Illinois Health Alliance Medicare PPO Plan Provider Directory This directory provides a list of Health Alliance Medicare PPO network providers. This directory is for beneficiaries in Adams, Boone, Brown, Bureau, Cass, Champaign, Christian, Clark, Coles, Crawford, Cumberland, De Witt, DeKalb, Douglas, Edgar, Effingham, Ford, Franklin, Hancock, Henry, Iroquois, Jackson, Jasper, Johnson, Kankakee, Knox, Livingston, Logan, Macon, Macoupin, Marshall, Mason, McDonough, McLean, Menard, Mercer, Montgomery, Morgan, Moultrie, Peoria, Perry, Piatt, Pike, Putnam, Rock Island, Saline, Sangamon, Schuyler, Scott, Stark, Tazewell, Vermilion, Williamson, Winnebago and Woodford counties in Illinois. Any changes made to this directory will be reflected within 24 hours. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Health Alliance Medicare PPO s network providers in your area, you can visit HealthAllianceMedicare.org or call our Member Service Department at 1-800-965-4022, Monday through Friday, 8 a.m. to 8 p.m. TTY/TDD users should call 711. Health Alliance Medicare is a PPO plan with a Medicare contract. Enrollment in Health Alliance Medicare depends on contract renewal. This information is available for free in other languages. Please call Member Services at 1-800-965-4022, Monday through Friday, 8 a.m. to 8 p.m. TTY/TDD users should call 711. The provider network may change at any time. You will receive notice when necessary. cps-ilmedppoproviderdirectory-0616 Y0034_16_31527a_FINAL Accepted
Table of Contents Section 1 - Introduction...ii What is the service area for Medicare PPO?... ii How do you find Medicare PPO providers in your area?...iii Section 2 - List of Providers... 1 Specialist... 1 Outpatient Mental Health Providers... 1 Ancillary... 1 Index... I-1 i
Section 1 Introduction This directory provides a list of Health Alliance Medicare PPO s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers who are listed in this directory. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers. If you receive care from a non-network provider and receive a bill from that provider, you should not pay it. Instead, please submit it to Health Alliance Medicare so we can determine what, if any, of the fees you actually must pay. If you obtain routine care from out-of-network providers, it may cost more than if you went to an in-network provider. PPO members: Emergency care can always be obtained in or out of the service area from the nearest available provider. If you have a medical emergency: Get help as quickly as possible. Call 911 for help or go to the nearest emergency room, Hospital or urgent care center. Call for an ambulance if you need it. You do not need to get approval or a referral first. As soon as possible, make sure to tell Health Alliance Medicare about your emergency. We need to follow up on your Emergency Care. You or someone else should call to tell us about your Emergency Care, usually within 48 hours. Emergency and urgent services care can always be obtained in or out of the service area from the nearest available provider. If you obtain routine care from out-of-network providers, it may cost more than if you went to an in-network