Upload
dinhliem
View
214
Download
0
Embed Size (px)
Citation preview
Live well.We’ll insure you do.
Live well.We’ll insure you do.
MERCYCARE HMO INC.
Provider Directory 2018 W9
State of Wisconsin
MercyCare ID Card
MercyCare ID cards include:
INSURED NUMBER: Identification number
GROUP NUMBER: How MercyCare identifies your benefit package
MEMBER NUMBER: Personal identification number
PCP NAME: Your primary care physician (family medicine, internal medicine, pediatrician)
PLAN ID: Designates your plan
NAME OF PLAN: Type of plan you have
Customer service department: (800) 895-2421
Important information to know:
This provider list is the only paper version you will receive, unless you call our customer service department at (800) 895-2421 for additional copies.
MercyCare encourages you to visit our website or contact customer service for the most current information regarding your provider network. To ensure accurate provider network listings, the on-line provider directory is continuously updated while the requestable paper directory is updated semi-annually only. Please visit www.mercycarehealthplans.com to see which providers participate in your plan.
Above is an illustration of a MercyCare HMO membership card. To determine which plan you are in, please refer to your ID card.
The card(s) you receive states the plan name, as well as the plan ID. Should you have any questions, or if you are unable to determine your specific plan name and/or plan ID, please call our customer service department at (800) 895-2421.
MercyCare Senior
Insured Number Effective Date Group Numberxxx-xx-xxxx xxxxxx
Member Number Last Name PCP Namexxx-xx-xxxx John Doe Dr. Smith
XX5
1
6
2
3 4
1
5
6
2
3
4
Hospitals, Emergency and Urgent Care Clinics
Skip the waiting room! Visit MercyInQuicker.org to reserve your spot at a participating facility.
Hospitals
Mercyhealth Hospital and Trauma Center 1000 Mineral Point Ave., Janesville (608) 756-6000
Mercyhealth Rockton Avenue Hospital 2400 N. Rockton Ave., Rockford (815) 971-5000
Mercyhealth Walworth Hospital and Medical Center N2950 State Rd. 67, Lake Geneva (262) 245-2230
Mercyhealth Harvard Hospital and Medical Center 901 Grant St., Harvard (815) 943-5431
Fort Memorial Hospital 611 Sherman Ave. East, Fort Atkinson (920) 568-5000
Watertown Memorial Hospital 125 Hospital Dr., Watertown (920) 261-4210
Emergency
Mercyhealth Hospital and Trauma Center 1000 Mineral Point Ave., Janesville (608) 756-6000
Mercyhealth Hospital and Trauma Center Emergency North 1000 Mineral Point Ave., Janesville (608) 756-6000
Mercyhealth Rockton Avenue Hospital 2400 N. Rockton Ave., Rockford (815) 971-5000
Mercyhealth Walworth Hospital and Medical Center N2950 State Rd. 67, Lake Geneva (262) 245-2230
Fort Memorial Hospital 611 Sherman Ave. East, Fort Atkinson (920) 568-5000
Watertown Memorial Hospital 125 Hospital Dr., Watertown (920) 261-4210
Urgent Care Clinics
Mercyhealth McHenry 3922 Mercy Dr., McHenry (815) 578-2020
Mercyhealth Woodstock 2000 Lake Ave., Woodstock (815) 337-1544
Mercyhealth East 3524 E. Milwaukee St., Janesville (608) 756-8484
Mercyhealth South 849 Kellogg Ave., Janesville (608) 755-7960
Mercyhealth North 3400 Deerfield Dr., Janesville (608) 314-3605
Mercyhealth Mall 1010 N. Washington St., Janesville (608) 741-3800
Mercyhealth Beloit 2825 Prairie Ave., Beloit (608) 363-5500
Mercyhealth Walworth N2950 State Rd. 67, Lake Geneva (262) 245-2230
Mercyhealth Whitewater 507 W. Main St., Whitewater (262) 473-0401
Fort HealthCare Lake Mills 200 E. Tyranena Park Rd., Lake Mills (920) 648-3113
Fort Memorial Hospital 611 Sherman Ave. East, Fort Atkinson (920) 568-5000
Watertown Memorial Hospital 125 Hospital Dr., Watertown (920) 261-4210
Mercyhealth Belvidere 1747 Henry Luckow Ln., Belvidere (815) 971-3055
Mercyhealth Byron 130 Kysor Dr., Byron (815) 971-3000
Mercyhealth Cherry Valley 6998 Redansa Dr., Rockford (815) 971-2000
Mercyhealth Rockton Avenue 2300 N. Rockton Ave., Building 1, Rockford (815) 971-2572
Mercyhealth Perryville 3401 N. Perryville Rd., Rockford (815) 971-8000
Mercyhealth Roscoe 5000 Prairie Rose Dr., Roscoe (815) 971-3450
Mercyhealth Winnebago 102 Landmark Dr., Winnebago (815) 971-3250
Index by city
Algonquin, IL ................... 34
Barrington, IL ............. 34-35
Beloit, WI ........................... 1
Belvidere, IL ..................... 35
Brodhead, WI .................. 1-2
Brown Deer, WI ................. 2
Byron, IL .......................... 36
Cambridge, WI .................. 2
Cherry Valley, IL ............... 36
Clinton, WI ......................... 2
Crystal Lake, IL ........... 36-37
Delavan, WI ...................... 2
Edgerton, WI ...................... 3
Elkhorn, WI ....................... 3
Evansville, WI ................ 3-4
Fort Atkinson, WI ............ 4-7
Harvard, IL ................. 37-38
Ixonia, WI ........................... 7
Janesville, WI ................7-19
Jefferson, WI ............. 19-20
Johnson Creek, WI ..... 20-21
Kenosha, WI ..................... 21
Lake Geneva, WI ....... 21-24
Loves Park, IL .................. 38
Lake Mills, WI ............ 24-25
Madison, WI ............... 25-26
Machesney Park, IL .... 39-40
McHenry, IL ..................... 40
Milton, WI ........................ 26
Milwaukee, WI ............ 26-27
Monona, WI ..................... 27
Monroe, WI ...................... 27
Mulford, IL ....................... 38
Niles, IL ............................ 39
Northbrook, IL ................. 40
Oconomowoc, WI............ 27
Racine, WI ........................ 27
Richmond, IL ................... 40
Rockford, IL ................ 41-55
Rockton, IL ....................... 55
Roscoe, IL ................... 55-56
Sheboygan, WI ................ 27
Waterloo, WI ............... 27-28
Watertown, WI ............ 28-32
Waukesha, WI .................. 32
West Allis, WI ................... 32
West Milwaukee, WI........ 32
Whitewater, WI ........... 32-33
Williams Bay, WI ............. 33
Winnebago, IL ................. 56
Woodstock, IL ............. 56-57
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Beloit, WI
Beloit Comprehensive Treatment Center
2240 Prairie Ave
(608) 361-7200
Beloit, WI 53511
Methadone Clinic Practice Status:
Beloit Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
Beloit Health & Rehabilitation Center
1905 West Hart Rd
(608) 365-2554
Beloit, WI 53511
Skilled Nursing Facility Practice Status:
Beloit Health & Rehabilitation Center, , Open
Board Certified: Not Accredited
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Beloit
2825 Prairie Ave
(608) 756-5555
Beloit, WI 53511
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Beloit, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
DeGarmo, Karla, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Mattison, Faith, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Mercyhealth Beloit
2825 Prairie Ave
(608) 363-5500
Beloit, WI 53511
Advanced Practice Nurse Prescriber Practice Status:
Bourdeaux, Erka, APNP Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Wisconsin School of Nursing, Madison
,
Medical School:
Residency:
Huenerberg, Carmen, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Parker, Natalie, APRN Open
Board Certified: National Certification Corporation (Women's Health Care Nurse Practitioner)Univ of Cincinnati, Cincinnati, OH
,
Medical School:
Residency:
Family Medicine Practice Status:
So, Jason, DO Open
Board Certified: American Board of Family Medicine
Des Moines Univ, Des Moines, IA
Univ of Illinois College of Medicine at Peoria, Peoria, IL
Medical School:
Residency:
Internal Medicine Practice Status:
Arayan, Asma, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine at Rockford, Rockford, IL
Gundersen Health System, La Crosse, WI
Medical School:
Residency:
Juan, Henry, MD Open
Board Certified: American Board of Internal Medicine
St. Louis University, Baguio Phillipines
Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Kaldor, Katheryn, DO Open
Board Certified: American Osteopathic Board of Obstetrics and Gynecology
Kansas City Univ of Medicine, Kansas City, MO
Philadelphia College of Osteopathic Medicine, Philadelphia, PA
Medical School:
Residency:
Wistrom, Elana, DO Open
Board Certified: American Osteopathic Board of Obstetrics and Gynecology
A.T. Still Univ, Kirksvill, MO
Henry Ford Macomb Hospital, Clinton Twp, MI
Medical School:
Residency:
Pediatrics Practice Status:
Peete, Emarcia, MD Open
