 0 0 0 0 0 0 0 0 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 84.16 0 0 0 0 0 0 84.16 0 0 1101194641 1841211513 10 Physicians HERRON BURNETTA E 606081732 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 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 2430.9 0 0 0 0 0 0 2430.9 0 0 1101194650 1881673952 10 Physicians KLEPEK JANNETTE 601533328 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 3 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.2 0 484.3 0 0 0 0 0 0 497.5 0 0 1101194660 1093836629 10 Physicians BARTKUS DARIUS 604023429 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 18 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1845.33 0 0 0 0 0 0 1845.33 0 0 1101194661 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 0 820.78 0 0 0 0 0 0 0 0 0 0 0 0 0 820.78 0 0 1101194665 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 0 278 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 13235.46 0 0 0 0 0 0 0 0 0 0 0 0 0 13235.46 0 0 1101194700 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 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 51495.81 0 0 0 0 0 0 0 0 0 0 0 0 0 51495.81 0 0 1101194703 1750308631 30 General Hospitals COMMUNITY HOSPITAL STAUNTON 620881173 64 Macoupin DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 0 0 0 0 249 0 0 0 0 22 0 0 0 315 0 0 0 0 0 0 0 0 0 368 0 0 0 0 22 0 0 0 648 0 0 0 0 0 0 0 0 0 368 0 0 0 0 70 0 0 0 648 0 0 0 0 0 0 0 0 0 64765.22 0 0 0 0 6148.5 0 0 0 134164.51 0 0 0 0 0 205078.23 0 0 1101194716 92 Waiver service provider--Disability (DHS/DRS) 16 Calhoun 0 0 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 2742.78 0 0 0 0 0 0 0 0 0 0 0 0 0 2742.78 0 0 1101194724 1013287853 60 Pharmacies MEIJER PHARMACY 176 627117962 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 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 10304 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13352.88 0 0 0 13352.88 0 0 1101194744 92 Waiver service provider--Disability (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25697.68 0 0 0 0 0 0 0 0 0 0 0 0 0 25697.68 0 0 1101194747 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95.24 0 0 0 0 0 0 95.24 0 0 1101194749 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 11483.82 0 0 0 0 0 0 0 0 0 0 0 0 0 11483.82 0 0 1101194758 1154579811 61 Independent Laboratories FERTILITY AND CRYOGENIC SERV 605164805 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 20 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 3928.92 0 0 0 0 0 0 0 0 3928.92 0 0 1101194763 1508880469 10 Physicians WOOD CHRISTOPHER 600043906 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 615.45 0 0 0 0 0 0 615.45 0 0 1101194771 1972732246 16 Nurse Practitioners RUNYON JENNIFER 614012807 56 Knox 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 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 3755.49 0 0 0 0 0 0 3755.49 0 0 1101194789 1760441976 30 General Hospitals LINCOLN DIALYSIS 626569115 62 Logan DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 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 1641 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2135.55 0 0 0 0 0 2135.55 0 0 1101194792 1225084585 10 Physicians HAYES-SHARPLEY CAROL 606313222 200 Cook 0 1 Family Practice 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.91 0 1630.2 0 0 0 0 0 0 1636.11 0 0 1101194797 1689660995 10 Physicians IMDAD ZARQA 605270872 200 Cook 0 0 Internal Medicine 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 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49344.77 0 0 0 0 0 0 49344.77 0 0 1101194803 1114264462 16 Nurse Practitioners RYAN JEFFREY 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 94.41 0 0 0 0 0 0 94.41 0 0 1101194808 22 Physical Therapists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 163.44 163.44 0 0 1101194855 1053341297 10 Physicians EGOFSKE PETER 606123714 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 20 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 287.71 0 310.28 0 0 0 0 0 0 597.99 0 0 1101194856 1639146111 10 Physicians WU SUSAN 625264169 63 Macon 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 21 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222.31 0 1833.13 0 0 0 0 0 0 2055.44 0 0 1101194858 10 Physicians 89 Rock Island 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101194871 1700033719 10 Physicians SANDIFORD PENELOPE A. 616052576 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 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 6638.43 0 0 0 0 0 0 6638.43 0 0 1101194874 1972638484 28 Waiver service provider--Supportive living facility (HFS) BARTON SENIOR RESIDENCES ZION 600994371 57 Lake 0 0 0 0 0 0 0 48 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 4779 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 508569.88 0 0 0 0 0 0 0 0 0 0 0 0 0 508569.88 0 0 1101194877 1881731255 10 Physicians POLAVARAPU NAGENDRA 604532699 200 Cook 0 0 Neonatology 0 0 0 0 0 0 0 0 0 0 0 0 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 3343.07 0 0 0 0 0 0 3343.07 0 0 1101194878 1508865338 10 Physicians KHAN MUHAMMAD 953586411 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 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 1757.08 0 0 0 0 0 0 1757.08 0 0 1101194894 1932285509 13 Podiatrists EKBAL MOEED 600762951 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 1486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1486 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1849.89 0 0 0 0 0 0 1849.89 0 0 1101194912 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 0 284 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 9042.38 0 0 0 0 0 0 0 0 0 0 0 0 0 9042.38 0 0 1101194917 1982779765 10 Physicians SACLARIDES THEODORE 606751611 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 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 0 925.08 0 0 0 0 0 0 925.08 0 0 1101194932 1427210319 10 Physicians KELLENBERGER NEAL 610081702 13 Boone 0 0 Family Practice 0 0 0 5 0 0 0 0 0 0 6 0 41 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 7 0 90 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 7 0 90 0 0 0 0 0 0 0 0 0 436.74 0 0 0 0 0 0 34.12 0 1756.65 0 0 0 0 0 0 2227.51 0 0 1101194940 1699921684 10 Physicians SAHA CHIRANJEEV 612015351 89 Rock Island 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 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 1466.19 0 0 0 0 0 0 1466.19 0 0 1101194952 1235362815 11 Dentists VARUGHESE DAISY 606322846 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 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 1854.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1854.27 0 0 1101194958 1386675809 10 Physicians ZISHOLTZ TODD C 606112336 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 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 1826.17 0 0 0 0 0 0 1826.17 0 0 1101194964 1730256470 12 Optometrists EPSTEIN PETER J 600477353 57 Lake 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 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 1076.97 0 0 0 0 0 0 1076.97 0 0 1101194973 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 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 1101194976 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 0 117 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 2698.44 0 0 0 0 0 0 0 0 0 0 0 0 0 2698.44 0 0 1101194982 1053613323 70 Ambulance Service Providers SURVIVAL FLIGHT INC 999999999 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18894.75 0 0 0 0 0 0 18894.75 0 0 1101194996 1750584918 47 Local Education Agencies FULTON COUNTY COMM DIST 3 614275357 37 Fulton 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280 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 6707.28 0 6707.28 0 0 1101195008 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 25049.73 0 0 0 0 0 0 0 0 0 0 0 0 0 25049.73 0 0 1101195034 1730107376 16 Nurse Practitioners SPARKMAN JAYME 631101010 826 Missouri 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 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 0 471.36 0 0 0 0 0 0 471.36 0 0 1101195040 1255396511 10 Physicians JONES CICILY 605638951 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 31 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 0 675.78 0 0 0 0 0 0 675.78 0 0 1101195049 1659691715 40 Federally Qualified Health Centers ACCESS AT GARY COMER YOUTH 606191254 200 Cook 0 1 0 34 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7310.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7310.19 0 0 1101195068 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 15201.45 0 0 0 0 0 0 0 0 0 0 0 0 0 15201.45 0 0 1101195070 1013032499 10 Physicians CHAPPIDI PRASAD 606344485 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 305 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1110 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6487.73 0 0 0 0 0 0 6487.73 0 0 1101195087 2100185505 10 Physicians KIN KARTSIMAS YULIYA 600611700 57 Lake 0 0 Anesthesiology 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 0 178 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 1970.18 0 0 0 0 0 0 1970.18 0 0 1101195104 1477613743 60 Pharmacies PEACE PHARMACY INC 606162014 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 738 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28019 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6880.47 0 0 0 6880.47 0 0 1101195113 1518914431 10 Physicians HAMPTON ALFREDA 606161768 200 Cook 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 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 1641.44 0 0 0 0 0 0 1641.44 0 0 1101195117 1700814225 10 Physicians HILL GREGORY 631416820 826 Missouri 0 0 Ophthalmology 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 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1555.89 0 0 0 0 0 0 1555.89 0 0 1101195122 1568638989 10 Physicians TREMB RYAN 605865007 107 Will 0 0 Family Practice 0 0 0 7 0 0 0 0 0 0 11 0 105 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 20 0 318 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 20 0 318 0 0 0 0 0 0 0 0 0 429.5 0 0 0 0 0 0 64.73 0 3407.58 0 0 0 0 0 0 3901.81 0 0 1101195135 11 Dentists 200 Cook 0 0 General Dentistry 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 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Physicians 91 Sangamon 0 0 Urology 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 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 0 0 0.4 0 0 0 0 0 0 0.4 0 0 1101195510 1306048632 40 Federally Qualified Health Centers HOWARD BROWN HEALTH CENTER 606132010 200 Cook 0 1 0 732 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2092 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2092 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145470.58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145470.58 0 0 1101195516 1477703189 10 Physicians BISHU SHREENATH 600451659 57 Lake 0 0 Pathology 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 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 279 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3412.86 0 0 0 0 0 0 0 0 3412.86 0 0 1101195522 1629208129 10 Physicians PANARKER ISHVARI 49155500 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 47 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5 0 47 0 0 0 0 0 0 0 0 0 97.42 0 0 0 0 0 0 4.36 0 1561.86 0 0 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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 5089.14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5089.14 0 0 1101195725 1093722738 10 Physicians BABCOCK GREGORY 618012530 19 Champaign 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 17 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 198.08 0 5184.59 0 0 0 0 0 0 5382.67 0 0 1101195783 2100186201 10 Physicians AUER ROY 631032236 96 St Clair 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 43 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 431.49 0 3.92 0 0 0 0 0 0 435.41 0 0 1101195813 1013112143 10 Physicians NICHOLS PETER 601302529 200 Cook 0 0 Psychiatry 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 0 239 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 12392.36 0 0 0 0 0 0 12392.36 0 0 1101195819 1366647521 10 Physicians LANCIA ANDREW J. 616052576 80 Peoria 0 0 Psychiatry 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 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22185.07 0 0 0 0 0 0 22185.07 0 0 1101195832 1700824497 10 Physicians PASKOV JULIAN 606402772 200 Cook 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 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 0 555.14 0 0 0 0 0 0 555.14 0 0 1101195839 1982617056 10 Physicians MILANI MICHAEL 605256539 200 Cook 0 0 Urology 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 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 2.18 0 3176.82 0 0 0 0 0 0 3179 0 0 1101195840 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 8042.32 0 0 0 0 0 0 0 0 0 0 0 0 0 8042.32 0 0 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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 0 183 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 23422.69 0 0 0 0 0 0 0 0 0 0 0 0 0 23422.69 0 0 1101195891 10 Physicians 200 Cook 0 0 Pediatric Hematology Oncology 0 0 0 0 0 0 0 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 0 830.69 0 0 0 0 0 0 830.69 0 0 1101195894 1316234297 11 Dentists FENTON JILL 611036898 109 Winnebago 0 0 General Dentistry 0 0 71 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 9470.27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9470.27 0 0 1101195918 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 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 11786.63 0 0 0 0 0 0 0 0 0 0 0 0 0 11786.63 0 0 1101195930 16 Nurse 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Hospitals MARYVILLE DIALYSIS 620625632 65 Madison 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 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 847 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268.05 0 0 0 0 0 268.05 0 0 1101197264 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 0 110 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 22633.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22633.04 0 0 1101197267 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 3007.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3007.62 0 0 1101197284 1437103280 10 Physicians SOBEL DORE 606225646 200 Cook 0 1 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 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 1845.01 0 0 0 0 0 0 1845.01 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REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 0 228 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 707 0 0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 824 0 0 0 0 0 0 0 2295 0 0 0 0 0 0 0 0 0 0 203296.09 0 0 0 0 0 0 0 1165334.42 0 0 0 0 0 0 0 0 0 1368630.51 0 0 1101198248 16 Nurse Practitioners 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.1 0 0 0 0 0 0 2.1 0 0 1101198251 10 Physicians 815 Indiana 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 3.05 0 0 0 0 0 0 3.05 0 0 1101198259 1871583245 11 Dentists DINKHA NAHRAIN 606263221 200 Cook 0 0 General Dentistry 0 0 48 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 205 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 6460.82 0 0 0 0 0 0 0 0 0 0 0 5645.25 0 0 0 0 12106.07 0 0 1101198261 1912163650 10 Physicians 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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 20429.96 0 0 0 0 0 0 20429.96 0 0 1101200347 2100190765 90 Waiver service provider--Elderly (DOA) ADDUS HOMECARE 605151765 30 DuPage 0 0 0 0 0 0 0 2406 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276905 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31661536.34 0 0 0 0 0 0 0 0 0 0 0 0 0 31661536.34 0 0 1101200363 1548311194 10 Physicians GURURAJAN KRISHNAMURTHY 606181537 200 Cook 0 0 Internal Medicine 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 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7877.53 0 0 0 0 0 0 7877.53 0 0 1101200364 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 0 194 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 4719.49 0 0 0 0 0 0 0 0 0 0 0 0 0 4719.49 0 0 1101200378 1518158914 16 Nurse Practitioners GURTLER JODY 618012500 19 Champaign 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 3546.86 0 0 0 0 0 0 3546.86 0 0 1101200397 2100190815 90 Waiver service provider--Elderly (DOA) FAMILY SERVICE OF CHAMPAIGN CO 618205129 19 Champaign 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67481.7 0 0 0 0 0 0 0 0 0 0 0 0 0 67481.7 0 0 1101200411 1083842868 10 Physicians QAZI SAMEER 999999999 63 Macon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 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 3864.09 0 0 0 0 0 0 3864.09 0 0 1101200447 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 5145.68 0 0 0 0 0 0 0 0 0 0 0 0 0 5145.68 0 0 1101200463 1457367070 10 Physicians AMIEWALAN ANTHONY 0 625213806 63 Macon 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 14 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1960.8 0 2905.21 0 0 0 0 0 0 4866.01 0 0 1101200466 1679535728 10 Physicians KOEPPEN MICHAEL D 620491912 76 Montgomery 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2603.2 0 0 0 0 0 0 2603.2 0 0 1101200470 1306852793 29 ICF/MR STRIVE 612771244 106 Whiteside 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10875 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1603928.66 0 0 0 0 0 0 0 0 0 0 1603928.66 0 0 1101200492 92 Waiver service provider--Disability (DHS/DRS) 37 Fulton 0 0 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 1805.54 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23307.33 0 0 0 0 0 0 23307.33 0 0 1101200535 1821109877 10 Physicians MARSH RAMONA 605151552 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 7 0 40 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 54 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 11 0 54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197.13 0 2367.26 0 0 0 0 0 0 2564.39 0 0 1101200540 1962599324 10 Physicians GALLAI JAMES B 627047450 91 Sangamon 0 0 Pulmonary Diseases 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 0 370.34 0 0 0 0 0 0 370.34 0 0 1101200551 1063453876 10 Physicians CHANDRA SANDEEP 604593500 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 10 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3186.28 0 0 0 0 0 0 3186.28 0 0 1101200595 1528051422 10 Physicians LUTAN ROBERT 620024568 65 Madison 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 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Physicians 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 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 1101200650 1922026673 10 Physicians JUERGENS PAUL 629595800 108 Williamson 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 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 0 337.87 0 0 0 0 0 0 337.87 0 0 1101200663 1801886890 16 Nurse Practitioners KRAUSE CHRISTINE I 611081673 109 Winnebago 0 0 0 0 0 39 0 0 0 0 0 0 0 0 42 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 2835.9 0 0 0 0 0 0 0 0 1708.96 0 0 0 0 0 0 4544.86 0 0 1101200664 1376561720 10 Physicians GROSSETT ROBERT T 462063272 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 786 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1245 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1245 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13753.93 0 572.43 0 0 0 0 0 0 14326.36 0 0 1101200680 1205934122 10 Physicians HARTH CATHERINE 605275965 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 6 0 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.33 0 4886.41 0 0 0 0 0 0 4898.74 0 0 1101200696 1104844885 16 Nurse Practitioners STOUT VALERIE L 606778004 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 0 456.4 0 0 0 0 0 0 456.4 0 0 1101200698 10 Physicians 54 Kankakee 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112.85 0 0 0 0 0 0 112.85 0 0 1101200700 1740396647 23 Occupational Therapists LARSON KATHLEEN 611075090 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 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 0 446.13 446.13 0 0 1101200702 1922299858 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF MT VERNON 628646560 49 Jefferson 0 0 0 0 0 0 0 33 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 2909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291281.27 0 0 0 0 0 0 0 0 0 0 0 0 0 291281.27 0 0 1101200727 1396738282 10 Physicians GONDI RAMA KRISHNA 631503643 200 Cook 0 0 Cardiovascular Diseases 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 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5153.62 0 0 0 0 0 0 5153.62 0 0 1101200736 1285606038 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICAN HOMEPATIENT INC 622345816 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1251 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24242.89 0 0 0 0 0 0 24242.89 0 0 1101200751 1568432094 13 Podiatrists DONETS SIMON 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hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 3 0 0 0 0 3 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0 0 0 3 0 0 0 4 0 0 0 0 0 0 0 0 0 3 0 0 0 0 88 0 0 0 4 0 0 0 0 0 0 0 0 0 254.87 0 0 0 0 0 0 0 0 84.67 0 0 0 0 0 339.54 0 0 1101208604 1003091042 55 Early Intervention Services SWANK ANNETTE 600852013 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 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 20750.66 0 0 0 0 0 0 20750.66 0 0 1101208636 1982802948 10 Physicians PARIKH AMIT 600315711 57 Lake 0 0 Surgery General 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 0 233 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 6791.8 0 0 0 0 0 0 6791.8 0 0 1101208699 1841288420 10 Physicians BRIGHTWELL DENNIS 600508350 71 McHenry 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 0 119 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 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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 1101210451 1588612626 10 Physicians O CONNELL JOHN 600165338 200 Cook 0 0 Family Practice 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 1069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1069 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2404.23 0 0 0 0 0 0 2404.23 0 0 1101210466 1649285941 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 606411807 200 Cook 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 0 916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26777 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48279.6 0 0 0 48279.6 0 0 1101210480 1386914653 16 Nurse Practitioners FRANKLIN TERESA 609012901 54 Kankakee 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 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 0 881.29 0 0 0 0 0 0 881.29 0 0 1101210486 1083870216 10 Physicians 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27839.59 0 0 0 0 0 0 0 0 0 0 0 0 0 27839.59 0 0 1101215439 1851442230 10 Physicians WLODAREK CRAIG 601601627 200 Cook 0 0 Neurology 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 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 0 564.29 0 0 0 0 0 0 564.29 0 0 1101215447 1811955636 10 Physicians HASAN YASMEEN 600987530 71 McHenry 0 1 Family Practice 0 0 0 6 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 175 0 0 0 0 0 0 0 0 0 427.88 0 0 0 0 0 0 0 0 1656.88 0 0 0 0 0 0 2084.76 0 0 1101215448 1881643948 10 Physicians ROSBOROUGH BRIAN 613501614 58 La Salle 0 1 Family Practice 0 0 0 3 0 0 0 0 0 0 4 0 61 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 4 0 90 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 4 0 90 0 0 0 0 0 0 0 0 0 159.16 0 0 0 0 0 0 71.44 0 3072.17 0 0 0 0 0 0 3302.77 0 0 1101215459 10 Physicians 816 Iowa 0 0 Urology 0 0 0 0 0 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 546 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3873.94 0 514.47 0 0 0 0 0 0 4388.41 0 0 1101215573 98 Waiver service provider--TBI (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 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 22032.92 0 0 0 0 0 0 0 0 0 0 0 0 0 22032.92 0 0 1101215584 1003912601 10 Physicians BLOUNT MORRIS 604773936 200 Cook 0 0 Psychiatry 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 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13291.39 0 0 0 0 0 0 13291.39 0 0 1101215587 1225189293 10 Physicians ROSENBLUM JORDAN 601533328 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 417 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 637 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17020.16 0 15.27 0 0 0 0 0 0 17035.43 0 0 1101215630 1871635078 10 Physicians MIANOWSKI ANNA 606345116 200 Cook 0 1 General Practice 0 0 0 0 0 0 0 0 0 0 63 0 113 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 2300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 2300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 951.79 0 4448.9 0 0 0 0 0 0 5400.69 0 0 1101215640 1770559312 10 Physicians BECKER FRANK 606114402 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1210.6 0 0 0 0 0 0 1210.6 0 0 1101215676 1265451603 10 Physicians GOLDBERG KENNETH N. 602011718 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 230 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 298 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5816.44 0 0 0 0 0 0 0 0 5816.44 0 0 1101215677 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 49.06 0 0 0 0 0 0 49.06 0 0 1101215711 94 Waiver service provider--Children's support 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0 0 0 0 0 0 0 45287.44 0 0 0 0 13712.34 0 0 0 189616.04 0 0 0 0 0 248615.82 0 0 1101215760 1942252697 10 Physicians BELLO ALFONSO MD 600257645 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 3 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39.03 0 4482.62 0 0 0 0 0 0 4521.65 0 0 1101215766 2100206184 90 Waiver service provider--Elderly (DOA) EUROPEAN SERVICE AT HOME INC 600670415 200 Cook 0 0 0 0 0 0 0 572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53703 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5004662.91 0 0 0 0 0 0 0 0 0 0 0 0 0 5004662.91 0 0 1101215772 1639370083 10 Physicians MORSTADT KIMBERLY 600468563 57 Lake 0 1 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 1 0 63 0 0 0 0 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 5.22 0 1134.72 0 0 0 0 0 0 1139.94 0 0 1101215773 92 Waiver service provider--Disability (DHS/DRS) 64 Macoupin 0 0 0 0 0 0 0 1 0 0 0 0 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"University of Illinois Hospital, paid under an ARS." 0 0 18 88 0 0 2383 0 0 0 0 1618 0 0 149 11058 0 0 0 0 0 47 374 0 0 3339 0 0 0 0 1883 0 0 151 45266 0 0 0 0 0 50 374 0 0 3340 0 0 0 0 14469 0 0 153 50624 0 0 0 0 0 6054.17 36803.9 0 0 1097369.04 0 0 0 0 17180562.01 0 0 446742.62 7294517.87 0 0 0 0 0 26062049.61 0 0 1101215809 1821067588 10 Physicians BELICH PAUL D 601545716 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 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 0 585 0 0 0 0 0 0 585 0 0 1101215813 1023033578 10 Physicians HANKO RODGER A 705083870 200 Cook 0 0 Emergency Medicine 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 0 332 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 8062.78 0 0 0 0 0 0 8062.78 0 0 1101215829 1912944703 48 Rural Health Clinics HYGIENIC INSTITUTE 613011097 58 La Salle 0 1 0 277 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 967 0 162 0 0 0 0 0 0 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BETANCOURT JOANNA E 601025937 71 McHenry 0 1 Pediatrics 0 0 0 123 0 0 0 0 0 0 60 0 151 0 0 0 0 0 0 0 0 0 513 0 0 0 0 0 0 136 0 353 0 0 0 0 0 0 0 0 0 513 0 0 0 0 0 0 136 0 353 0 0 0 0 0 0 0 0 0 12065.82 0 0 0 0 0 0 1096.18 0 14258.27 0 0 0 0 0 0 27420.27 0 0 1101215925 1679551014 10 Physicians GRANT CALVIN 604631097 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 537 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72.27 0 5383.55 0 0 0 0 0 0 5455.82 0 0 1101215929 1083869523 16 Nurse Practitioners ZAUCHA TAMARA 600155234 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 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 0 941.92 0 0 0 0 0 0 941.92 0 0 1101215936 1366431686 75 Department of Alcohol and Substance Abuse Provider CHESTNUT HEALTH SYSTEMS INC 620625632 65 Madison 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 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(Non-registered) HANGER PROSTHETICS ORTHOTICS 604354902 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 223 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2986.65 0 35344.3 0 0 0 0 38330.95 0 0 1101216651 1033249677 10 Physicians GARRESTSON CARA 606118709 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 160.91 0 0 0 0 0 0 160.91 0 0 1101216665 1679514541 70 Ambulance Service Providers LINCOLNSHIRE RIVERWOODS FIRE P 600693603 57 Lake 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 0 482 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 540198.79 0 0 0 0 0 0 540198.79 0 0 1101216715 10 Physicians 852 Wisconsin 0 0 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 693.7 0 0 0 0 0 0 0 0 0 0 0 0 0 693.7 0 0 1101219428 1831327592 10 Physicians LOVETT SHANNON 601533328 200 Cook 0 0 Emergency Medicine 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 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 3975.6 0 0 0 0 0 0 3975.6 0 0 1101219452 11 Dentists 53 Kane 0 0 General Dentistry 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 80.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.4 0 0 1101219460 1770749178 24 Speech Therapists RIZZUTO MARY ANN 604231456 107 Will 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 0 349 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 26727.76 26727.76 0 0 1101219469 1831107895 30 General Hospitals BARNES JEWISH WEST COUNTY HOSP 631416337 826 Missouri ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 26 0 0 0 0 18 0 0 0 418 0 0 0 0 0 0 0 0 0 30 0 0 0 0 18 0 0 0 613 0 0 0 0 0 0 0 0 0 30 0 0 0 0 61 0 0 0 617 0 0 0 0 0 0 0 0 0 2625.71 0 0 0 0 17515.2 0 0 0 33083.16 0 0 0 0 0 53224.07 0 0 1101219476 1144235383 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 606183823 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 335 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 9022 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.29 0 0 36883.34 0 0 0 36886.63 0 0 1101219483 1346255569 60 Pharmacies BOND DRUG COMPANY OF IL 5544 616167723 80 Peoria 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 1604 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45787 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83716.41 0 0 0 83716.41 0 0 1101219492 1740482215 47 Local Education Agencies MORRIS COMM HS DIST 101 604501234 40 Grundy 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 1909 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 1909 0 0 0 0 238.92 0 0 0 0 0 0 0 0 0 0 0 0 0 54339.7 0 54578.62 0 0 1101219493 1770763070 10 Physicians DJURIC MILENA 623013119 10 Adams 0 0 Psychiatry 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 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26337.61 0 0 0 0 0 0 26337.61 0 0 1101219498 1134228224 10 Physicians MATTER STEPHEN 617615516 72 McLean 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 24 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82.64 0 3973.06 0 0 0 0 0 0 4055.7 0 0 1101219508 1588893101 10 Physicians MEDVEDEV ALEXANDER 600051069 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 0 157 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 1413.93 0 0 0 0 0 0 1413.93 0 0 1101219534 1962715284 30 General Hospitals COBBLESTONE DIALYSIS 601203068 53 Kane DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 1566 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42757.89 0 0 0 0 0 42757.89 0 0 1101219556 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 0 111 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 23930.72 0 0 0 0 0 0 0 0 0 0 0 0 0 23930.72 0 0 1101219566 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 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 9734.37 0 0 0 0 0 0 0 0 0 0 0 0 0 9734.37 0 0 1101219568 1770740565 11 Dentists DITOLA GEORGE D 601602825 200 Cook 0 0 General Dentistry 0 0 107 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 389 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 12594.6 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 12970.95 0 0 1101219586 14 Chiropractors 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 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 51.95 0 0 0 0 0 0 51.95 0 0 1101219605 1063767424 60 Pharmacies WEBER MEDICAL CLINIC PHARMACY 624502432 88 Richland 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 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 4364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3816.38 0 0 0 3816.38 0 0 1101219613 1932119112 10 Physicians ROLLET JOHN C 627034514 91 Sangamon 0 1 Family Practice 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 0 320 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 3214.52 0 0 0 0 0 0 3214.52 0 0 1101219631 1396987053 10 Physicians SKOW GLENN 624711227 34 Fayette 0 1 Family Practice 0 0 0 5 0 0 0 0 0 0 2 0 82 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 3 0 142 0 0 0 0 0 0 0 0 0 406.49 0 0 0 0 0 0 4.61 0 3541.92 0 0 0 0 0 0 3953.02 0 0 1101219644 1548375769 70 Ambulance Service Providers ANDALUSIA VOLUNTEER AMBULANCE 612320265 89 Rock Island 0 0 0 0 0 0 0 0 0 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 5296.78 0 0 0 0 0 0 5296.78 0 0 1101219663 1407013469 55 Early Intervention Services MASUS MARY 605104556 53 Kane 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 0 216 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 20614.62 0 0 0 0 0 0 20614.62 0 0 1101219675 10 Physicians 107 Will 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 19.62 0 0 0 0 0 0 19.62 0 0 1101219684 1558340968 40 Federally Qualified Health Centers COMMUNITY HEALTH CENTERS SEIA 526323452 816 Iowa 0 1 0 41 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6216.07 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6216.07 0 0 1101219695 1104103670 16 Nurse Practitioners STEWART JESSICA M 616157822 80 Peoria 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 0 195 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 13022.78 0 0 0 0 0 0 13022.78 0 0 1101219700 1558301432 10 Physicians LOWREY JASON D 477313276 65 Madison 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 1071.88 0 0 0 0 0 0 1071.88 0 0 1101219715 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 0 333 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 23392.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.6 0 0 1101219726 91 Waiver service provider--Adults (DHS/DDD) 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 0 175 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 14171.74 0 0 0 0 0 0 0 0 0 0 0 0 0 14171.74 0 0 1101219727 1922095470 63 Other Providers of Medical Equipment/Supplies (Non-registered) "ALDEN ESTATES OF BARRINGTON, I" 600105402 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 0 248 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 40572.58 0 0 0 0 0 0 40572.58 0 0 1101219730 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 1101219738 1770734139 55 Early Intervention Services QUILL MICHELLE 600252550 200 Cook 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 0 291 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 31359.6 0 0 0 0 0 0 31359.6 0 0 1101219757 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 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850737.52 0 0 0 0 0 0 0 0 0 0 0 850737.52 0 0 1101221988 1942262258 10 Physicians JONES ROBIN 606123276 200 Cook 0 0 0 0 0 1 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 25 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 4 0 25 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 20.68 0 562.65 0 0 0 0 0 0 668.98 0 0 1101221992 1043251101 10 Physicians WATKIN WILLIAM G 602011700 200 Cook 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 0 129 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 1654.61 0 0 0 0 0 0 0 0 1654.61 0 0 1101221998 1164552774 10 Physicians JENNINGS JACK 631101016 826 Missouri 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 63 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1118.24 0 975.54 0 0 0 0 0 0 2093.78 0 0 1101222000 2100212418 90 Waiver service provider--Elderly (DOA) COMFORT KEEPERS 600902924 200 Cook 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 16050 0 0 0 0 0 0 0 0 0 0 0 0 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LURIE CHILDRENS HOSPITAL 606112991 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 0 0 0 0 0 5 0 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.93 0 0 59233.08 0 0 0 0 0 59307.01 0 0 1101225179 1134194327 10 Physicians SIDDIQUI ADNAN 630442436 826 Missouri 0 0 Infectious Diseases 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 0 287 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 2402.62 0 0 0 0 0 0 2402.62 0 0 1101225190 1801072236 60 Pharmacies WALMART PHARMACY 10-4405 605026015 53 Kane 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 0 723 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23201.7 0 0 0 23201.7 0 0 1101225191 1538371786 55 Early Intervention Services STARK JILL S 600894688 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 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0 108 0 433 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 162 0 5543 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 162 0 5543 0 0 0 0 0 0 0 0 0 334.87 0 0 0 0 0 0 1269.69 0 26412.12 0 0 0 0 0 0 28016.68 0 0 1101225259 1952350803 10 Physicians DHALI JAYSHREE 606253500 200 Cook 0 1 Endocrinology 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 0 246 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 2924.91 0 0 0 0 0 0 2924.91 0 0 1101225262 10 Physicians 200 Cook 0 1 Pediatrics 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 403.3 0 0 0 0 0 0 480.14 0 0 1101225276 1164458261 10 Physicians FALLERONI MARC 606113092 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 5 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1888.99 0 0 0 0 0 0 1888.99 0 0 1101225326 1144236613 10 Physicians LAGONE CYNTHIA 606114402 200 Cook 0 1 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 0 140 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 0 628.52 0 0 0 0 0 0 628.52 0 0 1101225327 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23945.56 0 0 0 0 0 0 0 0 0 0 0 0 0 23945.56 0 0 1101225334 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 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 11.87 0 0 0 0 0 0 11.87 0 0 1101225347 1427363068 10 Physicians NOVACK JARED D 602011718 200 Cook 0 0 Emergency 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 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 2477.7 0 0 0 0 0 0 2477.7 0 0 1101225351 2100215769 91 Waiver service provider--Adults (DHS/DDD) ACHIEVE DEVELOPMENT ASSOCIATIO 600771201 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 3736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 588035.99 0 0 0 0 0 0 0 0 0 0 0 0 0 588035.99 0 0 1101225369 2100215787 71 Medicar Provider JACKSON COUNTY MASS TRANSIT DI 629013309 47 Jackson 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 3326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3326 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20569.08 0 0 0 0 0 0 20569.08 0 0 1101225375 1285708149 63 Other Providers of Medical Equipment/Supplies (Non-registered) "HANGER, INC." 631082211 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 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 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 6024.92 0 0 0 0 6024.92 0 0 1101225377 1588681886 60 Pharmacies WALMART PHARMACY 10-5157 615508931 98 Tazewell 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 1229 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48212.1 0 0 0 48212.1 0 0 1101225379 1255536355 10 Physicians MORCOS OMAR 600771057 200 Cook 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 5 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 294 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.52 0 2673.05 0 0 0 0 0 0 2678.57 0 0 1101225405 1770634743 10 Physicians VAN HA THUONG 605275965 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 47 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.59 0 6319.51 0 0 0 0 0 0 6653.1 0 0 1101225450 1295933828 10 Physicians PATEL DHARMESH 477101682 815 Indiana 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 0 0 16 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 0 464.58 0 0 0 0 0 0 464.58 0 0 1101225454 1316003833 10 Physicians STEIN ADAM D 601228942 53 Kane 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 2 0 59 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.64 0 0 0 0 0 0 173.64 0 0 1101225553 1760628416 11 Dentists KHAN SAMIA 601011476 30 DuPage 0 0 General Dentistry 0 0 37 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 4684.