provider. What is the service area for Health Alliance Medicare PPO? The counties in our service area are listed below. Adams, Boone, Brown, Bureau, Cass, Champaign, Christian, Clark, Coles, Crawford, Cumberland, De Witt, DeKalb, Douglas, Edgar, Effingham, Ford, Franklin, Hancock, Henry, Iroquois, Jackson, Jasper, Johnson, Kankakee, Knox, Livingston, Logan, Macon, Macoupin, Marshall, Mason, McDonough, McLean, Menard, Mercer, Montgomery, Morgan, Moultrie, Peoria, Perry, Piatt, Pike, Putnam, Rock Island, Saline, Sangamon, Schuyler, Scott, Stark, Tazewell, Vermilion, Williamson, Winnebago and Woodford counties in Illinois. i
How do you find Health Alliance Medicare PPO providers in your area? This directory is organized alphabetically by city and by category (Primary Care Physicians, Specialty Care, etc.). Or, you can use the index that begins on page I-1 to find an alphabetical listing of all providers. If you have questions about Health Alliance Medicare PPO or require assistance in selecting a PCP, please call our Member Services Department at 1-800-965-4022, Monday through Friday, 8 a.m. to 8 p.m. TTY\TDD users should call 711. Or, visit HealthAllianceMedicare.org. Section 2 List of Network Providers ii
Specialist / Outpatient Mental Section 2 - List of Network Providers Midlevel providers (including nurse practitioners and physician assistants) cannot be selected as Primary Care Physicians. However, you may use the services of a midlevel provider by selecting his or her supervising physician as your designated Primary CarePhysician. Midlevel providers are indicated by italics. TRUHEARING PROVIDER AUDIOLOGY TRUHEARING CALL FOR IN-NETWORK PROVIDERS NEAR YOU. TRUHEARING PROVIDER PHONE: 855-205-5059 HEARING AIDS TRUHEARING CALL FOR IN-NETWORK PROVIDERS NEAR YOU. TRUHEARING PROVIDER PHONE: 855-205-5059 PEORIA, IL NEONATOLOGY KUMAR, PRAVEEN, MD MALE E-PRESCRIBE: NO PROVIDER #: 286657 NPI #: 1043264872 U OF I COLLEGE OF MEDICINE 530 NE GLEN OAK AVE PEORIA, IL 61637-0001 PEORIA COUNTY PHONE: (309) 655-3863 NORMAL, IL PSYCHOLOGY MEYER, REGINA L., PHD FEMALE E-PRESCRIBE: NO PROVIDER #: 369920 NPI #: 1851722474 DISCOVERY OF HOPE COUNSELING AND PSYCHOLOGICAL SER 706 OGLESBY AVE STE 105 NORMAL, IL 61761 MCLEAN COUNTY PHONE: (312) 620-3643 EAST MOLINE, IL MENTAL HEALTH MANLEY, KRISTI A., LMHC FEMALE E-PRESCRIBE: NO PROVIDER #: 335574 NPI #: 1972797629 LUTHERAN FAMILY SERVICES 17628 HUBBARD RD EAST MOLINE, IL 61244-9782 ROCK ISLAND COUNTY PHONE: (515) 251-4900 ST LOUIS, MO MENTAL HEALTH / SUBSTANCE ABUSE BARNES-JEWISH PSYCHIATRIC UNIT PROVIDER #: 128271 NPI #: 1033132220 1 BARNES JEWISH HOSPITAL PLZ ST LOUIS, MO 63110-1003 SAINT LOUIS CITY COUNTY PHONE: (314) 747-3000 URBANA, IL CHAMPAIGN URBANA DIALYSIS CENTER PROVIDER #: 046926 NPI #: 1568688109 1405 W PARK ST STE 100 URBANA, IL 61801-2356 CHAMPAIGN COUNTY PHONE: (217) 328-4100 TAYLORVILLE, IL TAYLORVILLE DIALYSIS PROVIDER #: 128574 NPI #: 1821057027 901 W SPRESSER ST TAYLORVILLE, IL 62568-1831 CHRISTIAN COUNTY PHONE: (217) 824-5460 CHARLESTON, IL MATTOON DIALYSIS PROVIDER #: 128610 NPI #: 1194794487 6051 DEVELOPMENT DR CHARLESTON, IL 61920-9467 COLES COUNTY PHONE: (217) 345-2550 ARLINGTON HGHTS, IL ARLINGTON HEIGHTS RENAL PROVIDER #: 225110 NPI #: 1003832148 17 W GOLF RD ARLINGTON HGHTS, IL 60005-3905 PHONE: (866) 544-6741 BUFFALO GROVE, IL BUFFALO GROVE DIALYSIS PROVIDER #: 202605 NPI #: 1871519926 1291 W DUNDEE RD BUFFALO GROVE, IL 60089-4009 PHONE: (847) 253-9400 1