Board Certified: Not Board Certified
Medical College of Wisconsin, Milwaukee, WI
Morehouse School of Medicine, Atlanta, GA
Medical School:
Residency:
Podiatry Practice Status:
Feuerstein, Catherine, DPM Open
Board Certified: American Board of Foot and Ankle Surgery
Scholl College of Podiatric Medicine, North Chicago, IL
North Port VA Residency, North Port, NY
Medical School:
Residency:
Mercyhealth Beloit Urgent Care
2825 Prairie Ave
(608) 363-5500
Beloit, WI 53511
Urgent Care Center Practice Status:
Mercyhealth Beloit Urgent Care, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Brodhead, WI
Mercyhealth Brodhead
2310 First Center Ave
(608) 897-8664
Brodhead, WI 53520
Advanced Practice Nurse Prescriber Practice Status:
Huenerberg, Carmen, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 1 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Family Medicine Practice Status:
Bluemel, Kevin, MD Closed
Board Certified: American Board of Family Medicine
Indiana University School of Medicine, Indianapolis, IN
Mercy Health System Family Practice Residency Program, Janesville, WI
Medical School:
Residency:
Wilke Chiropractic Office, SC
E101 4th Street
(608) 897-3010
Brodhead, WI 53520
Chiropractic Practice Status:
Malott, Travis, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Brown Deer, WI
Rogers Memorial Hospital - Brown Deer
4600 Schroeder Dr
(800) 767-4411
Brown Deer, WI 53223
Child & Adolescent Mental Health
ProgramPractice Status:
Rogers Memorial Hospital - Brown Deer, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Cambridge, WI
Fort HealthCare Cambridge Clinic
704 Katie Ct
(608) 423-1100
Cambridge, WI 53523
Family Medicine including Obstetrics Practice Status:
Nottestad, Stephanie, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin School of Medicine, Madison, WI
University of Wisconsin-Madison Family Medicine Residency Program,
Madison, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Sund, Joni, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Nebraska, Lincoln, NE
,
Medical School:
Residency:
Psychology Practice Status:
Mitchell, Colleen, PhD Open
Board Certified: Not Applicable
Adler Univ, Chicago, IL
,
Medical School:
Residency:
Clinton, WI
Alden Meadow Park Health Care Center, Inc.
709 Meadow Park Dr
(608) 676-2202
Clinton, WI 53525
Skilled Nursing Facility Practice Status:
Alden Meadow Park Health Care Center, Inc., , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Delavan, WI
Mercyhealth Delavan
1038 E Geneva St
(262) 728-4301
Delavan, WI 53115
Advanced Practice Nurse Prescriber Practice Status:
Wang, Lisa, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Univ of Massachusetts, Boston, MA
,
Medical School:
Residency:
Family Medicine Practice Status:
Gronau, Rachel, MD Open
Board Certified: American Board of Family Medicine
Medical College of Wisconsin, Milwaukee, WI
St. Luke's Family Medicine Residency, Milwaukee, WI
Medical School:
Residency:
Terry, Richard, DO Open
Board Certified: Not Board Certified
Michigan State Univ College of Osteopathic Medicine, East Lansing, MI
St. Joseph Family Medicine Residency Program, Milwaukee, WI
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Villegas Van der Linde, Silvia, MD Open
Board Certified: American Board of Obstetrics and Gynecology
UNIBE - Universidad Iberoamericana, Santo Domingo, Dominican
RepublicMount Sinai Hospital, Chicago, IL
Medical School:
Residency:
Walworth County Chiropractic
1221 E Phoenix St
(262) 728-8208
Delavan, WI 53115
Chiropractic Practice Status:
Heller, Clark, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Willowfield Nursing & Rehabilitation Center
905 E Geneva St
(262) 728-6319
Delavan, WI 53115
Skilled Nursing Facility Practice Status:
Willowfield Nursing & Rehabilitation Center, , Open
Board Certified: Not Accredited
Not Applicable,
Not Applicable,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 2 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Edgerton, WI
Edgerton Care Center
313 Stoughton Rd
(608) 884-1330
Edgerton, WI 53534
Skilled Nursing Facility Practice Status:
Edgerton Care Center, , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Mercyhealth Edgerton
217 N Main St
(608) 884-9431
Edgerton, WI 53534
Family Medicine Practice Status:
Frey, Justin, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin School of Medicine & Public Health, Madison, WI
Mercy Health System, Janesville, WI
Medical School:
Residency:
Rejon, Veronica, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin School of Medicine & Public Health, Madison, WI
Mercy Health System, Janesville, WI
Medical School:
Residency:
Internal Medicine Practice Status:
Akbar, Muhammad, MD Open
Board Certified: American Board of Internal Medicine
Univ of the Punjab - Allama Iqbal Medical College, Lahore, Pakistan
Monmouth Medical Center, Long Branch, NJ
Medical School:
Residency:
Petry Chiropractic & Wellness, LLC
75 West Fulton St
(608) 884-3100
Edgerton, WI 53534
Chiropractic Practice Status:
Houfe, Matthew, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Petry, John, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Elkhorn, WI
Holton Manor
645 N Church St
(262) 723-4963
Elkhorn, WI 53121
Skilled Nursing Facility Practice Status:
Holton Manor, , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Mercyhealth Elkhorn
839 N Wisconsin St
(262) 741-1400
Elkhorn, WI 53121
Family Medicine Practice Status:
Furey, Jessica, DO Open
Board Certified: Not Board Certified
Des Moines Univ, Des Moines, IA
Lakeland Health, St. Joseph, MI
Medical School:
Residency:
Kowalski, Jeffrey, MD Open
Board Certified: American Board of Family Medicine
Ross Univ School of Medicine, North Brunswick, NJ
Medical College of Wisconsin, St. Joseph's, Milwaukee, WI
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Knavel, James, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of Iowa College of Medicine, Iowa City, IA
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Evansville, WI
Evansville Manor
470 Garfield Ave
(608) 882-5700
Evansville, WI 53536
Skilled Nursing Facility Practice Status:
Evansville Manor, , Open
Board Certified: Not Accredited
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Evansville
300 Union St
(608) 756-5555
Evansville, WI 53536
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Evansville, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Otto, Kimberlyn, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
Not Applicable,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Quick, Cassandra, LPC Open
Board Certified: Not Applicable
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 3 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth Evansville
300 Union St
(608) 882-5613
Evansville, WI 53536
Advanced Practice Nurse Prescriber Practice Status:
Huenerberg, Carmen, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
White, Samuel, MD Open
Board Certified: American Board of Family Medicine
Medical Univ of South Carolina, Charleston, SC
Spartanburg Regional Family Medicine Residency Program, Spartanburg,
SC
Medical School:
Residency:
Wilke Chiropractic Office, SC
503 E Main St
(608) 882-4146
Evansville, WI 53536
Chiropractic Practice Status:
Wilke, Peter, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Fort Atkinson, WI
Fort HealthCare Behavioral Health - Fort Atkinson
500 McMillen St
(920) 563-9542
Fort Atkinson, WI 53538
Behavioral Health Clinic Practice Status:
Fort HealthCare Behavioral Health, Ft, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Psychiatry Practice Status:
Bleak, Jennifer, MD Limited
Board Certified: American Board of Psychiatry and Neurology
Univ of Illinois College of Medicine, Chicago, IL
Univ of Chicago, The Pritzker School of Medicine, Chicago, IL
Medical School:
Residency:
Fudala, Stanley, MD Limited
Board Certified: American Board of Psychiatry and Neurology
Medical Academy of Lubin, Poland
University of Cincinnati, Cincinnati, OH
Medical School:
Residency:
Fort HealthCare Behavioral Health - Fort Atkinson (Madison Ave)
1520 Madison Ave
(920) 563-4028
Fort Atkinson, WI 53538
Behavioral Health Clinic Practice Status:
Fort HealthCare Behavioral Health, Madison Ave, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Fort HealthCare Center for Dermatology
611 Sherman Ave East, 3rd Floor
(920) 568-1000
Fort Atkinson, WI 53538
Dermatology Practice Status:
Glinert, Robert, MD Open
Board Certified: American Board of Dermatology AND American Board of Internal