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4684.96 0 0 1101225556 1578674834 10 Physicians MOHIUDDIN FATIMA T 611081673 109 Winnebago 0 0 Allergy 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 0 163 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 6216.78 0 0 0 0 0 0 6216.78 0 0 1101225559 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 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 0 402.69 402.69 0 0 1101225561 1407876519 10 Physicians LEE THOMAS G 616052576 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 12 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0 0 0 0 0 0 0 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 1234.46 1234.46 0 0 1101230914 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 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 3213.61 3213.61 0 0 1101230915 2100221333 10 Physicians CLAYPOOL LORI A 528011014 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 20 0 45 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 32 0 97 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 32 0 97 0 0 0 0 0 0 0 0 0 5.33 0 0 0 0 0 0 1017.18 0 10458.52 0 0 0 0 0 0 11481.03 0 0 1101230916 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 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 10434.76 0 0 0 0 0 0 0 0 0 0 0 0 0 10434.76 0 0 1101230952 1427135284 10 Physicians WALSH MARY 606014101 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 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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 5017.76 0 0 0 0 0 0 5017.76 0 0 1101231002 30 General Hospitals 852 Wisconsin 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 81.48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.48 0 0 1101231005 1336176940 10 Physicians DONOVAN HUNT CHERYL 600154339 57 Lake 0 1 Pediatrics 0 0 0 3 0 0 0 0 0 0 6 0 11 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 11 0 14 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 11 0 14 0 0 0 0 0 0 0 0 0 330.17 0 0 0 0 0 0 235.01 0 928.96 0 0 0 0 0 0 1494.14 0 0 1101231013 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 143.28 0 0 0 0 0 0 0 0 0 0 0 0 0 143.28 0 0 1101231022 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 0 512.04 0 0 0 0 0 0 0 0 0 0 0 0 0 512.04 0 0 1101231056 1851457717 10 Physicians SHLYAK YEVGENIA 600622432 200 Cook 0 1 Internal Medicine 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 0 689 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2951.62 0 0 0 0 0 0 2951.62 0 0 1101231077 10 Physicians 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 0 0 0 0 0 0 0 0 0 0 1101231101 1407945827 10 Physicians DERRICK MELODY J 601228942 53 Kane 0 1 Family Practice 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 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 84.62 0 0 0 0 0 0 0 0 681.61 0 0 0 0 0 0 766.23 0 0 1101231113 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 14682.25 0 0 0 0 0 0 0 0 0 0 0 0 0 14682.25 0 0 1101231115 1922095579 10 Physicians KOLETTIS YANNIS 616157822 80 Peoria 0 0 Ophthalmology 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 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3059.38 0 0 0 0 0 0 3059.38 0 0 1101231136 1346479169 61 Independent Laboratories COUNSYL INC 940806218 805 California 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 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60342.78 0 0 0 0 0 0 0 0 60342.78 0 0 1101231142 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 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 1031.24 1031.24 0 0 1101231150 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 0 313 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 23722.85 0 0 0 0 0 0 0 0 0 0 0 0 0 23722.85 0 0 1101231162 1275622805 22 Physical Therapists JOYNER BRIAN 629595256 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 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 0 151.82 151.82 0 0 1101231166 47 Local Education Agencies 110 Woodford 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 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 0 654.58 0 654.58 0 0 1101231167 1790909984 29 ICF/MR MILESTONE INC ELMWOOD EAST 611031573 109 Winnebago 0 0 0 0 0 0 0 0 0 0 11 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 8030 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823284.59 0 0 0 0 0 0 0 0 0 0 823284.59 0 0 1101231189 1720193147 10 Physicians GARCHITORENA RICARDO 379321983 107 Will 0 0 Emergency Medicine 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 0 196 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 5231.2 0 0 0 0 0 0 5231.2 0 0 1101231191 1679792550 24 Speech Therapists HOFFMANN BARBARA 618212035 19 Champaign 0 0 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 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 7782.53 7782.53 0 0 1101231198 60 Pharmacies 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 15.49 0 0 0 15.49 0 0 1101231210 1669416095 16 Nurse Practitioners PINAWIN MAXITA 601220021 53 Kane 0 0 0 0 0 0 0 0 0 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 0 428.58 0 0 0 0 0 0 428.58 0 0 1101231212 1417941774 63 Other Providers of Medical Equipment/Supplies (Non-registered) J AND B MEDICAL SUPPLY CO INC 483932088 823 Michigan 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 1772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109432.4 0 0 0 0 0 0 109432.4 0 0 1101231214 1588941645 16 Nurse Practitioners TSCHANTZ BETHANY 627949639 91 Sangamon 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 0 105 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 4040.88 0 0 0 0 0 0 4040.88 0 0 1101231220 1467746388 91 Waiver service provider--Adults (DHS/DDD) BECK SHANNON 604461763 107 Will 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 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 27872.37 0 0 0 0 0 0 0 0 0 0 0 0 0 27872.37 0 0 1101231239 1457529265 24 Speech Therapists CONWAY AMALIA 606314429 200 Cook 0 0 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 0 129 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 13065.13 13065.13 0 0 1101231263 47 Local Education Agencies 72 McLean 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 0 272 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 7438.44 0 7438.44 0 0 1101231285 1669447843 10 Physicians FROEHLICH JUDITH 606740018 200 Cook 0 1 Pediatrics 0 0 0 11 0 0 0 0 0 0 2 0 15 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 2 0 21 0 0 0 0 0 0 0 0 0 1110.23 0 0 0 0 0 0 53.83 0 523.81 0 0 0 0 0 0 1687.87 0 0 1101231287 10 Physicians 852 Wisconsin 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 0 126.82 0 0 0 0 0 0 126.82 0 0 1101231327 1851326425 10 Physicians TALMI DANIT 802382436 806 Colorado 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 11 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.31 0 345.99 0 0 0 0 0 0 368.3 0 0 1101231330 1578559068 10 Physicians GUYNN TODD 611081673 109 Winnebago 0 0 Thoracic Surgery 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18045.87 0 0 0 0 0 0 18045.87 0 0 1101231357 1942379458 11 Dentists CLARK KELLY J 625571430 20 Christian 0 0 General Dentistry 0 0 78 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 9859.66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9859.66 0 0 1101231360 2100221778 90 Waiver service provider--Elderly (DOA) PREMIER HOME HEALTH CARE SERVI 999999999 833 New York 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 15931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15931 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1659380.19 0 0 0 0 0 0 0 0 0 0 0 0 0 1659380.19 0 0 1101231366 1851388797 63 Other Providers of Medical Equipment/Supplies (Non-registered) ALDEN TOWN MANOR REHABILITATIO 608043743 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 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 5687.1 0 0 0 0 0 0 5687.1 0 0 1101231399 16 Nurse Practitioners 49 Jefferson 0 0 0 0 0 0 0 0 0 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 0 250.96 0 0 0 0 0 0 250.96 0 0 1101231433 1386614899 63 Other Providers of Medical Equipment/Supplies (Non-registered) AMERICAN PROSTHETICS INC 528041800 816 Iowa 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 0 191 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 33559.26 0 0 0 0 33559.26 0 0 1101231448 1124233929 36 Community mental health provider METROPOLITAN FAMILY SERVICES 606174401 200 Cook 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261 0 0 2698.18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16955.05 0 0 19653.23 0 0 1101231452 1295935369 11 Dentists RAZZAK SINAN 608043638 200 Cook 0 0 General Dentistry 0 0 33 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 174 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 3081.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3081.54 0 0 1101231491 22 Physical Therapists 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 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 6072.49 6072.49 0 0 1101231520 1023035318 60 Pharmacies SAM'S CLUB PHARMACY 10-6339 600148017 71 McHenry 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3103.07 0 0 0 3103.07 0 0 1101231521 1033420302 11 Dentists RABADI KAIS 606294515 200 Cook 0 0 General Dentistry 0 0 172 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1014 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 1014 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 25833.03 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 26585.73 0 0 1101231529 1457307373 60 Pharmacies OSCO DRUG #1518 600504030 71 McHenry 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 0 383 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10539 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14406.29 0 0 0 14406.29 0 0 1101231532 1942313804 10 Physicians CHUPREVICH JOSEPH 613501604 58 La Salle 0 0 Psychiatry 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 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 868 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24476.02 0 0 0 0 0 0 24476.02 0 0 1101231536 1134201213 10 Physicians DAVIS CRAIG 629021462 47 Jackson 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 0 107 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 1823.47 0 0 0 0 0 0 1823.47 0 0 1101231544 1316946288 10 Physicians KHAN ALAM 606576157 200 Cook 0 0 Internal Medicine 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 0 856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 856 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6064.01 0 0 0 0 0 0 6064.01 0 0 1101231554 1730107715 10 Physicians SHAH UDAY 606173512 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 0 136 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 0 400.05 0 0 0 0 0 0 400.05 0 0 1101231565 1518974617 10 Physicians PAPARI VICTOR 627621000 91 Sangamon 0 0 Internal Medicine 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 0 309 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 3388.65 0 0 0 0 0 0 3388.65 0 0 1101231587 1447204136 10 Physicians ZINN-BATINA MARY E. 606118709 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 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 0 215.32 0 0 0 0 0 0 215.32 0 0 1101231631 10 Physicians 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 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 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1101236562 1427005347 70 Ambulance Service Providers VANDENBERG AMBULANCE 604879205 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 749 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 133878.9 0 0 0 0 0 0 133878.9 0 0 1101236567 30 General Hospitals 852 Wisconsin 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 0 469.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469.36 0 0 1101236575 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 311 0 0 35.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8942.36 0 0 8978.28 0 0 1101236581 1649363201 70 Ambulance Service Providers CITY OF CLINTON 527324436 816 Iowa 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 90 0 0 0 0 0 0 0 0 0 0 0 0 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Practice 0 0 0 2 0 0 0 0 0 0 1 0 51 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 115 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0 115 0 0 0 0 0 0 0 0 0 175.49 0 0 0 0 0 0 7.77 0 1324.57 0 0 0 0 0 0 1507.83 0 0 1101237386 1265613657 70 Ambulance Service Providers LOVINGTON COMMUNITY AMBULANCE 619379491 78 Moultrie 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 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 14927.37 0 0 0 0 0 0 14927.37 0 0 1101237394 1568793453 16 Nurse Practitioners VANHORN LORI 532153660 852 Wisconsin 0 0 0 0 0 0 0 0 0 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 0 135.68 0 0 0 0 0 0 135.68 0 0 1101237404 1598884629 43 Encounter rate clinic AUSTIN COOK COUNTY COMM HC 606513223 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 492 0 33 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1595 0 75 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 1595 0 75 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 324235.82 0 11752.25 0 0 0 0 0 405.25 0 0 0 0 0 0 0 0 0 336393.32 0 0 1101237406 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 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 61063.54 0 0 0 0 0 0 0 0 0 0 0 0 0 61063.54 0 0 1101237442 10 Physicians 65 Madison 0 0 Anesthesiology 0 0 0 0 0 0 0 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 2401.3 0 0 0 0 0 0 2401.3 0 0 1101237444 1477869709 24 Speech Therapists TRIPOLI JENNIFER 606491003 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 0 103 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 158 0 311 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178.36 0 10216.62 0 0 0 0 0 0 10394.98 0 0 1101237527 1669672275 16 Nurse Practitioners REDDY TONYA 606930167 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 0 0 0 0 0 0 0 0 0 0 1101237530 1447470869 55 Early Intervention Services LANIER TRACIE 606282305 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 6673.92 0 0 0 0 0 0 6673.92 0 0 1101237536 30 General Hospitals 824 Minnesota ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 110.61 0 0 1101237539 10 Physicians 200 Cook 0 0 Hematology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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464107035 815 Indiana 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 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 0 954.88 0 0 0 0 0 0 0 0 954.88 0 0 1101237604 1124073838 10 Physicians NEMICKAS TOMAS 600315709 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 40 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534.14 0 6799.94 0 0 0 0 0 0 7334.08 0 0 1101237607 1912218272 10 Physicians ZAKARIA MHD 604631814 200 Cook 0 0 Internal Medicine 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 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 751 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1295.5 0 0 0 0 0 0 1295.5 0 0 1101237610 1881654325 30 General Hospitals CHICAGO HEIGHTS DIALYSIS 604111733 200 Cook 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 0 101 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203 0 0 0 0 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0 0 0 0 0 625.77 0 0 1101237750 1639513963 28 Waiver service provider--Supportive living facility (HFS) HERITAGE WOODS OF CHARLESTON 619203291 24 Coles 0 0 0 0 0 0 0 18 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 2692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194267 0 0 0 0 0 0 0 0 0 0 0 0 0 194267 0 0 1101237755 1811976988 10 Physicians MICHELFELDER AARON 601545716 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 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 0 331.2 0 0 0 0 0 0 331.2 0 0 1101237758 1356301667 10 Physicians SHI FEINAN 606123723 200 Cook 0 0 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 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 86.29 0 0 0 0 0 0 0 0 86.29 0 0 1101237762 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24057.33 0 0 0 0 0 0 0 0 0 0 0 0 0 24057.33 0 0 1101237776 1780789750 10 Physicians GULLO GREGORY 601691019 200 Cook 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 535 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 888 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 888 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12734.17 0 934.73 0 0 0 0 0 0 13668.9 0 0 1101237787 1902977903 63 Other Providers of Medical Equipment/Supplies (Non-registered) LINCARE INC 600072483 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46857.24 0 0 0 0 0 0 46857.24 0 0 1101237791 16 Nurse Practitioners 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 0 0 0 0 0 0 0 0 0 0 1101237805 10 Physicians 826 Missouri 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 1101237816 1932392099 10 Physicians MOORE HENRY 619389388 24 Coles 0 0 Traumatic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 38.81 0 7043.68 0 0 0 0 0 0 7082.49 0 0 1101237832 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 0 131.96 0 0 0 0 0 0 131.96 0 0 1101237851 1508056987 10 Physicians MULLANGI PRAVEEN 627949248 91 Sangamon 0 0 Infectious Diseases 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 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5116.91 0 0 0 0 0 0 5116.91 0 0 1101237853 1588705651 16 Nurse Practitioners STRAZAR JEAN 628013058 66 Marion 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 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(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 15800.9 0 0 0 0 0 0 0 0 0 0 0 0 0 15800.9 0 0 1101237913 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24997.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24997.5 0 0 1101237931 1154563914 10 Physicians TRABOLSI MAIS 606781034 200 Cook 0 1 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 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 0 383.22 0 0 0 0 0 0 383.22 0 0 1101237940 1467550772 10 Physicians KNOX JUDITH 627949248 91 Sangamon 0 0 Dermatology 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 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 0 303.83 0 0 0 0 0 0 303.83 0 0 1101237943 1356400782 46 Ambulatory Surgical Treatment Centers CHAMPAIGN SURGICENTER LLC 618223743 19 Champaign ASTC Ambulatory Surgical Treatment Center. 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 0 476 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 84643.07 0 0 0 0 0 84643.07 0 0 1101237946 1548204035 10 Physicians SHAPIRO DAVID 606118709 200 Cook 0 0 Internal Medicine 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 0 121 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 5769.49 0 0 0 0 0 0 5769.49 0 0 1101237949 2100228367 91 Waiver service provider--Adults (DHS/DDD) CILA CORPORATION 628810728 66 Marion 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 17804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17804 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3589938.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3589938.6 0 0 1101237957 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21.02 0 0 0 0 0 0 21.02 0 0 1101237967 1902952609 16 Nurse Practitioners SCHNEIDER KARI 601533328 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 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 0 916.51 0 0 0 0 0 0 916.51 0 0 1101237968 98 Waiver service provider--TBI (DHS/DRS) 37 Fulton 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30146.02 0 0 0 0 0 0 0 0 0 0 0 0 0 30146.02 0 0 1101237978 1144481946 16 Nurse Practitioners DANIELS CHRISTINE 605406558 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 0 226.29 0 0 0 0 0 0 226.29 0 0 1101237980 1528058567 10 Physicians KAEGI CHARLES 606465738 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 58 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 5576.65 0 0 0 0 0 0 5576.65 0 0 1101237982 1578516290 39 Hospice PROMEDICA HOSPICE CARE ROCKFOR 611082521 109 Winnebago 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 0 194 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4124 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 608518.37 0 0 0 0 0 0 0 0 0 0 0 608518.37 0 0 1101237999 36 Community mental health provider 20 Christian 0 0 0 0 0 0 0 0 0 0 0 0 0 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 23.77 0 0 23.77 0 0 1101238000 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 6715.5 0 0 0 0 0 0 0 0 0 0 0 0 0 6715.5 0 0 1101238010 1821341041 16 Nurse Practitioners SCHUMACHER JODY L. 627949248 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 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0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1813.74 0 953.86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2767.6 0 0 1101238069 1811085889 10 Physicians SPEAR WILLIAM H 463739487 109 Winnebago 0 0 Cardiology 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 0 250 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 1562.04 0 0 0 0 0 0 1562.04 0 0 1101238091 1396879268 10 Physicians CHERRY NANCI 609361477 35 Ford 0 0 Emergency 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 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 0 551.37 0 0 0 0 0 0 551.37 0 0 1101238113 1326349598 55 Early Intervention Services SCHRANDT SARAH 601741480 53 Kane 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 0 258 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 18658.24 0 0 0 0 0 0 18658.24 0 0 1101238122 2100228540 91 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0 1101242883 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 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 15053.19 0 0 0 0 0 0 0 0 0 0 0 0 0 15053.19 0 0 1101242894 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101242944 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 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 1513.57 0 0 0 0 0 0 0 0 0 0 0 0 0 1513.57 0 0 1101242978 10 Physicians 852 Wisconsin 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.35 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 40732.75 0 0 0 0 0 0 0 0 0 0 0 0 0 40732.75 0 0 1101243154 1548286867 10 Physicians SEMENKOVICH CLAY F 631600352 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 27 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474.39 0 0 0 0 0 0 0 0 474.39 0 0 1101243179 1912090960 48 Rural Health Clinics THOMAS H. BOYD MEMORIAL HOSPIT 620441409 39 Greene 0 1 0 67 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4244.42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4244.42 0 0 1101243217 1063603769 10 Physicians LAROSSA GINA N 631600352 91 Sangamon 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 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 0 613.21 0 0 0 0 0 0 613.21 0 0 1101243240 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 0 265.47 0 0 0 0 0 0 265.47 0 0 1101243264 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19088.11 0 0 0 0 0 0 0 0 0 0 0 0 0 19088.11 0 0 1101243266 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 11803.65 0 0 0 0 0 0 0 0 0 0 0 0 0 11803.65 0 0 1101243273 1952328486 16 Nurse Practitioners DYER GERRI 629483150 108 Williamson 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 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 554 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5773.95 0 0 0 0 0 0 5773.95 0 0 1101243290 1255675526 11 Dentists GIBSON ROLAND 999999999 200 Cook 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 1159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1159 0 0 1101243314 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 25519.25 0 0 0 0 0 0 0 0 0 0 0 0 0 25519.25 0 0 1101243315 1124279864 10 Physicians YOHANNAN CHARLES 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1 0 0 0 1 0 0 0 0 0 0 0 0 0 5 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 5 0 0 0 0 12 0 0 0 1 0 0 0 0 0 0 0 0 0 187.19 0 0 0 0 7784.54 0 0 0 0 0 0 0 0 0 7971.73 0 0 1101249326 1346568748 10 Physicians ACURIO ADRIANA 606081732 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 151 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2534.45 0 35.14 0 0 0 0 0 0 2569.59 0 0 1101249343 1316255383 24 Speech Therapists SIMON CHRISTINE 604291244 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 5346.45 5346.45 0 0 1101249349 2100239767 13 Podiatrists REILLY BRIAN 606563306 200 Cook 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 1297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1297 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1921.25 0 0 0 0 0 0 1921.25 0 0 1101249353 1770640724 10 Physicians KONSTANTINOVIC PREDRAG 600442203 57 Lake 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 31 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 1786.24 0 0 0 0 0 0 1786.24 0 0 1101249362 1861445850 10 Physicians ONWUTA NNAEMEKA 600101999 57 Lake 0 0 Anesthesiology 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 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4190.71 0 0 0 0 0 0 4190.71 0 0 1101249365 1154654093 23 Occupational Therapists STRAUGHTER DOROTHY C 604397741 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 942 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67373.13 67373.13 0 0 1101249377 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 2615.2 2615.2 0 0 1101249385 10 Physicians 826 Missouri 0 0 Hematology 0 0 0 0 0 0 0 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 0 895.36 0 0 0 0 0 0 895.36 0 0 1101249394 2100239812 10 Physicians PEARSON ANTHONY 402053373 818 Kentucky 0 0 Cardiology 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 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 0 790.94 0 0 0 0 0 0 790.94 0 0 1101249397 2100239815 73 Other Transportation Providers ( Non-Registered) THE ARC OF IROQUOIS COUNTY 609701400 46 Iroquois 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 0 690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5787.72 0 0 0 0 0 0 5787.72 0 0 1101249401 1144391350 10 Physicians NOREUIL TIMOTHY O 105282436 54 Kankakee 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 10 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.48 0 0 0 0 0 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623014038 10 Adams 0 0 Pediatrics 0 0 0 1 0 0 0 0 0 0 23 0 11 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 29 0 44 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 29 0 44 0 0 0 0 0 0 0 0 0 91.9 0 0 0 0 0 0 353.59 0 3109.52 0 0 0 0 0 0 3555.01 0 0 1101256068 1801995634 10 Physicians SHAPIRO DOV 600624579 200 Cook 0 1 Pediatrics 0 0 0 18 0 0 0 0 0 0 10 0 18 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 19 0 33 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 19 0 33 0 0 0 0 0 0 0 0 0 1538.98 0 0 0 0 0 0 514.84 0 1857.16 0 0 0 0 0 0 3910.98 0 0 1101256072 1548202005 60 Pharmacies HOLY FAMILY PLAZA PHARMACY 600161236 200 Cook 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 0 489 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8703.24 0 0 0 8703.24 0 0 1101256093 1538279518 46 Ambulatory Surgical Treatment Centers CHILDRENS IN WESTCHESTER 601545802 200 Cook 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 50 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 25645.27 0 0 0 0 0 25645.27 0 0 1101256102 30 General Hospitals 845 Texas ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262.24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 262.24 0 0 1101256108 1184602518 63 Other Providers of Medical Equipment/Supplies (Non-registered) PRENTKE ROMICH COMPANY 446919786 836 Ohio 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 0 103 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 143516.33 0 0 0 0 0 0 143516.33 0 0 1101256119 10 Physicians 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101256120 1578756193 10 Physicians BURNS SEAN M 631417129 96 St Clair 0 0 Radiology 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Kane 0 0 0 0 0 0 0 0 0 0 16 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 10681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1719447.56 0 0 0 0 0 0 0 0 0 0 1719447.56 0 0 1101256425 1962677211 10 Physicians ARONSON SCHINASI DANA 606143363 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 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 1115.82 0 0 0 0 0 0 1115.82 0 0 1101256429 1902839525 10 Physicians KASSAR SAMER 629595896 108 Williamson 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 0 172 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 1518.34 0 0 0 0 0 0 1518.34 0 0 1101256446 1700981933 24 Speech Therapists MILLIGAN KIMBERLY 628124416 36 Franklin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42631.98 42631.98 0 0 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0 2410.75 0 0 1101256533 1841292083 33 Nursing Facilities CENTRAL BAPTIST VILLAGE 607064480 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 1736 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 213147.56 0 0 0 0 0 0 0 213147.56 0 0 1101256548 10 Physicians 53 Kane 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 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 1226.43 0 0 0 0 0 0 1226.43 0 0 1101256549 1447266564 10 Physicians KATCHEN MARC S 616151941 80 Peoria 0 0 Neurology 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 0 702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7972.18 0 0 0 0 0 0 7972.18 0 0 1101256557 1700874922 12 Optometrists GOLDSTEIN JAMES R 619385526 24 Coles 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 194 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 0 127 0 0 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0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 277 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 22698.2 0 0 0 0 0 0 0 0 0 0 0 0 0 22698.2 0 0 1101256757 1568471241 10 Physicians WILSON KATHRYN 616151941 80 Peoria 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 0 190 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 2358.07 0 0 0 0 0 0 2358.07 0 0 1101256791 1114965225 10 Physicians ROSSI PHILLIP 617477525 98 Tazewell 0 0 Surgery General 0 0 0 1 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 188 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 188 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 68 0 1626.98 0 0 0 0 0 0 1779.6 0 0 1101256807 98 Waiver service provider--TBI (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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16181.38 0 0 0 0 0 0 0 0 0 0 0 0 0 16181.38 0 0 1101256815 91 Waiver service 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Medicar Provider D AND I TRANSPORT INC 999999999 107 Will 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 0 653 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 10225.93 0 0 0 0 0 0 10225.93 0 0 1101257397 1952329021 10 Physicians PALELLA FRANK 606118709 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 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 0 308.09 0 0 0 0 0 0 308.09 0 0 1101257399 1477756732 10 Physicians KUNCHALA VINITHA 606930001 200 Cook 0 1 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 277.72 0 0 0 0 0 0 0 0 2365.14 0 0 0 0 0 0 2642.86 0 0 1101257400 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 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 27700.25 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 3 0 531 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9.68 0 23795.19 0 0 0 0 0 0 23804.87 0 0 1101257586 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 0 227 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 15175.74 0 0 0 0 0 0 0 0 0 0 0 0 0 15175.74 0 0 1101257604 1407034218 23 Occupational Therapists KROLOW AMY 611144937 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 334.58 334.58 0 0 1101257610 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 21813.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21813.09 0 0 1101257612 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 0 308 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 19 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 0 376.56 0 0 0 0 0 0 376.56 0 0 1101257673 1346295631 29 ICF/MR WALTER LAWSON CHILDRENS HOME 611112757 109 Winnebago 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 1778 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53832 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13611310.41 0 0 0 0 0 0 0 0 0 0 13611310.41 0 0 1101257688 1447290465 10 Physicians WESTIN CRAIG 600162359 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 15 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.8 0 794.93 0 0 0 0 0 0 884.73 0 0 1101257694 1740446269 28 Waiver service provider--Supportive living facility (HFS) WOODRIDGE SL RESIDENCE GENESEO 612547601 45 Henry 0 0 0 0 0 0 0 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 1209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 107503.97 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.2 0 0 0 0 0 0 94.2 0 0 1101261793 1548241250 10 Physicians STEVENS WILLIAM 627949639 91 Sangamon 0 0 Thoracic Surgery 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 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 38080.74 0 0 0 0 0 0 38080.74 0 0 1101261801 1740239334 33 Nursing Facilities HOLY FAMILY VILLA 604647332 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 3948 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 518911.94 0 0 0 0 0 0 0 518911.94 0 0 1101261802 1437262540 10 Physicians COLLETTE DEAN 616147300 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1094 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1718 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1718 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8257.15 0 248.8 0 0 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617640768 61 Livingston 0 0 General 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 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 0 981.41 0 0 0 0 0 0 981.41 0 0 1101268671 1578720678 10 Physicians DUNCAN KENYON D 618012529 19 Champaign 0 0 Anesthesiology 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 0 155 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 15795.12 0 0 0 0 0 0 15795.12 0 0 1101268689 1790707701 70 Ambulance Service Providers EMERGENCY 116 AMB SERV INC 615487113 110 Woodford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 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 21442.19 0 0 0 0 0 0 21442.19 0 0 1101268702 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 10038.58 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 280822.71 0 0 0 0 0 0 280822.71 0 0 1101268840 1992756290 12 Optometrists SYPHERD CARRIE 600143655 71 McHenry 0 0 Therapeutic Pharmaceutical Agents 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 0 148 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 0 902.02 0 0 0 0 0 0 902.02 0 0 1101268852 10 Physicians 54 Kankakee 0 0 Gastroenterology 0 0 0 0 0 0 0 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 0 343.17 0 0 0 0 0 0 343.17 0 0 1101268863 10 Physicians 30 DuPage 0 0 Rheumatology 0 0 0 0 0 0 0 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 62.74 0 0 0 0 0 0 62.74 0 0 1101268864 1730273566 10 Physicians ROGERSON ANTHONY 535661546 852 Wisconsin 0 0 Surgery Head/Neck 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 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 1298.14 0 0 0 0 0 0 1298.14 0 0 1101268870 36 Community mental health provider 90 Saline 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 219.6 0 0 219.6 0 0 1101268892 1134240252 10 Physicians PATEL ASMITA 606133077 200 Cook 0 0 Emergency 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 0 103 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 5095.82 0 0 0 0 0 0 5095.82 0 0 1101268905 1902876071 10 Physicians LIMJOCO JUAN 616129518 815 Indiana 0 0 Pathology 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 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 1750.08 0 0 0 0 0 0 0 0 1750.08 0 0 1101268911 1831131697 10 Physicians CONLON JOSEPH 627949248 91 Sangamon 0 0 Dermatology 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 0 142 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 5981.91 0 0 0 0 0 0 5981.91 0 0 1101268914 92 Waiver service provider--Disability (DHS/DRS) 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 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 21366.92 0 0 0 0 0 0 0 0 0 0 0 0 0 21366.92 0 0 1101268972 92 Waiver service provider--Disability (DHS/DRS) 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 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 39232.71 0 0 0 0 0 0 0 0 0 0 0 0 0 39232.71 0 0 1101268977 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 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 1165.84 1165.84 0 0 1101268990 1013926153 10 Physicians NEMCEK ALBERT 606118702 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 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Physicians TOOLAN BRIAN 605274503 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 11 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 143.4 0 3550.88 0 0 0 0 0 0 3694.28 0 0 1101269238 1467441519 10 Physicians ARMENIA MICHELE 600051529 200 Cook 0 0 Obstetric-Gynecology 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 5 0 12 0 0 0 0 0 0 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 29.3 0 198.81 0 0 0 0 0 0 228.11 0 0 1101269276 1093718900 39 Hospice SSM HOSPICE OF ILLINOIS 628642408 49 Jefferson 0 0 0 0 0 0 0 0 0 22 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 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69024.22 0 0 0 0 0 0 0 0 0 0 0 69024.22 0 0 1101269278 1922001189 63 Other Providers of Medical Equipment/Supplies (Non-registered) BINSONS HOSPITAL SUPPLIES INC 480151262 823 Michigan 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 0 722 0 0 0 0 0 0 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2607.18 1596224.64 0 0 0 0 0 3758424.25 0 0 1101269331 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16313.12 0 0 0 0 0 0 0 0 0 0 0 0 0 16313.12 0 0 1101269332 1245360478 10 Physicians SCHROEDER SANGEETA 606143363 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 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 0 947.61 0 0 0 0 0 0 947.61 0 0 1101269362 1518127950 10 Physicians HOLT NATHAN 617649774 61 Livingston 0 1 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 0 176 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 2103.25 0 0 0 0 0 0 2103.25 0 0 1101269391 1902813546 10 Physicians RAUT AARTI 605233808 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 62 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 0 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24650.5 0 0 0 0 0 0 0 0 0 0 0 0 0 24650.5 0 0 1101270816 1528203882 52 Certified local public health department MONTGOMERY CO HLTH DEPT 620490185 76 Montgomery 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 0 640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 640 0 0 1101270842 1942423256 22 Physical Therapists TU HOA 627621000 91 Sangamon 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 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 861 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59379.41 59379.41 0 0 1101270844 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11077.56 0 0 0 0 0 0 0 0 0 0 0 0 0 11077.56 0 0 1101270845 1942203500 10 Physicians MCDONALD RAYMOND J 603051804 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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Hospitals FRANCISCAN ST. 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0 0 0 24899 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33689.88 0 0 0 33689.88 0 0 1101280785 1952463705 52 Certified local public health department CARROLL COUNTY HEALTH DEPT 610531243 17 Carroll 0 0 0 16 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.1 0 336.35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 545.45 0 0 1101280807 1285706754 10 Physicians ALKHUDARI AZZAM 606123723 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 63 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 2067.01 0 0 0 0 0 0 2067.01 0 0 1101280818 1669488029 36 Community mental health provider NORTHSIDE HOUSING 2 GRAIS APAR 606263718 200 Cook 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 1321.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18820.88 0 0 20141.96 0 0 1101280829 1932320819 10 Physicians HOLT TRAVIS 617042101 72 McLean 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 4 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.62 0 1741.38 0 0 0 0 0 0 1759 0 0 1101280860 1548382690 36 Community mental health provider ASIAN HUMAN SERVICES CHICAGO 606404907 200 Cook 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1157 0 0 23239.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103798.74 0 0 127038.62 0 0 1101280862 1811044803 24 Speech Therapists BONNEY LARAMORE VANESSA 606523834 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 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 38835.26 38835.26 0 0 1101280910 1093794620 10 Physicians MAJMUNDAR AMEE R 606740018 200 Cook 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 17 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 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Per Diem rate." 