Ancillary CHICAGO, IL LOOP RENAL CENTER PROVIDER #: 225179 NPI #: 1235155391 1101 S CANAL ST CHICAGO, IL 60607-4901 PHONE: (866) 544-6741 LITTLE VILLAGE DIALYSIS PROVIDER #: 128592 NPI #: 1497714414 2334 W CERMAK RD CHICAGO, IL 60608-3812 PHONE: (773) 523-2939 WOODLAWN DIALYSIS PROVIDER #: 185712 NPI #: 1447565072 5060 S STATE ST CHICAGO, IL 60609-5328 PHONE: (773) 924-2149 CHILDRENS DIALYSIS CENTER PROVIDER #: 128489 NPI #: 1396704508 2611 N HALSTED ST CHICAGO, IL 60614-6593 PHONE: (773) 549-2010 WOODLAWN DIALYSIS PROVIDER #: 185133 NPI #: 1891009619 1164 E 55TH ST CHICAGO, IL 60615-5115 PHONE: (773) 363-9059 STONEY ISLAND DIALYSIS PROVIDER #: 185714 NPI #: 1992019608 18725 S STONY ISLAND AVE CHICAGO, IL 60617 PHONE: (773) 834-5830 STONY ISLAND DIALYSIS PROVIDER #: 185133 NPI #: 1891009619 8725 S STONY ISLAND AVE CHICAGO, IL 60617-2709 PHONE: (773) 221-7320 GRAND CROSSING DIALYSIS PROVIDER #: 210427 NPI #: 1730488214 7319 S COTTAGE GROVE AVE CHICAGO, IL 60619-1909 PHONE: (773) 783-3491 BEVERLY DIALYSIS PROVIDER #: 128522 NPI #: 1215023338 8109 S WESTERN AVE CHICAGO, IL 60620-5939 PHONE: (773) 238-5200 WEST LAWN DIALYSIS PROVIDER #: 178201 NPI #: 1780814558 7000 S PULASKI RD CHICAGO, IL 60629-5842 PHONE: (773) 284-5324 MONTCLARE DIALYSIS CENTER PROVIDER #: 128529 NPI #: 1861461030 7009 W BELMONT AVE CHICAGO, IL 60634-4533 PHONE: (773) 889-6051 WOODLAWN DIALYSIS PROVIDER #: 185133 NPI #: 1891009619 5841 S MARYLAND AVE CHICAGO, IL 60637-1443 PHONE: (773) 702-9893 LINCOLN PARK DIALYSIS PROVIDER #: 128500 NPI #: 1659330694 2484 N ELSTON AVE CHICAGO, IL 60647-2002 PHONE: (773) 348-0101 KENWOOD DIALYSIS PROVIDER #: 185133 NPI #: 1891009619 4259 S COTTAGE GROVE AVE STE 100 CHICAGO, IL 60653-2929 PHONE: (773) 285-3621 MT GREENWOOD DIALYSIS PROVIDER #: 128589 NPI #: 1982673166 3401 W 111TH ST CHICAGO, IL 60655-3329 PHONE: (773) 445-0558 COUNTRY CLUB HI, IL COUNTRY HILL DIALYSIS PROVIDER #: 140885 NPI #: 1073532420 4215 167TH ST COUNTRY CLUB HI, IL 60478-2017 PHONE: (708) 206-1845 EVANSTON, IL EVANSTON RENAL CENTER PROVIDER #: 160514 NPI #: 1689690893 1922 DEMPSTER ST EVANSTON, IL 60202-1016 PHONE: (847) 869-5336 2
Ancillary HAZEL CREST, IL HAZEL CREST RENAL CENTER PROVIDER #: 225098 NPI #: 1467478586 3470 W 183RD ST HAZEL CREST, IL 60429-2428 PHONE: (866) 544-6741 NILES, IL BIG OAK DIALYSIS PROVIDER #: 172270 NPI #: 1326289646 5623 W TOUHY AVE NILES, IL 60714-4019 PHONE: (847) 647-3140 OAK LAWN, IL STONEY CREEK DIALYSIS PROVIDER #: 128525 NPI #: 1295821304 6246 W 95TH ST OAK LAWN, IL 60453-2702 PHONE: (708) 233-9027 ORLAND PARK, IL PALOS PARK DIALYSIS PROVIDER #: 210416 NPI #: 1912286865 13155 S LA GRANGE RD ORLAND PARK, IL 60462-1162 PHONE: (708) 923-0928 SCHAUMBURG, IL SCHAUMBURG RENAL CENTER PROVIDER #: 184703 NPI #: 1184640237 1156 S ROSELLE RD SCHAUMBURG, IL 60193-4072 PHONE: (847) 524-4310 SOUTH HOLLAND, IL SOUTH HOLLAND RENAL CENTER PROVIDER #: 225107 NPI #: 