Medicine AND American Board of Allergy & ImmunologyRush Medical College, Chicago, IL
Univ of Rochester Associated Hospitals, Rochester, NY
Medical School:
Residency:
Okun, Martin, MD Open
Board Certified: American Board of Dermatology
Albert Einstein College of Medicine, New York, NY
Washington Univ School of Medicine, St. Louis, MO
Medical School:
Residency:
Fort HealthCare Center for Womens Health
650 McMillen St
(920) 563-8900
Fort Atkinson, WI 53538
Advanced Practice Nurse Prescriber Practice Status:
Dedrick, Joyce, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Univ of Wisconsin, Madison, WI
Not Applicable,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Aguirre de Baker, Nancy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
University of WI Madison, Madison, WI
University of WI Madison, Madison, WI
Medical School:
Residency:
Chuppa, Christine, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of WI Medical School, Madison, WI
Univ of MO, Kansas City, MO
Medical School:
Residency:
Lynk, Elizabeth, MD Open
Board Certified: Not Board Certified
Northwestern Univ Feinberg School of Medicine, Chicago, IL
St Joseph Hospital, Denver, CO
Medical School:
Residency:
Mokhtar, Julie, DO Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Osteopathic Medicine & Health Sciences, Des Moines, IA
Brooklyn Hospital Center, New York
Medical School:
Residency:
Fort HealthCare Ear, Nose and Throat Specialists
512 Wilcox St
(920) 563-6667
Fort Atkinson, WI 53538
Otolaryngology Practice Status:
Anderson, Michael, MD Open
Board Certified: American Board of Otolaryngology
Univ of Wisconsin, Madison, WI
Indiana University, Indianapolis, IN
Medical School:
Residency:
Hofmann, William, MD Open
Board Certified: American Board of Otolaryngology
Univ of Cincinnati College of Medicine, Cincinnati, OH
Indiana Univ Medical Center, Indianapolis, IN
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 4 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Fort HealthCare Fort Memorial Hospital
611 Sherman Ave East
(920) 568-5000
Fort Atkinson, WI 53538
Hospital Practice Status:
Fort HealthCare Fort Memorial Hospital, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Urgent Care Center Practice Status:
Fort HealthCare Fort Memorial Hospital-Urgent Care, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Fort HealthCare Home Health
611 Sherman Ave East
(920) 568-6500
Fort Atkinson, WI 53538
Home Health Provider Practice Status:
Fort HealthCare Home Health, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Fort HealthCare Integrated Family Care Clinic
1520 Madison Ave
(920) 563-5500
Fort Atkinson, WI 53538
Advanced Practice Nurse Prescriber Practice Status:
Ipsen, Susan, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Graceland College, Lamour, IA
,
Medical School:
Residency:
Family Medicine Practice Status:
Beck, Aaron, MD Open
Board Certified: American Board of Family Medicine
Medical College of Wisconsin, Milwaukee, WI
Univ of North Carolina at Chapel Hill School of Medicine, Hendersonville,
NC
Medical School:
Residency:
Internal Medicine Practice Status:
Winter, Jennifer, MD Open
Board Certified: American Board of Internal Medicine AND American Board of Pediatrics
Medical College of Wisconsin, Milwaukee, WI
Univ of Illinois College of Medicine, Peoria, IL
Medical School:
Residency:
Psychology Practice Status:
Roets, Cheryl, PhD Open
Board Certified: Not Applicable
Marquette Univ, Milwaukee, WI
Psychology,
Medical School:
Residency:
Fort HealthCare Internal Medicine & Pediatrics
500 McMillen St
(920) 563-5571
Fort Atkinson, WI 53538
Advanced Practice Nurse Prescriber Practice Status:
Jennrich, Heidi, APNP Open
Board Certified: Not Board Certified
Univ of Virginia School of Nursing,
,
Medical School:
Residency:
Mayer, Lauren, APNP Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse Practitioner - Primary Care)Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Smith, Geoffrey, DO Open
Board Certified: American Osteopathic Board of Family Medicine/OMT
Univ of Osteopathic Medicine & Health Sciences, Des Moines, IA
Des Moines General Hospital, Des Moines, IA
Medical School:
Residency:
Internal Medicine Practice Status:
Cannon, William, MD Open
Board Certified: Not Board Certified
Loyola Univ Chicago Stritch School of Medicine, Maywood, IL
Loyola Univ Medical Center, Maywood, IL
Medical School:
Residency:
Tackman, Thomas, MD Open
Board Certified: American Board of Internal Medicine
Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin Affiliated Hospitals,
Medical School:
Residency:
Pediatrics Practice Status:
Dewey, Julia, MD Open
Board Certified: American Board of Pediatrics
Pennsylvania State University College of Medicine, Hershey, PA
University of Wisconsin Medical School, Madison, WI
Medical School:
Residency:
Lemon, Katherine, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin Medical School, Madison, WI
Univ of Wisconsin Medicl School, Madison, WI
Medical School:
Residency:
Williams, Donald, MD Open
Board Certified: American Board of Pediatrics AND American Board of Internal Medicine
Univ of Illinois, Peoria, IL
Akron Children's Hospital, Akron, OH
Medical School:
Residency:
Fort HealthCare Orthopaedic Associates
1504 Madison Ave
(920) 563-7888
Fort Atkinson, WI 53538
Orthopedic Surgery Practice Status:
Foskett, James, MD Open
Board Certified: American Board of Orthopaedic Surgery
Loyola Univ Chicago, Stritch School of Medicine, Maywood, IL
Mayo Clinic, Rochester, MN
Medical School:
Residency:
Schuppner, Paul, DO Open
Board Certified: Not Board Certified
Midwestern Univ Chicago College of Osteopathic Medicine, Downers Grove, ILMichigan State Univ College of Osteopathic Medicine, Lansing, MI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 5 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Orthopedic Surgery Practice Status:
Zambrano, Isidoro, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
State Univ of New York College of Medicine Stony Brook Univ Hospital,
Medical School:
Residency:
Physician Assistant Practice Status:
Degnan, Deborah, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Fort HealthCare Surgical Associates
212 Milwaukee Ave West
(920) 563-7900
Fort Atkinson, WI 53538
Surgery Practice Status:
Erickson, Marc, MD Open
Board Certified: American Board of Surgery
Medical College of Wisconsin, Milwaukee, WI
Michigan State Univ, Butterworth Hosp,
Medical School:
Residency:
Kontny, Billie Gerard, MD Open
Board Certified: American Board of Surgery
Medical College of Wisconsin, Milwaukee, WI
Loyola Medical Center,, Maywood, IL
Medical School:
Residency:
McLaughlin, Jonathan, MD Open
Board Certified: American Board of Surgery
Univ of Minnesota, Minneapolis, MN
Butterworth Hospital Michigan State Univ, Grand Rapids, MI
Medical School:
Residency:
Fort HealthCare Urology Associates
520 Handeyside Ln, Ste 2
(920) 563-7744
Fort Atkinson, WI 53538
Urology Practice Status:
Kozler, Craig, MD Open
Board Certified: American Board of Urology
Michigan State University, East Lansing, MI
University of Michigan, Ann Arbor, MI
Medical School:
Residency:
Manakas, Christopher, MD Open
Board Certified: American Board of Urology
Indiana Univ School of Medicine, Indianapolis, IN
Univ of WI Hospital & Clinics, Madison, WI
Medical School:
Residency:
Luedtke-Storm-Mackey Chiropractic Clinic
825 Lexington Blvd, Ste 4
(920) 563-4970
Fort Atkinson, WI 53538
Chiropractic Practice Status:
Smith, Luke, DC Open
Board Certified: Not Applicable
National Univ of Health Science, Lombard, IL
,
Medical School:
Residency:
Tesch, Todd, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Chiropractic Practice Status:
Weyenberg, Ryan, DC Open
Board Certified: Not Applicable
Northwestern College of Chiropractic, Minneapolis, MN
,
Medical School:
Residency:
PMRis, SC - Fort Atkinson
611 Sherman Ave East
(877) 337-6747
Fort Atkinson, WI 53538
Physical Medicine & Rehabilitation Practice Status:
Fowler, William, MD Open
Board Certified: American Board of Physicial Medicine and Rehabilitation
Univ of North Dakota School of Medicine, Grand Forks, ND
Univ of Minnesota Hospital & Clinics, Minneapolis, MN
Medical School:
Residency:
Rock River Foot & Ankle Clinic
303 Hake St
(920) 563-2136
Fort Atkinson, WI 53538
Podiatry Practice Status:
Eckerman, Christopher, DPM Open
Board Certified: American Board of Foot and Ankle Surgery