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101286934 1639166259 10 Physicians SEIGLE MICHAEL 601247837 53 Kane 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 26 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 1126.7 0 0 0 0 0 0 1126.7 0 0 1101286951 10 Physicians 51 Jo Daviess 0 1 Family Practice 0 0 0 0 0 0 0 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 0 170.36 0 0 0 0 0 0 170.36 0 0 1101286958 92 Waiver service provider--Disability (DHS/DRS) 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 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 19471.65 0 0 0 0 0 0 0 0 0 0 0 0 0 19471.65 0 0 1101286973 1558331272 10 Physicians BONNAIG CARMEL 629183600 108 Williamson 0 0 Emergency Medicine 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 0 128 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 3730.82 0 0 0 0 0 0 3730.82 0 0 1101286976 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 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 18828.03 0 0 0 0 0 0 0 0 0 0 0 0 0 18828.03 0 0 1101286982 1164521928 10 Physicians NESSELROAD JAMES 614889517 56 Knox 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 82 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 7213.06 0 0 0 0 0 0 7213.06 0 0 1101286993 1942343447 30 General Hospitals SHRINERS HOSPITAL FOR CHILDREN 631313597 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 Children's Hospital 0 0 0 0 0 0 0 0 0 17 0 0 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9164.94 0 0 0 40909.26 0 0 0 0 0 50074.2 0 220.6 1101287002 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 790.41 0 0 0 0 0 0 0 0 0 0 0 0 0 790.41 0 0 1101287057 1770737140 63 Other Providers of Medical Equipment/Supplies (Non-registered) GENESIS HOME MEDICAL EQUIPMENT 612655016 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 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 2273.31 0 0 0 0 0 0 2273.31 0 0 1101287063 1770695793 10 Physicians CHANG STEPHEN 601901222 30 DuPage 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 72 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 2303.66 0 0 0 0 0 0 2303.66 0 0 1101287064 1174625867 10 Physicians SAXENA SANJAY 617043750 72 McLean 0 1 Pediatrics 0 0 0 89 0 0 0 0 0 0 0 0 99 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 183 0 0 0 0 0 0 0 0 236 0 0 0 0 0 0 0 0 0 8715.78 0 0 0 0 0 0 0 0 8407.69 0 0 0 0 0 0 17123.47 0 0 1101287067 1376569335 33 Nursing Facilities CHRISTIAN NURSING HOME 626562216 62 Logan 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 369932.25 0 0 0 0 0 0 0 369932.25 0 0 1101287130 1407906696 10 Physicians SILBERMAN CARL M 600611822 57 Lake 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 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 53.08 0 0 0 0 0 0 53.08 0 0 1101287146 91 Waiver service provider--Adults (DHS/DDD) 108 Williamson 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24517.68 0 0 0 0 0 0 0 0 0 0 0 0 0 24517.68 0 0 1101287148 1548492200 10 Physicians ADARAMOLA AKINDELE 627949248 91 Sangamon 0 0 Family Practice 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 0 276 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 2240.22 0 0 0 0 0 0 2240.22 0 0 1101287153 1134321680 47 Local Education Agencies PIKELAND C U SCH DIST 10 623631960 83 Pike 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 3544 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 3544 0 0 0 0 187.94 0 0 0 0 0 0 0 0 0 0 0 0 0 116168.62 0 116356.56 0 0 1101287155 1548490311 10 Physicians ABBEG ANDREW 946081826 96 St Clair 0 0 Internal Medicine 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 0 194 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 5822.09 0 0 0 0 0 0 5822.09 0 0 1101287163 1720020308 10 Physicians SALIMATH JAYARAJ 627949248 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 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 2147.01 0 0 0 0 0 0 2147.01 0 0 1101287164 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 26197.27 0 0 0 0 0 0 0 0 0 0 0 0 0 26197.27 0 0 1101287175 1629015904 63 Other Providers of Medical Equipment/Supplies (Non-registered) AD MEDICAL SUPPLY INC 606421285 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1171 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5344 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5344 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196350.61 0 574.68 0 0 0 0 196925.29 0 0 1101287177 1447266903 60 Pharmacies WALGREENS #07545 601944051 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17934 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81837.65 0 0 0 81837.65 0 0 1101287215 1700850526 63 Other Providers of Medical Equipment/Supplies (Non-registered) CASEYVILLE NURSING AND REHABIL 622321306 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 9153 0 0 0 0 0 0 9153 0 0 1101287221 1801901640 30 General Hospitals FRESENIUS MEDICAL CARE SALINE 629463352 90 Saline ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 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 2826 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9229.5 0 0 0 0 0 9229.5 0 0 1101287234 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 21774.07 0 0 0 0 0 0 0 0 0 0 0 0 0 21774.07 0 0 1101287242 1023011863 10 Physicians BUESCHER LUCINDA 627949639 91 Sangamon 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 97 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 3237.08 0 0 0 0 0 0 3237.08 0 0 1101287261 1699729186 10 Physicians SUSTENTO-REODICA NEDJEMA 606118709 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 26 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 0 757.26 0 0 0 0 0 0 0 0 757.26 0 0 1101287275 1174782916 10 Physicians HANSON MATTHEW 528041707 816 Iowa 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 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 2627.86 0 0 0 0 0 0 2627.86 0 0 1101287283 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 0 104 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 18876.48 0 0 0 0 0 0 0 0 0 0 0 0 0 18876.48 0 0 1101287286 1194838045 10 Physicians DIMITROPOULOS VASSILIOUS 606123844 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 21 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 206 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.02 0 4602.8 0 0 0 0 0 0 4682.82 0 0 1101287289 1952381766 10 Physicians MCKINNON SALLY 535462339 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 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 0 180.67 0 0 0 0 0 0 0 0 180.67 0 0 1101287301 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 0 126 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 15385.2 0 0 0 0 0 0 0 0 0 0 0 0 0 15385.2 0 0 1101287326 1538157045 10 Physicians SAWLANI HARESH 606344420 200 Cook 0 1 Internal Medicine 0 0 0 3 0 0 0 0 0 0 20 0 305 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 30 0 1395 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 30 0 1395 0 0 0 0 0 0 0 0 0 294.54 0 0 0 0 0 0 301.78 0 18414.77 0 0 0 0 0 0 19011.09 0 0 1101287346 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 6724.87 0 0 0 0 0 0 0 0 0 0 0 0 0 6724.87 0 0 1101287348 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 0 156.18 0 0 0 0 0 0 156.18 0 0 1101287349 1982623401 10 Physicians NADLER ROBERT B 606751611 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 6 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 202 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.72 0 6373.25 0 0 0 0 0 0 6398.97 0 0 1101287353 1972625333 10 Physicians WHITELEY MIRIAM 600261324 200 Cook 0 1 Family 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 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 0 403.49 0 0 0 0 0 0 403.49 0 0 1101287389 1316954134 10 Physicians ZIELINSKI MICHAEL D. 606118709 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 876.59 0 0 0 0 0 0 876.59 0 0 1101287396 16 Nurse Practitioners 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1101287405 1548553399 10 Physicians SKLANSKY JODI 600681125 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 5 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 1316.53 0 0 0 0 0 0 1321.7 0 0 1101287421 1508013038 36 Community mental health provider THRESHOLDS 606155641 200 Cook 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 787 0 0 305.32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78827.42 0 0 79132.74 0 0 1101287425 1225190242 10 Physicians GILBERT KENNETH 622233809 96 St Clair 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 0 111 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 6974.12 0 0 0 0 0 0 6974.12 0 0 1101287428 1548203615 10 Physicians YANG LEE 611033655 109 Winnebago 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 54 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 56 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1636.46 0 1309.77 0 0 0 0 0 0 2946.23 0 0 1101287440 1053529164 10 Physicians SOMMERVILLE RICHARD 631600352 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 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 0 635 0 0 0 0 0 0 635 0 0 1101287457 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29802.27 0 0 0 0 0 0 0 0 0 0 0 0 0 29802.27 0 0 1101287483 1508067596 10 Physicians DOTHAGER CHRISTINA 622691960 96 St Clair 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 1 0 21 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 43 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 13.86 0 536.64 0 0 0 0 0 0 636.15 0 0 1101287487 92 Waiver service provider--Disability (DHS/DRS) 48 Jasper 0 0 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 5119.84 0 0 0 0 0 0 0 0 0 0 0 0 0 5119.84 0 0 1101287496 10 Physicians 200 Cook 0 0 Pulmonary Diseases 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.2 0 0 0 0 0 0 235.2 0 0 1101287500 1144277534 10 Physicians ALJOUNDI BASSAM 631282197 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 3 0 111 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1628.31 0 0 0 0 0 0 1628.31 0 0 1101287518 1245291921 10 Physicians LUBECK DAVID 604302914 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 5 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19.22 0 2236.16 0 0 0 0 0 0 2255.38 0 0 1101287531 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 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 0 800.69 0 0 0 0 0 0 800.69 0 0 1101287561 1801068481 16 Nurse Practitioners ERTEL MICHELLE 631666971 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 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 1755.92 0 0 0 0 0 0 1755.92 0 0 1101287574 1679667737 91 Waiver service provider--Adults (DHS/DDD) CTF ILLINOIS 618207378 19 Champaign 0 0 0 0 0 0 0 490 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12316256.31 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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 7089.03 0 0 0 0 0 0 7089.03 0 0 1101289176 10 Physicians 107 Will 0 0 Allergy-Immunization 0 0 0 0 0 0 0 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 81.87 0 0 0 0 0 0 81.87 0 0 1101289179 1548377252 10 Physicians BAIN MICHELLE 606127300 200 Cook 0 0 Dermatology 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 0 226 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 11681.68 0 0 0 0 0 0 11681.68 0 0 1101289185 10 Physicians 815 Indiana 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 0 126.77 0 0 0 0 0 0 126.77 0 0 1101289186 1407893449 10 Physicians LEWICKY ANDREW O 606412703 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 11 0 138 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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DEPARTMENT 604024048 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224 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 38101.43 0 0 0 0 0 0 38101.43 0 0 1101289233 1861423659 10 Physicians SCHUTZENHOFER JAMES 628013056 66 Marion 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 68 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 0 394.78 0 0 0 0 0 0 394.78 0 0 1101289255 94 Waiver service provider--Children's support (DHS/DDD) 836 Ohio 0 0 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 35882 0 0 0 0 0 0 0 0 0 0 0 0 0 35882 0 0 1101289257 1093782831 10 Physicians MCDONNELL JAMES 601533304 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 1 0 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 266 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.41 0 11936.46 0 0 0 0 0 0 11942.87 0 0 1101289258 1396731444 10 Physicians DIPATRI ARTHUR J 606116649 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 1 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.37 0 12091.27 0 0 0 0 0 0 12124.64 0 0 1101289267 1144266016 10 Physicians BZDUSEK JEFFREY 604062428 200 Cook 0 0 Emergency Medicine 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 0 246 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 8753 0 0 0 0 0 0 8753 0 0 1101289300 2100279718 90 Waiver service provider--Elderly (DOA) COMFORT KEEPERS 600891865 57 Lake 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 22243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22243 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2802170.28 0 0 0 0 0 0 0 0 0 0 0 0 0 2802170.28 0 0 1101289302 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 1975.1 0 0 0 0 0 0 0 0 0 0 0 0 0 1975.1 0 0 1101289310 1255597167 10 Physicians BHATE AMIT D 601150723 27 Dekalb 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 991.53 0 0 0 0 0 0 991.53 0 0 1101289317 1316232184 33 Nursing Facilities DOBSON PLAZA NURSING & REHAB 602023622 200 Cook 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 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2107 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226724.56 0 0 0 0 0 0 0 226724.56 0 0 1101289318 1427000207 10 Physicians WOODHOUSE SHERMIAN 617613813 72 McLean 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 4 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.68 0 3463.12 0 0 0 0 0 0 3670.8 0 0 1101289324 1376549394 10 Physicians BACALAR CAREY 601691066 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 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 1082.46 0 0 0 0 0 0 1082.46 0 0 1101289325 1295739548 30 General Hospitals SALEM TOWNSHIP HOSPITAL 628814263 66 Marion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 Government Owned 0 0 0 0 157 0 0 0 0 2 0 0 0 213 0 0 0 0 0 0 0 0 0 179 0 0 0 0 2 0 0 0 329 0 0 0 0 0 0 0 0 0 179 0 0 0 0 4 0 0 0 329 0 0 0 0 0 0 0 0 0 117707.88 0 0 0 0 5904.58 0 0 0 85300.17 0 0 0 0 0 208912.63 0 0 1101289368 1568453876 10 Physicians SHAMS EHAB 606136211 200 Cook 0 0 Internal Medicine 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 0 519 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 5781.57 0 0 0 0 0 0 5781.57 0 0 1101289399 1942286760 10 Physicians WONG KATY KA-LOK 618223741 19 Champaign 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 2 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.43 0 0 0 0 0 0 170.43 0 0 1101289405 1396744207 16 Nurse Practitioners BRYANT NATALIE 631101010 826 Missouri 0 0 0 0 0 0 0 0 0 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 56.25 0 0 0 0 0 0 56.25 0 0 1101289438 1568472819 30 General Hospitals ROSELAND COMMUNITY HOSPITAL 606284200 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 1 0 0 0 821 0 0 0 0 1537 0 0 0 144 0 0 0 0 0 1 0 0 0 1174 0 0 0 0 360 0 0 0 179 0 0 0 0 0 3 0 0 0 1176 0 0 0 0 2538 0 0 0 187 0 0 0 0 0 0 0 0 0 141044.89 0 0 0 0 613933.54 0 0 0 15239.87 0 0 0 0 0 770218.3 0 40459.2 1101289450 1295829646 10 Physicians WOODARD DANEEN 606511631 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 0 615.68 0 0 0 0 0 0 615.68 0 0 1101289453 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0 0 0 0 37 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 100.25 0 0 0 0 0 0 0 0 1465.63 0 0 0 0 0 0 1565.88 0 0 1101289550 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 30464.13 0 0 0 0 0 0 0 0 0 0 0 0 0 30464.13 0 0 1101289555 1306812557 10 Physicians KALACHE ZEINA 606740018 200 Cook 0 1 Internal Medicine 0 0 0 2 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 174.94 0 0 0 0 0 0 0 0 56.38 0 0 0 0 0 0 231.32 0 0 1101289562 10 Physicians 200 Cook 0 1 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 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 1101289563 1255305454 33 Nursing Facilities MEADOWBROOK MANOR 604404918 107 Will 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 0 364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1401980.89 0 0 0 0 0 0 0 1401980.89 0 0 1101289586 1457360984 10 Physicians POPPER FRANCESCA 606313222 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 5 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 37 0 0 0 0 0 0 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 12.13 0 2221.18 0 0 0 0 0 0 2233.31 0 0 1101289601 1366438954 33 Nursing Facilities BREESE NURSING HOME 622301735 23 Clinton 0 0 0 0 0 0 0 0 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 0 692 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52305.53 0 0 0 0 0 0 0 52305.53 0 0 1101289603 1952581449 10 Physicians KURIAN BENCY 606740018 200 Cook 0 1 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 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 0 111.24 0 0 0 0 0 0 111.24 0 0 1101289607 1639119712 24 Speech Therapists CHANG SHINFAN 605406334 30 DuPage 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 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 2951.44 2951.44 0 0 1101289627 1871528778 10 Physicians FELLER ALEXANDER E 600450486 57 Lake 0 0 Anesthesiology 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 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616.45 0 0 0 0 0 0 616.45 0 0 1101289628 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 1502.8 0 0 0 0 0 0 1502.8 0 0 1101289638 1235437559 63 Other Providers of Medical Equipment/Supplies (Non-registered) VONO MEDICAL SUPPLIES 620561066 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 142 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 899 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21428.57 0 351.41 0 0 0 0 21779.98 0 0 1101289652 1962674895 29 ICF/MR STATION COURT 609013778 54 Kankakee 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 474183.17 0 0 0 0 0 0 0 0 0 0 474183.17 0 0 1101289655 1972772101 60 Pharmacies WALGREENS #11239 631102540 826 Missouri 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 0 721 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49333.89 0 0 0 49333.89 0 0 1101289656 1629102546 70 Ambulance Service Providers BENSENVILLE FIRE PROTECTION 601063020 30 DuPage 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 0 614 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 505431.78 0 0 0 0 0 0 505431.78 0 0 1101289666 2100280084 16 Nurse Practitioners MEYER MARY ANNE 606118709 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 25 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 55 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3187.97 0 2047.27 0 0 0 0 5235.24 0 0 1101301361 91 Waiver service provider--Adults (DHS/DDD) 27 Dekalb 0 0 0 0 0 0 0 2 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 25150.92 0 0 0 0 0 0 0 0 0 0 0 0 0 25150.92 0 0 1101301364 1508004706 16 Nurse Practitioners GUSTAVISON CASEY L 629011414 47 Jackson 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 0 541.86 0 0 0 0 0 0 541.86 0 0 1101301375 1548313125 11 Dentists SHIM YONG 605639076 30 DuPage 0 0 General Dentistry 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 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 4662.34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4662.34 0 0 1101301377 1184688756 10 Physicians SHAABAN AIMEN 522421009 816 Iowa 0 0 Surgery General 0 0 0 0 0 0 0 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 9021.74 0 0 0 0 0 0 9021.74 0 0 1101301383 1841451549 10 Physicians WEIS CHRISTINE R 601228942 53 Kane 0 1 Family Practice 0 0 0 4 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0 0 0 0 402.02 0 0 0 0 0 0 0 0 2017.54 0 0 0 0 0 0 2419.56 0 0 1101301405 1205986718 10 Physicians SINGH JONES ABHILASHA 605047222 30 DuPage 0 0 Emergency Medicine 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 0 125 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 3616.04 0 0 0 0 0 0 3616.04 0 0 1101301406 1013933068 10 Physicians KELLY JAMES 631101016 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 7 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 2 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 85.9 0 0 1101301456 10 Physicians 91 Sangamon 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73.4 0 0 0 0 0 0 73.4 0 0 1101301475 2100291893 92 Waiver service provider--Disability (DHS/DRS) "HEALTHCOM, INC" 619511066 78 Moultrie 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 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 957 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22362.23 0 0 0 0 0 0 0 0 0 0 0 0 0 22362.23 0 0 1101301476 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11154.92 0 0 0 0 0 0 0 0 0 0 0 0 0 11154.92 0 0 1101301488 1336272913 10 Physicians ALBISU JOSE A 606133077 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 128 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 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Psychiatry 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 0 447 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 14465.3 0 0 0 0 0 0 14465.3 0 0 1101302895 1588639926 10 Physicians BARR MICHAEL 612444024 89 Rock Island 0 0 Admitting Privileges 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 0 107 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 3065.08 0 0 0 0 0 0 3065.08 0 0 1101302900 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 0 127 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 20226.36 0 0 0 0 0 0 0 0 0 0 0 0 0 20226.36 0 0 1101302922 1629195268 24 Speech Therapists JOHNSON TAMARA 600743701 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 244 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13672.06 13672.06 0 0 1101302924 10 Physicians 200 Cook 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Nurse Practitioners 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859.6 0 0 0 0 0 0 859.6 0 0 1101303268 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 6852.56 0 0 0 0 0 0 0 0 0 0 0 0 0 6852.56 0 0 1101303276 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 2316.36 0 0 0 0 0 0 0 0 0 0 0 0 0 2316.36 0 0 1101303294 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 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 31340.91 0 0 0 0 0 0 0 0 0 0 0 0 0 31340.91 0 0 1101303305 91 Waiver service provider--Adults (DHS/DDD) 200 Cook 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 51340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80652.62 0 0 0 80652.62 0 0 1101304391 1659604700 24 Speech Therapists ORZECHOWSKI KATHRYN 604048506 107 Will 0 0 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 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 580 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45486.9 45486.9 0 0 1101304428 1407954431 60 Pharmacies NORTHSIDE REXALL PHARMACY 612541236 45 Henry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 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 8245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9320.16 0 0 0 9320.16 0 0 1101304450 10 Physicians 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.43 0 0 0 0 0 0 63.43 0 0 1101304474 1114037967 10 Physicians ROBINSON WARREN 604531842 200 Cook 0 1 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 73 0 0 0 0 0 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Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1017.14 1017.14 0 0 1101304613 1629236815 10 Physicians PAIK CHARLES 605323661 30 DuPage 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 46 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569.52 0 10047.04 0 0 0 0 0 0 10616.56 0 0 1101304621 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 13645.43 0 0 0 0 0 0 0 0 0 0 0 0 0 13645.43 0 0 1101304622 10 Physicians 30 DuPage 0 0 Gastroenterology 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 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 0 0 56.08 0 0 0 0 0 0 56.08 0 0 1101304666 1447367479 10 Physicians VAN THIEL DAVID H 604023263 200 Cook 0 0 Gastroenterology 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 7 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125.4 0 43.59 0 0 0 0 0 0 168.99 0 0 1101304671 1255362000 10 Physicians KAISER ROBERT 606751931 200 Cook 0 1 Gastroenterology 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 0 253 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 3020.9 0 0 0 0 0 0 3020.9 0 0 1101304681 1023157260 10 Physicians PATEL RAJAN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 1 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.22 0 3697.53 0 0 0 0 0 0 3702.75 0 0 1101304712 1154302289 10 Physicians MAHON GERALD 631031020 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 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 0 548.67 0 0 0 0 0 0 548.67 0 0 1101304733 1518985217 10 Physicians MUTCH DAVID 631101036 826 Missouri 0 0 Gynecology 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 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 1375.51 0 0 0 0 0 0 1375.51 0 0 1101304743 10 Physicians 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 173.87 0 0 0 0 0 0 173.87 0 0 1101304744 1053513515 47 Local Education Agencies ERIE CUSD 1 612509439 106 Whiteside 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 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 644 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14746.04 0 14746.04 0 0 1101304765 1922270370 29 ICF/MR COLLINS SQUARE 609152026 54 Kankakee 0 0 0 0 0 0 0 0 0 0 11 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 6259 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 613599.9 0 0 0 0 0 0 0 0 0 0 613599.9 0 0 1101304774 1326240623 10 Physicians PATEL SANJAY 601579408 30 DuPage 0 0 Psychiatry 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 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23772.29 0 0 0 0 0 0 23772.29 0 0 1101304785 1417197690 16 Nurse Practitioners TWAIT AMANDA A 604358139 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 76 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 2667.79 0 0 0 0 0 0 2667.79 0 0 1101304797 1538112255 10 Physicians SCLAMBERG STEVEN G 606344403 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 34 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 481.74 0 4141.78 0 0 0 0 0 0 4623.52 0 0 1101304798 1407936826 10 Physicians BARGER PHILIP 631101010 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 157.26 0 0 0 0 0 0 157.26 0 0 1101304807 98 Waiver service provider--TBI (DHS/DRS) 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 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 81949.88 0 0 0 0 0 0 0 0 0 0 0 0 0 81949.88 0 0 1101304833 1073625208 10 Physicians HART JOHN 611075161 109 Winnebago 0 1 Pediatrics 0 0 0 17 0 0 0 0 0 0 8 0 42 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 9 0 49 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 9 0 49 0 0 0 0 0 0 0 0 0 938 0 0 0 0 0 0 198.68 0 1837.6 0 0 0 0 0 0 2974.28 0 0 1101304841 1851384663 10 Physicians DIA MUHYALDEEN 604631029 200 Cook 0 0 Cardiovascular Diseases 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 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 933 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10687.54 0 0 0 0 0 0 10687.54 0 0 1101304857 1376659029 30 General Hospitals GRAHAM HOSPITAL ASSOC 615202444 37 Fulton DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 1 0 0 0 0 0 0 14 0 0 5 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 49 0 0 6 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 49 0 0 6 0 0 0 0 0 0 0 0 3.99 0 0 0 0 0 0 229.22 0 0 185.47 0 0 0 0 0 418.68 0 0 1101304860 16 Nurse Practitioners 47 Jackson 0 0 0 0 0 0 0 0 0 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 1.32 0 0 0 0 0 0 1.32 0 0 1101304868 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139.21 0 0 0 0 0 0 0 0 0 0 0 0 0 139.21 0 0 1101304919 1689674335 10 Physicians HECHT ALAN 606081732 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 1 858 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1463 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1463 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37.95 7840.93 0 227.36 0 0 0 0 0 0 8106.24 0 0 1101304920 92 Waiver service provider--Disability (DHS/DRS) 76 Montgomery 0 0 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 9266.14 0 0 0 0 0 0 0 0 0 0 0 0 0 9266.14 0 0 1101304926 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26004.85 0 0 0 0 0 0 0 0 0 0 0 0 0 26004.85 0 0 1101304971 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 1101304973 1548271380 10 Physicians IMAM JAVED 602023446 200 Cook 0 0 Oncology 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 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 616 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3629.59 0 0 0 0 0 0 3629.59 0 0 1101304974 1821035478 10 Physicians DANNHAUSEN BRUN CHRISTIAN 606890001 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 1 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3246.88 0 0 0 0 0 0 3246.88 0 0 1101304976 1558484246 10 Physicians FARMEN SARA 532272409 852 Wisconsin 0 0 Clinical Pathology 0 0 0 0 0 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 0 108.48 0 0 0 0 0 0 0 0 108.48 0 0 1101305006 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 23392.49 0 0 0 0 0 0 0 0 0 0 0 0 0 23392.49 0 0 1101305028 1093877045 94 Waiver service provider--Children's support (DHS/DDD) GOOD SHEPHERD CENTER 604291619 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31347.86 0 0 0 0 0 0 0 0 0 0 0 0 0 31347.86 0 0 1101305039 63 Other Providers of Medical Equipment/Supplies (Non-registered) 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14.92 0 0 0 0 0 0 14.92 0 0 1101305049 1619149374 10 Physicians ANDERSON MICHAEL 606313222 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 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 1818.95 0 0 0 0 0 0 1818.95 0 0 1101305061 1174624779 10 Physicians MUNI HARESH M 606253524 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 0 101 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 0 277.95 0 0 0 0 0 0 277.95 0 0 1101305070 1194756874 70 Ambulance Service Providers SANDOVAL FIRE DEPT 628821068 66 Marion 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 0 230 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 28727.59 0 0 0 0 0 0 28727.59 0 0 1101305085 13 Podiatrists 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 0 351.06 0 0 0 0 0 0 351.06 0 0 1101305095 1437305877 36 Community mental health provider DUPAGE COUNTY HEALTH DEPT 601582413 30 DuPage 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1239 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1239 0 0 1329.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66021.98 0 0 67351.02 0 0 1101305106 10 Physicians 30 DuPage 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 47.62 0 0 0 0 0 0 47.62 0 0 1101305151 1659331106 10 Physicians PAIVA JOHN 526551679 816 Iowa 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 454.1 0 13.49 0 0 0 0 0 0 467.59 0 0 1101305168 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(Non-registered) VISITING NURSES ASSOCIATION OF 611072574 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 698 0 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5739 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5739 0 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 147093.93 0 7245.36 0 0 0 0 154339.29 0 0 1101307421 1922029594 10 Physicians MORRISSEY DAVID 601262966 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 461 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 689 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7159.86 0 110.02 0 0 0 0 0 0 7269.88 0 0 1101307433 30 General Hospitals 64 Macoupin DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 0 0 0 0 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 0 207.11 0 0 0 0 0 207.11 0 0 1101307436 1700915915 23 Occupational Therapists JACKSON ROOKS LAKECIA 606282226 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 459 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 21 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 1837.07 0 0 0 0 0 0 1837.07 0 0 1101307531 1235105396 10 Physicians KICSAK KATHLEEN 606740018 200 Cook 0 1 Internal Medicine 0 0 0 3 0 0 0 0 0 0 3 0 16 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 5 0 38 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 5 0 38 0 0 0 0 0 0 0 0 0 109.87 0 0 0 0 0 0 20.72 0 1152.9 0 0 0 0 0 0 1283.49 0 0 1101307559 1629360284 36 Community mental health provider ADAPT OF ILLINOIS INC 611082315 109 Winnebago 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 257 0 0 357.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13109.15 0 0 13466.99 0 0 1101307562 1598813875 87 Psychologist(Encounter Only) GERTZ BETSY 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 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 3168.82 0 0 0 0 0 0 3168.82 0 0 1101307572 1144235276 60 Pharmacies WALGREEN CO 604533136 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 562 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 2712 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 79100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.68 0 0 144269.63 0 0 0 144505.31 0 0 1101307575 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 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 26838.04 0 0 0 0 0 0 0 0 0 0 0 0 0 26838.04 0 0 1101307599 50 Home Health Agencies - In Home 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 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 2109 0 0 0 0 0 0 2109 0 0 1101307610 1154306801 60 Pharmacies BRIOVARX LLC 352427298 801 Alabama 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 135490.51 0 0 0 135490.51 0 0 1101307624 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 21883.29 0 0 0 0 0 0 0 0 0 0 0 0 0 21883.29 0 0 1101307636 1912907270 10 Physicians SANCHEZ JOSEPH 606263221 200 Cook 0 1 Family Practice 0 0 0 5 0 0 0 0 0 0 0 0 38 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 63 0 0 0 0 0 0 0 0 0 440.33 0 0 0 0 0 0 0 0 1703.62 0 0 0 0 0 0 2143.95 0 0 1101307638 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 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 82704.62 0 0 0 0 0 0 0 0 0 0 0 0 0 82704.62 0 0 1101307649 1467493668 10 Physicians BARDFIELD STEVEN 605213186 30 DuPage 0 0 Physical Medicine/Rehabilitation 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 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45.51 0 186.82 0 0 0 0 0 0 232.33 0 0 1101307668 60 Pharmacies 844 Tennessee 0 0 0 0 0 0 0 0 0 0 0 0 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 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43.09 0 0 0 43.09 0 0 1101307699 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 10338.5 0 0 0 0 0 0 0 0 0 0 0 0 0 10338.5 0 0 1101307719 1467623173 10 Physicians FORD JOHNSON ARIN 605047222 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 12 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 188.88 0 5357.25 0 0 0 0 0 0 5546.13 0 0 1101307726 1679765705 16 Nurse Practitioners DICKSON SARAH 606405017 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 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 2487.19 0 0 0 0 0 0 2487.19 0 0 1101307750 1932278389 10 Physicians WEISSLER JONATHAN 604220786 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2022.81 0 0 0 0 0 0 2022.81 0 0 1101307751 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3888.65 0 0 0 0 0 0 0 0 0 0 0 0 0 3888.65 0 0 1101307799 1760430557 10 Physicians MAKDAH SALEM J 604631270 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 0 202 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 4126.76 0 0 0 0 0 0 4126.76 0 0 1101307816 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313.91 0 0 0 0 0 0 0 0 0 0 0 0 0 313.91 0 0 1101307838 10 Physicians 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 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 0 282.81 0 0 0 0 0 0 0 0 282.81 0 0 1101307841 1750527172 48 Rural Health Clinics GRAHAM MEDICAL GROUP LEWISTOWN 615421563 37 Fulton 0 1 0 243 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 630 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17764.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17764.81 0 0 1101307865 1134280563 11 Dentists SINGH JASMEEN 480836812 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 0 324 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 7300.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7300.19 0 0 1101307874 1801825450 10 Physicians MURPHY YVONNE 604023471 200 Cook 0 1 General Practice 0 0 0 9 0 0 0 0 0 0 1 0 44 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1 0 61 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1 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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 0 122 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 10877.05 0 0 0 0 0 0 0 0 0 0 0 0 0 10877.05 0 0 1101313083 1871569186 10 Physicians MUELLER ELIZABETH 601533328 200 Cook 0 0 Urology 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 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 0 715.61 0 0 0 0 0 0 715.61 0 0 1101313099 1114979143 47 Local Education Agencies GILLESPIE CUSD 7 620331167 64 Macoupin 0 0 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 91 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 3585 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 3585 0 0 0 0 639.59 0 0 0 0 0 0 0 0 0 0 0 0 0 41796.22 0 42435.81 0 0 1101313113 1184623746 10 Physicians PEACHEY KEITH 731436348 30 DuPage 0 1 Family Practice 0 0 0 4 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 94 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 94 0 0 0 0 0 0 0 0 0 305.52 0 0 0 0 0 0 0 0 1925.51 0 0 0 0 0 0 2231.03 0 0 1101313119 1790707735 10 Physicians VAN HARE GEORGE F 641843225 54 Kankakee 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 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 2484.23 0 0 0 0 0 0 2484.23 0 0 1101313135 1609948975 12 Optometrists GUSTAFSON STEVE 605439040 55 Kendall 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 113 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 175 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4262.06 0 2364.83 0 0 0 0 6626.89 0 0 1101313139 1508830456 10 Physicians FLANIGAN ROBERT 601545716 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 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 21.48 0 0 0 0 0 0 21.48 0 0 1101313142 1891846911 10 Physicians DUKA IRENA 601234717 53 Kane 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 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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2100303645 55 Early Intervention Services BIANCHINI SHERI 604652412 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 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23016.2 0 0 0 0 0 0 23016.2 0 0 1101313229 1356359566 16 Nurse Practitioners CRIST FRANKI 609361477 35 Ford 0 0 0 0 0 0 0 0 0 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 50.48 0 0 0 0 0 0 50.48 0 0 1101313238 1770592487 10 Physicians KIM DANIELLE 617016769 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83.85 0 0 0 0 0 0 83.85 0 0 1101313252 1558694190 16 Nurse Practitioners POELL JENIFER 606225646 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 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 2343.29 0 0 0 0 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0 0 0 0 0 1759.57 0 0 0 0 0 0 1759.57 0 0 1101313371 1194715532 11 Dentists ZORIN OLEG 606263221 200 Cook 0 0 General Dentistry 0 0 229 0 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 960 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 29304.05 0 0 0 0 0 0 0 0 0 0 0 9032.4 0 0 0 0 38336.45 0 0 1101313406 1932383973 28 Waiver service provider--Supportive living facility (HFS) COURTYARD ESTATES OF CANTON 615202700 37 Fulton 0 0 0 0 0 0 0 17 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 2511 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 223120.92 0 0 0 0 0 0 0 0 0 0 0 0 0 223120.92 0 0 1101313468 1912162215 10 Physicians ARVA NICOLETA 606116649 200 Cook 0 0 Pediatrics 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 4163.07 0 0 0 0 0 0 0 0 4163.07 0 0 1101313485 1366422958 16 Nurse Practitioners LANE RICHARD H 631600352 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 0 190.7 0 0 0 0 0 0 190.7 0 0 1101313505 1326072638 30 General Hospitals MOUNT VERNON DIALYSIS 628646583 49 Jefferson DIALYSIS Outpatient dialysis centers. 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 0 307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3550 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8894.67 0 0 0 0 0 8894.67 0 0 1101313517 1922026186 10 Physicians JOHNSON ERIC K 631600352 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 15 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 1221.21 0 0 0 0 0 0 1221.21 0 0 1101313523 1982622403 10 Physicians BROWN ANGELA L. 631101010 826 Missouri 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101313577 10 Physicians 826 Missouri 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Physicians MAHONEY ROBERT J 631600352 90 Saline 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 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 0 153.48 0 0 0 0 0 0 153.48 0 0 1101313623 1518911882 10 Physicians JOSEPH SUJA 606112991 200 Cook 0 0 Child Neurology 0 0 0 0 0 0 0 0 0 0 0 0 23 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 1653.93 0 0 0 0 0 0 1653.93 0 0 1101313639 1821391640 16 Nurse Practitioners SCHWEPPE LYNNE 610320857 97 Stephenson 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 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 1261.87 0 0 0 0 0 0 1261.87 0 0 1101313645 10 Physicians 200 Cook 0 1 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 2.16 0 0 0 0 0 0 2.16 0 0 1101313674 1215148085 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0 0 0 149.69 0 0 1101313715 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 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 0 350.9 0 0 0 0 0 0 350.9 0 0 1101313716 1508884602 10 Physicians REYES PEDRO 606414103 200 Cook 0 1 Family Practice 0 0 0 27 0 0 0 0 0 0 5 0 91 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 10 0 331 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 10 0 331 0 0 0 0 0 0 0 0 0 2282.09 0 0 0 0 0 0 17.63 0 4338.4 0 0 0 0 0 0 6638.12 0 0 1101313718 1467689844 10 Physicians BICKING GRIFFIN 999999999 818 Kentucky 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 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 1691.08 0 0 0 0 0 0 1691.08 0 0 1101313736 1891997870 10 Physicians SYED SALAHUDDIN 601691016 200 Cook 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 66 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 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LAB 606183122 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2045.79 0 14033.3 0 0 0 0 16079.09 0 0 1101318648 1316160823 36 Community mental health provider BRIDGEWAY INC 614629794 102 Warren 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 0 1469.54 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5508.43 0 0 6977.97 0 0 1101318650 1649419219 16 Nurse Practitioners HUNEMULLER HEATHER 612656790 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 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 2871.42 0 0 0 0 0 0 2871.42 0 0 1101318654 10 Physicians 815 Indiana 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 261.43 0 0 0 0 0 0 261.43 0 0 1101318657 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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 13950.99 0 0 0 0 0 0 0 0 0 0 0 0 0 13950.99 0 0 1101325941 1629295324 48 Rural Health Clinics ROSSVILLE MEDICAL CLINIC 609631012 100 Vermilion 0 1 0 75 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 242 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5298.