1881610996 16110 LA SALLE ST SOUTH HOLLAND, IL 60473-1299 PHONE: (708) 596-5489 ROBINSON, IL ROBINSON DIALYSIS PROVIDER #: 179477 NPI #: 1306086103 1215 N ALLEN ST STE B ROBINSON, IL 62454-1100 CRAWFORD COUNTY PHONE: (618) 544-7092 SYCAMORE, IL CRIMSON RIDGE HOME TRAINING PROVIDER #: 245800 NPI #: 1184900920 2540 HAUSER ROSS DR STE 200 SYCAMORE, IL 60178-3171 DEKALB COUNTY PHONE: (815) 748-3508 SYCAMORE DIALYSIS PROVIDER #: 128558 NPI #: 1295794485 2200 GATEWAY DR SYCAMORE, IL 60178-3113 DEKALB COUNTY PHONE: (815) 758-0205 EFFINGHAM, IL EFFINGHAM DIALYSIS PROVIDER #: 128598 NPI #: 1245290782 904 MEDICAL PARK DR STE 1 EFFINGHAM, IL 62401-2193 EFFINGHAM COUNTY PHONE: (217) 342-9558 VANDALIA, IL VANDALIA DIALYSIS PROVIDER #: 145798 NPI #: 1265618573 301 MATTES AVE VANDALIA, IL 62471-2061 FAYETTE COUNTY PHONE: (618) 283-1366 BENTON, IL BENTON DIALYSIS PROVIDER #: 128516 NPI #: 1609885185 1151 ROUTE 14 W BENTON, IL 62812-1500 FRANKLIN COUNTY PHONE: (618) 435-4850 MT VERNON, IL MOUNT VERNON DIALYSIS PROVIDER #: 128520 NPI #: 1326072638 4102 N WATER TOWER PL MT VERNON, IL 62864-6583 JEFFERSON COUNTY PHONE: (618) 244-3407 3
Ancillary BOURBONNAIS, IL KANKAKEE COUNTY DIALYSIS PROVIDER #: 128567 NPI #: 1073675138 581 WILLIAM R LATHAM SR DR STE 104 BOURBONNAIS, IL 60914-2439 KANKAKEE COUNTY PHONE: (815) 936-3088 BARRINGTON, IL BARRINGTON CREEK DIALYSIS PROVIDER #: 238931 NPI #: 1619240983 28160 W NORTHWEST HWY BARRINGTON, IL 60010-2324 LAKE COUNTY PHONE: (847) 381-1325 LAKE VILLA, IL LAKE VILLA DIALYSIS PROVIDER #: 128569 NPI #: 1346209590 37809 N IL ROUTE 59 LAKE VILLA, IL 60046-7332 LAKE COUNTY PHONE: (847) 245-4872 VERNON HILLS, IL LAKE COUNTY DIALYSIS PROVIDER #: 128551 NPI #: 1265401475 565 LAKEVIEW PKWY STE 176 VERNON HILLS, IL 60061-1822 LAKE COUNTY PHONE: (847) 918-0592 WAUKEGAN, IL WAUKEGAN RENAL CENTER PROVIDER #: 195354 NPI #: 1659397859 3350 GRAND AVE STE 100 WAUKEGAN, IL 60085-2206 LAKE COUNTY PHONE: (847) 782-0640 DIXON, IL DIXON KIDNEY CENTER PROVIDER #: 128559 NPI #: 1396706750 1131 N GALENA AVE DIXON, IL 61021-1015 LEE COUNTY PHONE: (815) 285-0595 LINCOLN, IL LINCOLN DIALYSIS PROVIDER #: 128600 NPI #: 1760441976 2100 5TH ST LINCOLN, IL 62656-9115 LOGAN COUNTY PHONE: (217) 732-6798 DECATUR, IL DECATUR EAST WOOD DIALYSIS PROVIDER #: 128606 NPI #: 1336100734 794 E WOOD ST DECATUR, IL 62523-1155 MACON COUNTY PHONE: (217) 425-6403 MACON COUNTY DIALYSIS PROVIDER #: 128605 NPI #: 1972562890 1090 W MCKINLEY AVE DECATUR, IL 62526-3208 MACON COUNTY PHONE: (217) 877-9351 RCG CENTRAL ILLINOIS- DECATUR PROVIDER #: 133675 NPI #: 1790890549 302 W HAY ST STE 207 DECATUR, IL 62526-4129 MACON COUNTY PHONE: (217) 876-8663 ALTON, IL ALTON DIALYSIS PROVIDER #: 128593 NPI #: 1154381697 309 HOMER M ADAMS PKWY ALTON, IL 62002-5929 MADISON COUNTY PHONE: (618) 462-0186 HOME HEALTH CARE BJC HOME CARE SERVICES - ALTON PROVIDER #: 043176 NPI #: 1326077199 3535 COLLEGE AVE STE B ALTON, IL 62002-5009 MADISON COUNTY PHONE: (618) 463-7541 EDWARDSVILLE, IL EDWARDSVILLE DIALYSIS PROVIDER #: 170610 NPI #: 1154586428 235 S BUCHANAN ST EDWARDSVILLE, IL 62025-2108 MADISON COUNTY PHONE: (618) 692-9217 4