Dr. William Scholl College of Podiatric Medicine, North Chicago, IL
Thoreck Hospital, Chicago, IL
Medical School:
Residency:
Graglia, Greg, DPM Open
Board Certified: American Board Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, North Chicago, IL
VA Salt Lake City Health Care Systems, Salt Lake City, UT
Medical School:
Residency:
Soderstrom, Victor, DPM Open
Board Certified: American Board of Podiatric Surgery (Foot and Ankle Surgery)
Illinois College of Podiatric Medicine, Chicago, IL
Northwest General Hospital, Milwaukee, WI
Medical School:
Residency:
Yaeggi, Brent, DPM Open
Board Certified: American Board of Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, Chicago, IL
Covenant Medical Center, Waterloo, IA
Medical School:
Residency:
Shopko Optical #4051
1425 Janesville Ave
(920) 563-2171
Fort Atkinson, WI 53538
Optometry Practice Status:
Adler, Brian, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
None listed,
Medical School:
Residency:
Cheek, Amanda, OD Open
Board Certified: Not Applicable
Indiana College of Optometry, Bloomington, IN
,
Medical School:
Residency:
Laschen, Anne-Marie, OD Open
Board Certified: Not Applicable
Michigan College of Optometry, Big Rapids, MI
,
Medical School:
Residency:
Moseman, Kristin, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 6 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
UW Health Ft Atkinson
1620 Mehta Lane
(920) 563-5544
Fort Atkinson, WI 53538
Family Medicine Practice Status:
Brantmeier, Scott, DO Open
Board Certified: American Board of Family Medicine
Chicago College of Osteopathic Medicine, Downers Grove, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
McGuire, Jeffrey, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin Medical School, Madison, WI
Univ of Wisconsin, Appleton-Fox Valley Family Practice Residency, Appleton, WI
Medical School:
Residency:
Quinn, Rachel, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin, Madison, WI
UW Family Medicine Residency Program, Madison, WI
Medical School:
Residency:
Family Medicine including Obstetrics Practice Status:
Meyer, Shauna, MD Open
Board Certified: American Board of Family Medicine
Univ of South Dakota School of Medicine, Sioux Falls, SD
UW Family Medicine Residency, St. Mary's Hospital, Madison, WI
Medical School:
Residency:
Ixonia, WI
WRMC Ixonia
W1046 Marietta Ave, Ste 230
(920) 206-6310
Ixonia, WI 53036
Advanced Practice Nurse Prescriber Practice Status:
Stinnett, Dana, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Box, Helen, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin Medical School, Madison, WI
Gunderson Lutheran, LaCrosse, WI
Medical School:
Residency:
Douglas, Linda, MD Open
Board Certified: American Board of Family Medicine
Washington Univ in St. Louis School of Medicine, St. Louis, MO
Carolinas Medical Center, Charlotte, NC
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
DeJong, Julie, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Wisconsin, Madison, WI
Univ of Iowa Hospital and Clinics, Iowa City, IA
Medical School:
Residency:
Janesville, WI
Cedar Crest Health Center
1702 S River Rd
(608) 756-0344
Janesville, WI 53546
Skilled Nursing Facility Practice Status:
Cedar Crest Health Center, , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Damrow Chiropractic Office
3628 Ridge Dr
(608) 754-3696
Janesville, WI 53548
Chiropractic Practice Status:
Byrnes-Pierce, Tina, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Damrow, James, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Keehn Chiropractic Office
2707 Kennedy Rd, Ste 202
(608) 755-1035
Janesville, WI 53545
Chiropractic Practice Status:
Hanewold, Lori, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
West, Betsy, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Mercy Assisted Care, Inc. Home Health Care
901 Mineral Point Ave
(800) 369-2201
Janesville, WI 53548
Home Health Provider Practice Status:
Mercy Assisted Care, Inc. Home Health Care, , Open
Board Certified: Not Accredited
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercy Assisted Care, Inc. Hospice Care
901 Mineral Point Ave
(800) 369-2201
Janesville, WI 53548
Hospice Care Practice Status:
Mercy Assisted Care, Inc. Hospice Care, , Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 7 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth Addiction Day Treatment Program
2600 Humes Rd, Ste 100
(608) 741-2117
Janesville, WI 53545
Advanced Practice Nurse Prescriber Practice Status:
Bunnell, Ann, APNP Open
Board Certified: American Nurses Credentialing Center (Child and Adolescent Mental
Health),
,
Medical School:
Residency:
Child & Adolescent Addictions Program Practice Status:
Mercyhealth Child and Adolescent Day Treatment, , Open
Board Certified:
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Schlegel, Courtney, LCSW Open
Board Certified: Not Applicable
UW-Madison School of Social Work, Madison, WI
,
Medical School:
Residency:
Psychiatry Practice Status:
Mallela, Rathna, MD Open
Board Certified: American Board of Psychology and Neurology
St George's Univ School of Medicine, Grenada, West Indies
SUNY Stony Brook Univ Hospital, Stony Brook, NY
Medical School:
Residency:
Mercyhealth at Home - Medical Equipment - Janesville
1010 N Washington St
(608) 755-7989
Janesville, WI 53548
Durable Medical Equipment Supplier Practice Status:
Mercyhealth at Home - Medical Equipment - Janesville,
,
Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Autism Program
580 N Washington St
(608) 756-5555
Janesville, WI 53548
Autism Treatment Practice Status:
Mercyhealth Autism Program, , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Behavioral Analyst - Autism Program Practice Status:
Burke, Amie, BA Open
Board Certified: Not Applicable
Southern Illinois Univ, Carbondale, IL
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Schlegel, Courtney, LCSW Open
Board Certified: Not Applicable
UW-Madison School of Social Work, Madison, WI
,
Medical School:
Residency:
Psychology Practice Status:
Keller, Kathryn, PhD Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - East
3524 E Milwaukee St
(608) 756-5555
Janesville, WI 53546
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - East, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Kropf, Anita, LCSW Open
Board Certified: Not Applicable
George Williams College,
Not Applicable,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Janesville
903 Mineral Point Ave
(608) 756-6530
Janesville, WI 53548
Substance Abuse Counselor Practice Status:
Grob, Ann, SAC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Janesville (Henry Palmer Building)
903 Mineral Point Ave
(608) 756-5555
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Addaquay-Corey, Audrey, APNP Open
Board Certified: American Nurses Credentialing Center (Psychiatric-Mental Health Nurse
Practitioner)Univ of Maryland, Baltimore, MD
,
Medical School:
Residency:
Bonaccorsi, Mary, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Rush Univ, Chicago, IL
,
Medical School:
Residency:
Bunnell, Ann, APNP Open
Board Certified: American Nurses Credentialing Center (Child and Adolescent Mental Health),
,
Medical School:
Residency:
Westmoreland, Danielle, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Psychiatric & Mental Health
Nurse Practitioner)Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 8 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Janesville
(Henry Palmer Building), , Board Certified: Not Applicable
,
,
Medical School:
Residency:
Clinical Substance Abuse Counselor Practice Status:
Hebert, Jaclyn, CSAC; LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Johnson, Sally, CSAC, LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Wilson, Beverly, CSAC; LPC Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Winiecki, Adrienne, CSAC Open
Board Certified: Not Applicable
Indiana Univ Northwest, Gary, IN
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Baumel, Victoria, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin - Milwaukee, Milwuakee, WI
,
Medical School:
Residency:
Benash, Jessica, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Friis, Kara, LCSW, SAC Open
Board Certified: Not Applicable
George Williams of Aurora Univ, Williams Bay, WI
,
Medical School:
Residency:
Kollmansberger, Benno, LPC, LCSW Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Kropf, Anita, LCSW Open
Board Certified: Not Applicable
George Williams College,
Not Applicable,
Medical School:
Residency:
Mattison, Faith, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Otto, Kimberlyn, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
Not Applicable,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Pedretti, Christine, LCSW Open
Board Certified: Not Applicable
UW-Milwaukee, Milwaukee WI
,
Medical School:
Residency:
Reed, Betsy, LCSW Open
Board Certified: Not Applicable
Barry Univ, Miami Shores, FL
,
Medical School:
Residency:
Splinter, Sarah, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Milwaukee, WI
,
Medical School:
Residency:
Stried, Chantel, LCSW Open
Board Certified: Not Applicable
George Williams College of Aurora Univ, Aurora, IL
Not Applicable,
Medical School:
Residency:
VandenAkker, Tricia, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin - Madison, Madison, WI
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Chellevold, Jennifer, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater
,
Medical School:
Residency:
Cisneros, Kamela, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
DeSloover, Dan, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater
,
Medical School:
Residency:
Hebert, Jaclyn, LPC; CSAC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Johnson, Sally, LPC; CSAC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Laehn, Larry, LPC, SAC Open
Board Certified: Not Applicable
Univ of Wisconsin, Oshkosh, WI
,
Medical School:
Residency:
Littig, Karen, LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Loescher, Bret, LPC, SAC Open
Board Certified: Not Applicable
WI School of Professional Psychology, Milwaukee, WI
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 9 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Licensed Professional Counselor Practice Status:
Mallon, Jocelyn, LPC, SAC Open
Board Certified: Not Applicable
Univ of Wisconsin-Whitewater, Whitewater, WI
,
Medical School:
Residency:
Mendenhall, Jeanine, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Oczus, Alicia, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Quick, Cassandra, LPC Open
Board Certified: Not Applicable
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Wilson, Beverly, CSAC; LPC Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Zamborsky, Melanie, LPC Open
Board Certified: Not Applicable
Seton Hill Univ, Greensburg, PA
,
Medical School:
Residency:
Psychiatry Practice Status:
Babu, Joshua, MD Open
Board Certified: American Board of Psychiatry and Neurology
Univ of Illinois-College of Medicine, Rockford, IL
Univ of Wisconsin, Madison, WI
Medical School:
Residency:
Callison, (Sue) Ann, MD Open
Board Certified: American Board of Psychiatry and Neurology (Child & Adolescent Psychiatry)University of Arizona, Tucson, AZ
Univ. of Arizona, Tucson, AZ
Medical School:
Residency:
Kirmani-Moe, Sobia, MD Open
Board Certified: Not Board Certified
The Texas A & M Health & Science Center, Byron, TX
Hennepin County Medical Center, Minneapolis, MN
Medical School:
Residency:
Kosnar, Tina, MD Open
Board Certified: American Board of Psychiatry and Neurology (Child & Adolescent
Psychiatry)Creighton Univ School of Medicine, Omaha, NE
Creighton-Nebraska Combined, Omaha, NE
Medical School:
Residency:
Wagner, Richard, MD Open
Board Certified: American Board of Psychiatry and Neurology
St. George Univ School of Medicine,
Texas Tech Univ Health Sciences Center, El Paso, TX
Medical School:
Residency:
Psychology Practice Status:
Hanson, Christine, PhD Open
Board Certified: Not Applicable
Ohio State Univ, Columbus, OH
,
Medical School:
Residency:
Psychology Practice Status:
Rose-Barajas, Michelle, PsyD Open
Board Certified: Not Applicable
Illinois School of Professional Psychology, Chicago, IL
,
Medical School:
Residency:
Watermolen, Katherine, PsyD Open
Board Certified: Not Applicable
Argosy Univ (Formerly MN School of Professional Psychology), Eagan,
MN,
Medical School:
Residency:
Substance Abuse Counselor Practice Status:
Friis, Kara, SAC, LCSW Open
Board Certified: Not Applicable
George Williams of Aurora Univ, Williams Bay, WI
,
Medical School:
Residency:
Laehn, Larry, SAC, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Oshkosh, WI
,
Medical School:
Residency:
Mallon, Jocelyn, SAC, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin-Whitewater, Whitewater, WI
,
Medical School:
Residency:
Maly, Sara, SAC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Mall
1010 N Washington St
(608) 756-5555
Janesville, WI 53548
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Mercy Mall, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - MercyCare Building
580 N Washington St
(608) 756-5555
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Bunnell, Ann, APNP Open
Board Certified: American Nurses Credentialing Center (Child and Adolescent Mental
Health),
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - North
3400 Deerfield Dr
(608) 756-5555
Janesville, WI 53546
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - North, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 10 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Licensed Clinical Social Worker Practice Status:
Kropf, Anita, LCSW Open
Board Certified: Not Applicable
George Williams College,
Not Applicable,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - West
1000 Mineral Point Ave
(608) 756-5555
Janesville, WI 53548
Licensed Clinical Social Worker Practice Status:
Otto, Kimberlyn, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
Not Applicable,
Medical School:
Residency:
Mercyhealth Cancer Ctr - Hematology/Medical Oncology
1000 Mineral Point Ave
(608) 756-6871
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Disch, Nicole, APRN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse)Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Hematology and/or Medical Oncology Practice Status:
Robinson, Emily, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)
Univ of Wisconsin Medical School, Madison, WI
North Carolina Baptist Hospital, Winston-Salem, NC
Medical School:
Residency:
Shekhani, Shahid, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)(Hospice & Palliative Care)Sind Medical College, Karachi, Pakistan
Prince Georges Hospital Center, Cheverly, MD
Medical School:
Residency:
Mercyhealth Cancer Ctr - Radiation Oncology
1000 Mineral Point Ave
(608) 756-6500
Janesville, WI 53548
Physician Assistant Practice Status:
Johnson, Amanda, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Western Michigan Univ, Kalamazoo, MI
None,
Medical School:
Residency:
Radiation Oncology Practice Status:
Kozak, Kevin, MD Open
Board Certified: American Board of Radiology-Radiation Oncology
Vanderbilt Univ School of Medicine, Nashville, TN
Harvard Radiation Oncology Program, Boston, MA
Medical School:
Residency:
Mercyhealth Cardiac Rehabilitiation Center - Janesville
1000 Mineral Point Ave
(608) 756-6868
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Berner, Julie, APRN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Martin, Jennifer, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
,
,
Medical School:
Residency:
Cardiology Practice Status:
Ahmed, Imdad, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular
Disease)(Electrophysiology)Gauhati Medical College, Guwahati Assam, India
Bronx Lebanon Hospital Center, Bronx, NY
Medical School:
Residency:
Gulliver, Eugene, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular
Disease)(Interventional Cardiology)Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Rengel, Lenore, MD Open
Board Certified: American Board of Internal Medicine
Saint Louis Univ School of Medicine, St. Louis, MO
Virginia Commonwealth Univ, Richmond, VA
Medical School:
Residency:
Volkert, Paul, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular
Disease)(Interventional Cardiology)Medical College of Wisconsin, Wauwatosa, WI
Medical College of WI Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Cardiology-Electrophysiology Practice Status:
Narra, Leela, MD Open
Board Certified: American Board of Internal Medicine (Clinical Cardiac
Elecrtophysiology)(Cardiovascular Disease)Guntur Medical College, Andhra Pradesh India
Cook County Hospital, Chicago, IL
Medical School:
Residency:
Smith, Jeffrey, MD Open
Board Certified: American Board of Internal Medicine (Clinical Cardiac Electrophysiology)(Cardiovascular Disease)Univ of Illinois College of Medicine, Chicago, IL
Northwestern Memorial Hospital, Chicago, IL
Medical School:
Residency:
Cardio-Thoracic Surgery Practice Status:
Goldstein, A. Sandor, MD Open
Board Certified: American Board of Thoracic Surgery
McGill University, Canada
University of Toronto, Tononto, Ontario, Canada
Medical School:
Residency:
Snider, John, MD Open
Board Certified: American Board of Thoracic Surgery (Thoracic and Cardiac Surgery)
,
,
Medical School:
Residency:
Wolnak, Kenneth, DO Open
Board Certified: American Osteopathic Board of Thoracic Cardiovascular Surgery
Chicago College of Osteopathic Medicine, Downers Grove, IL
Chicago College of Osteopathic Medicine,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 11 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Cardiovascular Disease Practice Status:
Chilukuri, Karuna, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry, IndiaSt. John Hospital and Medical Center, Detroit, MI
Medical School:
Residency:
Stoiber, Thomas, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Univ of Wisconsin Medical School, Madison, WI
Medical College of Wisconsin, Madison, WI
Medical School:
Residency:
Interventional Cardiology Practice Status:
Gulliver, Eugene, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular
Disease)(Interventional Cardiology)Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Volkert, Paul, MD Open
Board Certified: American Board of Internal Medicine (Interventional Cardiology) (Cardiovascular Disease )Medical College of Wisconsin, Wauwatosa, WI
Medical College of WI Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Pediatric Cardiology Practice Status:
Kazmouz, Suhaib, MD Open
Board Certified: American Board of Pediatrics (Pediatric Cardiology)
Aleppo Univ, Aleppo, Syria
Crozer Chester Medical Center, Chester, PA
Medical School:
Residency:
Masood, Syed, MD Open
Board Certified: American Board of Pediatrics
Dow Medical Univ - Pakistan, Karachi Sindh Pakistan
Louisiana State Univ Health Science Center, Shreveport, LA
Medical School:
Residency:
Physician Assistant Practice Status:
Dorshorst, Robert, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin - Madison, Madison, WI
,
Medical School:
Residency:
Streff, Scott, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Mercyhealth Complementary Medicine Center
1010 N Washington St
(608) 741-6799
Janesville, WI 53548
Acupuncture Practice Status:
Warnke, Matthew, Lac Open
Board Certified: Not Applicable
Southwest Acupuncture College, Santa Fe, New Mexico
,
Medical School:
Residency:
Chiropractic Practice Status:
Bridge, Karen, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Chiropractic Practice Status:
Priske, Scott, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Mercyhealth Comprehensive Inpatient Rehab Ctr
1000 Mineral Point Ave
(608) 756-6822
Janesville, WI 53548
Physical Medicine & Rehabilitation Practice Status:
Garcia, Ronald Allan M, MD Open
Board Certified: American Board of Physical Medicine and Rehabilitation
Univ of the East-Ramon Magsaysay Memorial Med Cntr, Philippines
Rehabilitation Insititue of Chicago, Northwestern University Medical
School, Chicago, IL
Medical School:
Residency:
Mercyhealth Diabetes Center
1010 N Washington St
(608) 741-2459
Janesville, WI 53548
Family Medicine Practice Status:
Reid, Timothy, MD Does NOT Practice as a PCP
Board Certified: American Board of Family Medicine
Medical College of Ohio, Toledo, OH
St. Elizabeth Med Cntr-South, Edgewood, KY
Medical School:
Residency:
Mercyhealth Dialysis Center
903 Mineral Point Ave
(608) 741-3814
Janesville, WI 53548
Nephrology Practice Status:
Anjum, Ehteshamul, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Patna Medical College, Patna Bihar, India
Metropolitan Hospital Center, New York, NY
Medical School:
Residency:
Mercyhealth East
3524 E Milwaukee St
(608) 756-7100
Janesville, WI 53546
Advanced Practice Nurse Prescriber Practice Status:
Baird, Susan, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Carlow Univ, Pittsburgh, PA
,
Medical School:
Residency:
Allergy & Immunology Practice Status:
Johnson, Tad, MD Open
Board Certified: American Board of Allergy and Immunology AND American Board of
PediatricsMayo Clinic Collegeo f Medicine, Rochester, MN
Children's Hospital of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Ragotzy, Ronald, MD Open
Board Certified: American Board of Allergy and Immunology
Wayne State Univ School of Medicine, Detroit, MI
Southwest MI Area Health Education Center, Kalamazoo, MI
Medical School:
Residency:
Dermatology Practice Status:
Nelsen, David, MD Open
Board Certified: American Board of Dermatology
Univ of Minnesota, Minneapolis, MN
Marshfield Clinic, Marshfield, WI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 12 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Endocrinology Practice Status:
Litonjua, Patrick Paul, MD Open
Board Certified: American Board of Internal Medicine (Endocrinology, Diabetes and
Metabolism)Univ of the Philippines College of Medicine, Manila, Philippines
Univ of the Philippines-Philippine General Hospital, Ermita Manila
Philippines
Medical School:
Residency:
Family Medicine Practice Status:
Altbuch, Arthur, MD Open
Board Certified: American Board of Family Medicine (Geriatric Medicine) (Sports
Medicine)Albany Medical College, Albany, NY
Bayfront Medical Center, St. Petersburg, FL
Medical School:
Residency:
Bean, Ryne, MD Open
Board Certified: American Board of Family Medicine
Windsor Univ School of Medicine, Canyon, St Kitts and Nevis
Mercyhealth Family Medicine Residency Program, Janesville, WI
Medical School:
Residency:
Ewing, Debra, DO Open
Board Certified: American Osteopathic Association
Oklahoma State Univ, Tulsa, OK
Via Christi Riverside Medical Center, Wichita, KS
Medical School:
Residency:
Hahn, Leanne, MD Open
Board Certified: American Board of Family Medicine
Medical College of Wisconsin, Milwaukee, WI
Mercy Health System Family Practice Residency Program, Janesville, WI
Medical School:
Residency:
Hussli, Jennifer, MD Open
Board Certified: American Board of Family Medicine
Univ of Sint Eustatius School of Medicine, Goldenrock, Sint Eustatius, Netherlands, Dutch CaribbeanMercy Health System, Janesville, WI
Medical School:
Residency:
Maldonado, Dennys, MD Open
Board Certified: American Board of Family Medicine
Ross University, North Brunswick, NJ
Mercy Health System, Janesville, WI
Medical School:
Residency:
Poste, Alethea, MD Open
Board Certified: American Board of Family Medicine
Univ Autonoma de Guadalajara, Guadalajar, Mexico
Mercy Health System, Janesville, WI
Medical School:
Residency:
Internal Medicine Practice Status:
Bautista, Ryndon, MD Open
Board Certified: American Board of Internal Medicine
Univ of Philippines College of medicine, Manila, Philippines
Univ of Illinois at Chicago - Advocate Christ Medical Center, Oak Lawn, IL
Medical School:
Residency:
Goelzer, Kristen, MD Closed
Board Certified: American Board of Internal Medicine AND American Board of Pediatrics
Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Honarkhah, Nader, MD Open
Board Certified: American Board of Internal Medicine
Medical College of Ohio, Toledo, OH
Oakwood Hospital & Medical Center, Dearborn, MI
Medical School:
Residency:
Khan, Kauseruzzaman, MD Open
Board Certified: American Board of Internal Medicine
Dhaka Medical College, Dhaka, Bangladesh
Mercy Catholic Medical Center, Darby, PA
Medical School:
Residency:
Ophthalmology Practice Status:
Lovelace, Kimberley, MD Open
Board Certified: American Board of Ophthalmology
Univ of Arkansas for Medical Sciences, Little Rock, AR
Univ of Tennessee Medical, Memphis, TN
Medical School:
Residency:
Optometry Practice Status:
Rockwell, John, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Angeline, Michael, MD Open
Board Certified: American Board of Orthopaedic Surgery (Orthopaedic Sports Medicine)
Georgetown Univ School of Medicine, Washington, DC
Univ of Chicago Medical Center, Chicago, IL
Medical School:
Residency:
Palmer, Douglas, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Schulman, Sidney, MD Open
Board Certified: American Board of Orthopaedic Surgery
University of Toronto Faculty of Medicine, Toronto, ON
University of Ottawa, Faculty of Medicine, Ottawa, ON
Medical School:
Residency:
Otolaryngology Practice Status:
Riggs, Landon, MD Open
Board Certified: American Board of Otolaryngology
Loyola Univ of Chicago Stritch School of Medicine, Maywood, IL
Loyola Univ of Chicago, Maywood, IL
Medical School:
Residency:
Yang, Eric, MD Open
Board Certified: American Board of Otolaryngology
Univ of Southern California, Keck School of Medicine, Los Angeles, CA
Univ of Utah, Salt Lake City, UT
Medical School:
Residency:
Pediatric Gastroenterology Practice Status:
Deutsch, David, MD Open
Board Certified: American Board of Pediatrics (Pediatric Gastroenterology)
Univ of Illinois College of Medicine - Rockford, Rockford, IL
Columbus Children's Hospital/The Ohio State Univ, Columbus, OH
Medical School:
Residency:
Nguyen, Kim-Doan, MD Open
Board Certified: American Board of Internal Medicine AND American Board of Pediatrics
(Pediatric Gastroenterology)American Univ of the Caribbean School of Medicine, Coral Gables, FL
Univ of Missouri-Columbia, Columbia, MO
Medical School:
Residency:
Vortia, Eugene, MD Open
Board Certified: American Board of Pediatrics (Pediatric Gastroenterology) and American Board of Internal MedicineUniv of Ghana Medical School, Korle Bu, ACCRA Ghanna
MI State Univ - Kalamazoo Ctr for Medical Studies, Kalamazoo, MI
Medical School:
Residency:
Pediatrics Practice Status:
Goelzer, Mark, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin Medical School, Madison, WI
University of MI Medical Center, Ann Arbor, MI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 13 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Pediatrics Practice Status:
Goelzer, Kristen, MD Closed
Board Certified: American Board of Pediatrics AND American Board of Internal Medicine
Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Gordon, Christal, MD Open
Board Certified: American Board of Pediatrics
Creighton Univ School of Medicine, Omaha, NE
Univ of Michigan Hospitals, Ann Arbor, MI
Medical School:
Residency:
Loconto, Elizabeth, DO Open
Board Certified: Not Board Certified
A.T. Still Univ, Kirksville College of Osteopathic Medicine, Kirksville, MO
Children's Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Nowak, Blaine, MD Open
Board Certified: American Board of Pediatrics
Medical College of Wisconsin, Milwaukee, WI
Milwaukee Childrens Hospital, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Imhoff, Tiana, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rosalind Franklin Univ, North Chicago, IL
,
Medical School:
Residency:
Murphy, Cristina, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Midwestern Universit, Downers Grove, IL
,
Medical School:
Residency:
Schnell, Tina, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado Health Science Center, Denver, CO
Not Applicable,
Medical School:
Residency:
Schulz, Eric, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rosalind Franklin Univ of Medicine and Science, North Chicago, IL
,
Medical School:
Residency:
Podiatry Practice Status:
Feuerstein, Catherine, DPM Open
Board Certified: American Board of Foot and Ankle Surgery
Scholl College of Podiatric Medicine, North Chicago, IL
North Port VA Residency, North Port, NY
Medical School:
Residency:
Reinicke, Alan, DPM Open
Board Certified: American Board of Foot and Ankle Surgery
Scholl College of Podiatric Medicine, Chicago, IL
Not Applicable,
Medical School:
Residency:
Rheumatology Practice Status:
Bolek Berquist, Jilaine, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Univ of Illinois Collegeof Medicine, Rockford, IL
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Sarakbi, Housam Aldeen, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Damascus Univ Medical School, Damascus Syria
Finch Univ of Health Sciences/The Chicago Medical School, North Chicago, IL
Medical School:
Residency:
Sports Medicine Practice Status:
Maldonado, Dennys, MD Open
Board Certified: Not Board Certified
Ross University, North Brunswick, NJ
Mercy Heatlh System, Janesville, WI
Medical School:
Residency:
Mercyhealth East Urgent Care
3524 E Milwaukee St
(608) 756-8484
Janesville, WI 53546
Urgent Care Center Practice Status:
Mercyhealth East Urgent Care, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Eye Center - Janesville
3524 E Milwaukee St
(608) 756-7110
Janesville, WI 53548
Ophthalmology Practice Status:
Bussa, John, MD Open
Board Certified: American Board of Ophthalmology
University of Texas Health Science Center, San Antonio, TX
Walter Reed Army Medical Center, Washington, DC
Medical School:
Residency:
Luellwitz, David, DO Open
Board Certified: American Osteopathic Board of Ophthalmology
Western Univ of Health Sciences, Pomona, CA
Midwestern University, Olympia Fields, IL
Medical School:
Residency:
Thomassen, Thom, MD Open
Board Certified: American Board of Ophthalmology
Duke University, Durham, NC
Walter Reed Army Medical Center, Washington, DC
Medical School:
Residency:
Whitehead, A. Jeffrey, MD Open
Board Certified: American Board of Ophthalmology
Univ of Wisconsin, Madison, WI
Washington Univ in St. Louis, St. Louis, MO
Medical School:
Residency:
Optometry Practice Status:
Dunphy, Erin, OD Open
Board Certified: Not Applicable
Southern College of Optometry, Memphis, TN
Not Applicable,
Medical School:
Residency:
McLaughlin, Michelle, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Mercyhealth Eye Center - Janesville Health Mall
1010 N Washington St
(608) 741-6794
Janesville, WI 53548
Optometry Practice Status:
Dunphy, Erin, OD Open
Board Certified: Not Applicable
Southern College of Optometry, Memphis, TN
Not Applicable,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 14 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Optometry Practice Status:
McLaughlin, Michelle, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Rockwell, John, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Sheetz, Brandon, OD Open
Board Certified: Not Applicable
IL College of Optometry, Chicago, Il
,
Medical School:
Residency:
Mercyhealth Hand Center
557 N Washington St
(608) 741-3812
Janesville, WI 53548
Orthopedic Surgery Practice Status:
Palmer, Douglas, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Pittenger, David, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
Blodgett Memorial Medical Center, Grand Rapids MI
Medical School:
Residency:
Mercyhealth Hospital & Trauma Center - Janesville
1000 Mineral Point Ave
(608) 756-6000
Janesville, WI 53548
Adult Addictions Program Practice Status:
Mercyhealth Addiction Day Treatment Program, , Adult
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Adult Mental Health Program Practice Status:
Mercyhealth WINGS Program, , Adult
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Hospital Practice Status:
Mercyhealth Hospital & Trauma Center - Janesville, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Neurology Practice Status:
Levine, Ross, MD Open
Board Certified: American Board of Psychiatry and Neurology
UW Medical School, Madison, WI
UW Health, Madison, WI
Medical School:
Residency:
Mercyhealth Hospital Emergency Department -Janesville
1000 Mineral Point Ave
(608) 756-6611
Janesville, WI 53548
Emergency Department Practice Status:
Mercyhealth Hospital & Trauma Center - Janesville, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth HPB Outpatient Palliative Care Clinic
903 Mineral Point Ave
(608) 563-7720
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
van Veldhuisen, Kathleen, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Mercyhealth Lung Center
903 Mineral Point Ave
(608) 752-6255
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
McCarthy, Leaellyn, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Samford University, Birmingham, AL
,
Medical School:
Residency:
Pulmonary Disease Practice Status:
Tuck, Hazen, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
MedicineThe Chicago Medical School (Rosalind Franklin Univ), North Chicago, IL
Univ of Illinois, Peoria, IL
Medical School:
Residency:
Pulmonary Disease (Critical Care
Medicine)Practice Status:
Cook, Robert, MD Open
Board Certified: American Board of Internal Medicine (Sleep Medicine)
OH State University College of Medicine, Columbus, OH
Barnes Hosp, Washington U, St. Louis, MO
Medical School:
Residency:
Mercyhealth Mall
1010 N Washington St
(608) 741-2430
Janesville, WI 53548
Family Medicine Practice Status:
Perez, Enrique, MD Open
Board Certified: American Board of Family Medicine
Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin/St. Luke's Hospital, Racine, WI
Medical School:
Residency:
Internal Medicine Practice Status:
Pogorelova, Mariya, MD Open
Board Certified: American Board of Internal Medicine
Karaganda State Medical Institute, Varagana, Vazakhstan