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5298.81 0 0 1101325953 1205861937 10 Physicians GANDHI ASHA 600855701 57 Lake 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 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 1101325995 1316171317 10 Physicians GARRETTO ROBERT 379321983 60 Lee 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 0 157 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 6142.49 0 0 0 0 0 0 6142.49 0 0 1101326001 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.15 0 0 0 0 0 0 33.15 0 0 1101326012 92 Waiver service provider--Disability (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10414.93 0 0 0 0 0 0 0 0 0 0 0 0 0 10414.93 0 0 1101326022 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 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 19636.94 0 0 0 0 0 0 0 0 0 0 0 0 0 19636.94 0 0 1101326023 10 Physicians 200 Cook 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 1101326024 1174717003 12 Optometrists QUILLEASH ROBERT 616130003 80 Peoria 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 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 97 0 0 0 0 0 0 97 0 0 1101326026 1629233713 55 Early Intervention Services MAZZEFFI JENNIFER 601544126 30 DuPage 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 0 180 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 13887.6 0 0 0 0 0 0 13887.6 0 0 1101326030 10 Physicians 71 McHenry 0 1 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 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 47.62 0 0 0 0 0 0 47.62 0 0 1101326061 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 100.43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.43 0 0 1101326091 43 Encounter rate clinic 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 405.25 0 0 1101326101 11 Dentists 53 Kane 0 0 General Dentistry 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552.85 0 0 1101326106 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 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 1469.89 0 0 0 0 0 0 0 0 0 0 0 0 0 1469.89 0 0 1101326130 1346277480 16 Nurse Practitioners HEALY LAURA 604321439 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1188.73 0 0 0 0 0 0 1188.73 0 0 1101326140 1194902353 28 Waiver service provider--Supportive living facility (HFS) BETH ANNE PLACE 606513117 200 Cook 0 0 0 0 0 0 0 39 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 5032 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 619487.85 0 0 0 0 0 0 0 0 0 0 0 0 0 619487.85 0 0 1101326148 1609032150 10 Physicians POWELL EMILIE S 606733039 200 Cook 0 0 Emergency Medicine 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 0 199 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 5070.62 0 0 0 0 0 0 5070.62 0 0 1101326159 1508991282 30 General Hospitals OTTAWA REG HOSP AND HEALTHCARE 613501604 58 La Salle ARS-PD Hospitals paid a Per Diem rate. 0 0 General Hospital - Adult and Child 0 453 0 0 1 0 0 0 0 253 0 0 0 1 0 0 0 0 0 0 1868 0 0 1 0 0 0 0 99 0 0 0 1 0 0 0 0 0 0 1963 0 0 1 0 0 0 0 769 0 0 0 1 0 0 0 0 0 0 39723.57 0 0 0 0 0 0 0 223028.75 0 0 0 46.12 0 0 0 0 0 262798.44 0 5686.29 1101326161 91 Waiver service 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1376672212 10 Physicians ALEKSANDROVICH ELLEN 606313222 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 163 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1872.33 0 0 0 0 0 0 1872.33 0 0 1101326207 10 Physicians 200 Cook 0 0 Geriatrics 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101326225 91 Waiver service provider--Adults (DHS/DDD) 76 Montgomery 0 0 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 8051.87 0 0 0 0 0 0 0 0 0 0 0 0 0 8051.87 0 0 1101326252 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 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 1103.16 0 0 1103.16 0 0 1101326258 1467452573 10 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12 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108.63 0 294.58 0 0 0 0 0 0 403.21 0 0 1101326331 1558512939 10 Physicians PATEL NEHA 482781076 24 Coles 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 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 0 497.4 0 0 0 0 0 0 497.4 0 0 1101326356 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15311.52 0 0 0 0 0 0 0 0 0 0 0 0 0 15311.52 0 0 1101326364 1952335192 48 Rural Health Clinics CORK MEDICAL CENTER 624411010 21 Clark 0 1 0 402 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1299 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1299 0 188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45651.98 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45651.98 0 0 1101326369 1720017262 10 Physicians CHACKO SIJU 463222500 815 Indiana 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 422.56 0 0 0 0 0 0 422.56 0 0 1101326370 1316988694 10 Physicians BECKER JOHN 627044183 91 Sangamon 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 849 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1150 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1150 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16737.93 0 1107.18 0 0 0 0 0 0 17845.11 0 0 1101326374 1063605814 10 Physicians BRANDON EDEN 606176605 200 Cook 0 1 Internal Medicine 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 2 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 614 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6371.28 0 0 0 0 0 0 6371.28 0 0 1101326379 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 6703.29 0 0 0 0 0 0 0 0 0 0 0 0 0 6703.29 0 0 1101326382 1205944394 52 Certified local public health department KNOX COUNTY HEALTH DEPT 614012436 56 Knox 0 0 General Practice 0 48 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1538.92 0 764.67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2303.59 0 0 1101326383 60 Pharmacies 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 251.77 0 0 0 251.77 0 0 1101326384 1316193824 10 Physicians MATOKA DEREK 601533328 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 0 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4017.12 0 0 0 0 0 0 4017.12 0 0 1101326385 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 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 6878.9 0 0 0 0 0 0 0 0 0 0 0 0 0 6878.9 0 0 1101326396 1780834747 16 Nurse Practitioners CRISS ERICA 620023931 65 Madison 0 0 0 0 0 1 0 0 0 0 0 0 0 0 41 0 0 0 0 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 83 0 0 0 0 0 0 0 0 0 143.02 0 0 0 0 0 0 0 0 2440.65 0 0 0 0 0 0 2583.67 0 0 1101326403 1053450601 75 Department of Alcohol and Substance Abuse Provider CENTRAL EAST ALCOHOL AND DRUG 619201902 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 618 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 118758.61 0 0 118758.61 0 0 1101326422 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 27962.4 0 0 0 0 0 0 0 0 0 0 0 0 0 27962.4 0 0 1101326425 1316927155 10 Physicians SIMPSON GILES 601545716 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 0 134 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 5728.11 0 0 0 0 0 0 5728.11 0 0 1101326434 1538294483 40 Federally Qualified Health Centers CHICAGO HLTH OUTREACH HOMELESS 606405017 200 Cook 0 1 Homeless 0 782 0 15 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 4220 0 19 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 4220 0 19 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 291667.53 0 0 0 0 0 0 0 42.14 0 0 0 0 0 0 0 0 0 291709.67 0 0 1101326469 1356568281 24 Speech Therapists O''NEILL COLLEEN 606313222 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 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 0 519.6 519.6 0 0 1101326496 1912055179 11 Dentists ZAJAC JAMES 605153064 30 DuPage 0 0 General Dentistry 0 0 52 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 318 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 18570.88 0 0 0 0 0 0 0 0 0 0 0 1129.05 0 0 0 0 19699.93 0 0 1101326499 1043283849 10 Physicians BASHA AHSAN 609012901 54 Kankakee 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1204.38 0 0 0 0 0 0 1204.38 0 0 1101326505 1942278502 10 Physicians MUHSIN ADNAN 610210737 60 Lee 0 1 Internal Medicine 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 0 383 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 5968.48 0 0 0 0 0 0 5968.48 0 0 1101326521 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 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 14151.39 0 0 0 0 0 0 0 0 0 0 0 0 0 14151.39 0 0 1101326528 1083641146 10 Physicians PILLER SIMON 604721639 200 Cook 0 0 Pediatrics 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 0 100 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 9.92 0 839.09 0 0 0 0 0 0 849.01 0 0 1101326529 55 Early Intervention Services 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 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 0 474.22 0 0 0 0 0 0 474.22 0 0 1101326539 94 Waiver service provider--Children's support (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 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 7459.51 0 0 0 0 0 0 0 0 0 0 0 0 0 7459.51 0 0 1101326553 1437319290 10 Physicians SHARMA RICHA 370275339 87 Randolph 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 0 165 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 4385.65 0 0 0 0 0 0 4385.65 0 0 1101326570 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 15732.45 0 0 0 0 0 0 0 0 0 0 0 0 0 15732.45 0 0 1101326572 92 Waiver service provider--Disability (DHS/DRS) 25 Crawford 0 0 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 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0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14005.05 0 0 0 0 0 0 0 0 0 0 0 0 0 14005.05 0 0 1101326658 1285698100 10 Physicians YEN ESMOND 606740018 200 Cook 0 0 Obstetric-Gynecology 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 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177.47 0 368.94 0 0 0 0 0 0 546.41 0 0 1101326681 1316171812 10 Physicians OHARA KELLY 606118709 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 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 91.7 0 0 0 0 0 0 91.7 0 0 1101326686 1770713000 16 Nurse Practitioners HEISE AMELIA 619442460 31 Edgar 0 0 0 0 0 0 0 0 0 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 0 727.12 0 0 0 0 0 0 727.12 0 0 1101326688 1619007275 10 Physicians ROSBOROUGH DAVID 616033143 80 Peoria 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 149 0 0 0 0 0 0 0 0 0 0 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0 0 0 1555.4 0 0 0 0 0 0 1555.4 0 0 1101326780 1417967589 16 Nurse Practitioners PAPINEAU ELAINE 609012901 54 Kankakee 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 0 151 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 1030.68 0 0 0 0 0 0 1030.68 0 0 1101326784 1609920768 10 Physicians PALMER DENNIS D 612311317 74 Mercer 0 0 General Practice 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 28 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 76.84 0 0 0 0 0 0 0 0 318.7 0 0 0 0 0 0 395.54 0 0 1101326798 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 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 20278.74 0 0 0 0 0 0 0 0 0 0 0 0 0 20278.74 0 0 1101326802 1528147444 10 Physicians CHASSELS LOREN JAY 620522028 50 Jersey 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 0 116 0 0 0 0 0 0 0 0 0 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1003038688 10 Physicians MLYNARCZYK ELIZABETH 600892089 57 Lake 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 30 0 62 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 54 0 118 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 54 0 118 0 0 0 0 0 0 0 0 0 48.88 0 0 0 0 0 0 2382.87 0 8259.77 0 0 0 0 0 0 10691.52 0 0 1101326909 13 Podiatrists 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 31.18 0 0 0 0 0 0 31.18 0 0 1101326923 1962456616 22 Physical Therapists PESTINE ALIZA 600894691 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7475.66 7475.66 0 0 1101326926 1801837778 60 Pharmacies CVS PHARMACY 08760 602011150 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4047 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4149.35 0 0 0 4149.35 0 0 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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 0 225 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 2334.26 0 0 0 0 0 0 2334.26 0 0 1101330756 1114051802 55 Early Intervention Services MARSHALL GWENDOLYN M. 606433729 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 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57200.86 0 0 0 0 0 0 57200.86 0 0 1101330777 1710083563 10 Physicians SEMANS BRUCE 625639507 91 Sangamon 0 0 Dermatology 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 0 331.11 0 0 0 0 0 0 0 0 331.11 0 0 1101330784 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 0 131 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 18639.21 0 0 0 0 0 0 0 0 0 0 0 0 0 18639.21 0 0 1101330798 1568499770 10 Physicians MOCHARNUK ROBERT 627949639 91 Sangamon 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 0 126 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 7991.46 0 0 0 0 0 0 7991.46 0 0 1101330835 1407075468 91 Waiver service provider--Adults (DHS/DDD) HAWK PHILLIP 604431762 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 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 542 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100883.2 0 0 0 0 0 0 0 0 0 0 0 0 0 100883.2 0 0 1101330836 1740213149 10 Physicians DODHIA NAVINCHANDRA 605066222 53 Kane 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 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 813 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6856.57 0 0 0 0 0 0 6856.57 0 0 1101330839 1619212107 16 Nurse Practitioners HAUBRICH NICOLLETTE 623012719 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 2078.43 0 0 0 0 0 0 2078.43 0 0 1101330858 1952631269 10 Physicians PATEL DUSHYANTKUMAR 627949248 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 83 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 2033.13 0 0 0 0 0 0 2033.13 0 0 1101330865 1649213539 33 Nursing Facilities MANORCARE OF PALOS HTS EAST 604631010 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 79 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 5390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 643426.92 0 0 0 0 0 0 0 643426.92 0 0 1101330866 1851387120 10 Physicians ZARET PHILLIP H 600482700 57 Lake 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 0 218 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 4280.62 0 0 0 0 0 0 4280.62 0 0 1101330872 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3949.6 0 0 0 0 0 0 0 0 0 0 0 0 0 3949.6 0 0 1101330894 1841347069 16 Nurse Practitioners CLAY TRACY L 610320268 97 Stephenson 0 0 0 0 0 0 0 0 0 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 0 230.67 0 0 0 0 0 0 230.67 0 0 1101330902 1861410268 10 Physicians HARRIS SANDRA 605066222 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.17 0 2095.13 0 0 0 0 0 0 2100.3 0 0 1101330918 1639166481 10 Physicians RIFKIN SHELBY D 606123714 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 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 1101330945 1265425953 10 Physicians ALEXANDER ANGELO 601691019 200 Cook 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 37 0 58 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 74 0 128 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 74 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1197.44 0 5871.09 0 0 0 0 0 0 7068.53 0 0 1101330960 1083760631 11 Dentists BEYER GARY 600902979 200 Cook 0 0 General Dentistry 0 0 69 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 234 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 7265.52 0 0 0 0 0 0 0 0 0 0 0 376.35 0 0 0 0 7641.87 0 0 1101330995 1801928320 10 Physicians HOOVER ADINA I 606313222 200 Cook 0 0 Emergency 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 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 2976.19 0 0 0 0 0 0 2976.19 0 0 1101331017 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 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 17280.51 0 0 0 0 0 0 0 0 0 0 0 0 0 17280.51 0 0 1101331024 1073668380 11 Dentists SONI AMEE 606261707 200 Cook 0 0 General Dentistry 0 0 68 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 12040.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12040.2 0 0 1101331029 1053541318 10 Physicians JAMEN-ESPOSITO ERIN M 605275965 30 DuPage 0 1 Pediatrics 0 0 0 26 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 2428.97 0 0 0 0 0 0 0 0 1111.3 0 0 0 0 0 0 3540.27 0 0 1101331031 94 Waiver service provider--Children's support (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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50.25 0 0 0 0 0 0 0 0 0 0 0 0 0 50.25 0 0 1101331041 1760705834 10 Physicians BUCHA JURATE M 611081673 109 Winnebago 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 11 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.56 0 663.33 0 0 0 0 0 0 715.89 0 0 1101331058 1356407845 10 Physicians ROSENTHAL LISA 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 0 146 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 5215.31 0 0 0 0 0 0 5215.31 0 0 1101331069 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 25055.97 0 0 0 0 0 0 0 0 0 0 0 0 0 25055.97 0 0 1101331141 1487732939 63 Other Providers of Medical Equipment/Supplies (Non-registered) ABC MEDICAL SUPPLY INC 600672605 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 113 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3865 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3865 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313510.43 0 43.15 0 0 0 0 313553.58 0 0 1101331153 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 31.01 0 0 0 0 0 0 31.01 0 0 1101331162 1538153408 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0 0 0 0 0 354 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6135.95 0 0 0 0 0 0 6135.95 0 0 1101331232 1932215068 11 Dentists FEHLMAN BRUCE 612541320 45 Henry 0 0 General Dentistry 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 534.1 0 0 1101331255 1821023243 10 Physicians BAKKEN C DAVID 600043906 200 Cook 0 0 Internal Medicine 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 214.01 0 0 0 0 0 0 214.01 0 0 1101331266 1659444677 22 Physical Therapists KOKOCINSKI TOMASZ 606342616 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 9906.8 9906.8 0 0 1101331267 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 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 1135.9 1135.9 0 0 1101331283 1821175092 10 Physicians INZERELLO ANTHONY T 477061510 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 7 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 0 862.15 0 0 0 0 0 0 862.15 0 0 1101331284 1114187705 10 Physicians KELLY MOLLY 617649774 61 Livingston 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5779.97 0 0 0 0 0 0 5779.97 0 0 1101331289 1053336776 10 Physicians ROSENOW JOSHUA 606118709 200 Cook 0 0 Neurology 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 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 2770.7 0 0 0 0 0 0 2770.7 0 0 1101331325 98 Waiver service provider--TBI (DHS/DRS) 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 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 1890 0 0 0 0 0 0 0 0 0 0 0 0 0 1890 0 0 1101331334 1093813388 13 Podiatrists CHON MARIA 603023839 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 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 45.21 0 0 0 0 0 0 45.21 0 0 1101331338 1710133210 10 Physicians STANLEY TOM D 611144937 109 Winnebago 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 40 0 62 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 0 509.1 0 6847.78 0 0 0 0 0 0 7356.88 0 0 1101331348 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 24207.13 0 0 0 0 0 0 0 0 0 0 0 0 0 24207.13 0 0 1101331349 2100321767 70 Ambulance Service Providers ROCKTON FIRE PROTECTION DIST 610722405 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 0 111 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 80000.06 0 0 0 0 0 0 80000.06 0 0 1101331357 1164694519 29 ICF/MR SMITH SQUARE 612655843 89 Rock Island 0 0 0 0 0 0 0 0 0 0 16 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 9867 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 850267.4 0 0 0 0 0 0 0 0 0 0 850267.4 0 0 1101331364 1972711513 10 Physicians SHOBANDE OLATOKUNBO 850823814 200 Cook 0 0 Internal Medicine 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 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 0 257.88 0 0 0 0 0 0 257.88 0 0 1101331378 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 62.74 0 0 0 0 0 0 62.74 0 0 1101331394 1790090876 40 Federally Qualified Health Centers HEARTLAND HEALTH CENTER WILSON 606408090 200 Cook 0 1 0 81 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 13007.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13007.95 0 0 1101331398 1649386889 10 Physicians GALANOPOULOS ALISON C 600761226 200 Cook 0 1 Pediatrics 0 0 0 26 0 0 0 0 0 0 7 0 25 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 10 0 61 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 10 0 61 0 0 0 0 0 0 0 0 0 2724.13 0 0 0 0 0 0 142.71 0 3511.56 0 0 0 0 0 0 6378.4 0 0 1101331405 1790769073 48 Rural Health Clinics CMH RURAL HEALTH - OBLONG 624492409 25 Crawford 0 1 0 280 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1142 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22975.36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22975.36 0 0 1101331412 1750334306 16 Nurse Practitioners WESTPHAL CHRISTOPHER 613542757 58 La Salle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 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 0 385.02 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 2967.55 0 0 2967.55 0 0 1101337481 1457517039 10 Physicians OSAYIMWEN UCHENNA N 602011700 200 Cook 0 1 Pediatrics 0 0 0 9 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 3 0 13 0 0 0 0 0 0 0 0 0 917.88 0 0 0 0 0 0 47.1 0 569.94 0 0 0 0 0 0 1534.92 0 0 1101337487 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 0 220 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 18175.17 0 0 0 0 0 0 0 0 0 0 0 0 0 18175.17 0 0 1101337525 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 19685.82 0 0 0 0 0 0 0 0 0 0 0 0 0 19685.82 0 0 1101337535 1316293863 22 Physical Therapists NEWTON COLLEEN 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102 0 0 0 0 0 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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 0 147 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 4904.2 0 0 0 0 0 0 4904.2 0 0 1101337693 1073601324 10 Physicians WILLIAMS ALLEN 611081673 109 Winnebago 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 9 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 75.21 0 1533.93 0 0 0 0 0 0 1609.14 0 0 1101337715 1831449172 60 Pharmacies WALGREENS 9431 605549784 53 Kane 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 0 655 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21468 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14860.87 0 0 0 14860.87 0 0 1101337729 1003941113 10 Physicians COLEGROVE TANNER 606118709 200 Cook 0 0 Obstetric-Gynecology 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 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 29.48 0 2053.22 0 0 0 0 0 0 2082.7 0 0 1101337732 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4.8 0 0 0 0 0 0 4.8 0 0 1101337737 1538114715 10 Physicians HOCKENBERRY LESTER 604263556 200 Cook 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 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 0 494.82 0 0 0 0 0 0 494.82 0 0 1101337739 1558312579 10 Physicians WAGNER ELLIOTT J 852512400 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 123 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.47 0 13.25 0 0 0 0 0 0 891.72 0 0 1101337751 2100328169 90 Waiver service provider--Elderly (DOA) "BEST IN HOME SERVICE, INC." 600624032 200 Cook 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 10978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10978 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1003420.86 0 0 0 0 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0 0 0 0 0 0 513 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4480.84 0 1911.32 0 0 0 0 0 0 6392.16 0 0 1101337849 1124256854 10 Physicians HAAS ELLEN 617613691 72 McLean 0 0 Obstetric-Gynecology 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 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 0 359.5 0 2478.49 0 0 0 0 0 0 2837.99 0 0 1101337858 1447313705 10 Physicians WILLIAMS SHELLIE 605276686 30 DuPage 0 0 Geriatrics 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 0 169 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 1891.88 0 0 0 0 0 0 1891.88 0 0 1101337869 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 24782.39 0 0 0 0 0 0 0 0 0 0 0 0 0 24782.39 0 0 1101337911 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 0 231 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11182.96 0 0 0 0 0 0 0 0 0 0 0 0 0 11182.96 0 0 1101338984 1679773980 10 Physicians NIELSEN JANET 601545716 200 Cook 0 0 Family Practice 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 0 124 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 2103.14 0 0 0 0 0 0 2103.14 0 0 1101339013 1427174341 23 Occupational Therapists TOOHILL CHRISTINA 627621000 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3334.66 3334.66 0 0 1101339043 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 0 285 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 13180.47 0 0 0 0 0 0 0 0 0 0 0 0 0 13180.47 0 0 1101339062 1942238514 63 Other Providers of Medical Equipment/Supplies (Non-registered) KINEX MEDICAL COMPANY LLC 531882477 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 952.16 0 689.64 0 0 0 0 1641.8 0 0 1101339087 1912927385 70 Ambulance Service Providers UNITED LIFECARE AMBULANCE SRVC 624543339 25 Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 940 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128830.36 0 0 0 0 0 0 128830.36 0 0 1101339090 1619149325 10 Physicians JOSEPH DEEPA MATHEW 605612703 30 DuPage 0 1 Pediatrics 0 0 0 8 0 0 0 0 0 0 8 0 15 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 14 0 19 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 14 0 19 0 0 0 0 0 0 0 0 0 491.04 0 0 0 0 0 0 443.23 0 1171.57 0 0 0 0 0 0 2105.84 0 0 1101339094 1376790071 10 Physicians GOSKA GREGORY 999999999 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 87.08 0 0 0 0 0 0 87.08 0 0 1101339102 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 0 322 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 72282.7 0 0 0 0 0 0 0 0 0 0 0 0 0 72282.7 0 0 1101339111 1912953191 10 Physicians URBAN MARTIN 610324864 97 Stephenson 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 603 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1116 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1116 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13867.39 0 922.58 0 0 0 0 0 0 14789.97 0 0 1101339120 1457413908 10 Physicians ARORA VINEET 605615314 30 DuPage 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 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 0 793.1 0 0 0 0 0 0 793.1 0 0 1101339124 1487643573 10 Physicians PORTO SUSAN 605462312 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 9 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 117 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.42 0 5728.51 0 0 0 0 0 0 5769.93 0 0 1101339125 1407820228 63 Other Providers of Medical Equipment/Supplies (Non-registered) AUTUMN MEADOWS 622062204 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7627.5 0 0 0 0 0 0 7627.5 0 0 1101339129 1679781355 10 Physicians LEVI ROBERTO 606595113 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 15 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 0 224 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 207.11 0 1033.64 0 0 0 0 0 0 1240.75 0 0 1101339135 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11776.03 0 0 0 0 0 0 0 0 0 0 0 0 0 11776.03 0 0 1101339161 1437382959 10 Physicians CAPRIO TIMOTHY 999999999 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 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 1410.42 0 0 0 0 0 0 1410.42 0 0 1101339189 1255329546 10 Physicians PIERSON JANICE 604095459 200 Cook 0 1 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 0 263 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 1231 0 0 0 0 0 0 1231 0 0 1101339190 1023017019 10 Physicians NGUYEN PAUL 601783180 27 Dekalb 0 0 Cardiovascular Diseases 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 3057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3057 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23592.52 0 0 0 0 0 0 23592.52 0 0 1101339209 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 0 0 0 0 0 0 0 0 0 0 1101339226 1952312498 70 Ambulance Service Providers "A-TEC AMBULANCE, INC" 601247827 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1750 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6014 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6014 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329289.95 0 0 0 0 0 0 329289.95 0 0 1101339236 1235198235 30 General Hospitals ROCKFORD DIALYSIS 611032839 109 Winnebago DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 2507 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18056.18 0 0 0 0 0 18056.18 0 0 1101339276 1396753059 12 Optometrists EDWARDS ROBERT 627021448 91 Sangamon 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 127 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 6206.28 0 0 0 0 0 0 6206.28 0 0 1101339284 1639261621 10 Physicians ENG EUDORA 606118702 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 82 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 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0 0 0 0 0 0 0 0 0 49.91 0 0 0 0 0 0 49.91 0 0 1101339400 1578577201 22 Physical Therapists FALCONER CHAD 999999999 10 Adams 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 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 1117.94 1117.94 0 0 1101339406 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 22.18 0 0 0 0 0 0 22.18 0 0 1101339410 10 Physicians 852 Wisconsin 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 0 137.03 0 0 0 0 0 0 137.03 0 0 1101339422 1932276672 10 Physicians BAUMGARTEL PETER 600485261 57 Lake 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 289 0 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 367 0 204 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4034.09 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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 26149.48 0 0 0 0 0 0 0 0 0 0 0 0 0 26149.48 0 0 1101339444 1215148952 10 Physicians MOORE SATHEAVY 63090 826 Missouri 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 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 61.64 0 0 0 0 0 0 0 0 61.64 0 0 1101339498 1851395578 10 Physicians BERKENBILE DAVID 622492898 65 Madison 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432.54 0 0 0 0 0 0 432.54 0 0 1101339515 1588610257 60 Pharmacies OSCO DRUG #3348 601036534 30 DuPage 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 0 236 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7595 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10580.52 0 0 0 10580.52 0 0 1101339518 1235107731 10 Physicians SCHWARTZERS DEBRA 606740018 200 Cook 0 1 Internal Medicine 0 0 0 6 0 0 0 0 0 0 5 0 21 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 10 0 34 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 10 0 34 0 0 0 0 0 0 0 0 0 593.77 0 0 0 0 0 0 63.65 0 780.45 0 0 0 0 0 0 1437.87 0 0 1101339520 24 Speech 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.23 40.23 0 0 1101339522 1891801973 10 Physicians VAN JULIE 604405125 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52.3 0 741.1 0 0 0 0 0 0 793.4 0 0 1101339523 10 Physicians 826 Missouri 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 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 0 213.44 0 0 0 0 0 0 213.44 0 0 1101339535 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 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 1718.64 0 0 0 0 0 0 0 0 0 0 0 0 0 1718.64 0 0 1101339537 1801847017 12 Optometrists RADDATZ MAUREEN 629463334 90 Saline 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 348 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 823 0 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12476.62 0 4487.93 0 0 0 0 16964.55 0 0 1101339542 1497952816 11 Dentists DELAFUENTE CARLA 606233548 200 Cook 0 0 General Dentistry 0 0 72 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 357 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 11211.47 0 0 0 0 0 0 0 0 0 0 0 752.7 0 0 0 0 11964.17 0 0 1101339546 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 10430.56 0 0 0 0 0 0 0 0 0 0 0 0 0 10430.56 0 0 1101339577 1467486902 10 Physicians BAILEY DONALD M 477140556 815 Indiana 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 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 0 357.55 0 0 0 0 0 0 357.55 0 0 1101339603 10 Physicians 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 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 1101339605 1346300225 24 Speech Therapists FORD CHRISTINE 600904750 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 7864.41 7864.41 0 0 1101339607 1922172881 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 629483762 108 Williamson 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 228 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276.74 0 52292.84 0 0 0 0 52569.58 0 0 1101339620 1003045436 63 Other Providers of Medical Equipment/Supplies (Non-registered) PREMIER PROS AND ORTHO LLC 631226195 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 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 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 18990.87 0 0 0 0 18990.87 0 0 1101339635 1073703393 10 Physicians ARIKATI SANTHI 627949248 91 Sangamon 0 0 Internal Medicine 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 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 421 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4854.43 0 0 0 0 0 0 4854.43 0 0 1101339644 1205876414 10 Physicians MIRZA NUREAIN 601485374 30 DuPage 0 0 Pulmonary Diseases 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 1951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1951 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18668.95 0 0 0 0 0 0 18668.95 0 0 1101339649 1558380246 16 Nurse Practitioners SCHAFFER TINA 616360002 80 Peoria 0 0 0 0 0 2 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 2 0 0 0 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0 0 0 0 4653 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 304968.61 0 0 0 0 0 0 0 0 0 0 0 0 0 304968.61 0 0 1101347012 63 Other Providers of Medical Equipment/Supplies (Non-registered) 836 Ohio 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 6404.84 0 0 0 0 0 0 6404.84 0 0 1101347018 1336326453 47 Local Education Agencies POLO COMM UNIT SCHOOL DIST 222 610641724 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 883 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15264.09 0 15264.09 0 0 1101347027 1265626105 10 Physicians HUMPHREY ANDREA 629011474 47 Jackson 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 27 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2060.8 0 4279.11 0 0 0 0 0 0 6339.91 0 0 1101347039 1841256377 10 Physicians OLEARY SHAUN T 600051069 200 Cook 0 0 Neurology 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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 5559.72 5559.72 0 0 1101347220 1487920153 91 Waiver service provider--Adults (DHS/DDD) LATANYA MASON INONGE 604383732 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 1048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1048 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100805.4 0 0 0 0 0 0 0 0 0 0 0 0 0 100805.4 0 0 1101347222 1295858694 10 Physicians LOPEZ JOAQUIN 604022319 200 Cook 0 1 Pediatrics 0 0 0 12 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 976.54 0 0 0 0 0 0 0 0 1658.34 0 0 0 0 0 0 2634.88 0 0 1101347247 10 Physicians 852 Wisconsin 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 1101347257 92 Waiver service provider--Disability (DHS/DRS) 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 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SARMIENTO EDGARDO 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 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 4308.25 0 0 0 0 0 0 4308.25 0 0 1101361286 1720150303 10 Physicians LEONARD DEENA FINTEL 600891970 57 Lake 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 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 0 342.78 0 0 0 0 0 0 342.78 0 0 1101361294 1073717443 10 Physicians TODOROVA KOTEVA KRISTINA 606123861 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 65 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 3478.78 0 0 0 0 0 0 3478.78 0 0 1101361303 1932294618 10 Physicians GONZALEZ DIAZ GISELA 601081522 30 DuPage 0 1 Pediatrics 0 0 0 69 0 0 0 0 0 0 1 0 67 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 1 0 116 0 0 0 0 0 0 0 0 0 154 0 0 0 0 0 0 1 0 116 0 0 0 0 0 0 0 0 0 7163.87 0 0 0 0 0 0 5.22 0 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0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101362193 1992721120 10 Physicians BULLOCK ARNOLD 622261534 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 3 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 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 0 0 240.87 0 0 0 0 0 0 240.87 0 0 1101362204 1699864124 10 Physicians CARLOS IMELDA SANTOS 601882795 30 DuPage 0 1 Pediatrics 0 0 0 51 0 0 0 0 0 0 1 0 46 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 1 0 99 0 0 0 0 0 0 0 0 0 197 0 0 0 0 0 0 1 0 99 0 0 0 0 0 0 0 0 0 6352.21 0 0 0 0 0 0 5.22 0 5182.56 0 0 0 0 0 0 11539.99 0 0 1101362208 1598878373 10 Physicians HARMS CRAIG 620101801 65 Madison 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15.65 0 188.67 0 0 0 0 0 0 204.32 0 0 1101362212 1497875298 43 Encounter rate clinic CICERO HEALTH CENTER 608042135 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 461 0 104 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2044 0 234 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2044 0 234 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 390965.55 0 32402.33 0 0 0 0 0 405.25 0 0 0 0 0 0 0 0 0 423773.13 0 0 1101362219 1063528255 10 Physicians HILL CARL E E 602021552 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 419.5 0 0 0 0 0 0 419.5 0 0 1101362224 1306923370 16 Nurse Practitioners MARABLE JULIE 601545716 200 Cook 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 53 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 2162.8 0 0 0 0 0 0 2248.45 0 0 1101362244 1912990268 70 Ambulance Service Providers CITY OF TERRE HAUTE 478071924 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 2324.6 0 0 0 0 0 0 2324.6 0 0 1101362260 1467529545 10 Physicians MUPPAVARAPU SATHEESH 601876002 30 DuPage 0 0 Physical Medicine/Rehabilitation 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 0 297 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 7298.9 0 0 0 0 0 0 7298.9 0 0 1101362292 1992021729 10 Physicians STEPHENS ARCHER CHANTALE 606740018 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 0 135 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 1382.9 0 0 0 0 0 0 1382.9 0 0 1101362314 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 11328.89 0 0 0 0 0 0 0 0 0 0 0 0 0 11328.89 0 0 1101362327 16 Nurse Practitioners 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 42.92 0 0 0 0 0 0 42.92 0 0 1101362345 1629247283 28 Waiver service provider--Supportive living facility (HFS) EVERGREEN VILLAGE SUPPORTIVE 617617800 72 McLean 0 0 0 0 0 0 0 39 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 3488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 315728.21 0 0 0 0 0 0 0 0 0 0 0 0 0 315728.21 0 0 1101362367 1174748354 23 Occupational Therapists FONNER KIM 619389253 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61 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 46452.92 46452.92 0 0 1101362377 1972541712 10 Physicians SHARP LYDIA 601533328 30 DuPage 0 0 Emergency 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 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 1670.96 0 0 0 0 0 0 1670.96 0 0 1101362409 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 78.09 0 0 0 0 0 0 78.09 0 0 1101362418 1548251382 33 Nursing Facilities HERITAGE HEALTH LITCHFIELD 620562716 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1916 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 137356.17 0 0 0 0 0 0 0 137356.17 0 0 1101362435 1851340855 10 Physicians CABRERA ERNEST 606171174 200 Cook 0 0 Internal 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 0 968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 968 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5494.62 0 0 0 0 0 0 5494.62 0 0 1101362457 1891878856 63 Other Providers of Medical Equipment/Supplies (Non-registered) A Z MEDICAL SUPPLY INC 600053165 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 533 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10590 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10590 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 867799.98 0 153.04 0 0 0 0 867953.02 0 0 1101362460 1255413852 10 Physicians BULA MELANIA L 618012529 19 Champaign 0 0 0 0 0 0 0 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 0 252.74 0 0 0 0 0 0 0 0 252.74 0 0 1101362465 1609901396 24 Speech Therapists BAIRD BARBARA 620628500 65 Madison 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 0 164 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 11786.36 11786.36 0 0 1101362490 1851366967 10 Physicians ARNOLD JON 625264163 63 Macon 0 0 Pulmonary Diseases 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 0 302 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 4909.41 0 0 0 0 0 0 4909.41 0 0 1101362499 1760496103 10 Physicians ORHAN SUSAN 601691065 200 Cook 0 0 Obstetric-Gynecology 0 0 0 9 0 0 0 0 0 0 226 0 229 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 588 0 539 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 588 0 539 0 0 0 0 0 0 0 0 0 624.49 0 0 0 0 0 0 19055.7 0 24959.81 0 0 0 0 0 0 44640 0 0 1101362513 1730108804 10 Physicians AL SHARIF NABIL 628121969 36 Franklin 0 0 Cardiovascular Diseases 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 0 155 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 1083.45 0 0 0 0 0 0 1083.45 0 0 1101362522 1164482295 10 Physicians BRODD ANDERS 612654856 89 Rock Island 0 1 Pediatrics 0 0 0 13 0 0 0 0 0 0 26 0 52 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 34 0 79 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 34 0 79 0 0 0 0 0 0 0 0 0 995.95 0 0 0 0 0 0 900.28 0 2459.73 0 0 0 0 0 0 4355.96 0 0 1101362527 1710070057 10 Physicians KENNEY TOM 617055283 72 McLean 0 1 Family Practice 0 0 0 2 0 0 0 0 0 0 17 0 127 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 24 0 299 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 24 0 299 0 0 0 0 0 0 0 0 0 202.89 0 0 0 0 0 0 200.99 0 5072.42 0 0 0 0 0 0 5476.3 0 0 1101362531 1437146594 63 Other Providers of Medical Equipment/Supplies (Non-registered) KCI USA INC 462781959 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 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 23015.73 0 0 0 0 0 0 23015.73 0 0 1101362584 1477530426 33 Nursing Facilities PARK RIDGE CARE CENTER 600682523 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 34 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 2556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 237548.19 0 0 0 0 0 0 0 237548.19 0 0 1101362587 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 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 34822.99 0 0 0 0 0 0 0 0 0 0 0 0 0 34822.99 0 0 1101362590 10 Physicians 200 Cook 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 1101362594 1194817080 11 Dentists FLYNN DENISE 615544570 98 Tazewell 0 0 Orthodontist 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34355.57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34355.57 0 0 1101362603 1205190113 22 Physical Therapists MCARTHUR SHANNON 600257645 200 Cook 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 0 122 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 1260.42 1260.42 0 0 1101362621 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 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 1112.05 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1112.05 0 0 1101362648 1639437924 60 Pharmacies KOMED HOLMAN PHARMACY 606533030 200 Cook 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 1182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52284 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109157.5 0 0 0 109157.5 0 0 1101362662 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 16055.1 0 0 0 0 0 0 0 0 0 0 0 0 0 16055.1 0 0 1101362670 1770705949 16 Nurse Practitioners GRUBER MICHAEL 601181454 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 389.14 0 0 0 0 0 0 389.14 0 0 1101362688 1639390230 10 Physicians BROWN SARA 606733039 200 Cook 0 0 Family Practice 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 4 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.65 0 2368.42 0 0 0 0 0 0 2416.07 0 0 1101362694 97 Waiver service provider--Children's residential (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 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 0 747.74 0 0 0 0 0 0 0 0 0 0 0 0 0 747.74 0 0 1101362696 36 Community mental health provider 98 Tazewell 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 1028.88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.69 0 0 1355.57 0 0 1101362703 1073509824 10 Physicians CRABB JEREMIAH 616151941 80 Peoria 0 0 Internal 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 0 572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 572 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5145.92 0 0 0 0 0 0 5145.92 0 0 1101362709 1023183431 33 Nursing Facilities WHITE HALL NURSING AND REHAB C 620921001 39 Greene 0 0 0 0 0 0 0 0 0 0 0 0 0 66 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 4268 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 379955.06 0 0 0 0 0 0 0 379955.06 0 0 1101362718 1114177102 10 Physicians KONRAD AARON 623014038 10 Adams 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 820 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1098 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10944.4 0 1289.24 0 0 0 0 0 0 12233.64 0 0 1101362721 1043207251 10 Physicians MANJUNATH RAJINI 606731250 200 Cook 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 2 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 583 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22.96 0 7608.41 0 0 0 0 0 0 7631.37 0 0 1101362725 1609908383 10 Physicians GUPTA RENU 605177748 30 DuPage 0 0 Psychiatry 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 2776.01 0 0 0 0 0 0 2776.01 0 0 1101362726 1972518686 70 Ambulance Service Providers CITY OF LAKE FOREST 600451283 57 Lake 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 0 246 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 192709 0 0 0 0 0 0 192709 0 0 1101362748 1629178181 10 Physicians MENEELY TIMOTHY 618012529 19 Champaign 0 1 Family Practice 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 98.44 0 0 0 0 0 0 104.84 0 0 1101362763 1548467996 60 Pharmacies WALGREENS #10718 620561165 76 Montgomery 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 1685 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 43115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 235.68 0 0 69638.53 0 0 0 69874.21 0 0 1101362764 1558315911 10 Physicians BURSETH ERIC 606313222 200 Cook 0 0 Cardiology 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 0 145 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 1223.89 0 0 0 0 0 0 1223.89 0 0 1101362777 1679540207 10 Physicians BALLANTYNE FORD 535625531 852 Wisconsin 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 0 214.13 0 0 0 0 0 0 214.13 0 0 1101362778 1053312280 10 Physicians DYMOWSKI JOHN 605151500 30 DuPage 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 3 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 144.81 0 341.53 0 0 0 0 0 0 486.34 0 0 1101362818 1902137201 10 Physicians NDUKA NGOZI 606233596 200 Cook 0 0 Emergency Medicine 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 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 5212.34 0 0 0 0 0 0 5212.34 0 0 1101362823 1528193257 24 Speech Therapists DIAK KATHRYN 627621000 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217 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 15743.2 15743.2 0 0 1101362832 1710292727 16 Nurse Practitioners HOURSELT SARAH 601228942 53 Kane 0 0 0 0 0 7 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 618.46 0 0 0 0 0 0 0 0 1385.31 0 0 0 0 0 0 2003.77 0 0 1101362833 92 Waiver service 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0 0 0 0 0 0 0 0 0 915 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1189 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1189 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13371.77 