Ancillary GRANITE CITY, IL GRANITE CITY DIALYSIS CENTER PROVIDER #: 128566 NPI #: 1952360703 9 AMERICAN VLG GRANITE CITY, IL 62040-3706 MADISON COUNTY PHONE: (618) 452-5858 CENTRALIA, IL CENTRALIA DIALYSIS PROVIDER #: 128517 NPI #: 1467461947 1231 STATE ROUTE 161 CENTRALIA, IL 62801-6739 MARION COUNTY PHONE: (618) 533-2535 LITCHFIELD, IL LITCHFIELD DIALYSIS PROVIDER #: 128595 NPI #: 1184683138 915 SAINT FRANCIS WAY LITCHFIELD, IL 62056-1775 MONTGOMERY COUNTY PHONE: (217) 327-2200 JACKSONVILLE, IL JACKSONVILLE DIALYSIS PROVIDER #: 128599 NPI #: 1316916513 1515 W WALNUT ST JACKSONVILLE, IL 62650-1150 MORGAN COUNTY PHONE: (217) 243-3042 OLNEY, IL OLNEY DIALYSIS PROVIDER #: 128524 NPI #: 1003885229 117 N BOONE ST OLNEY, IL 62450-2109 RICHLAND COUNTY PHONE: (618) 393-4234 SPRINGFIELD, IL SPRINGFIELD CENTRAL DIALYSIS PROVIDER #: 127613 NPI #: 1720047970 600 N GRAND AVE W SPRINGFIELD, IL 62702-2538 SANGAMON COUNTY PHONE: (217) 788-3688 SPRINGFIELD MONTVALE DIALYSIS PROVIDER #: 128596 NPI #: 1518926781 2930 MONTVALE DR STE A SPRINGFIELD, IL 62704-5376 SANGAMON COUNTY PHONE: (217) 793-2781 RUSHVILLE, IL RUSHVILLE DIALYSIS PROVIDER #: 128597 NPI #: 1205805488 112 SULLIVAN DR RUSHVILLE, IL 62681-1293 SCHUYLER COUNTY PHONE: (217) 322-2652 BELLEVILLE, IL SHILOH DIALYSIS PROVIDER #: 254147 NPI #: 1871848895 1095 N GREEN MOUNT RD BELLEVILLE, IL 62221-3303 ST. CLAIR COUNTY PHONE: (618) 628-1108 METRO EAST DIALYSIS PROVIDER #: 128523 NPI #: 1588633812 5105 W MAIN ST BELLEVILLE, IL 62226-4728 ST. CLAIR COUNTY PHONE: (618) 233-9018 E ST LOUIS, IL SAUGET DIALYSIS PROVIDER #: 128585 NPI #: 1659337418 2061 GOOSE LAKE RD E ST LOUIS, IL 62206-2822 ST. CLAIR COUNTY PHONE: (618) 332-7801 FREEPORT, IL DRIFTWOOD DIALYSIS PROVIDER #: 238835 NPI #: 1225300056 1808 S WEST AVE FREEPORT, IL 61032-6712 STEPHENSON COUNTY PHONE: (815) 232-0295 FREEPORT DIALYSIS PROVIDER #: 128528 NPI #: 1568431864 1028 S KUNKLE BLVD FREEPORT, IL 61032-6914 STEPHENSON COUNTY PHONE: (815) 232-2477 5
Ancillary STERLING, IL WHITESIDE DIALYSIS PROVIDER #: 128530 NPI #: 1538128533 4406 E LINCOLNWAY STERLING, IL 61081-9749 WHITESIDE COUNTY PHONE: (815) 535-0447 MARION, IL MARION DIALYSIS PROVIDER #: 128518 NPI #: 1932118403 324 S 4TH ST MARION, IL 62959-1241 WILLIAMSON COUNTY PHONE: (618) 997-8410 HUTCHINS PARK, IL ROCKFORD DIALYSIS PROVIDER #: 128527 NPI #: 1235198235 3339 N ROCKTON AVE HUTCHINS PARK, IL 61103-2839 WINNEBAGO COUNTY PHONE: (800) 424-6589 ROCKFORD, IL STONECREST DIALYSIS PROVIDER #: 186510 NPI #: 1518276955 1302 E STATE ST ROCKFORD, IL 61104-2228 WINNEBAGO COUNTY PHONE: (815) 968-5794 CHURCHVIEW DIALYSIS PROVIDER #: 128526 NPI #: 1285694729 417 WARE AVE ROCKFORD, IL 61107-6413 WINNEBAGO COUNTY PHONE: (815) 397-4123 CHURCHVIEW DIALYSIS PROVIDER #: 128526 NPI #: 1285694729 5970 CHURCHVIEW DR ROCKFORD, IL 61107-2574 WINNEBAGO COUNTY PHONE: (815) 637-9644 ROXBURY DIALYSIS PROVIDER #: 128578 NPI #: 1003875402 622 ROXBURY RD ROCKFORD, IL 61107-5089 WINNEBAGO COUNTY PHONE: (815) 397-0713 WASHINGTON, IN DAVIESS COUNTY DIALYSIS PROVIDER #: 226110 NPI #: 1972568806 310 NE 14TH ST WASHINGTON, IN 47501-2137 DAVIESS COUNTY PHONE: (812) 254-9950 JASPER, IN JASPER DIALYSIS PROVIDER #: 226025 NPI #: 1114983046 721 W 13TH ST STE 105 JASPER, IN 47546-1856 DUBOIS