0 895.79 0 0 0 0 0 0 14267.56 0 0 1101363356 1528263373 10 Physicians PUPPALA ANUJ 605213186 107 Will 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 17 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 196.88 0 2217.09 0 0 0 0 0 0 2413.97 0 0 1101363360 2100353778 13 Podiatrists ZYGMUNT KENNETH 601265017 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 316.68 0 0 0 0 0 0 316.68 0 0 1101363370 98 Waiver service provider--TBI (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 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 21672.12 0 0 0 0 0 0 0 0 0 0 0 0 0 21672.12 0 0 1101363375 1548217466 10 Physicians BOLL ROBERT 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Health Rehabilitation Facilities (SMHRF) THORNTON HEIGHTS TERRACE LTD 604112002 200 Cook 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 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4772 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 514089.88 0 0 0 0 0 0 0 514089.88 0 0 1101363482 1154347383 10 Physicians GOULD JENNIFER 631600352 107 Will 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 8 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.67 0 349.64 0 0 0 0 0 0 391.31 0 0 1101363494 1861513996 43 Encounter rate clinic RUTH M. ROTHSTEIN CORE CENTER 606123741 200 Cook 0 1 Direct Access 0 372 0 4 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 1141 0 10 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 1141 0 10 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 232011.82 0 405.25 0 0 0 0 0 5268.25 0 0 0 0 0 0 0 0 0 237685.32 0 0 1101363501 1376644385 30 General Hospitals ST ALEXIUS MEDICAL CENTER 601941018 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 1400 0 0 0 0 934 0 0 0 1617 0 0 0 0 0 0 0 0 0 1903 0 0 0 0 1007 0 0 0 3161 0 0 0 0 0 0 0 0 0 2123 0 0 0 0 5836 0 0 0 3569 0 0 0 0 0 0 0 0 0 370981.82 0 0 0 0 6749909.21 0 0 0 610107.62 0 0 0 0 0 7730998.65 0 0 1101363504 1477618197 12 Optometrists MAY GAIL 605631269 30 DuPage 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 70 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3203.8 0 1493.28 0 0 0 0 4697.08 0 0 1101363507 1356378822 24 Speech Therapists DUCEY TRACY 627621000 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 3598.21 3598.21 0 0 1101363513 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 7585.18 0 0 0 0 0 0 0 0 0 0 0 0 0 7585.18 0 0 1101363517 1437138120 16 Nurse Practitioners RAMSAY CINDY 612822904 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 526.97 0 0 0 0 0 0 526.97 0 0 1101363526 1104066554 16 Nurse Practitioners BRIAN JASON 617014364 72 McLean 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 269.38 0 0 0 0 0 0 269.38 0 0 1101363527 1588638811 10 Physicians DESTEFANI THOMAS B 601228942 53 Kane 0 1 Pediatrics 0 0 0 38 0 0 0 0 0 0 1 0 31 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 0 0 0 3744.91 0 0 0 0 0 0 67.01 0 2453.1 0 0 0 0 0 0 6265.02 0 0 1101363545 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 0 217 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 24094.4 0 0 0 0 0 0 0 0 0 0 0 0 0 24094.4 0 0 1101363553 10 Physicians 200 Cook 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 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 114.05 0 0 0 0 0 0 114.05 0 0 1101363558 10 Physicians 109 Winnebago 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 0 194.75 0 0 0 0 0 0 194.75 0 0 1101363562 1770576613 10 Physicians WIKOFF CATHERINE L 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0 0 0 0 0 0 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 1985.61 0 0 0 0 0 0 0 0 0 0 0 0 0 1985.61 0 0 1101365438 1336328830 24 Speech Therapists RIEGEL HOLLY 618012534 19 Champaign 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 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 6412.38 6412.38 0 0 1101365453 1013086990 12 Optometrists DEWAARD DAVID D 606405622 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 1 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 242 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29.28 0 7026.4 0 0 0 0 7055.68 0 0 1101365461 1497890990 10 Physicians THOMPSON NICOLE 606777007 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5051.08 0 0 0 0 0 0 5051.08 0 0 1101365494 10 Physicians 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 0 194.24 0 0 0 0 0 0 194.24 0 0 1101365510 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 0 167 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 18357.75 0 0 0 0 0 0 0 0 0 0 0 0 0 18357.75 0 0 1101365535 1447247572 10 Physicians LENGEMANN JAMES 606781034 200 Cook 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3.82 0 602.83 0 0 0 0 0 0 606.65 0 0 1101365559 1477532364 10 Physicians TERRELL DARIA 606910287 200 Cook 0 0 Orthopedic Surgery 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 0 125 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 2018.54 0 0 0 0 0 0 2018.54 0 0 1101365564 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21897.09 0 0 0 0 0 0 0 0 0 0 0 0 0 21897.09 0 0 1101365576 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 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 40.63 0 0 0 0 0 0 40.63 0 0 1101365591 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 28121.59 0 0 0 0 0 0 0 0 0 0 0 0 0 28121.59 0 0 1101365633 10 Physicians 109 Winnebago 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 1101365635 1710935242 10 Physicians ANDERSON EDWIN 604405125 107 Will 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 4 0 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MILLINGTON SCOTT 613542757 58 La Salle 0 0 Anesthesiology 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 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 2521.28 0 0 0 0 0 0 2521.28 0 0 1101365668 1871542829 36 Community mental health provider ROBERT YOUNG CENTER 612656106 89 Rock Island 0 0 Childrens mental health 238 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 902 0 0 557 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 4548 0 0 557 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 4548 0 0 17685.46 0 0 360.6 0 0 0 0 0 0 0 0 0 0 0 0 227764.55 0 0 245810.61 0 0 1101365680 2100356098 91 Waiver service provider--Adults (DHS/DDD) SHAMROCK SERVICES 628642157 49 Jefferson 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 10636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10636 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2290989.8 0 0 0 0 0 0 0 0 0 0 0 0 0 2290989.8 0 0 1101365685 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 0 265 0 0 0 0 0 0 0 0 0 0 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0 0 5 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59.65 0 7596.02 0 0 0 0 0 0 7655.67 0 0 1101365749 1245319698 11 Dentists BARBAGALLO MARGUERITE A 601873977 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 0 121 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 3111.97 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3111.97 0 0 1101365754 1497957955 47 Local Education Agencies ROCK FALLS ELEM SCHOOL DIST 13 610711229 106 Whiteside 0 0 0 0 0 91 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 4140 0 0 0 0 155 0 0 0 0 0 0 0 0 0 0 0 0 0 4140 0 0 0 0 1074.82 0 0 0 0 0 0 0 0 0 0 0 0 0 117312.8 0 118387.62 0 0 1101365762 1134176688 60 Pharmacies OSCO DRUG #3284 601812411 30 DuPage 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 0 166 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4497 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5491.22 0 0 0 5491.22 0 0 1101365778 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Waiver service provider--Disability (DHS/DRS) 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 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 9401.55 0 0 0 0 0 0 0 0 0 0 0 0 0 9401.55 0 0 1101365932 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 0 301 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 15001.26 0 0 0 0 0 0 0 0 0 0 0 0 0 15001.26 0 0 1101365939 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 111.2 0 0 0 0 0 0 0 0 111.2 0 0 1101365962 92 Waiver service provider--Disability (DHS/DRS) 70 McDonough 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 229.62 0 0 0 0 0 0 0 0 0 0 0 0 0 229.62 0 0 1101365964 1235119058 63 Other Providers of Medical 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0 0 0 0 0 0 70.27 0 199.13 0 0 0 0 0 0 269.4 0 0 1101366014 1861498529 63 Other Providers of Medical Equipment/Supplies (Non-registered) DEACONESS HOME MEDICAL 477101674 815 Indiana 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 0 304 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 5742.92 0 0 0 0 0 0 5742.92 0 0 1101366035 1306949615 10 Physicians MACMILLAN CAROL 605276686 30 DuPage 0 0 Child Neurology 0 0 0 7 0 0 0 0 0 0 13 0 86 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 39 0 130 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 39 0 130 0 0 0 0 0 0 0 0 0 50.26 0 0 0 0 0 0 179.9 0 8896.32 0 0 0 0 0 0 9126.48 0 0 1101366044 1497921761 10 Physicians SAMEE MOHAMMED 606162441 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 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 1917.32 0 0 0 0 0 0 1917.32 0 0 1101366098 1194732909 10 Physicians SINGER MARC 601545716 200 Cook 0 0 Colon - Rectal Surgery 0 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(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 9999.18 0 0 0 0 0 0 0 0 0 0 0 0 0 9999.18 0 0 1101369367 1316242423 16 Nurse Practitioners MANKO ALLISON 602011700 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 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 1065.9 0 0 0 0 0 0 1065.9 0 0 1101369406 1811074651 30 General Hospitals SSM HEALTH CARDINAL GLENNON CH 631041003 826 Missouri CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 General Hospital - Children Section 0 0 0 0 480 0 0 0 0 981 0 0 0 1074 0 0 0 0 0 0 0 0 0 612 0 0 0 0 221 0 0 0 2281 0 0 0 0 0 0 0 0 0 612 0 0 0 0 1945 0 0 0 2732 0 0 0 0 0 0 0 0 0 86448.83 0 0 0 0 5434569.98 0 0 0 577761.04 0 0 0 0 0 6098779.85 0 54901.82 1101369411 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 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119722.24 0 0 1101372526 2100362944 10 Physicians MULVEY SHARI 616142012 80 Peoria 0 0 Pediatrics 0 0 0 22 0 0 0 0 0 0 20 0 26 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 21 0 31 0 0 0 0 0 0 0 0 0 29 0 0 0 0 0 0 21 0 31 0 0 0 0 0 0 0 0 0 1040.97 0 0 0 0 0 0 90.47 0 634.05 0 0 0 0 0 0 1765.49 0 0 1101372547 10 Physicians 200 Cook 0 1 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 76.96 0 0 0 0 0 0 76.96 0 0 1101372564 1699767129 10 Physicians KIM OLIVER 600680578 200 Cook 0 0 Clinical Pathology 0 0 0 3 0 0 0 0 0 0 756 0 187 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5723 0 226 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 5723 0 226 0 0 0 0 0 0 0 0 0 11.86 0 0 0 0 0 0 28793.01 0 13126.91 0 0 0 0 0 0 41931.78 0 0 1101372579 1093860249 47 Local Education Agencies YORKVILLE SCHOOL DISTRICT 115 605601499 55 Kendall 0 0 0 0 0 229 0 0 0 0 0 0 0 0 0 0 0 0 0 394 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 19105 0 0 0 0 479 0 0 0 0 0 0 0 0 0 0 0 0 0 19105 0 0 0 0 3277.32 0 0 0 0 0 0 0 0 0 0 0 0 0 545421.88 0 548699.2 0 0 1101372597 1558421875 10 Physicians HAWKINS JAMES 606291813 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 34 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 0 122 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4387.97 0 11688.59 0 0 0 0 0 0 16076.56 0 0 1101372607 1861638181 28 Waiver service provider--Supportive living facility (HFS) VICTORY CENTRE OF GALEWOOD 607072955 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 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5109 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586041.08 0 0 0 0 0 0 0 0 0 0 0 0 0 586041.08 0 0 1101372621 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 0 213 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 24947.52 0 0 0 0 0 0 0 0 0 0 0 0 0 24947.52 0 0 1101372624 1538188628 10 Physicians DRACHLER ARMIN M. 602011718 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58.96 0 1880.5 0 0 0 0 0 0 1939.46 0 0 1101372625 1205949484 10 Physicians BIRN ANNA 606303215 200 Cook 0 1 Family Practice 0 0 0 21 0 0 0 0 0 0 5 0 83 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 6 0 234 0 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 6 0 234 0 0 0 0 0 0 0 0 0 1636.4 0 0 0 0 0 0 31.4 0 5340.95 0 0 0 0 0 0 7008.75 0 0 1101372633 91 Waiver service provider--Adults (DHS/DDD) 40 Grundy 0 0 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 23826.6 0 0 0 0 0 0 0 0 0 0 0 0 0 23826.6 0 0 1101372643 1255418406 12 Optometrists MCMAHON TIMOTHY 606123748 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 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 0 686.8 0 0 0 0 0 0 686.8 0 0 1101372657 24 Speech Therapists 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 874.38 874.38 0 0 1101372682 1760423461 10 Physicians AWOFADEJU AYOOLA 339012699 57 Lake 0 0 Internal Medicine 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 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 2670.85 0 0 0 0 0 0 2670.85 0 0 1101372702 1588820351 10 Physicians HERNANDEZ PERAZA ZULMA 606127232 200 Cook 0 0 Neurology 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 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 2908.92 0 0 0 0 0 0 2908.92 0 0 1101372736 1952627259 30 General Hospitals FRESENIUS MEDICAL CARE LOMBARD 601486419 30 DuPage DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2281 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34048.9 0 0 0 0 0 34048.9 0 0 1101372752 55 Early Intervention Services 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 323.55 0 0 0 0 0 0 323.55 0 0 1101372763 10 Physicians 816 Iowa 0 0 Pediatric Endocrinology 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47.62 0 0 0 0 0 0 47.62 0 0 1101372808 1346497625 10 Physicians FRANCIS AMY 606313222 200 Cook 0 0 General Practice 0 0 0 6 0 0 0 0 0 0 0 0 35 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 686.35 0 0 0 0 0 0 0 0 4460.77 0 0 0 0 0 0 5147.12 0 0 1101372815 1922256601 10 Physicians KESSLER ERIC 600485364 57 Lake 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 0 195 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 0 960.81 0 0 0 0 0 0 960.81 0 0 1101372816 1255417382 10 Physicians DAYHOFF CLYDE 609151232 54 Kankakee 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 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 0 236.64 0 0 0 0 0 0 236.64 0 0 1101372828 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 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 0 150.36 150.36 0 0 1101372842 1366431686 75 Department of Alcohol and Substance Abuse Provider CHESTNUT HEALTH SYSTEMS WOMEN 617011429 72 McLean 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 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 4485.45 0 0 4485.45 0 0 1101372870 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 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 34.7 0 0 0 0 0 0 0 0 34.7 0 0 1101372873 1699798454 10 Physicians FELTMAN DALIA 602011718 200 Cook 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 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 10185.12 0 0 0 0 0 0 10185.12 0 0 1101372880 1871609859 10 Physicians OWCZAREK MIROSLAW 605638113 30 DuPage 0 0 Anesthesiology 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 1414.8 0 0 0 0 0 0 1414.8 0 0 1101372885 92 Waiver service provider--Disability (DHS/DRS) 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 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 3786.44 0 0 0 0 0 0 0 0 0 0 0 0 0 3786.44 0 0 1101372911 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 14091.21 0 0 0 0 0 0 0 0 0 0 0 0 0 14091.21 0 0 1101372913 2100363331 97 Waiver service provider--Children's residential (DHS/DDD) LITTLE CITY FOUNDATION 600674791 200 Cook 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 10307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10307 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4220415.96 0 0 0 0 0 0 0 0 0 0 0 0 0 4220415.96 0 0 1101372931 1861789000 22 Physical Therapists MUSSER COURTNEY 999999999 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 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 1406.77 1406.77 0 0 1101372938 1538173414 10 Physicians PULIDO ALEJANDRO 379321983 53 Kane 0 0 Family Practice 0 0 0 0 0 0 0 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 0 164.17 0 0 0 0 0 0 164.17 0 0 1101372941 1265481725 10 Physicians MEYER JONATHAN 606615763 200 Cook 0 0 Family Practice 0 0 0 0 0 0 0 0 0 0 30 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 387.55 0 0 0 0 0 0 0 0 387.55 0 0 1101372952 1639341662 64 Imaging Services UNITED IMAGING AND DIAGNOSTICS 600681171 200 Cook 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 1201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1201 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5118.34 0 0 0 0 0 0 5118.34 0 0 1101372969 1801814223 10 Physicians JARVIS MICHAEL 631101010 826 Missouri 0 0 Psychiatry 0 0 0 0 0 0 0 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 0 275.83 0 0 0 0 0 0 275.83 0 0 1101372972 10 Physicians 63 Macon 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 0 107.62 0 0 0 0 0 0 107.62 0 0 1101372973 1841361748 30 General Hospitals RONALD MCDONALDS CHILDRENS HSP 601533328 200 Cook CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 PERINATAL LEVEL III CENTER 0 0 0 0 284 0 0 0 0 103 0 0 0 1196 0 0 0 0 0 0 0 0 0 333 0 0 0 0 123 0 0 0 2477 0 0 0 0 0 0 0 0 0 335 0 0 0 0 1278 0 0 0 2821 0 0 0 0 0 0 0 0 0 60083.79 0 0 0 0 2790299.7 0 0 0 305072.54 0 0 0 0 0 3155456.03 0 0 1101372980 1801101555 10 Physicians BLANKEMEIER JULIE 600162335 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 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 37.51 0 0 0 0 0 0 37.51 0 0 1101373002 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 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 11811.48 0 0 0 0 0 0 0 0 0 0 0 0 0 11811.48 0 0 1101373012 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 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 1426.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1426.88 0 0 1101373018 1912900192 30 General Hospitals FOX VALLEY DIALYSIS LTD 605045502 53 Kane DIALYSIS Outpatient dialysis centers. 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 0 661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119589.91 0 0 0 0 0 119589.91 0 0 1101373037 1104061662 36 Community mental health provider ELM CITY REHABILITATION CTR 626502926 77 Morgan 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1965 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1965 0 0 217.08 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 120270.26 0 0 120487.34 0 0 1101373044 2100363462 91 Waiver service provider--Adults (DHS/DDD) RCAP ENTERPRISE INC 615268789 80 Peoria 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887568.47 0 0 0 0 0 0 0 0 0 0 0 0 0 887568.47 0 0 1101373054 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 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 6634.97 0 0 0 0 0 0 0 0 0 0 0 0 0 6634.97 0 0 1101373067 1083621544 10 Physicians BULL DOUGLAS 618203909 19 Champaign 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 7 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.81 0 3713.7 0 0 0 0 0 0 3803.51 0 0 1101373096 1265525729 10 Physicians OTTOLIN MARK 605407430 30 DuPage 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 96 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 1419.4 0 0 0 0 0 0 1419.4 0 0 1101373101 10 Physicians 200 Cook 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 49.22 0 0 0 0 0 0 49.22 0 0 1101373102 1023065984 10 Physicians INDYK ANDRZEJ 606302346 200 Cook 0 1 Family Practice 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 0 270 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 270 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 2808.77 0 0 0 0 0 0 2978.01 0 0 1101373124 1104819697 10 Physicians KAVANAUGH KENNETH 606781034 200 Cook 0 1 Family Practice 0 0 0 6 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 611.35 0 0 0 0 0 0 0 0 1284.34 0 0 0 0 0 0 1895.69 0 0 1101373144 1326266107 10 Physicians WOOD CATHERINE 600051069 200 Cook 0 1 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 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 34.22 0 0 0 0 0 0 34.22 0 0 1101373147 10 Physicians 80 Peoria 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 71.9 0 88.2 0 0 0 0 0 0 160.1 0 0 1101373165 1184641441 60 Pharmacies WAL MART 10 0792 612319400 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1397 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42271 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69721.78 0 0 0 69721.78 0 0 1101373169 1912052804 70 Ambulance Service Providers OAKWOOD EMERGENCY RESCUE 618589533 100 Vermilion 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 0 153 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 21878.46 0 0 0 0 0 0 21878.46 0 0 1101373178 1154331965 63 Other Providers of Medical Equipment/Supplies (Non-registered) APRIA HEALTHCARE 528061344 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 15033.04 0 0 0 0 0 0 15033.04 0 0 1101373209 1720038979 10 Physicians FAROOKI BASHEERUDDIN 606253532 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 348 0 0 0 0 0 0 0 0 0 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DIALYSIS 606295842 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 0 132 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1521 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170978.62 0 0 0 0 0 170978.62 0 0 1101373260 1972672715 10 Physicians SHAH ASHOK C 606131214 33 Effingham 0 1 Family Practice 0 0 0 4 0 0 0 0 0 0 4 0 135 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 6 0 691 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 6 0 691 0 0 0 0 0 0 0 0 0 57.6 0 0 0 0 0 0 12.41 0 4385.39 0 0 0 0 0 0 4455.4 0 0 1101373264 1235395930 10 Physicians RECHITSKY MICHAEL 606081732 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 629 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1015 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11719.58 0 285.04 0 0 0 0 0 0 12004.62 0 0 1101373272 2100363690 91 Waiver service provider--Adults (DHS/DDD) "DEVELOPMENTAL FOUNDATIONS, INC" 618223506 19 Champaign 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 18201 0 0 0 0 0 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Physicians 47 Jackson 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 0 315.84 0 0 0 0 0 0 315.84 0 0 1101377231 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 73.4 0 0 0 0 0 0 73.4 0 0 1101377232 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 22184.9 0 0 0 0 0 0 0 0 0 0 0 0 0 22184.9 0 0 1101377251 1548426919 10 Physicians URBASZEWSKI CLAIRE 600856165 57 Lake 0 0 Family Practice 0 0 0 1 0 0 0 0 0 0 2 0 13 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 29 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 0 29 0 0 0 0 0 0 0 0 0 84.62 0 0 0 0 0 0 0 0 295.53 0 0 0 0 0 0 380.15 0 0 1101377256 1972535102 10 Physicians WHITEHORN KAREN N 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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 23878.06 0 0 0 0 0 0 0 0 0 0 0 0 0 23878.06 0 0 1101382343 10 Physicians 22 Clay 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101382350 1609038579 10 Physicians ARTEMYEVA GALINA 605407430 30 DuPage 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1592.82 0 0 0 0 0 0 1592.82 0 0 1101382351 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 0 260 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 47848.4 0 0 0 0 0 0 0 0 0 0 0 0 0 47848.4 0 0 1101382362 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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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 2724.04 0 0 0 0 0 0 2724.04 0 0 1101382674 1376644435 16 Nurse Practitioners COLLINS TIMOTHY 606776926 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 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 0 229.86 0 0 0 0 0 0 229.86 0 0 1101382681 1891700076 60 Pharmacies BOND DRUG COMPANY OF IL 4939 605231203 30 DuPage 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 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3292 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6084.88 0 0 0 6084.88 0 0 1101382696 1124052030 10 Physicians PITTMAN DAVID 627032403 91 Sangamon 0 1 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 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 0 778.18 0 0 0 0 0 0 778.18 0 0 1101382717 92 Waiver service provider--Disability (DHS/DRS) 200 Cook 0 0 0 0 0 0 0 1 0 0 0 0 0 0 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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 23756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23756 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3463363.62 0 0 0 0 0 0 0 0 0 0 0 0 0 3463363.62 0 0 1101386595 1831112234 10 Physicians SABRI MOUSTAFA N 606313222 200 Cook 0 0 Cardiology 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 0 254 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 2014.08 0 0 0 0 0 0 2014.08 0 0 1101386600 1346281888 10 Physicians ROSANIA DAVID 606930623 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49.68 0 0 0 0 0 0 49.68 0 0 1101386604 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 0 226 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 24676.92 0 0 0 0 0 0 0 0 0 0 0 0 0 24676.92 0 0 1101386641 1225038532 10 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0 0 1101386668 1003955618 10 Physicians SHANLEY JOHN 370275339 57 Lake 0 0 Emergency 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 0 102 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 5856.17 0 0 0 0 0 0 5856.17 0 0 1101386686 91 Waiver service provider--Adults (DHS/DDD) 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 0 182 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 24073.98 0 0 0 0 0 0 0 0 0 0 0 0 0 24073.98 0 0 1101386701 60 Pharmacies 833 New York 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97303.78 0 0 0 97303.78 0 0 1101386722 1720033160 10 Physicians MAKS JONATHAN 600911824 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 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 0 673.13 0 0 0 0 0 0 673.13 0 0 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600842451 57 Lake 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 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2726 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 360569.66 0 0 0 0 0 0 0 360569.66 0 0 1101397745 1174540611 10 Physicians BACH RICHARD G 631304425 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 19 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 0 796.7 0 0 0 0 0 0 796.7 0 0 1101397748 1669402194 10 Physicians MASON LAWRENCE 611112754 109 Winnebago 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 3 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7438.24 0 0 0 0 0 0 7438.24 0 0 1101397761 1356348221 33 Nursing Facilities HELIA HEALTHCARE OF BELLEVILLE 622233808 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 21 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 2667 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 614293.9 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101398086 1902854623 30 General Hospitals CGH MEDICAL CENTER 610811278 106 Whiteside DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 Government Owned 0 0 0 0 1223 0 0 0 0 407 0 0 0 1786 0 0 0 0 0 0 0 0 0 2130 0 0 0 0 455 0 0 0 4938 0 0 0 0 0 0 0 0 0 2130 0 0 0 0 1782 0 0 0 4938 0 0 0 0 0 0 0 0 0 187202.92 0 0 0 0 181388.2 0 0 0 411507.2 0 0 0 0 0 780098.32 0 0 1101398089 1447228788 30 General Hospitals FREEPORT MEM HOSP 610324864 97 Stephenson DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 1191 0 0 0 0 282 0 0 0 1488 0 0 0 0 0 0 0 0 0 2161 0 0 0 0 327 0 0 0 4829 0 0 0 0 0 0 0 0 0 2161 0 0 0 0 1359 0 0 0 4885 0 0 0 0 0 0 0 0 0 198060.07 0 0 0 0 255099.63 0 0 0 368948.34 0 0 0 0 0 822108.04 0 0 1101398104 1598824039 10 Physicians ARONSON ROBERT 604355264 107 Will 0 0 Pulmonary Diseases 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 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"JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 233 0 50 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 800 0 98 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 800 0 98 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 170878.78 0 14589 0 0 0 0 0 2026.25 0 0 0 0 0 0 0 0 0 187494.03 0 0 1101401361 1285743955 10 Physicians BRYAN DOUGLAS 600987401 71 McHenry 0 0 Vascular Surgery 0 0 0 0 0 0 0 0 0 0 2 0 42 0 0 0 0 0 0 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 2 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17.62 0 2855.82 0 0 0 0 0 0 2873.44 0 0 1101401374 1245390285 60 Pharmacies SCHNUCKS PHARMACY 754 611081671 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14516.9 0 0 0 14516.9 0 0 1101401417 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 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Island 0 0 Radiation Oncology 0 0 0 0 0 0 0 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 0 223.6 0 0 0 0 0 0 223.6 0 0 1101409512 1558451716 36 Community mental health provider MENTAL HEALTH CENTERS 623631300 83 Pike 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 0 208 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 16871.85 0 0 16871.85 0 0 1101409522 98 Waiver service provider--TBI (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 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 9411.32 0 0 0 0 0 0 0 0 0 0 0 0 0 9411.32 0 0 1101409537 1942341409 10 Physicians OWAISI ANJUM 605638611 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 112 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 132105.24 0 0 0 0 0 0 132105.24 0 0 1101409579 1932161056 10 Physicians FRIEDMAN MICHAEL 606930623 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 46 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 504 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 159.32 0 4285.29 0 0 0 0 0 0 4444.61 0 0 1101409620 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 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 5040.12 5040.12 0 0 1101409626 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 15295.14 0 0 0 0 0 0 0 0 0 0 0 0 0 15295.14 0 0 1101409628 25 Audiologists 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 6.78 6.78 0 0 1101409638 1417289067 16 Nurse Practitioners WILLIAMS LINDSEY J 631666971 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 1420.52 0 0 0 0 0 0 1420.52 0 0 1101409646 16 Nurse Practitioners 852 Wisconsin 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101409651 1831140292 10 Physicians MITCHELL MICHAEL 605238723 30 DuPage 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 227 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 313 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3127.23 0 264.85 0 0 0 0 0 0 3392.08 0 0 1101409688 1265427033 63 Other Providers of Medical Equipment/Supplies (Non-registered) NORTHERN IL HOME MED SUPPLY 610814602 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 246 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2124 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41383.77 0 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82331 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16.06 0 0 116565.19 0 0 0 116581.25 0 0 1101409790 33 Nursing Facilities 53 Kane 0 0 0 0 0 0 0 0 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 0 410 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60450.36 0 0 0 0 0 0 0 60450.36 0 0 1101409797 1942289459 10 Physicians FLEISSNER MICHAEL 631312331 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 78 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 2434.87 0 0 0 0 0 0 2434.87 0 0 1101409819 1811997638 63 Other Providers of Medical Equipment/Supplies (Non-registered) MEDLINE INDUSTRIES INC 600604486 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1538 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14809 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14809 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 887369.02 0 92.72 0 0 0 0 887461.74 0 0 1101409828 1093720856 10 Physicians SEMENOV IRENE 600261361 200 Cook 0 0 Neurology 0 0 0 0 0 0 0 0 0 0 0 0 71 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 0 569.65 0 0 0 0 0 0 569.65 0 0 1101409856 1962495952 10 Physicians AZRAK ELIE 631366119 826 Missouri 0 0 Cardiology 0 0 0 0 0 0 0 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 0 211.85 0 0 0 0 0 0 211.85 0 0 1101409881 1477758555 10 Physicians ASHER YOGEN 606118709 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2721.49 0 0 0 0 0 0 2721.49 0 0 1101409885 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 14785.53 0 0 0 0 0 0 0 0 0 0 0 0 0 14785.53 0 0 1101409900 1235122466 12 Optometrists SNOWDEN CLAUD R 620952002 65 Madison 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 228 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 475 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10672.01 0 1434.72 0 0 0 0 12106.73 0 0 1101409911 1710941588 70 Ambulance Service Providers BUDS AMBULANCE SERVICE 604190659 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3992 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2083595.08 0 0 0 0 0 0 2083595.08 0 0 1101409924 1518035385 10 Physicians GOLDBERG STEVEN B. 600761838 200 Cook 0 1 Pediatrics 0 0 0 12 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 26 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 1151.01 0 0 0 0 0 0 0 0 490.34 0 0 0 0 0 0 1641.35 0 0 1101409949 10 Physicians 96 St Clair 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101409950 1013968262 39 Hospice GENESIS HOSPICE 527227709 816 Iowa 0 0 0 0 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 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99151.29 0 0 0 0 0 0 0 0 0 0 0 99151.29 0 0 1101409974 1952570509 47 Local Education Agencies CARY C C SCHOOL DIST 26 600131426 71 McHenry 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 0 0 0 0 116 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 5790 0 0 0 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 5790 0 0 0 0 793.13 0 0 0 0 0 0 0 0 0 0 0 0 0 80139.68 0 80932.81 0 0 1101409977 1700972999 10 Physicians SPIRTOVIC SUADA 604355765 107 Will 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 373.76 0 0 0 0 0 0 373.76 0 0 1101409998 1790915700 25 Audiologists PURDY JAMIE 627949639 91 Sangamon 0 0 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 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 2839.48 2839.48 0 0 1101410007 10 Physicians 852 Wisconsin 0 0 Surgery General 0 0 0 0 0 0 0 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 1101410010 1194986240 11 Dentists OSAN MARIA 604382711 200 Cook 0 0 Prosthodontist 0 0 24 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 4779.45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4779.45 0 0 1101410011 1235260357 24 Speech Therapists MOSEY GAIL P 604509649 40 Grundy 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 0 289 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 21009.66 21009.66 0 0 1101410025 1003843517 10 Physicians TAM MARIA 606576161 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.2 0 0 0 0 0 0 78.2 0 0 1101410027 1972533990 36 Community mental health provider COMPREHENSIVE CONNECTIONS 628648178 49 Jefferson 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1122 0 0 394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1122 0 0 15898.81 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126316.42 0 0 142215.23 0 0 1101410036 1437279130 74 Hospital-Based Transportation Providers MORRISON COMMUNITY HOSPITAL 612703042 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 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 1652 0 0 0 0 0 0 1652 0 0 1101410059 1295819688 16 Nurse Practitioners SHALLOW CHARLENE 627026700 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 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 1377.91 0 0 0 0 0 0 1377.91 0 0 1101410074 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 36548.1 0 0 0 0 0 0 0 0 0 0 0 0 0 36548.1 0 0 1101410080 1710182670 10 Physicians BAILEY MICHELE 606123849 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 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 92.09 0 0 0 0 0 0 92.09 0 0 1101410089 1164507604 48 Rural Health Clinics THOMAS H. BOYD MEMORIAL HOSPIT 620161436 39 Greene 0 1 Direct Access 0 202 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 560 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17701.72 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17701.72 0 0 1101410090 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 11733.56 0 0 0 0 0 0 0 0 0 0 0 0 0 11733.56 0 0 1101410092 1841295342 13 Podiatrists KULEKOWSKIS ANNMARIE 606184715 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1007 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6891.72 0 0 0 0 0 0 6891.72 0 0 1101410098 63 Other Providers of Medical Equipment/Supplies (Non-registered) 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 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 18012.08 0 0 0 0 0 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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 22672.68 0 0 0 0 0 0 22672.68 0 0 1101410182 1053490383 11 Dentists SHAH REENA 606116649 200 Cook 0 0 Pedodontics 0 0 21 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 1732.85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732.85 0 0 1101410202 1033245105 10 Physicians CHASANOV MAXIM 600041431 200 Cook 0 0 Psychiatry 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 0 266 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 5939.28 0 0 0 0 0 0 5939.28 0 0 1101410213 1851309041 10 Physicians BONAGURO RONALD 604532300 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 5 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 2108.29 0 0 0 0 0 0 2110.47 0 0 1101410231 1760631683 16 Nurse Practitioners ALLEN SUSAN 627011034 91 Sangamon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 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 3215.66 0 0 0 0 0 0 3215.66 0 0 1101410232 1841240322 10 Physicians AHMED MOHAMMED NADEEM 618012529 19 Champaign 0 0 Pediatrics 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 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 1473.75 0 0 0 0 0 0 1473.75 0 0 1101410247 92 Waiver service provider--Disability (DHS/DRS) 104 Wayne 0 0 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 4769.81 0 0 0 0 0 0 0 0 0 0 0 0 0 4769.81 0 0 1101410259 1225047921 10 Physicians ALSHAHROUR ADEEB 606392103 200 Cook 0 0 Obstetric-Gynecology 0 0 0 3 0 0 0 0 0 0 45 0 92 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 62 0 177 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 62 0 177 0 0 0 0 0 0 0 0 0 294.54 0 0 0 0 0 0 2735.86 0 9008.45 0 0 0 0 0 0 12038.85 0 0 1101410265 10 Physicians 200 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0 0 0 0 0 0 0 0 0 5420.16 0 0 0 0 0 0 17.6 0 2947.71 0 0 0 0 0 0 8385.47 0 0 1101415714 11 Dentists 96 St Clair 0 0 General Dentistry 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 802.16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 802.16 0 0 1101415721 1578844478 16 Nurse Practitioners BHATT VANCHHANA 600842452 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 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 1854.09 0 0 0 0 0 0 1854.09 0 0 1101415731 30 General Hospitals 824 Minnesota ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1131.37 0 0 1101415743 1932187259 10 Physicians RINK PETER 612656152 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 4 0 6 0 0 0 0 0 0 0 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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 7392.23 0 0 0 0 0 0 7392.23 0 0 1101415827 1326114091 10 Physicians LIPPITZ JONATHON 602011718 200 Cook 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 97 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 4533.31 0 0 0 0 0 0 4533.31 0 0 1101415829 1417962549 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 604264042 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 245 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 839 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33715.1 0 0 0 33715.1 0 0 1101415871 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 5754.65 0 0 0 0 0 0 0 0 0 0 0 0 0 5754.65 0 0 1101415890 97 Waiver service provider--Children's residential (DHS/DDD) 30 DuPage 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 757 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300211.04 0 0 0 0 0 0 0 0 0 0 0 0 0 300211.04 0 0 1101415898 91 Waiver service provider--Adults (DHS/DDD) 85 Pulaski 0 0 0 0 0 0 0 2 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 14092.31 0 0 0 0 0 0 0 0 0 0 0 0 0 14092.31 0 0 1101415917 1730183203 33 Nursing Facilities BALMORAL NURSING HOME 606251001 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 73 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 5627 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329514.46 0 0 0 0 0 0 0 329514.46 0 0 1101415946 16 Nurse Practitioners 36 Franklin 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 0 0 220.52 0 0 0 0 0 0 298.39 0 0 1101415954 1144345901 47 Local Education Agencies LINDOP SCHOOL DIST 92 601553930 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 29 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 591 0 0 0 0 25.9 0 0 0 0 0 0 0 0 0 0 0 0 0 12131.07 0 12156.97 0 0 1101415984 1205941234 60 Pharmacies METROPOLIS DRUGS 1 629602311 69 Massac 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 79 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 11306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12853.47 0 0 0 12853.47 0 0 1101415988 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 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 26196.64 0 0 0 0 0 0 0 0 0 0 0 0 0 26196.64 0 0 1101415996 1831157619 11 Dentists STARSIAK MARY A 606342623 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 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 2460.38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2460.38 0 0 1101416003 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 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 8156.11 0 0 0 0 0 0 0 0 0 0 0 0 0 8156.11 0 0 1101416029 1942240890 10 Physicians ISLAM NIGEL 477140541 815 Indiana 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 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 0 304.78 0 0 0 0 0 0 304.78 0 0 1101416039 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 12175.4 0 0 0 0 0 0 0 0 0 0 0 0 0 12175.4 0 0 1101416048 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 36.47 0 0 0 0 0 0 36.47 0 0 1101416058 1912286865 30 General Hospitals PALOS PARK DIALYSIS 604621162 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 37 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 0 0 0 0 0 0 0 0 0 1101416071 1134456742 10 Physicians ESPEL JULIA C 601228942 53 Kane 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 0 203 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 4289.19 0 0 0 0 0 0 4289.19 0 0 1101416097 1801809322 10 Physicians UCKERMAN MARY 601975979 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 556 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3676 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3676 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25852.97 0 5641.9 0 0 0 0 0 0 31494.87 0 0 1101416100 1326040981 13 Podiatrists SEHY STEPHEN 631321228 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 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 0 851 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2030.73 0 0 0 0 0 0 2030.73 0 0 1101416104 1871511568 10 Physicians BROOKS CHRISTOPHER 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1346315017 10 Physicians WIET RICHARD 606123844 200 Cook 0 0 Otolaryngology 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 0 230 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 4575.72 0 0 0 0 0 0 4575.72 0 0 1101416154 1336129642 48 Rural Health Clinics UNION COUNTY OUTPT HLTH CLINIC 629061668 99 Union 0 0 0 199 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12196.89 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12196.89 0 0 1101416157 92 Waiver service provider--Disability (DHS/DRS) 50 Jersey 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6317.88 0 0 0 0 0 0 0 0 0 0 0 0 0 6317.88 0 0 1101416180 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 2697.18 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 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1028.36 0 0 0 0 0 1028.36 0 0 1101416965 1487791091 16 Nurse Practitioners LEONARDI JOSEPH L 623012834 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 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 0 882.7 0 0 0 0 0 0 882.7 0 0 1101416967 2100407385 11 Dentists JOHNSON WILLIAM 615502027 98 Tazewell 0 0 Unspecified 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 457 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11936.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11936.75 0 0 1101416968 1720011919 10 Physicians DASSANI JITENDRA 606313222 200 Cook 0 0 Internal Medicine 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 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 443 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7360.74 0 0 0 0 0 0 7360.74 0 0 1101416984 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1073.59 0 0 0 0 0 0 1073.59 0 0 1101419134 1477509628 63 Other Providers of Medical Equipment/Supplies (Non-registered) DOUBEK MEDICAL SUPPLY INC 608032890 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1732 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16659 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16659 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1302400.63 0 116.76 0 0 0 0 1302517.39 0 0 1101419143 1932261484 10 Physicians LEVINE STACIE 605275965 30 DuPage 0 0 Geriatrics 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 0 286 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 1715.32 0 0 0 0 0 0 1715.32 0 0 1101419172 1558368803 10 Physicians BARTOLOMEO ORAZIO 600103347 57 Lake 0 1 Family Practice 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 40 0 0 0 0 0 0 0 0 0 1 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 0 647.73 0 0 0 0 0 0 647.73 0 0 1101419214 1235264441 24 Speech Therapists ROSENTHAL CHRISTINE 605380702 53 Kane 0 0 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0 0 0 0 0 0 0 0 0 7 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11.57 0 3529.97 0 0 0 0 0 0 3541.54 0 0 1101422504 1255610085 91 Waiver service provider--Adults (DHS/DDD) TESNOW DOUGLAS 606144946 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 1704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42660.21 0 0 0 0 0 0 0 0 0 0 0 0 0 42660.21 0 0 1101422511 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 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 16233.61 0 0 0 0 0 0 0 0 0 0 0 0 0 16233.61 0 0 1101422560 1043229974 10 Physicians BAKANAS ERIN 631600352 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 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 49.22 0 0 0 0 0 0 49.22 0 0 1101422585 1427096700 10 Physicians PISICK EVAN 600992676 57 Lake 0 0 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Bureau 0 0 Urology 0 0 0 0 0 0 0 0 0 0 94 0 313 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 1505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161 0 1505 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 917.73 0 13536.95 0 0 0 0 0 0 14454.68 0 0 1101422627 88 Other behavior health professional 101 Wabash 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 291.9 0 0 0 0 0 0 291.9 0 0 1101422636 1740576990 11 Dentists SHARMA PRIYANKA 605172657 30 DuPage 0 0 General Dentistry 0 0 26 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 2704.95 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2704.95 0 0 1101422649 1568567774 10 Physicians BERGMAN REBECCA 600693036 57 Lake 0 1 Pediatrics 0 0 0 7 0 0 0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 2 0 10 0 0 0 0 0 0 0 0 0 858.9 0 0 0 0 0 0 48.12 0 534.5 0 0 0 0 0 0 1441.52 0 0 1101422671 1275795841 10 Physicians SANTIAGO IVAN 618321100 100 Vermilion 0 0 Physical Medicine/Rehabilitation 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 0 531 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 5941.26 0 0 0 0 0 0 5941.26 0 0 1101422676 1770583072 10 Physicians FREMGEN MICHAEL 601343591 53 Kane 0 0 Emergency Medicine 0 0 0 1 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 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 0 111.36 0 0 0 0 0 0 0 0 174.93 0 0 0 0 0 0 286.29 0 0 1101422689 1558436600 33 Nursing Facilities STEARNS NURSING AND REHAB CTR 620404154 65 Madison 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 0 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 552150.12 0 0 0 0 0 0 0 552150.12 0 0 1101422696 1134164247 30 General Hospitals ARA SOUTH BARRINGTON DIALYSIS 600109115 57 Lake DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 989 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1463.04 0 0 0 0 0 1463.04 0 0 1101422727 1932484979 63 Other Providers of Medical Equipment/Supplies (Non-registered) UNITED SEATING AND MOBILITY 601485406 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 864 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1180401.08 0 0 0 0 0 0 1180401.08 0 0 1101422728 1639370539 10 Physicians MEYER SARA 637034911 826 Missouri 0 0 Obstetric-Gynecology 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 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71.9 0 89.56 0 0 0 0 0 0 161.46 0 0 1101422750 1316954373 10 Physicians STRZEMBOSZ ANDRE 630451315 826 Missouri 0 0 Radiology Diagnosis 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 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161.86 0 173.1 0 0 0 0 0 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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 4230.26 0 0 0 0 0 0 4230.26 0 0 1101423091 1477710051 10 Physicians ABHYANKAR ARCHANA 631032236 80 Peoria 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 26 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 611.55 0 0 0 0 0 0 0 0 611.55 0 0 1101423097 1487664561 30 General Hospitals PROVIDENT HOSPITAL OF COOK CO 606152400 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 0 Government Owned 0 0 0 0 1151 0 0 0 0 35 0 0 0 1295 0 0 0 0 0 0 0 0 0 1448 0 0 0 0 44 0 0 0 1979 0 0 0 0 0 0 0 0 0 1450 0 0 0 0 94 0 0 0 1982 0 0 0 0 0 0 0 0 0 1317463.96 0 0 0 0 402892.07 0 0 0 2175546.28 0 0 0 0 0 3895902.31 0 0 1101423113 1962703850 22 Physical Therapists STEARNS NOAH 629595256 108 Williamson 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 0 337 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 2631.88 2631.88 0 0 1101423140 1427150317 10 Physicians HARMON SUSAN M 626565066 62 Logan 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 1 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190.36 0 0 3499.91 0 0 0 0 0 0 3690.27 0 0 1101423168 1366423360 10 Physicians MASSAD LESLIE S 631600352 200 Cook 0 0 Obstetric-Gynecology 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 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 1046.93 0 0 0 0 0 0 1046.93 0 0 1101423177 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 0 0 0 0 0 0 0 0 0 0 1101423198 1598931719 10 Physicians COLAVINCENZO MARIA 606118709 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 116.37 0 0 0 0 0 0 116.37 0 0 1101423204 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3061.68 0 0 0 0 0 0 0 0 0 0 0 0 0 3061.68 0 0 1101423234 1225198849 10 Physicians TSONIS GEORGE 606941789 200 Cook 0 0 Emergency 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 0 114 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 4271.27 0 0 0 0 0 0 4271.27 0 0 1101423249 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 29760.09 0 0 0 0 0 0 0 0 0 0 0 0 0 29760.09 0 0 1101423257 1376501841 10 Physicians CHIEN SHELBY 333232815 25 Crawford 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4732.07 0 0 0 0 0 0 4732.07 0 0 1101423275 1023006566 32 Rehabilitation Hospitals SCHWAB REHAB HOSP 606081612 200 Cook REHAB Rehabilitation hospitals paid a Per Diem rate. 0 0 0 561 0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 1419 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 0 3224 0 0 0 0 0 0 0 857 0 0 0 0 0 0 0 0 0 0 220352.16 0 0 0 0 0 0 0 688544.35 0 0 0 0 0 0 0 0 0 908896.51 0 1760.35 1101423279 1013909480 10 Physicians ZHAO YAN 605151500 30 DuPage 0 0 Pathology 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 0 148 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 2249.47 0 0 0 0 0 0 0 0 2249.47 0 0 1101423281 1346251071 10 Physicians ANG STEPHEN 628013065 66 Marion 0 0 Gastroenterology 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 0 409 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 5920.28 0 0 0 0 0 0 5920.28 0 0 1101423294 1093980872 10 Physicians GRUNER CHARLES R 606930623 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 6 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57.37 0 6599.68 0 0 0 0 0 0 6657.05 0 0 1101423316 10 Physicians 852 Wisconsin 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 39.86 0 0 0 0 0 0 39.86 0 0 1101423319 1295754380 60 Pharmacies GALVA PHARMACY 614341710 45 Henry 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 0 288 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8215 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6757.17 0 0 0 6757.17 0 0 1101423320 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 0 161 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 19461.63 0 0 0 0 0 0 0 0 0 0 0 0 0 19461.63 0 0 1101423343 1245215854 10 Physicians GATTUSO PAOLO 436141509 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 127 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 329 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3445.24 0 104.76 0 0 0 0 0 0 3550 0 0 1101423353 2100413771 90 Waiver service provider--Elderly (DOA) CASA CENTRAL SOCIAL SVCS CORP 606222803 200 Cook 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 21312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21312 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2062588.71 0 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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 21641.25 0 0 0 0 0 0 0 0 0 0 0 0 0 21641.25 0 0 1101423515 10 Physicians 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87.08 0 0 0 0 0 0 87.08 0 0 1101423518 1639274624 10 Physicians TERRADO LOURDES R 605275965 30 DuPage 0 0 Internal Medicine 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 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5754.61 0 0 0 0 0 0 5754.61 0 0 1101423529 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 3152.63 0 0 0 0 0 0 0 0 0 0 0 0 0 3152.63 0 0 1101423549 1841231719 60 Pharmacies CVS PHARMACY 08512 604662366 200 Cook 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 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1003862400 10 Physicians GALVIN SHANNON 606118709 200 Cook 0 0 Infectious Diseases 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 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 1790.64 0 0 0 0 0 0 1790.64 0 0 1101424990 1841262789 10 Physicians PINEDA RAYMUND 629011472 47 Jackson 0 0 Internal Medicine 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 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 522 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6104.59 0 0 0 0 0 0 6104.59 0 0 1101424997 1174530489 30 General Hospitals PEKIN HOSPITAL 615544936 98 Tazewell DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 0 0 0 0 558 0 0 0 0 39 0 0 0 378 0 0 0 0 0 0 0 0 0 742 0 0 0 0 40 0 0 0 525 0 0 0 0 0 0 0 0 0 742 0 0 0 0 210 0 0 0 608 0 0 0 0 0 0 0 0 0 150489.6 0 0 0 0 137073.01 0 0 0 79862.83 0 0 0 0 0 367425.44 0 0 1101425022 1518921659 16 Nurse Practitioners CHERNY LILY 117474300 36 Franklin 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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 2310.95 0 0 0 0 0 0 2310.95 0 0 1101425964 1598857278 10 Physicians SHEPPARD SUSAN 617612281 72 McLean 0 1 Family Practice 0 0 0 1 0 0 0 0 0 0 15 0 78 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 19 0 207 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 19 0 207 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 141.74 0 4353.37 0 0 0 0 0 0 4600.07 0 0 1101425976 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 93.27 0 0 0 0 0 0 93.27 0 0 1101425977 1548440027 10 Physicians EGGENER SCOTT 605276686 30 DuPage 0 0 Urological Surgery 0 0 0 0 0 0 0 0 0 0 3 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1462.87 0 0 0 0 0 0 1462.87 0 0 1101426005 1881685071 10 Physicians HUSSAIN JABEEN 606222743 200 Cook 0 0 Psychiatry 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 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1065 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28284.45 0 0 0 0 0 0 28284.45 0 0 1101426007 1659373371 10 Physicians WISE STEPHEN 606081732 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 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 3798.33 0 0 0 0 0 0 3798.33 0 0 1101426008 1114905171 10 Physicians KUZNIAR TOMASZ 602011718 200 Cook 0 0 Internal Medicine 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 0 241 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 3412.14 0 0 0 0 0 0 3412.14 0 0 1101426011 1215925805 63 Other Providers of Medical Equipment/Supplies (Non-registered) QUAD CITY PROSTHETIC INC 612016865 89 Rock Island 0 0 0 0 0 0 0 0 0 0 0 0 0 0 77 0 209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 166 0 574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7864.82 0 94197.44 0 0 0 0 102062.26 0 0 1101426032 1447234273 12 Optometrists WILLINGHAM VICTORIA 629597678 108 Williamson 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 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 387 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8593.11 0 0 0 0 0 0 8593.11 0 0 1101426045 1972531507 10 Physicians JESSEN MELANIE 606405759 200 Cook 0 1 Family Practice 0 0 0 3 0 0 0 0 0 0 1 0 89 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 217 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 217 0 0 0 0 0 0 0 0 0 266.16 0 0 0 0 0 0 2.6 0 1419.75 0 0 0 0 0 0 1688.51 0 0 1101426078 1740400563 55 Early Intervention Services OTTEN CAROL A 601921723 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 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 3018.06 0 0 0 0 0 0 3018.06 0 0 1101426084 1427242452 10 Physicians JOBANPUTRA SMITA 604112619 200 Cook 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 35 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81 0 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1919.69 0 9185.3 0 0 0 0 0 0 11104.99 0 0 1101426091 1932371382 29 ICF/MR EDWARDSVILLE TERRACE 620253661 65 Madison 0 0 0 0 0 0 0 0 0 0 16 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 7186 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 808960.5 0 0 0 0 0 0 0 0 0 0 808960.5 0 0 1101426095 92 Waiver service provider--Disability (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 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 34927.95 0 0 0 0 0 0 0 0 0 0 0 0 0 34927.95 0 0 1101426096 1407048093 10 Physicians MOHAMMED NUMAIRUDDIN 605638669 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 676.24 0 0 0 0 0 0 676.24 0 0 1101426108 92 Waiver service provider--Disability (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2322 0 0 0 0 0 0 0 0 0 0 0 0 0 2322 0 0 1101426109 1639491756 16 Nurse Practitioners GIBSON KILEY L. 606731264 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 0 123 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 3150.01 0 0 0 0 0 0 3150.01 0 0 1101426122 1689976649 10 Physicians LIYANAPATABENDI CHOOL 606136211 200 Cook 0 0 Internal Medicine 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 1873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1873 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23509.66 0 0 0 0 0 0 23509.66 0 0 1101426138 10 Physicians 57 Lake 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 0 0 0 0 0 0 0 0 0 0 1101426141 1912952250 10 Physicians SCHUMER MATTHEW 637035095 826 Missouri 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 0 126 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 0 556.33 0 0 0 0 0 0 556.33 0 0 1101426148 1457582926 10 Physicians HASANAT REWA M 606118709 200 Cook 0 0 Family Practice 0 0 0 2 0 0 0 0 0 0 0 0 41 0 0 0 0 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 83 0 0 0 0 0 0 0 0 0 225.9 0 0 0 0 0 0 0 0 768.82 0 0 0 0 0 0 994.72 0 0 1101426173 1518062736 10 Physicians HAMILTON JONI LYNN 601022752 71 McHenry 0 1 Pediatrics 0 0 0 8 0 0 0 0 0 0 2 0 16 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 3 0 20 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 17.97 0 1026.71 0 0 0 0 0 0 1787.68 0 0 1101426182 1306974159 42 Waiver service provider--MFTD (HFS) ALMOST HOME KIDS 605409528 30 DuPage 0 0 0 0 0 0 0 6 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 2306 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 2306 0 0 0 0 0 0 0 0 0 0 0 28312.32 0 0 0 0 0 0 2186120.35 0 0 0 0 0 0 2214432.67 0 0 1101426184 1013173061 10 Physicians PERKINS SARAH 601533328 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 5 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 179 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.54 0 3523.37 0 0 0 0 0 0 3735.91 0 0 1101426193 1407955206 10 Physicians ROWLAND KENDRITH 618012530 19 Champaign 0 0 Oncology 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 0 180 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 2997.51 0 0 0 0 0 0 2997.51 0 0 1101426195 1689616815 13 Podiatrists FLEISCHLI JOHN G 627047452 91 Sangamon 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 0 337 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 2674.75 0 0 0 0 0 0 2674.75 0 0 1101426202 1811957251 46 Ambulatory Surgical Treatment Centers THE SURGERY CENTER OF CENTRALI 628013001 66 Marion ARS-LS Long-term stay hospitals paid under an ARS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38 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 2811.7 0 0 0 0 0 2811.7 0 0 1101426208 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 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 0 238.98 0 0 0 0 0 0 238.98 0 0 1101426216 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101426241 1235100546 10 Physicians SALHADAR ALIA 600681143 30 DuPage 0 0 Clinical Pathology 0 0 0 2 0 0 0 0 0 0 886 0 77 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5902 0 89 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 5902 0 89 0 0 0 0 0 0 0 0 0 11.86 0 0 0 0 0 0 28638.47 0 5025 0 0 0 0 0 0 33675.33 0 0 1101426242 1427019611 10 Physicians MUTCHNIK STEVEN 600761248 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 19 0 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 884 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33.04 0 5059.5 0 0 0 0 0 0 5092.54 0 0 1101426271 1952409765 30 General Hospitals MIDWEST MEDICAL CENTER 610368118 51 Jo Daviess DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 113 0 0 0 0 19 0 0 0 154 0 0 0 0 0 0 0 0 0 172 0 0 0 0 20 0 0 0 476 0 0 0 0 0 0 0 0 0 174 0 0 0 0 80 0 0 0 779 0 0 0 0 0 0 0 0 0 102541.59 0 0 0 0 2228.13 0 0 0 191698.82 0 0 0 0 0 296468.54 0 0 1101426305 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 2166.88 2166.88 0 0 1101426323 10 Physicians 108 Williamson 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 82.14 0 0 0 0 0 0 82.14 0 0 1101426327 1184619785 10 Physicians GOLDIN HARRY 600761231 200 Cook 0 0 Dermatology 0 0 0 0 0 0 0 0 0 0 1 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101.18 0 0 0 0 0 0 1101.18 0 0 1101426333 10 Physicians 815 Indiana 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 0 151.63 0 0 0 0 0 0 151.63 0 0 1101426342 1164418869 10 Physicians IBRAHIM DENISE 606740018 200 Cook 0 0 Orthopedic Surgery 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 10 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 184.59 0 1345.19 0 0 0 0 0 0 1529.78 0 0 1101426357 1548275738 60 Pharmacies WALGREEN CO 05603 601783303 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 487 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 71234 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38.62 0 0 119255.6 0 0 0 119294.22 0 0 1101426385 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 63.54 0 0 0 0 0 0 63.54 0 0 1101426386 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 0 128 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 7876.28 0 0 0 0 0 0 0 0 0 0 0 0 0 7876.28 0 0 1101426393 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 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 0 867.09 867.09 0 0 1101426399 1346494705 10 Physicians EMMERT DANIEL 631101010 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1203.28 0 0 0 0 0 0 1203.28 0 0 1101426410 1649434036 13 Podiatrists FRIEDRICH TIMOTHY 49154021 200 Cook 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 0 507 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 6163.94 0 0 0 0 0 0 6163.94 0 0 1101426412 1447487905 55 Early Intervention Services PLUMMER DEBRA 601082380 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 0 101 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 11281.18 0 0 0 0 0 0 11281.18 0 0 1101426424 1679650287 13 Podiatrists KAZMER GARY 606234313 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 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 0 112.63 0 0 0 0 0 0 112.63 0 0 1101426428 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 6952.76 0 0 0 0 0 0 0 0 0 0 0 0 0 6952.76 0 0 1101426431 1073550570 33 Nursing Facilities MANORCARE OF ELK GROVE VILLAGE 600072972 200 Cook 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 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7882 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1176146.13 0 0 0 0 0 0 0 1176146.13 0 0 1101426432 1538194600 10 Physicians KOWALSKI DAVID 624012003 33 Effingham 0 1 Internal Medicine 0 0 0 3 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 46 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 322.84 0 0 0 0 0 0 0 0 254.62 0 0 0 0 0 0 577.46 0 0 1101426440 1366601890 60 Pharmacies CVS PHARMACY 04368 463214066 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1447 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 586.95 0 0 0 586.95 0 0 1101426458 1114129673 47 Local Education Agencies SILVIS SCHOOL DISTRICT 34 612821579 89 Rock Island 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 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 527 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724.8 0 724.8 0 0 1101426461 1326094194 10 Physicians KLEIN TOM 606462514 200 Cook 0 0 Internal 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 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 696 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6663.67 0 0 0 0 0 0 6663.67 0 0 1101426466 1881803583 10 Physicians LORENCE ANNA 610368118 51 Jo Daviess 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 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 0 371.29 0 0 0 0 0 0 371.29 0 0 1101426497 2100416915 94 Waiver service provider--Children's support (DHS/DDD) JEWISH CHILD AND FAMILY SERVIC 600912933 200 Cook 0 0 0 0 0 0 0 22 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 11521.48 0 0 0 0 0 0 0 0 0 0 0 0 0 11521.48 0 0 1101426523 1740483262 10 Physicians LINAREZ ESTEBAN 603024463 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 77 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 1639.65 0 0 0 0 0 0 1639.65 0 0 1101426604 1043337660 63 Other Providers of Medical Equipment/Supplies (Non-registered) ROCKFORD ORTHOPEDIC APPL 611041015 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 267 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4414.77 0 40316.5 0 0 0 0 44731.27 0 0 1101426607 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 22038.06 0 0 0 0 0 0 0 0 0 0 0 0 0 22038.06 0 0 1101426613 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19809.44 0 0 0 0 0 0 0 0 0 0 0 0 0 19809.44 0 0 1101426625 1265688378 10 Physicians PARKER BRANDON 606112615 200 Cook 0 0 Pediatrics 0 0 0 0 0 0 0 0 0 0 2 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91.6 0 3217.27 0 0 0 0 0 0 3308.87 0 0 1101426641 1144256017 10 Physicians ALEXANDER JOHN 611082425 109 Winnebago 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 79 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 3706.79 0 0 0 0 0 0 3706.79 0 0 1101426644 1841289527 10 Physicians BONAMINIO PHYLLIS 604535574 200 Cook 0 0 Rheumatology 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 191.39 0 0 0 0 0 0 191.39 0 0 1101426660 1609039163 10 Physicians ABBAS HUMA 605064356 53 Kane 0 0 Psychiatry 0 0 0 0 0 0 0 0 0 0 0 0 30 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 3889.04 0 0 0 0 0 0 3889.04 0 0 1101426664 1083605067 10 Physicians YAJNIK SANTOSH 600077301 200 Cook 0 0 Radiation Oncology 0 0 0 0 0 0 0 0 0 0 0 0 44 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 2099.2 0 0 0 0 0 0 2099.2 0 0 1101426669 10 Physicians 200 Cook 0 0 Cardiology 0 0 0 0 0 0 0 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 47.62 0 0 0 0 0 0 47.62 0 0 1101426678 1104065291 13 Podiatrists BRYNICZKA ADAM 601772274 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 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 0 225.44 0 0 0 0 0 0 225.44 0 0 1101426695 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 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 18315.96 0 0 0 0 0 0 0 0 0 0 0 0 0 18315.96 0 0 1101426698 10 Physicians 200 Cook 0 1 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 0 114.19 0 0 0 0 0 0 114.19 0 0 1101426711 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 1384.24 0 0 0 0 0 0 0 0 0 0 0 0 0 1384.24 0 0 1101426717 1588866040 47 Local Education Agencies SCHUYLER INDUSTRY CUSD 5 626811048 92 Schuyler 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 2642 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0 0 0 2642 0 0 0 0 533.7 0 0 0 0 0 0 0 0 0 0 0 0 0 29827.23 0 30360.93 0 0 1101426718 1073623336 10 Physicians BRETSCHER MARY 627032403 91 Sangamon 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 18 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 6276.76 0 0 0 0 0 0 6276.76 0 0 1101426747 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 28182.08 0 0 0 0 0 0 0 0 0 0 0 0 0 28182.08 0 0 1101426761 16 Nurse Practitioners 23 Clinton 0 0 0 0 0 0 0 0 0 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 86.36 0 0 0 0 0 0 86.36 0 0 1101426765 1881925055 10 Physicians LIN VICKY C 600071405 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 8 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.9 0 1573.23 0 0 0 0 0 0 1805.13 0 0 1101426768 1154319994 10 Physicians BAKIR MOUHAMAD 627949369 91 Sangamon 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 1 0 0 334 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 681 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 226.65 0 0 9277.38 0 0 0 0 0 0 9504.03 0 0 1101426775 1487832804 91 Waiver service provider--Adults (DHS/DDD) RESIDENTIAL OPTIONS INC 62002 65 Madison 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 22914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4107306.06 0 0 0 0 0 0 0 0 0 0 0 0 0 4107306.06 0 0 1101426794 1073597795 10 Physicians GELLER STEVEN 606734477 200 Cook 0 0 Pulmonary Diseases 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 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 567 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3831.63 0 0 0 0 0 0 3831.63 0 0 1101426795 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 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 3549.72 3549.72 0 0 1101426801 1285678383 10 Physicians VON FISCHER BENJAMIN 953586411 200 Cook 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 0 104 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 3906.77 0 0 0 0 0 0 3906.77 0 0 1101426803 1124179817 13 Podiatrists ANDERSON NICOLAS 605462082 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53 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 1384.96 0 0 0 0 0 0 1384.96 0 0 1101426811 1487668224 10 Physicians VARGA PETER 606162332 200 Cook 0 0 Pediatric Cardiology 0 0 0 0 0 0 0 0 0 0 2 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 195.37 0 15984.56 0 0 0 0 0 0 16179.93 0 0 1101426824 92 Waiver service provider--Disability (DHS/DRS) 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 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 0 657.52 0 0 0 0 0 0 0 0 0 0 0 0 0 657.52 0 0 1101426826 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 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3071.2 3071.2 0 0 1101426842 1417103623 10 Physicians LEE GRACE 606751611 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 48 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 4354.95 0 0 0 0 0 0 4354.95 0 0 1101426859 1477668929 10 Physicians SHAH PALMI N 606751611 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 1549 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2534 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2534 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15490.82 0 5.86 0 0 0 0 0 0 15496.68 0 0 1101426886 1366510166 60 Pharmacies MEDICAP PHARMACY 629062039 99 Union 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 0 790 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23254 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17753.41 0 0 0 17753.41 0 0 1101426894 1336185511 16 Nurse Practitioners ROBISON SHERI 615544969 98 Tazewell 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 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2063.44 0 0 0 0 0 0 2063.44 0 0 1101426906 1689674038 36 Community mental health provider ALEXIAN BROTHERS CENTER FOR ME 600047814 200 Cook 0 0 17 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 90 0 0 30 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1375 0 0 30 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1375 0 0 1185.36 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 48928.38 0 0 50133.74 0 0 1101426908 1710928700 10 Physicians GARCIA RAMON 606313222 200 Cook 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 0 225 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 3757.39 0 0 0 0 0 0 3757.39 0 0 1101426911 1235391921 10 Physicians DURKIN MICHAEL J 631600352 200 Cook 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 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 0 201.92 0 0 0 0 0 0 201.92 0 0 1101426916 1851394548 10 Physicians CHEN CORY Y 606930623 200 Cook 0 1 Internal Medicine 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 2 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 142 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.6 0 1898.24 0 0 0 0 0 0 1910.84 0 0 1101426919 2100417337 16 Nurse Practitioners MELICK EMILY 630433411 49 Jefferson 0 0 0 0 0 0 0 0 0 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 2090.68 0 0 0 0 0 0 2090.68 0 0 1101426922 10 Physicians 53 Kane 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 0 0 0 0 0 0 0 0 0 0 1101426936 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 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1946.13 0 0 0 0 0 0 0 0 0 1946.13 0 0 1101426944 1063715878 29 ICF/MR CONRAD HOUSE 606601017 200 Cook 0 0 0 0 0 0 0 0 0 0 12 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 8275 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1060595.09 0 0 0 0 0 0 0 0 0 0 1060595.09 0 0 1101426960 1134100688 10 Physicians ALTSHULER BARRY 600101700 57 Lake 0 1 Pediatrics 0 0 0 18 0 0 0 0 0 0 8 0 33 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 10 0 44 0 0 0 0 0 0 0 0 0 59 0 0 0 0 0 0 10 0 44 0 0 0 0 0 0 0 0 0 1873.01 0 0 0 0 0 0 40.56 0 2475.32 0 0 0 0 0 0 4388.89 0 0 1101426969 1558336248 63 Other Providers of Medical Equipment/Supplies (Non-registered) NOVACAREPROSTHETICSORTHOTICS 637034928 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 217.2 0 1012.58 0 0 0 0 1229.78 0 0 1101426970 22 Physical Therapists 109 Winnebago 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 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 1148.85 1148.85 0 0 1101426991 1336246800 10 Physicians HORNER TIMOTHY 618321100 100 Vermilion 0 1 Family Practice 0 0 0 5 0 0 0 0 0 0 19 0 72 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 48 0 108 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 48 0 108 0 0 0 0 0 0 0 0 0 470.77 0 0 0 0 0 0 266.33 0 2140.02 0 0 0 0 0 0 2877.12 0 0 1101426998 1972576833 10 Physicians MCGEE EDWIN 606910263 200 Cook 0 0 Thoracic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 26 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 27011.41 0 0 0 0 0 0 27011.41 0 0 1101427028 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 14420.45 0 0 0 0 0 0 0 0 0 0 0 0 0 14420.45 0 0 1101427035 1760532709 10 Physicians QAMAR IZHAR 606371447 200 Cook 0 0 Pediatrics 0 0 0 101 0 0 0 0 0 0 80 0 102 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 344 0 249 0 0 0 0 0 0 0 0 0 284 0 0 0 0 0 0 344 0 249 0 0 0 0 0 0 0 0 0 7736.65 0 0 0 0 0 0 4953.81 0 15517.68 0 0 0 0 0 0 28208.14 0 0 1101427045 1174591663 10 Physicians GILVYDIS RIMVYDAS 601344200 53 Kane 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25.25 0 526.95 0 0 0 0 0 0 552.2 0 0 1101427048 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 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 0 831.24 0 0 0 0 0 0 0 0 0 0 0 0 0 831.24 0 0 1101427056 1801862818 10 Physicians JANUARY CRAIG 535625531 200 Cook 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 209.95 0 0 0 0 0 0 209.95 0 0 1101427067 1891885695 12 Optometrists KAPOOR BHANU 600671848 200 Cook 0 0 Therapeutic Pharmaceutical Agents 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 0 292 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 8286.67 0 0 0 0 0 0 8286.67 0 0 1101427069 1811151806 10 Physicians TOKHI ASHISH 627047450 91 Sangamon 0 0 Internal Medicine 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 0 122 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 3612.58 0 0 0 0 0 0 3612.58 0 0 1101427077 1174560353 10 Physicians KABATAY LEE HO MARIA RHODORA 615544936 98 Tazewell 0 1 Family Practice 0 0 0 2 0 0 0 0 0 0 3 0 32 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 0 85 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 3 0 85 0 0 0 0 0 0 0 0 0 177.7 0 0 0 0 0 0 11.58 0 1318.22 0 0 0 0 0 0 1507.5 0 0 1101427119 1700817400 10 Physicians SHARMA VIKAS V 605275965 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7837.27 0 0 0 0 0 0 7837.27 0 0 1101427136 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19122.91 0 0 0 0 0 0 0 0 0 0 0 0 0 19122.91 0 0 1101427137 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 15725.44 0 0 0 0 0 0 0 0 0 0 0 0 0 15725.44 0 0 1101427139 1912103714 10 Physicians SIBOL MICHAEL P 606313222 200 Cook 0 0 Physical Medicine/Rehabilitation 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 0 220 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 3789.07 0 0 0 0 0 0 3789.07 0 0 1101427148 1487655726 10 Physicians LABAO ISRAEL D 608042218 200 Cook 0 1 Family Practice 0 0 0 1 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 51 0 0 0 0 0 0 0 0 0 169.24 0 0 0 0 0 0 0 0 1591.78 0 0 0 0 0 0 1761.02 0 0 1101427161 1548224132 10 Physicians THOMASSON JEFFREY L. 631417129 96 St Clair 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 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 0 393.1 0 0 0 0 0 0 0 0 393.1 0 0 1101427172 1871546390 16 Nurse Practitioners GIACALONE LAURA 605638113 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 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 0 444 0 0 0 0 0 0 444 0 0 1101427175 1972560688 60 Pharmacies ALLIANCERX WALGREENS PRIME #16 152751213 839 Pennsylvania 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 0 172 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 504144.24 0 0 0 504144.24 0 0 1101427181 1013285352 11 Dentists CINCIONE ALEXIS 606324949 200 Cook 0 0 General Dentistry 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 796.8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 796.8 0 0 1101427182 1891860664 63 Other Providers of Medical Equipment/Supplies (Non-registered) HANGER PROSTHETICS ORTHOTICS 600507012 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 139 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1012.98 0 21853.08 0 0 0 0 22866.06 0 0 1101427193 1699707851 10 Physicians SABAHAT ALVIA 601975940 30 DuPage 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 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 0 445.57 0 0 0 0 0 0 445.57 0 0 1101427214 1801802277 60 Pharmacies WALGREENS #13106 606177334 200 Cook 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 0 789 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22337 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41660.14 0 0 0 41660.14 0 0 1101427219 1821184193 10 Physicians ALBARCHA BASSAM 622012989 96 St Clair 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 0 164 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 2029.3 0 0 0 0 0 0 2029.3 0 0 1101427220 1588865091 10 Physicians HENTZELMAN JOSHUA 622062822 96 St Clair 0 0 Otorhinolaryngology 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 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 3954.12 0 0 0 0 0 0 3954.12 0 0 1101427232 1073741666 10 Physicians NELSON KENT 606733039 200 Cook 0 1 Pediatrics 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 2338.12 0 0 0 0 0 0 2338.12 0 0 1101427239 1083703383 10 Physicians WAQAR SAIAMA 631101010 826 Missouri 0 0 Oncology 0 0 0 0 0 0 0 0 0 0 0 0 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 0 153.23 0 0 0 0 0 0 153.23 0 0 1101427273 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 5 0 0 0 0 0 0 0 0 0 0 0 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HURLEY MARY 60612 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 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 2713.61 0 0 0 0 0 0 2713.61 0 0 1101427369 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 4523.19 0 0 0 0 0 0 0 0 0 0 0 0 0 4523.19 0 0 1101427391 1407856974 70 Ambulance Service Providers S E LIVINGSTON CTY AMBULANCE 617391068 61 Livingston 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 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 478 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99672.8 0 0 0 0 0 0 99672.8 0 0 1101427414 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 19096.44 0 0 0 0 0 0 0 0 0 0 0 0 0 19096.44 0 0 1101427416 98 Waiver 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0 0 0 0 0 0 0 357 0 83 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5485.54 0 1332.41 0 0 0 0 0 0 6817.95 0 0 1101427523 10 Physicians 80 Peoria 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 2.24 0 0 0 0 0 0 2.24 0 0 1101427549 10 Physicians 13 Boone 0 0 Gynecology 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 943.2 0 0 0 0 0 0 943.2 0 0 1101427554 1275721250 10 Physicians PISANO JENNIFER 606053113 200 Cook 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 20 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 0 509.25 0 0 0 0 0 0 509.25 0 0 1101427556 1568412203 16 Nurse Practitioners KARAM MAYA 606313222 200 Cook 0 0 0 0 0 3 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 81 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 81 0 0 0 0 0 0 0 0 0 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0 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20797.61 0 0 0 0 0 0 0 0 0 0 0 0 0 20797.61 0 0 1101427702 1548417827 36 Community mental health provider THRESHOLDS 609015547 54 Kankakee 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1091 0 0 68 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1091 0 0 4356.84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100304.24 0 0 104661.08 0 0 1101427708 1245537943 16 Nurse Practitioners HELDT ANGELA 609012901 54 Kankakee 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 0 100 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 1334.23 0 0 0 0 0 0 1334.23 0 0 1101427727 30 General Hospitals 66 Marion DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 0 0 0 0 0 0 0 0 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 1101427740 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 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 0 157.48 0 0 0 0 0 0 157.48 0 0 1101427752 1881699080 10 Physicians MUNOZ GILBERTO 606118709 200 Cook 0 1 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 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 0 512.81 0 0 0 0 0 0 512.81 0 0 1101427768 1114934148 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 607141408 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 541 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 2643 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 84100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 231.72 0 0 217347.49 0 0 0 217579.21 0 0 1101427776 1962623827 10 Physicians WIETFELDT ELIZABETH 627949248 91 Sangamon 0 0 Colon - Rectal Surgery 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 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 0 740.33 0 0 0 0 0 0 740.33 0 0 1101427778 1730123902 10 Physicians MERCADO SERGIO 605045895 30 DuPage 0 0 Family Practice 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 0 364 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 1920.13 0 0 0 0 0 0 1920.13 0 0 1101427815 10 Physicians 80 Peoria 0 0 Orthopedic Surgery 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101427832 1598019010 16 Nurse Practitioners BRANDT MEGAN 610811252 106 Whiteside 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 0 217 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 2954.57 0 0 0 0 0 0 2954.57 0 0 1101427842 1326230087 10 Physicians GEISENDORFER ABRAM 623014038 10 Adams 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 2 0 102 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1.09 0 19144.04 0 0 0 0 0 0 19145.13 0 0 1101427844 1063508190 10 Physicians OLIVIER MILDRED 601691062 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 5 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 221 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 525.76 0 0 0 0 0 0 525.76 0 0 1101427848 1649499476 10 Physicians FETZER MARTIN 606740018 200 Cook 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 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 0 444.49 0 0 0 0 0 0 444.49 0 0 1101427876 1225090590 10 Physicians BABU AMBIKA 606123723 200 Cook 0 0 Endocrinology 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 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 0 389.28 0 0 0 0 0 0 389.28 0 0 1101427879 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78.34 0 0 0 0 0 0 78.34 0 0 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COMMUNITY HOSPITAL 623631350 83 Pike DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 General Hospital - Adult and Child 1 0 0 0 401 0 0 0 0 41 0 0 0 380 0 0 0 0 0 4 0 0 0 704 0 0 0 0 45 0 0 0 890 0 0 0 0 0 4 0 0 0 704 0 0 0 0 160 0 0 0 890 0 0 0 0 0 192.73 0 0 0 159678.09 0 0 0 0 17472.76 0 0 0 283388.53 0 0 0 0 0 460732.11 0 0 1101428931 1679679658 10 Physicians DRAKE TIMOTHY 627949248 91 Sangamon 0 1 Internal Medicine 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 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 0 317.71 0 0 0 0 0 0 317.71 0 0 1101428973 1659592624 10 Physicians NADEEM AHMED 731279711 109 Winnebago 0 0 Emergency 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 0 161 