COUNTY PHONE: (812) 482-3205 PRINCETON, IN PRINCETON DIALYSIS PROVIDER #: 226012 NPI #: 1003139114 2227 SHERMAN DR PRINCETON, IN 47670-1062 GIBSON COUNTY PHONE: (812) 385-2906 VINCENNES, IN VINCENNES DIALYSIS PROVIDER #: 171365 NPI #: 1447216387 700 WILLOW ST VINCENNES, IN 47591-1028 KNOX COUNTY PHONE: (877) 588-5688 INDIANAPOLIS, IN EAGLE HIGHLANDS DIALYSIS PROVIDER #: 293923 NPI #: 1093055923 6925 SHORE TER INDIANAPOLIS, IN 46254-4675 MARION COUNTY PHONE: (317) 295-0423 EVANSVILLE, IN NORTH EVANSVILLE DIALYSIS PROVIDER #: 226113 NPI #: 1861457798 1151 W BUENA VISTA RD EVANSVILLE, IN 47710-3334 VANDERBURGH COUNTY PHONE: (812) 401-0140 EAST EVANSVILLE DIALYSIS PROVIDER #: 226116 NPI #: 1548224082 1312 PROFESSIONAL BLVD EVANSVILLE, IN 47714-8007 VANDERBURGH COUNTY PHONE: (812) 491-6300 6
Ancillary NEWBURGH, IN NEWBURGH DIALYSIS PROVIDER #: 226210 NPI #: 1487984639 4311 STATE ROUTE 261 STE A NEWBURGH, IN 47630-2653 WARRICK COUNTY PHONE: (812) 853-2010 MINNEAPOLIS, MN DURABLE MEDICAL EQUIPMENT TACTILE SYSTEMS TECHNOLOGY INC PROVIDER #: 196316 NPI #: 1427131424 1331 TYLER ST NE STE 200 MINNEAPOLIS, MN 55413-1638 HENNEPIN COUNTY PHONE: (612) 355-5100 SULLIVAN, MO HOME HEALTH CARE BHC HOME CARE SERVICES - SULLIVAN PROVIDER #: 043176 NPI #: 1326077199 113 PROGRESS PKWY SULLIVAN, MO 63080-2359 CRAWFORD COUNTY PHONE: (573) 468-5167 CLINTON, MO KANSAS AVENUE DIALYSIS PROVIDER #: 293969 NPI #: 1548697402 604 KANSAS AVE CLINTON, MO 64735-3069 HENRY COUNTY PHONE: (660) 890-0830 HANNIBAL, MO HANNIBAL DIALYSIS PROVIDER #: 178205 NPI #: 1265767628 119 PROGRESS RD HANNIBAL, MO 63401-6628 MARION COUNTY PHONE: (573) 406-0165 FARMINGTON, MO HOME HEALTH CARE BJC HOME CARE SERVICES - PARKLAND PROVIDER #: 043176 NPI #: 1326077199 757 WEBER RD FARMINGTON, MO 63640-3318 SAINT FRANCOIS COUNTY PHONE: (573) 760-8575 BELLEVUE, NE DIALYSIS CLINIC INC BELLEVUE PROVIDER #: 243215 NPI #: 1861425340 4112 TWIN CREEK DR BELLEVUE, NE 68123-4083 SARPY COUNTY PHONE: (402) 934-9560 TWINSBURG, OH DURABLE MEDICAL EQUIPMENT EDGEPARK PROVIDER #: 056804 NPI #: 1609858729 1810 SUMMIT COMMERCE PARK TWINSBURG, OH 44087-2300 SUMMIT COUNTY PHONE: (800) 321-0591 7
Index A ALTON DIALYSIS... 4 ARLINGTON HEIGHTS RENAL... 1 B BARNES-JEWISH PSYCHIATRIC UNIT... 1 BARRINGTON CREEK DIALYSIS... 4 BENTON DIALYSIS...3 BEVERLY DIALYSIS... 2 BHC HOME CARE SERVICES - SULLIVAN... 7 BIG OAK DIALYSIS... 3 BJC HOME CARE SERVICES - ALTON... 4 BJC HOME CARE SERVICES - PARKLAND...7 BUFFALO GROVE DIALYSIS... 1 C CENTRALIA DIALYSIS... 5 CHAMPAIGN URBANA DIALYSIS CENTER... 1 CHILDRENS DIALYSIS CENTER...2 CHURCHVIEW DIALYSIS... 6, 6 COUNTRY HILL DIALYSIS... 2 CRIMSON RIDGE HOME TRAINING... 3 D DAVIESS COUNTY DIALYSIS... 6 DECATUR EAST WOOD DIALYSIS... 4 DIALYSIS CLINIC INC BELLEVUE... 7 DIXON KIDNEY CENTER... 4 DRIFTWOOD DIALYSIS... 5 E EAGLE HIGHLANDS DIALYSIS... 6 EAST EVANSVILLE DIALYSIS... 6 EDGEPARK... 7 EDWARDSVILLE DIALYSIS... 4 EFFINGHAM DIALYSIS...3 EVANSTON RENAL CENTER... 2 F FREEPORT DIALYSIS...5 G GRAND CROSSING DIALYSIS... 2 GRANITE CITY DIALYSIS CENTER...5 H HANNIBAL DIALYSIS... 7 HAZEL CREST RENAL CENTER... 3 J JACKSONVILLE DIALYSIS... 5 I-1