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 5027.04 0 0 0 0 0 0 5027.04 0 0 1101428980 92 Waiver service provider--Disability (DHS/DRS) 83 Pike 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 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0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 10744.8 0 0 0 0 0 0 0 0 0 0 0 0 0 10744.8 0 0 1101429131 2100419549 10 Physicians ROBIN JASON C 602011700 200 Cook 0 0 Internal Medicine 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 0 525 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 3443.79 0 0 0 0 0 0 3443.79 0 0 1101429136 1235147216 22 Physical Therapists EDMONDS RACHEL 629950095 52 Johnson 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 0 251 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 2171.57 2171.57 0 0 1101429137 1063610319 10 Physicians OWOSO AKINKUNLE 631101010 826 Missouri 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 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 1081.07 0 0 0 0 0 0 1081.07 0 0 1101429143 1487859054 55 Early Intervention 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0 0 0 1 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 105 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5429.01 0 0 0 0 0 0 5429.01 0 0 1101429218 1790840916 10 Physicians CUTTER THOMAS 605615314 30 DuPage 0 0 Anesthesiology 0 0 0 0 0 0 0 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 3473.25 0 0 0 0 0 0 3473.25 0 0 1101429261 1215983374 10 Physicians NEWMAN REBECCA L 606116649 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 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 3889.7 0 0 0 0 0 0 3889.7 0 0 1101429268 1336172121 10 Physicians KONANUR RAMAPRASAD 617613558 72 McLean 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 60 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 3378.94 0 0 0 0 0 0 3378.94 0 0 1101429282 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 5.39 0 0 0 0 0 0 5.39 0 0 1101429319 1205095528 10 Physicians BUCHANAN AMY 601533328 200 Cook 0 1 Family Practice 0 0 0 6 0 0 0 0 0 0 1 0 37 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 9 0 0 0 0 0 0 1 0 57 0 0 0 0 0 0 0 0 0 491.4 0 0 0 0 0 0 5.17 0 1034.36 0 0 0 0 0 0 1530.93 0 0 1101429320 1821012410 10 Physicians GOPI SHANTHI 605171437 200 Cook 0 1 Pediatrics 0 0 0 131 0 0 0 0 0 0 6 0 121 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 8 0 240 0 0 0 0 0 0 0 0 0 401 0 0 0 0 0 0 8 0 240 0 0 0 0 0 0 0 0 0 14766.7 0 0 0 0 0 0 86.02 0 11133.78 0 0 0 0 0 0 25986.5 0 0 1101429369 1376745166 10 Physicians NICEWICZ MARIA JOLANTA 606313716 200 Cook 0 1 Pediatrics 0 0 0 71 0 0 0 0 0 0 21 0 66 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 38 0 109 0 0 0 0 0 0 0 0 0 212 0 0 0 0 0 0 38 0 109 0 0 0 0 0 0 0 0 0 7262 0 0 0 0 0 0 998.35 0 7973.68 0 0 0 0 0 0 16234.03 0 0 1101429385 1518166461 10 Physicians MOHIUDDIN MOHTASHAM 606081732 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 432 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4737.42 0 0 0 0 0 0 4737.42 0 0 1101429413 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39639.2 0 0 0 0 0 0 0 0 0 0 0 0 0 39639.2 0 0 1101429440 33 Nursing Facilities 823 Michigan 0 0 0 0 0 0 0 0 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 0 181 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71130 0 0 0 0 0 0 0 71130 0 0 1101429454 1548204662 16 Nurse Practitioners SANTANGELO SUSAN 609013661 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 548.98 0 0 0 0 0 0 548.98 0 0 1101429489 1538372800 10 Physicians OGDEN MARGARET ALLISON 631600352 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 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 0 155.88 0 0 0 0 0 0 155.88 0 0 1101429493 1598806929 10 Physicians WITTKOPF MARIA 600052382 200 Cook 0 0 Otorhinolaryngology 0 0 0 0 0 0 0 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 0 856.19 0 0 0 0 0 0 856.19 0 0 1101429508 1568480374 10 Physicians LEHMAN JOHN J 622265359 96 St Clair 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 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 538 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1951.04 0 0 0 0 0 0 1951.04 0 0 1101429522 91 Waiver service provider--Adults (DHS/DDD) 64 Macoupin 0 0 0 0 0 0 0 4 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 13573.88 0 0 0 0 0 0 0 0 0 0 0 0 0 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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 15465.12 0 0 0 0 0 0 0 0 0 0 0 0 0 15465.12 0 0 1101436564 1235216425 10 Physicians JULKA RAHUL 605151550 30 DuPage 0 0 Gastroenterology 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 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4069.38 0 0 0 0 0 0 4069.38 0 0 1101436578 1063477438 10 Physicians KERN BRIAN 753120288 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 0 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 112 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3959.95 0 0 0 0 0 0 3959.95 0 0 1101436599 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 23170.05 0 0 0 0 0 0 0 0 0 0 0 0 0 23170.05 0 0 1101436603 1942421144 10 Physicians AHMED ACHAL 600146260 200 Cook 0 0 Endocrinology 0 0 0 0 0 0 0 0 0 0 1 0 58 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 131 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 6.3 0 2399.54 0 0 0 0 0 0 2405.84 0 0 1101436606 1477660256 10 Physicians RIERMAIER MICHAEL 601232304 53 Kane 0 1 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 8 0 82 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 164 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 8 0 164 0 0 0 0 0 0 0 0 0 104.96 0 0 0 0 0 0 618.25 0 18588.63 0 0 0 0 0 0 19311.84 0 0 1101436613 1700859360 12 Optometrists BECKER KEVIN 623014038 10 Adams 0 0 Therapeutic Pharmaceutical Agents 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 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 458 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7550.21 0 0 0 0 0 0 7550.21 0 0 1101436621 1720064736 10 Physicians FENG TIAN B 617612281 72 McLean 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1413.01 0 0 0 0 0 0 1413.01 0 0 1101436635 1447277967 16 Nurse Practitioners POTTER DAVID 63110 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 780.55 0 0 0 0 0 0 780.55 0 0 1101436646 1053305540 10 Physicians DAVIS DAVID 619384693 24 Coles 0 0 Family Practice 0 0 0 4 0 0 0 0 0 0 7 0 87 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 10 0 349 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 10 0 349 0 0 0 0 0 0 0 0 0 342.65 0 0 0 0 0 0 91.6 0 3334.54 0 0 0 0 0 0 3768.79 0 0 1101436661 1679518518 10 Physicians AIJAZ MAIMOONA 605670192 30 DuPage 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 7 0 49 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 213 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 53.38 0 3361.3 0 0 0 0 0 0 3414.68 0 0 1101436680 60 Pharmacies 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 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 0 141 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.79 0 0 0 42.79 0 0 1101436682 1669586228 16 Nurse Practitioners MINORE LAURA J 611112754 109 Winnebago 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 80.61 0 0 0 0 0 0 80.61 0 0 1101436698 1427076124 10 Physicians LUEDER GREGG 631600352 80 Peoria 0 0 Ophthalmology 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 3 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 59 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2161.56 0 0 0 0 0 0 2161.56 0 0 1101436701 1720078884 10 Physicians KODWANI NAND 630213802 826 Missouri 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4411.19 0 0 0 0 0 0 4411.19 0 0 1101436714 1861756090 60 Pharmacies CVS PHARMACY 2375 601153020 27 Dekalb 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17673 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15463.38 0 0 0 15463.38 0 0 1101436719 1528020690 10 Physicians AMATO LAWRENCE J 600731302 30 DuPage 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 0 292 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 1011.62 0 0 0 0 0 0 1011.62 0 0 1101436739 1811903073 10 Physicians LINDSTROM STEPHANIE 616360001 98 Tazewell 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 16 0 0 0 0 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 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 935.78 0 0 0 0 0 0 935.78 0 0 1101436748 1780660878 28 Waiver service provider--Supportive living facility (HFS) POINTE AT KILPATRICK 604452399 200 Cook 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 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7809 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 764029.03 0 0 0 0 0 0 0 0 0 0 0 0 0 764029.03 0 0 1101436810 1932153103 10 Physicians GORDON ALEXANDER 600162359 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 43 0 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 83 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 274.13 0 3867.55 0 0 0 0 0 0 4141.68 0 0 1101436856 1417181116 10 Physicians CONCEPCION FREDERMAN 602011700 200 Cook 0 0 Cardiovascular Diseases 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 1146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1146 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9763.31 0 0 0 0 0 0 9763.31 0 0 1101436859 1497958912 10 Physicians YU-TUNGOL DEBBIE C 601228942 53 Kane 0 1 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 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 0 853.99 0 0 0 0 0 0 853.99 0 0 1101436863 1710085998 16 Nurse Practitioners VEENSTRA BRITTNEY 627949248 91 Sangamon 0 0 0 0 0 0 0 0 0 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 2767.83 0 0 0 0 0 0 2767.83 0 0 1101436884 2100427302 10 Physicians TABAKIN NEIL 191824246 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 0 136.66 0 0 0 0 0 0 136.66 0 0 1101436891 1992891238 63 Other Providers of Medical Equipment/Supplies (Non-registered) COMFORT MEDICAL LLC 330657603 810 Florida 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 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 82445.43 0 0 0 0 0 0 82445.43 0 0 1101436955 1508894981 28 Waiver service provider--Supportive living facility (HFS) BARTON SENIOR RESIDENCE CHGO 606081244 200 Cook 0 0 0 0 0 0 0 43 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 6272 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 724363.92 0 0 0 0 0 0 0 0 0 0 0 0 0 724363.92 0 0 1101436960 1235173675 10 Physicians DAVILA VICTOR G 631600352 88 Richland 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 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 59.39 0 0 0 0 0 0 59.39 0 0 1101436970 1699779538 10 Physicians SMITH DANIEL 625491224 63 Macon 0 1 Family 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 47 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 4 0 47 0 0 0 0 0 0 0 0 0 77.87 0 0 0 0 0 0 6.62 0 791.47 0 0 0 0 0 0 875.96 0 0 1101436980 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 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 1101436983 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 14790.38 0 0 0 0 0 0 0 0 0 0 0 0 0 14790.38 0 0 1101437000 1437182979 10 Physicians STEVOFF CHRISTIAN 601533304 200 Cook 0 0 Gastroenterology 0 0 0 0 0 0 0 0 0 0 0 0 67 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 2348.45 0 0 0 0 0 0 2348.45 0 0 1101437001 1447280284 30 General Hospitals LORETTO HOSPITAL 606445059 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 General Hospital - Adult and Child 3 0 0 0 933 0 0 0 0 411 0 0 0 154 0 0 0 0 0 3 0 0 0 1243 0 0 0 0 486 0 0 0 277 0 0 0 0 0 11 0 0 0 1304 0 0 0 0 2967 0 0 0 544 0 0 0 0 0 25.96 0 0 0 225811.01 0 0 0 0 1511348.14 0 0 0 34463.06 0 0 0 0 0 1771648.17 0 0 1101437034 1972601243 10 Physicians KWEDAR JOHN 627949248 91 Sangamon 0 0 Ophthalmology 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 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 121 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2901.8 0 0 0 0 0 0 2901.8 0 0 1101437040 1396725016 63 Other Providers of Medical Equipment/Supplies (Non-registered) ROTECH 520037730 816 Iowa 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 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 0 881.6 0 0 0 0 0 0 881.6 0 0 1101437088 1629067038 10 Physicians SRECKOVIC GEORGE 604632391 200 Cook 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 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 152 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 803.61 0 0 0 0 0 0 803.61 0 0 1101437092 1275584153 55 Early Intervention Services CHIRIKOS DEBBIE 601029685 71 McHenry 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 8047.65 0 0 0 0 0 0 8047.65 0 0 1101437094 1790731180 60 Pharmacies OSCO DRUG 3720 604416631 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33 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 7232 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22329.61 0 0 0 22329.61 0 0 1101437113 1689665572 33 Nursing Facilities HERITAGE HEALTH CHILLICOTHE 615232258 80 Peoria 0 0 0 0 0 0 0 0 0 0 0 0 0 28 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 3321 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463311.14 0 0 0 0 0 0 0 463311.14 0 0 1101437126 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 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 971.36 971.36 0 0 1101437140 1992097174 60 Pharmacies MARIANOS PHARMACY 8502 600611538 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3897 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9506.31 0 0 0 9506.31 0 0 1101437141 1184727984 10 Physicians MANNIX CHRISTINA 631952334 200 Cook 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 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 1769.42 0 0 0 0 0 0 1769.42 0 0 1101437286 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 0 224 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 28607.78 0 0 0 0 0 0 0 0 0 0 0 0 0 28607.78 0 0 1101437304 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 40117.17 0 0 0 0 0 0 0 0 0 0 0 0 0 40117.17 0 0 1101437325 1396760203 10 Physicians RAPOPORT MYRA I 600685802 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 644 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 859 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5959.42 0 311.93 0 0 0 0 0 0 6271.35 0 0 1101437342 1649492133 47 Local Education Agencies GRANT COMM CONS SCH DIST 110 622082422 96 St Clair 0 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 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 713 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8688.31 0 8688.31 0 0 1101437349 1275514366 10 Physicians VANOSDOL THOMAS 601374418 30 DuPage 0 0 Allergy-Immunization 0 0 0 0 0 0 0 0 0 0 0 0 18 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 3657.53 0 0 0 0 0 0 3657.53 0 0 1101437350 1962678268 12 Optometrists KROHN AUSTIN C 623013257 10 Adams 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 0 218 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 3181.15 0 0 0 0 0 0 3181.15 0 0 1101437367 1861658668 16 Nurse Practitioners HORINEK JENNIFER 616151941 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 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 0 150.23 0 0 0 0 0 0 150.23 0 0 1101437394 1831486802 55 Early Intervention Services RUSSELL KRISTINA 606106639 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 0 143 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 10095.86 0 0 0 0 0 0 10095.86 0 0 1101437399 1255369641 10 Physicians TJARKS MARY 612656897 89 Rock Island 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177.44 0 134.9 0 0 0 0 0 0 312.34 0 0 1101437411 1871737486 16 Nurse Practitioners ABSOLAM MICHELLE 600475292 57 Lake 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 0 121 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 3593.56 0 0 0 0 0 0 3593.56 0 0 1101437412 1114998713 10 Physicians STONE ARVEY M 606731285 200 Cook 0 0 Internal Medicine 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 0 229 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 4934.8 0 0 0 0 0 0 4934.8 0 0 1101437435 1942401906 47 Local Education Agencies FREEBURG C C SCHOOL DIST 70 622431534 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 669 0 0 0 0 0 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0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 684.82 0 0 0 0 0 0 684.82 0 0 1101454587 1821366063 16 Nurse Practitioners ALLISON CAROLINE E 605638113 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 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 0 584.67 0 0 0 0 0 0 584.67 0 0 1101454594 1851575039 10 Physicians KHAN AHMIR H 600102542 57 Lake 0 0 Neurology 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 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 0 135.41 0 1031.5 0 0 0 0 0 0 1166.91 0 0 1101454612 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 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 29496.68 0 0 0 0 0 0 0 0 0 0 0 0 0 29496.68 0 0 1101454622 1184660052 30 General Hospitals ARA CRYSTAL LAKE DIALYSIS LLC 600147933 71 McHenry DIALYSIS Outpatient dialysis centers. 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101454629 1760457204 46 Ambulatory Surgical Treatment Centers ORTHOPAEDIC SURGERY CTR OF IL 627046487 91 Sangamon ASTC Ambulatory Surgical Treatment Center. 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 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 3651.62 0 0 0 0 0 3651.62 0 0 1101454636 2100445054 91 Waiver service provider--Adults (DHS/DDD) LAND OF LINCOLN GOODWILL IND. 627026310 91 Sangamon 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2053 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 126416.46 0 0 0 0 0 0 0 0 0 0 0 0 0 126416.46 0 0 1101454655 10 Physicians 89 Rock Island 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 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 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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 28748.77 0 0 0 0 0 0 0 0 0 0 0 0 0 28748.77 0 0 1101454810 1942219639 13 Podiatrists THORNTON MARTHA 612311365 74 Mercer 0 0 0 0 0 0 0 0 0 0 0 0 0 0 57 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 1087.39 0 0 0 0 0 0 1087.39 0 0 1101454822 1316101181 10 Physicians ABRAHAM ALIN 601228942 200 Cook 0 1 Internal Medicine 0 0 0 6 0 0 0 0 0 0 0 0 34 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 69 0 0 0 0 0 0 0 0 0 372.85 0 0 0 0 0 0 0 0 1230.28 0 0 0 0 0 0 1603.13 0 0 1101454837 30 General Hospitals 845 Texas NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 459.86 0 0 0 0 0 0 0 0 22.45 0 0 0 0 0 482.31 0 0 1101454868 1437324084 10 Physicians PATEL AMIT 606740018 200 Cook 0 0 Urology 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 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 57 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 89.35 0 1173.11 0 0 0 0 0 0 1262.46 0 0 1101454885 1558451716 36 Community mental health provider MENTAL HEALTH CENTERS OF W ILL 623531300 14 Brown 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 285 0 0 17.96 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8266.89 0 0 8284.85 0 0 1101454904 1245215938 16 Nurse Practitioners KENDRICKS LORETTA 623012834 10 Adams 0 0 0 0 0 0 0 0 0 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 0 174.82 0 0 0 0 0 0 174.82 0 0 1101454999 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 0 102 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 23984.89 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 19 0 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94.33 0 339.4 0 0 0 0 0 0 433.73 0 0 1101455157 1053404343 10 Physicians WONG SZE 606162013 200 Cook 0 1 Pediatrics 0 0 0 6 0 0 0 0 0 0 0 0 172 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 526 0 0 0 0 0 0 0 0 0 470.88 0 0 0 0 0 0 0 0 8950.3 0 0 0 0 0 0 9421.18 0 0 1101455165 1376639062 16 Nurse Practitioners WOLTER MATTHEW P 618012529 19 Champaign 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 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 0 446.2 0 0 0 0 0 0 446.2 0 0 1101455167 1457346280 10 Physicians CHIMATA MURTHY 464107035 815 Indiana 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 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 0 871.88 0 0 0 0 0 0 0 0 871.88 0 0 1101455171 1629003397 10 Physicians KIM HOWARD 606173983 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 584 0 144 0 0 0 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Physicians STEHLING DUSTIN 627949248 91 Sangamon 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 36 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 85 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2102.57 0 5685.97 0 0 0 0 0 0 7788.54 0 0 1101464855 1053351353 10 Physicians DE LOS SANTOS MIGDONIA M 606121925 200 Cook 0 1 General Practice 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 0 548 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 2571.95 0 0 0 0 0 0 2571.95 0 0 1101464864 2100455282 12 Optometrists JONES DEBORAH S 616152170 80 Peoria 0 0 Therapeutic Pharmaceutical Agents 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 0 320 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 7459.67 0 0 0 0 0 0 7459.67 0 0 1101464878 1457330870 40 Federally Qualified Health Centers FRIEND FAMILY HLTH CTR WEST 606361526 200 Cook 0 1 0 271 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 774 0 164 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 35 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2059.43 0 0 0 0 0 0 2059.43 0 0 1101465230 1104811967 70 Ambulance Service Providers VILLAGE OF BOLINGBROOK 604403825 107 Will 0 0 0 0 0 0 0 0 0 0 0 0 0 0 743 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2098 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2446839.06 0 0 0 0 0 0 2446839.06 0 0 1101465258 1518112267 10 Physicians TATKA KEITH 705083870 200 Cook 0 0 Emergency 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 326.7 0 0 0 0 0 0 326.7 0 0 1101465267 1043267461 10 Physicians DIETERICH MARK 602011718 200 Cook 0 0 Pathology 0 0 0 0 0 0 0 0 0 0 99 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 199 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2234.83 0 9.71 0 0 0 0 0 0 2244.54 0 0 1101465284 1639169998 12 Optometrists WEINGART RONALD 611071439 109 Winnebago 0 0 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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 41.68 0 0 0 0 0 0 41.68 0 0 1101465543 1164756664 16 Nurse Practitioners WEST DEREK M 477061510 31 Edgar 0 0 0 0 0 0 0 0 0 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 47.62 0 0 0 0 0 0 47.62 0 0 1101465549 1487871232 10 Physicians MCCORMICK ANNA 627810001 91 Sangamon 0 0 Emergency Medicine 0 0 0 0 0 0 0 0 0 0 1 0 189 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 205 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5574.66 0 0 0 0 0 0 5574.66 0 0 1101465553 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 24371.16 0 0 0 0 0 0 0 0 0 0 0 0 0 24371.16 0 0 1101465570 1124126966 60 Pharmacies CVS PHARMACY 01170 604311202 107 Will 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 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Cook 0 0 Obstetric-Gynecology 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 0 491.58 0 0 0 0 0 0 491.58 0 0 1101474809 1205830981 10 Physicians DAHAL RAJENDRA 612821804 89 Rock Island 0 0 Nephrology 0 0 0 0 0 0 0 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 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 4843.62 0 0 0 0 0 0 4843.62 0 0 1101474819 1699773101 10 Physicians EPSTEIN BRAD 601234991 53 Kane 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 0 338.78 0 0 0 0 0 0 338.78 0 0 1101474826 1245260082 10 Physicians SCHMIDT LANA 624011268 33 Effingham 0 0 Dermatology 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 0 293 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 2443.31 0 0 0 0 0 0 2443.31 0 0 1101474833 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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 2680.34 0 0 0 0 0 0 2680.34 0 0 1101484284 10 Physicians 816 Iowa 0 0 Infectious Diseases 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66.4 0 0 0 0 0 0 66.4 0 0 1101484317 10 Physicians 200 Cook 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 0 0 0 0 0 0 0 0 0 0 1101484329 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 5321.88 0 0 0 0 0 0 0 0 0 0 0 0 0 5321.88 0 0 1101484336 1174534564 10 Physicians TABRIZ MUHAMMAD 604631025 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 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 670 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6674.8 0 0 0 0 0 0 0 0 0 0 0 0 0 6674.8 0 0 1101484561 1598883076 10 Physicians TIPIRNENI SAMATHA 618012529 19 Champaign 0 0 Physical Medicine/Rehabilitation 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 0 107 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 3408.65 0 0 0 0 0 0 3408.65 0 0 1101484567 1629148739 63 Other Providers of Medical Equipment/Supplies (Non-registered) P & O CARE 622081342 96 St Clair 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 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 351 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50886.26 0 0 0 0 50886.26 0 0 1101484570 1700997301 10 Physicians TRIPATHY NEENA 618012529 19 Champaign 0 1 Pediatrics 0 0 0 39 0 0 0 0 0 0 0 0 56 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 3504.66 0 0 0 0 0 0 0 0 2457.77 0 0 0 0 0 0 5962.43 0 0 1101484578 24 Speech 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30 General Hospitals MARKHAM RENAL CENTER 999999999 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 177 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2024 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26345.69 0 0 0 0 0 26345.69 0 0 1101484649 1972845998 16 Nurse Practitioners VENTIMIGLIA AMANDA 620404701 65 Madison 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 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 0 420.23 0 0 0 0 0 0 420.23 0 0 1101484650 1275695470 30 General Hospitals WARNER HOSPITAL AND HEALTH SER 617272272 28 De Witt DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42.18 0 0 0 0 0 42.18 0 0 1101484659 1023034188 10 Physicians NOWELL ANA 606575147 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 248.28 0 0 0 0 0 0 248.28 0 0 1101485717 1992907455 47 Local Education Agencies BLACKHAWK AREA SP ED DIST 865 612444428 89 Rock Island 0 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 5818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85166.85 0 85166.85 0 0 1101485720 1285663328 40 Federally Qualified Health Centers LAKE COUNTY HEALTH DEPARTMENT 600353110 57 Lake 0 1 0 331 0 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1221 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1221 0 356 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81075.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81075.4 0 0 1101485725 1255659587 10 Physicians RAJJOUB MOHANNAD 616151941 80 Peoria 0 0 Obstetric-Gynecology 0 0 0 3 0 0 0 0 0 0 59 0 109 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 246 0 271 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 246 0 271 0 0 0 0 0 0 0 0 0 72.84 0 0 0 0 0 0 7906.6 0 17875.73 0 0 0 0 0 0 25855.17 0 0 1101485738 10 Physicians 24 Coles 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 50.54 0 0 0 0 0 0 0 0 50.54 0 0 1101485740 1982727830 10 Physicians FERRERA DEAN 463739487 80 Peoria 0 0 Cardiovascular Diseases 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 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 0 752.06 0 0 0 0 0 0 752.06 0 0 1101485744 1306898960 30 General Hospitals ST VINCENT HOSPITAL 462601902 815 Indiana NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 9 0 0 0 0 3 0 0 0 5 0 0 0 0 0 0 0 0 0 10 0 0 0 0 3 0 0 0 5 0 0 0 0 0 0 0 0 0 10 0 0 0 0 25 0 0 0 5 0 0 0 0 0 0 0 0 0 1574.85 0 0 0 0 16217.78 0 0 0 60.87 0 0 0 0 0 17853.5 0 0 1101485758 1063410868 10 Physicians CHANIN MATTHEW P 452132664 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 18 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 4 0 0 0 0 0 0 23123.1 0 0 0 0 0 0 0 0 0 0 0 1505.4 0 0 0 0 24628.5 0 0 1101486262 1265486690 10 Physicians BUFALINO VINCENT 605406520 30 DuPage 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 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 0 111.74 0 0 0 0 0 0 111.74 0 0 1101486271 30 General Hospitals 200 Cook ARS-LS Long-term stay hospitals paid under an ARS 0 0 General Hospital - Adult and Child 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1101486273 10 Physicians 836 Ohio 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 14.23 0 0 0 0 0 0 0 0 14.23 0 0 1101486280 1245331602 11 Dentists JAIN MANOHAR 601013843 30 DuPage 0 0 General Dentistry 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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Pharmacies WALGREENS #12109 463242408 200 Cook 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 0 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3548 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3795.37 0 0 0 3795.37 0 0 1101499205 1366469629 60 Pharmacies WALMART PHARMACY 10-0747 622062537 96 St Clair 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 0 932 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25955 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22525.08 0 0 0 22525.08 0 0 1101499232 1457345381 10 Physicians PAPIERSKI PAUL 601814297 30 DuPage 0 0 Surgery Hand 0 0 0 0 0 0 0 0 0 0 6 0 13 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 99.93 0 0 0 0 0 0 99.93 0 0 1101499254 1942553490 29 ICF/MR HAMMOND HOUSE 606211201 200 Cook 0 0 0 0 0 0 0 0 0 0 11 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 7270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 655497.28 0 0 0 0 0 0 0 0 0 0 655497.28 0 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Macon 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 5227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 290969.64 0 0 0 0 0 0 0 0 0 0 0 0 0 290969.64 0 0 1101500133 10 Physicians 815 Indiana 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151.32 0 0 0 0 0 0 151.32 0 0 1101500147 1457576993 47 Local Education Agencies LAGRANGE SCHOOL DISTRICT 102 605261802 200 Cook 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 309 0 0 0 0 30.16 0 0 0 0 0 0 0 0 0 0 0 0 0 6898.39 0 6928.55 0 0 1101500166 1992704332 10 Physicians PATEL SAMIR 625213882 63 Macon 0 1 Pediatrics 0 0 0 37 0 0 0 0 0 0 5 0 50 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 5 0 79 0 0 0 0 0 0 0 0 0 3002.91 0 0 0 0 0 0 36.87 0 2806.03 0 0 0 0 0 0 5845.81 0 0 1101500175 1770648917 40 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Practitioners LOCKART BARBARA 606112991 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 0 938.19 0 0 0 0 0 0 938.19 0 0 1101500985 1760782650 16 Nurse Practitioners WHITLATCH TERESA 606731258 200 Cook 0 1 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 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 1707.79 0 0 0 0 0 0 1707.79 0 0 1101501015 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 0 208 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 27016.66 0 0 0 0 0 0 0 0 0 0 0 0 0 27016.66 0 0 1101501029 1932497922 16 Nurse Practitioners WEAVER REBECCA J. 616151941 80 Peoria 0 0 General Psychiatry Residency 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2686.77 0 0 0 0 0 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Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 36 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5183.05 0 0 0 0 0 0 5183.05 0 0 1101505361 1720279573 10 Physicians RUBAN DMITRY 605047205 30 DuPage 0 0 Neurology 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 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 3453.77 0 0 0 0 0 0 3453.77 0 0 1101505365 10 Physicians 815 Indiana 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 224.17 0 0 0 0 0 0 224.17 0 0 1101505397 10 Physicians 850 Washington 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 52.94 0 0 0 0 0 0 0 0 52.94 0 0 1101505400 1265418933 16 Nurse Practitioners CUNNINGHAM DEBRA M 631418573 53 Kane 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 15 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 85.65 0 0 0 0 0 0 0 0 1388.14 0 0 0 0 0 0 1473.79 0 0 1101505414 1689769531 10 Physicians KAMBEROS NATALIE 601545716 200 Cook 0 0 Pediatric Hematology Oncology 0 0 0 0 0 0 0 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 2230.12 0 0 0 0 0 0 2230.12 0 0 1101505419 1750369419 10 Physicians CONNOLLY EDWARD 612656133 89 Rock Island 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 63 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 124 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1796.1 0 3815.81 0 0 0 0 0 0 5611.91 0 0 1101505421 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 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 102.8 0 0 0 0 0 0 102.8 0 0 1101505458 1174694343 12 Optometrists 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90 Waiver service provider--Elderly (DOA) HENRY COUNTY HEALTH DEPT 614438319 45 Henry 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 3893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3893 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 220328.55 0 0 0 0 0 0 0 0 0 0 0 0 0 220328.55 0 0 1101505495 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 12735.53 0 0 0 0 0 0 0 0 0 0 0 0 0 12735.53 0 0 1101505504 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 0 230 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 26883.02 0 0 0 0 0 0 0 0 0 0 0 0 0 26883.02 0 0 1101505524 1073508172 10 Physicians ATASSI MOHAMAD 604622627 200 Cook 0 0 Cardiology 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 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3505.11 0 0 0 0 0 0 3505.11 0 0 1101505533 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 7498.32 0 0 0 0 0 0 0 0 0 0 0 0 0 7498.32 0 0 1101505538 1922100742 10 Physicians PLATTNER PAUL 618012529 19 Champaign 0 0 Orthopedic Surgery 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 0 122 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 3859.54 0 0 0 0 0 0 3859.54 0 0 1101505557 1720279045 16 Nurse Practitioners PACHOLSKI-TOMAKA CATHERINE 605276686 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 0 151 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 11055.9 0 0 0 0 0 0 11055.9 0 0 1101505578 1972508398 10 Physicians SAFI MALAZ 622062822 96 St Clair 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 373 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31.39 0 5430.36 0 0 0 0 0 0 5461.75 0 0 1101505579 1316243751 63 Other Providers of Medical Equipment/Supplies (Non-registered) FAIRMEADOWS HOME HEALTH CENTER 463192932 815 Indiana 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 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 0 406.77 0 0 0 0 0 0 406.77 0 0 1101505584 1538150107 16 Nurse Practitioners TRUJILLO HANSEN DANNEILLE 629595209 108 Williamson 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 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 3036 0 0 0 0 0 0 3036 0 0 1101505587 2100496005 25 Audiologists OREILLY VICTORIA 604023483 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 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 0 336.92 336.92 0 0 1101505618 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 0 224 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 17728.92 0 0 0 0 0 0 0 0 0 0 0 0 0 17728.92 0 0 1101505655 1982775631 30 General Hospitals CENTER FOR RENAL REPLACEMENT 607121735 200 Cook DIALYSIS Outpatient dialysis centers. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19 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 1890 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7620.39 0 0 0 0 0 7620.39 0 0 1101505663 1790703916 10 Physicians PATEL PARAG 600681130 200 Cook 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 420 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.64 0 8426.49 0 0 0 0 0 0 8434.13 0 0 1101505667 94 Waiver service provider--Children's support (DHS/DDD) 82 Piatt 0 0 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 1042.88 0 0 0 0 0 0 0 0 0 0 0 0 0 1042.88 0 0 1101505670 1033153325 70 Ambulance Service Providers VILLAGE OF SOUTH CHICAGO HTS 604114815 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 106 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 165276.84 0 0 0 0 0 0 165276.84 0 0 1101505672 1417944109 10 Physicians KATZ ARTHUR H 463213927 200 Cook 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 4 0 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1096 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1096 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81.21 0 10031.39 0 0 0 0 0 0 10112.6 0 0 1101505704 1245227842 16 Nurse Practitioners JULIAN STIEGEL EDITHA E 600478444 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 345.39 0 0 0 0 0 0 345.39 0 0 1101505705 1366487969 10 Physicians GANJU ARUNA 606118702 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 1 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 1.33 0 948.25 0 0 0 0 0 0 949.58 0 0 1101505718 1497735385 63 Other Providers of Medical Equipment/Supplies (Non-registered) NEUMANNS HOME MEDICAL 605062831 53 Kane 0 0 0 0 0 0 0 0 0 0 0 0 0 0 151 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1733 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28189.29 0 0 0 0 0 0 28189.29 0 0 1101505728 1134259781 10 Physicians SPARROW ROBERT 616033168 80 Peoria 0 0 Surgery General 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 0 337 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 10024.66 0 0 0 0 0 0 10024.66 0 0 1101505755 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 49.22 0 0 0 0 0 0 49.22 0 0 1101505781 1881609048 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 605405323 30 DuPage 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 0 131 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4380 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3152.86 0 0 0 3152.86 0 0 1101505782 1235144478 60 Pharmacies BOND DRUG COMPANY OF ILLINOIS 617611007 72 McLean 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 1309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40919 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 69142.81 0 0 0 69142.81 0 0 1101505810 1336167030 10 Physicians HRUSKA KEITH A. 631101002 200 Cook 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 5 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.25 0 1376.52 0 0 0 0 0 0 1378.77 0 0 1101505832 1760462246 10 Physicians MASSARANI-WAFAI RAZAN 601545716 200 Cook 0 0 Clinical Pathology 0 0 0 0 0 0 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.95 0 0 0 0 0 0 0 0 20.95 0 0 1101505878 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 17537.94 0 0 0 0 0 0 0 0 0 0 0 0 0 17537.94 0 0 1101505888 1497931729 10 Physicians SKYLES JASON K. 631417129 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 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80.64 0 0 0 0 0 0 0 0 80.64 0 0 1101505895 10 Physicians 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 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 0 101.21 0 0 0 0 0 0 101.21 0 0 1101505898 1851306575 10 Physicians MACWAN KAMLESH 616370001 80 Peoria 0 0 Neonatology 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 0 104 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 48005.3 0 0 0 0 0 0 48005.3 0 0 1101505904 16 Nurse Practitioners 31 Edgar 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 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47 Local Education Agencies MT VERNON TWP HS DIST 201 628644140 49 Jefferson 0 0 0 0 0 75 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 888 0 0 0 0 144 0 0 0 0 0 0 0 0 0 0 0 0 0 888 0 0 0 0 1014.84 0 0 0 0 0 0 0 0 0 0 0 0 0 58370.45 0 59385.29 0 0 1101506022 1093867921 10 Physicians PAWLOWSKI THOMAS 606221449 200 Cook 0 1 Family Practice 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 0 416 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 3149.27 0 0 0 0 0 0 3149.27 0 0 1101506025 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 1101506050 1669564738 10 Physicians LIU JOSEPH 616151941 80 Peoria 0 1 Family Practice 0 0 0 3 0 0 0 0 0 0 37 0 78 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 42 0 179 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 42 0 179 0 0 0 0 0 0 0 0 0 279.22 0 0 0 0 0 0 124.04 0 4018.65 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0 0 10 0 0 0 0 0 0 0 0 58 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 233 0 0 0 0 0 0 0 0 0 901.61 0 0 0 0 0 0 0 0 3738.48 0 0 0 0 0 0 4640.09 0 0 1101506403 1205934395 10 Physicians DARWEESH MUTAZZ HAJ 604631428 200 Cook 0 1 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 0 320 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 6790.47 0 0 0 0 0 0 6790.47 0 0 1101506408 1073786612 29 ICF/MR TORRENCE PLACE 604115125 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 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 893599.77 0 0 0 0 0 0 0 0 0 0 893599.77 0 0 1101506414 2100496832 90 Waiver service provider--Elderly (DOA) JAPANESE AMERICAN SERVICE COMM 606405403 200 Cook 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 3449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3449 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 346298.94 0 0 0 0 0 0 0 0 0 0 0 0 0 346298.94 0 0 1101506435 1700815123 10 Physicians LAZARUS MARTIN 600257657 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 361 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 483 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8205.12 0 49.04 0 0 0 0 0 0 8254.16 0 0 1101506442 1104829886 10 Physicians TURGUT TANSEL 625264163 63 Macon 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 593 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4144.08 0 0 0 0 0 0 4144.08 0 0 1101506454 1649269580 10 Physicians MEHAFFEY MARY G 601873152 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 6 0 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 539.56 0 0 0 0 0 0 539.56 0 0 1101506459 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101506542 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 0 195 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 14554.84 0 0 0 0 0 0 0 0 0 0 0 0 0 14554.84 0 0 1101506548 1851343123 16 Nurse Practitioners FERNAU STEPHEN P. 605638113 30 DuPage 0 0 0 0 0 0 0 0 0 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 0 152.14 0 0 0 0 0 0 152.14 0 0 1101506553 1083664106 10 Physicians SENESE MARIANNE 601262816 30 DuPage 0 0 Pediatrics 0 0 0 43 0 0 0 0 0 0 4 0 31 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 4 0 39 0 0 0 0 0 0 0 0 0 111 0 0 0 0 0 0 4 0 39 0 0 0 0 0 0 0 0 0 4019.12 0 0 0 0 0 0 9.28 0 1422.23 0 0 0 0 0 0 5450.63 0 0 1101506554 2100496972 10 Physicians YU ANDREW 601203861 53 Kane 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 5 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 393 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40.25 0 2489.15 0 0 0 0 0 0 2529.4 0 0 1101506578 10 Physicians 815 Indiana 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 88.97 0 0 0 0 0 0 0 0 88.97 0 0 1101506586 10 Physicians 10 Adams 0 1 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 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 0 231.08 0 0 0 0 0 0 231.08 0 0 1101506609 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 18725.03 0 0 0 0 0 0 0 0 0 0 0 0 0 18725.03 0 0 1101506613 1114123296 10 Physicians LINDLEY KATHRYN J 631600352 89 Rock Island 0 0 Internal Medicine 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 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1101507551 1659385185 10 Physicians ROMOLO ROBERT G 606941789 200 Cook 0 0 Emergency 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 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 3086.75 0 0 0 0 0 0 3086.75 0 0 1101507568 1699810507 10 Physicians BULLOCK TRAVIS 370245009 200 Cook 0 0 Urology 0 0 0 0 0 0 0 0 0 0 8 0 41 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.38 0 2396.42 0 0 0 0 0 0 2396.8 0 0 1101507579 16 Nurse Practitioners 826 Missouri 0 0 0 0 0 0 0 0 0 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 0 539.22 0 0 0 0 0 0 539.22 0 0 1101507606 1538325998 10 Physicians BUMRA RACHNA 601692422 200 Cook 0 0 Internal Medicine 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 0 158 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 1118.19 0 0 0 0 0 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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 63745.38 0 0 0 0 0 0 63745.38 0 0 1101507660 1639277569 10 Physicians BILLINGSLEA CAMILLE L 606123714 200 Cook 0 0 Family Practice 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 0 112 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 2127.82 0 0 0 0 0 0 2127.82 0 0 1101507673 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 26169.66 0 0 0 0 0 0 0 0 0 0 0 0 0 26169.66 0 0 1101507675 1003827411 10 Physicians SAYEF NAZNEEN 606162419 200 Cook 0 1 Internal Medicine 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 16 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 61.12 0 1655.02 0 0 0 0 0 0 1716.14 0 0 1101507689 1932411550 11 Dentists SAAD MILAD 600852372 57 Lake 0 0 General Dentistry 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 340 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9289.04 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9289.04 0 0 1101507703 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 23408.48 0 0 0 0 0 0 0 0 0 0 0 0 0 23408.48 0 0 1101507719 1467450098 10 Physicians LOCHMUELLER GLEN 601751066 53 Kane 0 0 Otolaryngology 0 0 0 0 0 0 0 0 0 0 0 0 25 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 0 538.77 0 0 0 0 0 0 538.77 0 0 1101507726 1780668244 10 Physicians PATEL PARESH 600182044 200 Cook 0 1 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 0 710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 710 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4495.99 0 0 0 0 0 0 4495.99 0 0 1101507739 1730428129 16 Nurse Practitioners DOUGLASS LAUREN 622265373 96 St Clair 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 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 1151.91 0 0 0 0 0 0 1151.91 0 0 1101507753 1689600835 10 Physicians DUDAR IRINA 607121830 200 Cook 0 0 Anesthesiology 0 0 0 0 0 0 0 0 0 0 2 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20.1 0 680.46 0 0 0 0 0 0 700.56 0 0 1101507760 1467444950 10 Physicians MEHMOOD SAJID 601239402 53 Kane 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 0 280 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 8916.77 0 0 0 0 0 0 8916.77 0 0 1101507769 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 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 27693.84 0 0 0 0 0 0 0 0 0 0 0 0 0 27693.84 0 0 1101507771 1386725232 10 Physicians SIDDIQUI MARYAM 605277594 30 DuPage 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 0 0 0 4 0 22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141.11 0 3600.84 0 0 0 0 0 0 3741.95 0 0 1101507784 1710048145 91 Waiver service provider--Adults (DHS/DDD) TIEMERSMA AMY C 604632434 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 0 109 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 1180.82 0 0 0 0 0 0 0 0 0 0 0 0 0 1180.82 0 0 1101507795 1952320327 10 Physicians RESNICK DANIEL 600681173 200 Cook 0 0 Traumatic Surgery 0 0 0 0 0 0 0 0 0 0 1 0 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 287 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16101.05 0 0 0 0 0 0 16101.05 0 0 1101507796 1497701510 10 Physicians GLOVER CARMON 761165707 107 Will 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 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 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0 0 0 0 11383.82 0 0 0 0 0 0 0 0 0 0 0 0 0 11383.82 0 0 1101507993 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 0 239 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 22271.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22271.04 0 0 1101508008 1700807591 10 Physicians MURO KENJI 606575196 200 Cook 0 0 Vascular Surgery 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 0 172 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 5834.41 0 0 0 0 0 0 5834.41 0 0 1101508012 1124099098 30 General Hospitals MEMORIAL MED CTR CHILDRENS HSP 627810001 91 Sangamon CHILDRENS Hospital designated as childrens hospitals and paid a Per Diem rate. 0 0 General Hospital - Children Section 0 0 0 0 174 0 0 0 0 9 0 0 0 1288 0 0 0 0 0 0 0 0 0 194 0 0 0 0 9 0 0 0 2063 0 0 0 0 0 0 0 0 0 194 0 0 0 0 17 0 0 0 2257 0 0 0 0 0 0 0 0 0 35163.58 0 0 0 0 63925.36 0 0 0 235596.75 0 0 0 0 0 334685.69 0 0 1101508038 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 0 102 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 7834.34 0 0 0 0 0 0 0 0 0 0 0 0 0 7834.34 0 0 1101508065 10 Physicians 852 Wisconsin 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 62.74 0 0 0 0 0 0 62.74 0 0 1101508078 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 0 303 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 22896.45 0 0 0 0 0 0 0 0 0 0 0 0 0 22896.45 0 0 1101508082 1568657823 10 Physicians YOON JOHN 605275965 30 DuPage 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 0 237 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 1303.3 0 0 0 0 0 0 1303.3 0 0 1101508084 10 Physicians 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Crawford 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 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 1988.74 0 0 0 0 0 0 1988.74 0 0 1101514510 1790942142 10 Physicians LING BENJAMIN 601545716 200 Cook 0 0 Nephrology 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 0 321 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 2460.85 0 0 0 0 0 0 2460.85 0 0 1101514514 1134115231 10 Physicians PEREZ TAMAYO ALEJANDRA 606081732 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 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 3738.3 0 0 0 0 0 0 3738.3 0 0 1101514559 1205847589 10 Physicians LAFFEY STEVEN 631952334 106 Whiteside 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 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 1471.54 0 0 0 0 0 0 1471.54 0 0 1101514572 1205802147 10 Physicians 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24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11341.16 0 0 0 0 0 0 0 0 0 0 0 0 0 11341.16 0 0 1101514853 1164474979 10 Physicians SUMMERVILLE BRUCE 600315709 57 Lake 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 54 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 131 0 184 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 576.75 0 5283.52 0 0 0 0 0 0 5860.27 0 0 1101514869 1376579623 60 Pharmacies SCHNUCKS PHARMACY 707 618213059 19 Champaign 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 0 389 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14963 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 31191.91 0 0 0 31191.91 0 0 1101514885 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 0 252 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 22495.04 0 0 0 0 0 0 0 0 0 0 0 0 0 22495.04 0 0 1101514923 1730110834 10 Physicians PURI LALIT 606118709 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 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0 1101515166 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 16335.87 0 0 0 0 0 0 0 0 0 0 0 0 0 16335.87 0 0 1101515169 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 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8.63 0 0 0 0 0 0 8.63 0 0 1101515175 1427114875 11 Dentists LEE YU- JIN 606302729 200 Cook 0 0 General Dentistry 0 0 42 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 269 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 7699.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7699.92 0 0 1101515184 1689846040 33 Nursing Facilities WINDSOR ESTATES NURSING AND RE 604782903 200 Cook 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 0 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5434 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 709917.49 0 0 0 0 0 0 0 709917.49 0 0 1101515197 1720250640 29 ICF/MR WALSH TERRACE 614019773 56 Knox 0 0 0 0 0 0 0 0 0 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10781 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 828066.8 0 0 0 0 0 0 0 0 0 0 828066.8 0 0 1101515209 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 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 83.55 0 0 0 0 0 0 83.55 0 0 1101515228 1689876153 47 Local Education Agencies IL VALLEY CENTRAL UNIT 321 615231373 80 Peoria 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 0 168 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 6845.69 0 6845.69 0 0 1101515238 1831156124 63 Other Providers of Medical Equipment/Supplies (Non-registered) CARLE MEDICAL SUPPLY 618323838 100 Vermilion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 318 0 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2358 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2358 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52886.15 0 1250.72 0 0 0 0 54136.87 0 0 1101515242 10 Physicians 65 Madison 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 0 151.62 0 0 0 0 0 0 151.62 0 0 1101515245 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 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 0 786.44 0 0 0 0 0 0 786.44 0 0 1101515251 1215973599 10 Physicians MARKS KELLYN 606118709 200 Cook 0 1 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 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 0 477.01 0 0 0 0 0 0 477.01 0 0 1101515258 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 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 43047.34 0 0 0 0 0 0 0 0 0 0 0 0 0 43047.34 0 0 1101515260 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 35990.81 0 0 0 0 0 0 0 0 0 0 0 0 0 35990.81 0 0 1101515284 1922070614 10 Physicians MATHEW SURESH 631366132 826 Missouri 0 0 Nephrology 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 104 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1824.59 0 0 0 0 0 0 1824.59 0 0 1101515289 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 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 16392.57 0 0 0 0 0 0 0 0 0 0 0 0 0 16392.57 0 0 1101515296 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 0 185 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 15589.38 0 0 0 0 0 0 0 0 0 0 0 0 0 15589.38 0 0 1101515307 1518172675 10 Physicians GOTTLIEB ORI 605275965 30 DuPage 0 0 Anesthesiology 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 0 108 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 10713.66 0 0 0 0 0 0 10713.66 0 0 1101515314 1720046618 10 Physicians HEIDENRY VALERIE 605046065 30 DuPage 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 0 0 118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6481.97 0 0 0 0 0 0 6481.97 0 0 1101515357 1477671345 61 Independent Laboratories NORTHSHORE CLINICAL LABORATORI 606254420 200 Cook 0 0 0 0 0 0 0 0 0 0 0 1 631 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3866 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 122.83 149169.55 0 0 0 0 0 0 0 0 149292.38 0 0 1101515359 1740533546 40 Federally Qualified Health Centers VNA HEALTH CARE 999999999 53 Kane 0 0 0 906 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3143 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3143 0 116 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240405.87 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 240405.87 0 0 1101515367 1083610612 10 Physicians HALL ROBERT 600505593 71 McHenry 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 11 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 68.88 0 510.53 0 0 0 0 0 0 579.41 0 0 1101515388 1649302217 10 Physicians SCHROEDER BILL 604532600 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 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 4539.56 0 0 0 0 0 0 4539.56 0 0 1101515409 1609189679 16 Nurse Practitioners VAYL GREGORY 611112754 109 Winnebago 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 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 798.08 0 0 0 0 0 0 798.08 0 0 1101515423 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 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 1344.96 1344.96 0 0 1101515454 1033161518 10 Physicians DIAMOND EDWARD 606734477 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 0 137 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 1125.44 0 0 0 0 0 0 1125.44 0 0 1101515460 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 17.96 0 0 0 0 0 0 17.96 0 0 1101515470 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 10943.06 0 0 0 0 0 0 0 0 0 0 0 0 0 10943.06 0 0 1101515473 1710148010 10 Physicians SAHNI NEHA 602011718 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 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 3609.53 0 0 0 0 0 0 3609.53 0 0 1101515474 1972518108 60 Pharmacies WALGREEN CO 15364 602022365 200 Cook 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 0 402 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12483 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27295.7 0 0 0 27295.7 0 0 1101515479 1861418170 10 Physicians LUBNIEWSKI ANTHONY 631600352 200 Cook 0 0 Ophthalmology 0 0 0 0 0 0 0 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 82.53 0 0 0 0 0 0 82.53 0 0 1101515485 1356397277 60 Pharmacies OSCO DRUG 3230 601892000 30 DuPage 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 0 169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5597 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4184.98 0 0 0 4184.98 0 0 1101515486 1881673499 10 Physicians AHMED ASIF J 612015351 89 Rock Island 0 0 Anesthesiology 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 1808.29 0 0 0 0 0 0 1808.29 0 0 1101515494 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 4024.76 0 0 0 0 0 0 0 0 0 0 0 0 0 4024.76 0 0 1101515506 47 Local Education Agencies 66 Marion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 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 12327.22 0 12327.22 0 0 1101515512 1669424529 47 Local Education Agencies NORTHWESTERN ILLINOIS ASSOC 610813016 106 Whiteside 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2386 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 71657.87 0 71657.87 0 0 1101515522 1144294463 10 Physicians FEARON MAUREEN 601533304 200 Cook 0 1 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 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 0 630.26 0 0 0 0 0 0 630.26 0 0 1101515523 1053330993 10 Physicians EGNER JAMES 618012529 19 Champaign 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 0 321 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 17134.22 0 0 0 0 0 0 17134.22 0 0 1101515526 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 12093.16 0 0 0 0 0 0 0 0 0 0 0 0 0 12093.16 0 0 1101515530 63 Other Providers of Medical Equipment/Supplies (Non-registered) 845 Texas 0 0 0 0 0 0 0 0 0 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 2583.06 0 0 0 0 0 0 2583.06 0 0 1101515539 1124053400 13 Podiatrists PATEL SHWETAL 623014038 10 Adams 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 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 603 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3354.74 0 0 0 0 0 0 3354.74 0 0 1101515542 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 0 280.74 0 0 0 0 0 0 280.74 0 0 1101515543 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 0 0 0 0 0 0 0 0 0 0 1101515550 1497861470 10 Physicians GUPTA SEEMA 605406782 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 0 150 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 0 829.36 0 0 0 0 0 0 829.36 0 0 1101515551 1841385267 12 Optometrists SPENCER MARK 606412641 200 Cook 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 43 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 85 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2681.73 0 1112.64 0 0 0 0 3794.37 0 0 1101515558 1396882429 23 Occupational Therapists MURPHY KRISTA 627621000 91 Sangamon 0 0 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 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74679.65 74679.65 0 0 1101515590 1770707135 10 Physicians SRINIVASAN SUSHANT 535625531 852 Wisconsin 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 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 1207.48 0 0 0 0 0 0 1207.48 0 0 1101515594 1376731273 60 Pharmacies SCHUNCKS PHARMACY 730 618749457 19 Champaign 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 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 6217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3670.29 0 0 0 3670.29 0 0 1101515628 1760579817 70 Ambulance Service Providers VILLAGE OF WESTCHESTER 601542519 200 Cook 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 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 388082.31 0 0 0 0 0 0 388082.31 0 0 1101515635 1457328502 10 Physicians OLSON WILLIAM 528073461 816 Iowa 0 0 Surgery General 0 0 0 0 0 0 0 0 0 0 2 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 30 0 0 0 0 0 0 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 86.78 0 450.51 0 0 0 0 0 0 537.29 0 0 1101515642 1679685630 10 Physicians RAKSIN PATRICIA 606123714 200 Cook 0 0 Neurology Surgery 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 1101515647 1194752998 29 ICF/MR POLK HOUSE 606601017 200 Cook 0 0 0 0 0 0 0 0 0 0 12 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 7640 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1042198.55 0 0 0 0 0 0 0 0 0 0 1042198.55 0 0 1101515667 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 0 147 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 12692.28 0 0 0 0 0 0 0 0 0 0 0 0 0 12692.28 0 0 1101515672 2100506090 91 Waiver service provider--Adults (DHS/DDD) "LEEDA SERVICES OF ILLINOIS, IN" 606261675 200 Cook 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 45374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45374 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7551578.76 0 0 0 0 0 0 0 0 0 0 0 0 0 7551578.76 0 0 1101515674 1962647149 16 Nurse Practitioners WILLIAMS LESLIE A 761165707 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 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 2811.21 0 0 0 0 0 0 2811.21 0 0 1101515690 1154569580 10 Physicians ELMAN LILA 600903936 200 Cook 0 1 Pediatrics 0 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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 0 231 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 19116.15 0 0 0 0 0 0 0 0 0 0 0 0 0 19116.15 0 0 1101515816 10 Physicians 816 Iowa 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 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 1101515819 1003919101 50 Home Health Agencies - In Home LOYOLA CENTER FOR HOME CARE 601545716 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 704 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78144 0 0 0 0 0 0 78144 0 0 1101515846 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 53.45 53.45 0 0 1101515870 12 Optometrists 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 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0 0 0 0 0 164.03 0 0 0 0 0 1509.99 0 0 1101516233 1407815822 10 Physicians BITRAN J 600681270 200 Cook 0 0 Oncology 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 0 245 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 2615.48 0 0 0 0 0 0 2615.48 0 0 1101516287 1114112612 10 Physicians KUTTY RAFIQ 600683271 200 Cook 0 0 Pulmonary Diseases 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 0 406 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 9668.55 0 0 0 0 0 0 9668.55 0 0 1101516298 1306880281 10 Physicians REDDY NARAYANA 616360001 80 Peoria 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 0 241 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 3389.85 0 0 0 0 0 0 3389.85 0 0 1101516319 1750553103 29 ICF/MR DAVIES SQUARE 615541572 98 Tazewell 0 0 0 0 0 0 0 0 0 0 15 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 9624 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 748341.2 0 0 0 0 0 0 0 0 0 0 748341.2 0 0 1101516339 1053586552 28 Waiver service provider--Supportive living facility (HFS) CONCORD PLACE 601642435 200 Cook 0 0 0 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6314 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 718610.58 0 0 0 0 0 0 0 0 0 0 0 0 0 718610.58 0 0 1101516346 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 0 190.36 0 0 0 0 0 0 190.36 0 0 1101516357 1255426169 10 Physicians WILLIAMS STEVEN 609012901 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 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 1490.12 0 0 0 0 0 0 1490.12 0 0 1101516378 92 Waiver service provider--Disability (DHS/DRS) 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18680.64 0 0 0 0 0 0 0 0 0 0 0 0 0 18680.64 0 0 1101516381 1215986393 12 Optometrists MCDOWELL JASON 626502717 77 Morgan 0 0 Diagnostic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 159 0 119 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 386 0 120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4488.94 0 3460.8 0 0 0 0 7949.74 0 0 1101516398 1306891676 10 Physicians NATKIN JORY 600251373 200 Cook 0 1 Family Practice 0 0 0 0 0 0 0 0 0 0 1 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 40 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12.09 0 659.09 0 0 0 0 0 0 671.18 0 0 1101516413 11 Dentists 200 Cook 0 0 General Dentistry 0 0 5 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 0 878.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 878.75 0 0 1101516431 1770734352 75 Department of Alcohol and Substance Abuse Provider ROSECRANCE INC 604233181 107 Will 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 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 6823.06 0 0 6823.06 0 0 1101516442 1891777850 10 Physicians KRAGT JOEL 600566048 200 Cook 0 1 Family Practice 0 0 0 2 0 0 0 0 0 0 1 0 12 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 1 0 22 0 0 0 0 0 0 0 0 0 183.07 0 0 0 0 0 0 2.62 0 503.93 0 0 0 0 0 0 689.62 0 0 1101516446 1902943319 16 Nurse Practitioners SIPE KIMBERLY 616157831 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 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 0 201.7 0 0 0 0 0 0 201.7 0 0 1101516454 1073565867 10 Physicians GLUSMAN MARIANA 606116649 200 Cook 0 1 Pediatrics 0 0 0 22 0 0 0 0 0 0 2 0 35 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 2 0 54 0 0 0 0 0 0 0 0 0 66 0 0 0 0 0 0 2 0 54 0 0 0 0 0 0 0 0 0 1399.2 0 0 0 0 0 0 2.6 0 2640.19 0 0 0 0 0 0 4041.99 0 0 1101516462 1104873140 16 Nurse Practitioners MIKAITIS-ROSSI TANIA 333232857 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 1220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1220 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3439.98 0 0 0 0 0 0 3439.98 0 0 1101516466 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56.04 56.04 0 0 1101516470 24 Speech Therapists 55 Kendall 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 37.36 37.36 0 0 1101516488 1871794172 10 Physicians GORETZKE SEAN 631102515 826 Missouri 0 0 Child 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 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 2830.08 0 0 0 0 0 0 2830.08 0 0 1101516494 1528141819 10 Physicians BENIGNO JENNIFER A. 600478718 57 Lake 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 0 104 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 3046.34 0 0 0 0 0 0 3046.34 0 0 1101516502 91 Waiver service provider--Adults (DHS/DDD) 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 0 290 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 17112.98 0 0 0 0 0 0 0 0 0 0 0 0 0 17112.98 0 0 1101516504 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 1.97 0 0 0 0 0 0 1.97 0 0 1101516506 1437161155 10 Physicians THULBORN KEITH 606777007 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 358 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 524 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 17724.43 0 0 0 0 0 0 0 0 17724.43 0 0 1101516539 1316983091 10 Physicians BELL CALVIN 627810001 91 Sangamon 0 0 Emergency Medicine 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 0 156 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 3186.54 0 0 0 0 0 0 3186.54 0 0 1101516549 1518152818 10 Physicians LAZAR SORIN 464106258 815 Indiana 0 0 Internal Medicine 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 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 366 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7674.48 0 0 0 0 0 0 7674.48 0 0 1101516558 1710096482 40 Federally Qualified Health Centers ALIVIO MEDICAL CENTER 606083837 200 Cook 0 1 0 228 0 64 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 679 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52097.19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 52097.19 0 0 1101516566 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 19266.62 0 0 0 0 0 0 0 0 0 0 0 0 0 19266.62 0 0 1101516580 91 Waiver service 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NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1101516654 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 0 438.15 0 0 0 0 0 0 438.15 0 0 1101516656 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 37347.35 0 0 0 0 0 0 0 0 0 0 0 0 0 37347.35 0 0 1101516658 10 Physicians 200 Cook 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 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1785.3 0 0 0 0 0 0 1785.3 0 0 1101516674 1255428538 10 Physicians AWAN 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BRADFORD 604023441 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 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 0 298.2 0 0 0 0 0 0 298.2 0 0 1101525318 1205027810 10 Physicians JABR AYMAN 604620724 200 Cook 0 1 Family Practice 0 0 0 1 0 0 0 0 0 0 17 0 284 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 20 0 2563 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 20 0 2563 0 0 0 0 0 0 0 0 0 112.41 0 0 0 0 0 0 300.5 0 15922.39 0 0 0 0 0 0 16335.3 0 0 1101525336 10 Physicians 826 Missouri 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 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 1101525339 1942489448 25 Audiologists THOMAS JEAN F 618012529 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 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 2319.86 2319.86 0 0 1101525346 1396962106 47 Local Education Agencies FLOSSMOOR SCHOOL DISTRICT 161 604111104 200 Cook 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 0 0 0 94 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 2629 0 0 0 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 2629 0 0 0 0 317.39 0 0 0 0 0 0 0 0 0 0 0 0 0 43419.76 0 43737.15 0 0 1101525348 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 24852.62 0 0 0 0 0 0 0 0 0 0 0 0 0 24852.62 0 0 1101525354 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 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 1101525384 10 Physicians 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41.71 0 0 0 0 0 0 0 0 41.71 0 0 1101525391 1285790337 10 Physicians HAGEMANN ANDREA R 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200 Cook 0 1 Pediatrics 0 0 0 6 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 517.18 0 0 0 0 0 0 0 0 147.66 0 0 0 0 0 0 664.84 0 0 1101525613 1659372555 10 Physicians PAPAS CORDEN PAMELA C 601975966 30 DuPage 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 2276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2276 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13043.33 0 0 0 0 0 0 0 0 13043.33 0 0 1101525638 1700815818 10 Physicians PRABHAKARAN SHYAM 606118709 200 Cook 0 0 Neurology 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 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 1836.84 0 0 0 0 0 0 1836.84 0 0 1101525641 1962481143 10 Physicians ANDROS GREG 604319341 107 Will 0 0 Urology 0 0 0 0 0 0 0 0 0 0 9 0 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7.87 0 2772.43 0 0 0 0 0 0 2780.3 0 0 1101525652 1326094236 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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 5314.52 0 0 0 0 0 0 0 0 0 0 0 0 0 5314.52 0 0 1101525707 1851315287 10 Physicians HERTSBERG ANNA 606733039 200 Cook 0 0 Cardiology 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 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 509 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5299 0 0 0 0 0 0 5299 0 0 1101525755 1245260108 13 Podiatrists ADAMS WILLIAM 629486334 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 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 0 386.15 0 0 0 0 0 0 386.15 0 0 1101525766 92 Waiver service provider--Disability (DHS/DRS) 16 Calhoun 0 0 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 31138.43 0 0 0 0 0 0 0 0 0 0 0 0 0 31138.43 0 0 1101525769 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 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40828.5 0 0 0 0 0 0 0 0 0 0 0 0 0 40828.5 0 0 1101525776 1093701575 10 Physicians ORONSAYE OSARETIN L 606081732 200 Cook 0 0 Obstetric-Gynecology 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 3658.94 0 0 0 0 0 0 3658.94 0 0 1101525791 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 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 2057.58 2057.58 0 0 1101525793 1528225463 16 Nurse Practitioners KATOPODIS ANASTASIA 606062405 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 0 917.9 0 0 0 0 0 0 917.9 0 0 1101525800 1548321250 36 Community mental health provider ADAPT OF ILLINOIS INC 629202415 99 Union 0 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2686 0 0 247 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2686 0 0 9414.92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 116084.21 0 0 125499.13 0 0 1101525801 1356369037 10 Physicians CHOW RAYMOND B 600485360 57 Lake 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 3 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 1270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9187.64 0 0 0 0 0 0 9187.64 0 0 1101525807 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 1101525825 1598887283 55 Early Intervention Services SMITH BONNIE J 604509649 40 Grundy 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 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 11169.09 0 0 0 0 0 0 11169.09 0 0 1101525826 1851577373 10 Physicians NEGA TODD J. 602011718 200 Cook 0 0 Infectious Diseases 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 0 163 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 3011.27 0 0 0 0 0 0 3011.27 0 0 1101525831 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 27665.04 0 0 0 0 0 0 0 0 0 0 0 0 0 27665.04 0 0 1101525838 92 Waiver service provider--Disability (DHS/DRS) 91 Sangamon 0 0 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 29492.82 0 0 0 0 0 0 0 0 0 0 0 0 0 29492.82 0 0 1101525864 1003801150 30 General Hospitals GENESIS MEDICAL CENTER DEWITT 527421210 816 Iowa NON-COST "Non-cost reporting hospitals, paid a Per Diem rate." 0 0 General Hospital - Adult and Child 0 0 0 0 6 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 12 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 0 0 0 707.34 0 0 0 0 0 0 0 0 1411.59 0 0 0 0 0 2118.93 0 0 1101525870 1922148360 29 ICF/MR ALDEN SPRINGS 601082105 30 DuPage 0 0 0 0 0 0 0 0 0 0 17 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 11574 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1706424.52 0 0 0 0 0 0 0 0 0 0 1706424.52 0 0 1101525875 1053450601 75 Department of Alcohol and Substance Abuse Provider CENTRAL EAST ALCOHOL AND DRUG 619200532 24 Coles 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 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 36760.8 0 0 36760.8 0 0 1101525882 1124005517 60 Pharmacies GOTTLIEB PROF BLD PHARMACY 601601634 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 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 2698 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16881.02 0 0 0 16881.02 0 0 1101525905 1073787164 60 Pharmacies WALGREENS #10938 610681533 79 Ogle 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 258 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 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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 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 10666.57 0 0 0 0 0 0 0 0 0 0 0 0 0 10666.57 0 0 1101527184 1649257163 10 Physicians JACKSON GREGORY P. 602011700 200 Cook 0 0 Radiology Diagnosis 0 0 0 0 0 0 0 0 0 0 267 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 321 0 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4225.03 0 624.91 0 0 0 0 0 0 4849.94 0 0 1101527198 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 0 201 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 13982.05 0 0 0 0 0 0 0 0 0 0 0 0 0 13982.05 0 0 1101527207 1730132945 10 Physicians HELLER WILLIAM A 606776473 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 36 0 86 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 218 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 170.02 0 2380.78 0 0 0 0 0 0 2550.8 0 0 1101527222 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0 0 0 0 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41275.79 0 0 0 0 0 0 0 0 0 0 0 0 0 41275.79 0 0 1101527454 1346551702 16 Nurse Practitioners STARNES MARY 600442203 57 Lake 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 989.61 0 0 0 0 0 0 989.61 0 0 1101527465 10 Physicians 80 Peoria 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 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 0 218.46 0 0 0 0 0 0 218.46 0 0 1101527475 1407887938 10 Physicians BONE RICHARD 606313222 200 Cook 0 0 Internal Medicine 0 0 0 45 0 0 0 0 0 0 2256 0 982 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 9584 0 1526 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 9584 0 1526 0 0 0 0 0 0 0 0 0 422.2 0 0 0 0 0 0 92425.64 0 60603.09 0 0 0 0 0 0 153450.93 0 0 1101527484 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 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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 211.99 0 0 0 0 0 0 211.99 0 0 1101534668 1871728675 10 Physicians KAZMI IMRAN 601813933 30 DuPage 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 0 953.34 0 0 0 0 0 0 953.34 0 0 1101534675 1710201793 33 Nursing Facilities ROSEVILLE REHAB HEALTH CARE 614739581 102 Warren 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 0 108 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2661 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 178904.24 0 0 0 0 0 0 0 178904.24 0 0 1101534690 1902819717 10 Physicians OSADNIK RENATA 601429558 71 McHenry 0 1 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 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 0 337.62 0 0 0 0 0 0 337.62 0 0 1101534717 1366450678 10 Physicians RAJAGURU SUBBIAH 616151941 80 Peoria 0 0 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 115 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 231 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5.54 0 1155.43 0 0 0 0 0 0 1160.97 0 0 1101534726 1609086180 10 Physicians SHEIKH AHMAD Z 641801143 30 DuPage 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 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 0 180.01 0 0 0 0 0 0 180.01 0 0 1101534727 1548388044 16 Nurse Practitioners JOHNSON RHONDA 611033128 109 Winnebago 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 0 530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 530 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13.94 0 0 0 0 0 0 13.94 0 0 1101534728 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 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 338 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 16955.25 0 0 0 0 0 0 0 0 0 0 0 0 0 16955.25 0 0 1101534730 1073510335 10 Physicians MCNAUGHTON SCOTT 601228942 53 Kane 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 18 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 38 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6.3 0 1067.03 0 0 0 0 0 0 1073.33 0 0 1101534741 1033375605 10 Physicians POWELL KIMBERLY NICHOLE 627949639 91 Sangamon 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 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 12633.68 0 0 0 0 0 0 12633.68 0 0 1101534750 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 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 15901.48 0 0 0 0 0 0 0 0 0 0 0 0 0 15901.48 0 0 1101534752 1477622819 10 Physicians ANWAR SYED 601235899 53 Kane 0 0 Psychiatry 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 0 947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 947 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24515.1 0 0 0 0 0 0 24515.1 0 0 1101534759 1093783987 10 Physicians SADOWSKI ELIZABETH 537265314 852 Wisconsin 0 0 Radiology 0 0 0 0 0 0 0 0 0 0 5 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 1 0 0 0 0 0 0 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 83.78 0 69.14 0 0 0 0 0 0 152.92 0 0 1101534761 1891025557 16 Nurse Practitioners WOKER RACHEL 535475081 47 Jackson 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 0 224 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 1849.24 0 0 0 0 0 0 1849.24 0 0 1101534769 97 Waiver service provider--Children's residential (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 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 559 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 263205.72 0 0 0 0 0 0 0 0 0 0 0 0 0 263205.72 0 0 1101534776 1609878420 10 Physicians SAMMARCO MICHAEL J 610320268 97 Stephenson 0 0 Obstetric-Gynecology 0 0 0 0 0 0 0 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 0 380.59 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1101534828 1730112525 10 Physicians PERROTT CHARLES A 600650451 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 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 71.21 0 0 0 0 0 0 71.21 0 0 1101534830 1982732566 47 Local Education Agencies CHAMPAIGN CU SCHOOL DISTRICT 4 618205818 19 Champaign 0 0 0 0 0 45 0 0 0 0 0 0 0 0 0 0 0 0 0 687 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 19773 0 0 0 0 94 0 0 0 0 0 0 0 0 0 0 0 0 0 19773 0 0 0 0 617.51 0 0 0 0 0 0 0 0 0 0 0 0 0 489311.27 0 489928.78 0 0 1101534841 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 2.46 0 0 0 0 0 0 2.46 0 0 1101534845 1568467306 33 Nursing Facilities ROSEWOOD CARE CENTER SWANSEA 622212301 96 St Clair 0 0 0 0 0 0 0 0 0 0 0 0 0 21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1889 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176058.36 0 0 0 0 0 0 0 176058.36 0 0 1101534880 1659361525 10 Physicians KASTNER GREGORY 624541168 25 Crawford 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 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 98.45 0 0 0 0 0 0 98.45 0 0 1101534892 1194701490 12 Optometrists CARON JEFFREY 601355402 27 Dekalb 0 0 Therapeutic Pharmaceutical Agents 0 0 0 0 0 0 0 0 0 0 0 0 11 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333.07 0 234.24 0 0 0 0 567.31 0 0 1101534897 91 Waiver service provider--Adults (DHS/DDD) 91 Sangamon 0 0 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 0 305.97 0 0 0 0 0 0 0 0 0 0 0 0 0 305.97 0 0 1101534920 1437164282 70 Ambulance Service Providers CALUMET PARK FIRE DEPT 608275703 200 Cook 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 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1120 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 189562.1 0 0 0 0 0 0 189562.1 0 0 1101534936 1841247236 10 Physicians MANGANELLI PAUL 605406558 30 DuPage 0 0 Physical Medicine/Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 29 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 0 302.92 0 0 0 0 0 0 302.92 0 0 1101534960 63 Other Providers of Medical Equipment/Supplies (Non-registered) 30 DuPage 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1741.19 0 0 0 0 0 0 1741.19 0 0 1101534973 1679743991 25 Audiologists LUX DENISE 615503143 98 Tazewell 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 145 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 4643.6 4643.6 0 0 1101534994 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 0 111 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 26177.58 0 0 0 0 0 0 0 0 0 0 0 0 0 26177.58 0 0 1101534995 1912934670 10 Physicians VOIRIN TERRY G 601873152 30 DuPage 0 0 Ophthalmology 0 0 0 0 0 0 0 0 0 0 3 0 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 261 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2674.56 0 0 0 0 0 0 2674.56 0 0 1101534998 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 46.02 0 0 0 0 0 0 46.02 0 0 1101535018 1861672677 63 Other Providers of Medical Equipment/Supplies (Non-registered) GRANITE CITY ORTHOPEDIC PHYSIC 620341904 65 Madison 0 0 0 0 0 0 0 0 0 0 0 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 0 703.85 0 0 0 0 703.85 0 0 1101535022 1659322535 10 Physicians BAXAMUSA TAIZOON 600531272 200 Cook 0 0 Orthopedic Surgery 0 0 0 0 0 0 0 0 0 0 38 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 78 0 128 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 212.84 0 1661.74 0 0 0 0 0 0 1874.58 0 0 1101535033 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 19255.17 0 0 0 0 0 0 0 0 0 0 0 0 0 19255.17 0 0 1101535046 1255578118 60 Pharmacies KANKAKEE AREA PHARMACY INC 609013673 54 Kankakee 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 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 4145 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2232.62 0 0 0 2232.62 0 0 1101535084 1215965660 10 Physicians SHAH ATUL 622861867 87 Randolph 0 0 Cardiology 0 0 0 0 0 0 0 0 0 0 0 0 269 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 528 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5601.75 0 0 0 0 0 0 5601.75 0 0 1101535088 2100525506 10 Physicians MUELLERLEILE MICHAEL 500107046 816 Iowa 0 0 Cardiovascular Diseases 0 0 0 0 0 0 0 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 32.09 0 0 0 0 0 0 32.09 0 0 1101535098 1174515035 10 Physicians IYER ANITA 601203843 53 Kane 0 0 Obstetric-Gynecology 0 0 0 1 0 0 0 0 0 0 61 0 92 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 101 0 141 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 101 0 141 0 0 0 0 0 0 0 0 0 14.6 0 0 0 0 0 0 4422.49 0 10422.75 0 0 0 0 0 0 14859.84 0 0 1101535101 1497859649 30 General Hospitals NORTHWESTERN MEMORIAL HOSPITAL 606112908 200 Cook DRG Hospitals reimbursed under our Diagnosis Related Group (DRG) system. 0 0 PERINATAL LEVEL III CENTER 15 0 0 0 2561 0 0 0 0 2504 0 0 73 7249 0 0 0 0 0 30 0 0 0 3886 0 0 0 0 3058 0 0 73 20354 0 0 0 0 0 88 0 0 0 3886 0 0 0 0 23675 0 0 79 20354 0 0 0 0 0 572.73 0 0 0 1158046.24 0 0 0 0 20083939.61 0 0 152249.69 2916208.23 0 0 0 0 0 24311016.5 0 0 1101535113 1689794489 43 Encounter rate clinic LOGAN SQUARE HLTH CTR COOK CO 606472938 200 Cook ARS-C.O.P. "JH Stroger, Oak Forest and Provident Hospitals, paid under an alternate reimbursement system" 0 1 Direct Access 0 371 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1361 0 130 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 268194.09 0 20667.75 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 288861.84 0 0 1101535115 1427052885 16 Nurse Practitioners DUBAY MCDERMIT JEANETTE 607142828 200 Cook 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 202.52 0 0 0 0 0 0 202.52 0 0 1101535138 1447254255 10 Physicians PATEL PIUSHKUMAR J 601228942 53 Kane 0 1 Internal Medicine 0 0 0 0 0 0 0 0 0 0 1 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 217 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2.18 0 2749.24 0 0 0 0 0 0 2751.42 0 0 1101535141 1780602250 16 Nurse Practitioners MCGLAUGHLIN ALICIA 631102515 826 Missouri 0 0 0 0 0 0 0 0 0 0 0 0 0 0 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 0 0 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