Index JASPER DIALYSIS... 6 K KANKAKEE COUNTY DIALYSIS...4 KANSAS AVENUE DIALYSIS... 7 KENWOOD DIALYSIS...2 KUMAR, PRAVEEN, MD... 1 L LAKE COUNTY DIALYSIS... 4 LAKE VILLA DIALYSIS...4 LINCOLN DIALYSIS... 4 LINCOLN PARK DIALYSIS...2 LITCHFIELD DIALYSIS... 5 LITTLE VILLAGE DIALYSIS... 2 LOOP RENAL CENTER... 2 M MACON COUNTY DIALYSIS...4 MANLEY, KRISTI A., LMHC... 1 MARION DIALYSIS... 6 MATTOON DIALYSIS... 1 METRO EAST DIALYSIS... 5 MEYER, REGINA L., PHD... 1 MONTCLARE DIALYSIS CENTER... 2 MOUNT VERNON DIALYSIS... 3 MT GREENWOOD DIALYSIS... 2 N NEWBURGH DIALYSIS... 7 NORTH EVANSVILLE DIALYSIS... 6 O OLNEY DIALYSIS...5 P PALOS PARK DIALYSIS... 3 PRINCETON DIALYSIS... 6 R RCG CENTRAL ILLINOIS-DECATUR... 4 ROBINSON DIALYSIS... 3 ROCKFORD DIALYSIS... 6 ROXBURY DIALYSIS...6 RUSHVILLE DIALYSIS... 5 S SAUGET DIALYSIS... 5 SCHAUMBURG RENAL CENTER... 3 SHILOH DIALYSIS... 5 SOUTH HOLLAND RENAL CENTER... 3 SPRINGFIELD CENTRAL DIALYSIS... 5 I-2
Index SPRINGFIELD MONTVALE DIALYSIS... 5 STONECREST DIALYSIS... 6 STONEY CREEK DIALYSIS... 3 STONEY ISLAND DIALYSIS... 2 STONY ISLAND DIALYSIS... 2 SYCAMORE DIALYSIS... 3 T TACTILE SYSTEMS TECHNOLOGY INC... 7 TAYLORVILLE DIALYSIS... 1 TRUHEARING... 1, 1 V VANDALIA DIALYSIS...3 VINCENNES DIALYSIS...6 W WAUKEGAN RENAL CENTER... 4 WEST LAWN DIALYSIS... 2 WHITESIDE DIALYSIS... 6 WOODLAWN DIALYSIS... 2, 2, 2 I-3
DISCRIMINATION IS AGAINST THE LAW Health Alliance complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Health Alliance does not exclude people or treat them differently because of race, color, national origin, age, disability or sex. Health Alliance: Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o Written information in other formats (large print audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages If you need these services, contact customer service. If you believe that Health Alliance has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Health Alliance Medicare, Member Services, 301 S. Vine Street, Urbana, IL 61801 or 316 Fifth Street, Wenatchee, WA 98801, telephone for members in Illinois, Indiana, Iowa and Ohio: 1-800-965-4022; telephone for members in Washington: 1-877-750-3350 TTY: 711, fax: 217-337-3425, MemberServices@healthalliance.org. You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Member Services is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, TTY: 1-800-537-7697. Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. LA DISCRIMINACIÓN ES CONTRA LA LEY Health Alliance cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Health Alliance no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo. Health Alliance: Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes: Intérpretes de lenguaje de señas capacitados. Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos). Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes: Intérpretes capacitados. Información escrita en otros idiomas. Si necesita recibir estos servicios, comuníquese con servicio al cliente. Si considera que Health Alliance no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Health Alliance Medicare, Member Services, 301 S. Vine Street, Urbana, IL 61801 o 316 Fifth St., Wenatchee, WA 98801; Teléfono para los miembros en Illinois, Indiana, Iowa, y Ohio: 1-800-965-4022, Teléfono para los miembros en Washington: 1-877-750-3350, TTY: 711 o 1-800-833-6388, fax: 509-662-0735, correo electrónico: MemberServices@healthalliance.org. Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo, Member Services está a su disposición para brindársela. También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación: U.S. Department of Health and Human Services 200 Independence Avenue, SW, Room 509F, HHH Building, Washington, D.C. 20201 1-800-368-1019, 1-800-537-7697 (TDD) Puede obtener los formularios de reclamo en el sitio web http://www.hhs.gov/ocr/office/file/index.html. ATENCIÓN: Si habla Español, servicios de asistencia lingüística, de forma gratuita, están disponibles para usted. IA, IL, IN, OH: Llame 1-800-965-4022, WA Llame: 1-877-750-3350 (TTY: 711). 注意 : 如果你講中文, 語言協助服務, 免費的, 都可以給你 IA, IL, IN, OH: 呼叫 1-800-965-4022, WA: 呼叫 1-877-750-3350(TTY: 711) cmp-nondiscnotice15mwwacombo-1216
UWAGA: Jeśli mówić Polskie, usługi pomocy języka, bezpłatnie, są dostępne dla Ciebie. IA, IL, IN, OH: Zadzwoń 1-800-965-4022, WA: Zadzwoń 1-877-750-3350 (TTY: 711). Chú ý: Nếu bạn nói Tiếng Việt, các dịch vụ hỗ trợ ngôn ngữ, miễn phí, có sẵn cho bạn. IA, IL, IN, OH: Gọi 1-800-965-4022, WA: Gọi 1-877-750-3350 (TTY: 711). 주의 : 당신이한국어, 무료언어지원서비스를말하는경우사용할수있습니다. 1-800-965-4022 IA, IL, IN, OH: 전화 WA: 1-877-750-3350 전화 (TTY: 711). ВНИМАНИЕ: Если вы говорите русский, вставки услуги языковой помощи, бесплатно, доступны для вас. IA, IL, IN, OH: Вызов 1-800-965-4022, WA: Вызов 1-877-750-3350 (TTY: 711). Pansin: Kung magsalita ka Tagalog, mga serbisyo ng tulong sa wika, nang walang bayad, ay magagamit sa iyo. IA, IL, IN, OH: Tumawag 1-800-965-4022, WA: Tumawag 1-877-750-3350 (TTY: 711). انتباه: ا ذا كنت تتكلم العربية فا ن خدمات المساعدة اللغوية متوفرة لك مجانا. ا يلينوي ا نديانا ا وهايو: اتصل بالرقم 1-800-965-4022 ولاية واشنطن: اتصل بالرقم: 1-877-750-3350 (ا ذا كنت تعاني من الصمم ا و صعوبة في السمع فاتصل على الرقم 711) Aufmerksamkeit: Wenn Sie Deutsch sprechen, Sprachassistenzdienste sind kostenlos, zur Verfügung. IA, IL, IN, OH: Anruf 1-800-965-4022, WA: Anruf 1-877-750-3350 (TTY: 711). ATTENTION: Si vous parlez français, les services d'assistance linguistique, gratuitement, sont à votre disposition. IA, IL, IN, OH: Appelez 1-800-965-4022, WA: Appelez 1-877-750-3350 (TTY: 711). ધ ય : તમ વ ત ત જર ત, ભ ષ સહ ય સ વ ઓ, મફત, તમ ર મ ટ ઉપલબ છ. IA, IL, IN, OH: ક લ 1-800-965-4022, WA: ક લ 1-877-750-3350 (TTY: 711). 注意 : あなたは 日本語 無料で言語支援サービスを 話す場合は あなたに利用可能です 1-800-965-4022 IA, IL, IN, OH: コール 1-877-750-3350 WA: コール (TTY: 711) LET OP: Als je spreekt pennsylvania nederlandse, taalkundige bijstand diensten, gratis voor u beschikbaar zijn. IA, IL, IN, OH: Bel 1-800-965-4022, WA: Bel 1-877-750-3350 (TTY: 711). УВАГА: Якщо ви говорите український, вставки послуги мовної допомоги, безкоштовно, доступні для вас. IA, IL, IN, OH: Виклик 1-800-965-4022, WA: Виклик 1-877-750-3350 (TTY: 711). ATTENZIONE: Se si parla italiano, servizi di assistenza linguistica, a titolo gratuito, sono a vostra disposizione. IA, IL, IN, OH: Chiamare 1-800-965-4022, WA: Chiamare 1-877-750-3350 (TTY: 711).
1-800-965-4022 TTY/TDD 711 HealthAllianceMedicare.org