St. Joseph Hospital, Joel, MD
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 15 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Podiatry Practice Status:
Zainer, Gregory, DPM Open
Board Certified: American Board of Podiatric Medicine
Ohio College of Podiatric Medicine, Clevelan, OH
Not Applicable,
Medical School:
Residency:
Mercyhealth Michael Berry Building
1000 Mineral Point Ave
(608) 756-6588
Janesville, WI 53548
Advanced Practice Nurse Practice Status:
Salter Braun, Nicole, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wsconsin - Milwaukee, Milwaukee, WI
,
Medical School:
Residency:
Advanced Practice Nurse Prescriber Practice Status:
Schlueter, Stephanie, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Gastroenterology Practice Status:
Castillo, Rodrigo, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
P. Universidad Javeriana, Bogota, Columbia
Hahnemann Univ Hospital, Philadelphia, PA
Medical School:
Residency:
Khoury, Ramez, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Damascus Univ, Damascus, Syria
The Graduate Hospital, Philadelphia, PA
Medical School:
Residency:
Gynecologic Oncology Practice Status:
Mahdavi, Ali, MD Open
Board Certified: American Board of Obstetrics and Gynecology (Gynecologic Oncology)
Tehran Univ of Medical Sciences, Tehran, Iran
Providence Hospital and Medical Center, Southfield, MI
Medical School:
Residency:
Hematology and/or Medical Oncology Practice Status:
Khan, Mohammad, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)
Dow Medical College, Karachi, Pakistan
St. Barnabas Hospital, Bronx, NY
Medical School:
Residency:
Neurology Practice Status:
Holla, Smitha, MD Open
Board Certified: American Board of Psychiatry and Neurology
Bangalore Medical College and Research Institute, Bengaluru,
Karnataka, IndiaUniv of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Mercyhealth Neurosurgery Center
1000 Mineral Point Ave
(608) 756-6826
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Bestland, Jennifer, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Marquette Univ College of Nursing, Milwaukee, WI
Not Applicable,
Medical School:
Residency:
Advanced Practice Nurse Prescriber Practice Status:
Casper, Kelli, APNP Open
Board Certified: American Nurses Credentialing Center (Acute Care Nurse Practitioner)
UW Madison School of Nursing, Madison, WI
,
Medical School:
Residency:
Castelein, Courtney, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Chamerlain College, Downers Grove, IL
,
Medical School:
Residency:
Neurosurgery Practice Status:
Rust, Merle, MD Open
Board Certified: American Board of Neurological Surgery
Univ of Illinois College of Medicine, Peoria, IL
Univ of Illinois College of Medicine, Peoria, IL
Medical School:
Residency:
Sturm, Christopher, MD Open
Board Certified: American Board of Neurological Surgery
St. Louis Univ School of Medicine, St. Louis, MO
St. Louis Univ School of Medicine, St. Louis, MO
Medical School:
Residency:
Physician Assistant Practice Status:
Watring, Allysa, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Mercyhealth North
3400 Deerfield Dr
(608) 314-3600
Janesville, WI 53546
Family Medicine Practice Status:
Bowers, Ronald, MD Open
Board Certified: Not Board Certified
OH State University College of Medicine, Columbus, OH
St. Francis Hospital Center, Beech Grove, IN
Medical School:
Residency:
Kramer, Tamara, MD Open
Board Certified: American Board of Family Medicine
University of WI- Madison, Madison, WI
Mercy Family Medicine Residency Program, Janesville, WI
Medical School:
Residency:
Family Medicine including Obstetrics Practice Status:
Dabson, Janet, MD Open
Board Certified: American Board of Family Medicine
St. George's Univ, Grenada, West Indies
Mercy Health System Family Practice Residency Program, Janesville, WI
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Miller, Kristin, DO Open
Board Certified: American Board of Obstetrics and Gynecology
Des Moines Univ College of Osteopathic Medicine, Des Moines, IA
Tripler Army Medical Center, Honolulu, HI
Medical School:
Residency:
Pediatrics Practice Status:
Roe, Jonathan, MD Open
Board Certified: American Board of Pediatrics
Medical College of Milwaukee, Milwaukee, WI
Univ of Massachusetts Medical Center, Worchester, MA
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 16 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth North Emergency
3400 Deerfield Dr
(608) 314-3605
Janesville, WI 53546
Emergency Department Practice Status:
Mercyhealth Hospital & Trauma Center - North, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth North Urgent Care
3400 Deerfield Dr
(608) 314-3605
Janesville, WI 53546
Urgent Care Center Practice Status:
Mercyhealth North Urgent Care, ,
Board Certified:
,
,
Medical School:
Residency:
Mercyhealth Pain Center - Janesville
1000 Mineral Point Ave
(608) 756-6049
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Junghen, Jennifer, APNP Open
Board Certified: American Academy of Nurse Practitioners (Adult Nurse Practitioner)
Univ of Wisconsin-Milwaukee, Milwaukee
,
Medical School:
Residency:
Pain Management Practice Status:
Shah, Jaymin, DO Open
Board Certified: American Board of Anesthesiology (Pain Medicine)
Chicago College of Osteopathic Medicine, Downers Grove, IL
Medical College of WI, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Dombeck, Nathan, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
,
,
Medical School:
Residency:
Mercyhealth Plastic Surgery, Skin & Laser Center
1000 Mineral Point Ave
(608) 756-6300
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Ratzlaff, Karri, APNP Open
Board Certified: American Nurses Credentialing Center (Acute Care Nurse Practitioner)
Univ of Wisconsin School of Nursing, Madison, WI
,
Medical School:
Residency:
Physician Assistant Practice Status:
De Vos, Alissa, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Plastic Surgery Practice Status:
Paulius Quinn, Karina, MD Open
Board Certified: American Board of Surgery
Univ of Illinois at Chicago, Chicago, IL
Univ of IL - Mt. Sinai Hospital Program, Chicago, IL
Medical School:
Residency:
Mercyhealth Sleep Center - Janesville
903 Mineral Point Ave
(608) 758-5765
Janesville, WI 53548
Pulmonary Disease (Critical Care
Medicine)Practice Status:
Cook, Robert, MD Open
Board Certified: American Board of Internal Medicine (Sleep Medicine)
OH State University College of Medicine, Columbus, OH
Barnes Hosp, Washington U, St. Louis, MO
Medical School:
Residency:
Mercyhealth South
849 Kellogg Ave
(608) 755-7960
Janesville, WI 53546
Family Medicine Practice Status:
Altbuch, Arthur, MD Open
Board Certified: American Board of Family Medicine (Geriatric Medicine) (Sports
Medicine)Albany Medical College, Albany, NY
Bayfront Medical Center, St. Petersburg, FL
Medical School:
Residency:
Cooper, Keith, DO Open
Board Certified: American Osteopathic Association
Chicago College of Osteopathic Medicine, Downers Grove, IL
Medical College of Ohio, Toledo, OH
Medical School:
Residency:
DeFauw, Nicholas, DO Open
Board Certified: American Osteopathic Association (Family Medicine)
Michigan State Univ College of Osteopathic Medicine, East Lansing, MI
St. John Providence Health System, Warren, MI
Medical School:
Residency:
Stahlecker, Jared, MD Open
Board Certified: Not Board Certified
Ross Univ School of Medicine, Roseau, Dominica
Mercyhealth, Janesville, WI
Medical School:
Residency:
Family Medicine including Obstetrics Practice Status:
Anderson, Jane, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin, Madison, WI
Mercy Health System, Janesville, WI
Medical School:
Residency:
Horton, James, MD Open
Board Certified: American Board of Family Medicine
Univ of Texas Medical School at Houston, Houston, TX
UAB-Huntsville Family Medicine Residency, Huntsville, AL
Medical School:
Residency:
Shaikh, Suhail, MD Open
Board Certified: American Board of Family Medicine
Sindh Medical College Univ or Karachi, Karachi, Pakistan
Univ of Texas Medical School at San Antonio, San Antonio, TX
Medical School:
Residency:
Psychology Practice Status:
Wakely, David, PhD Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 17 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth South Urgent Care
849 Kellogg Ave
(608) 755-7960
Janesville, WI 53546
Urgent Care Center Practice Status:
Mercyhealth South Urgent Care, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Sports Medicine & Rehab Ctr - Janesville
557 N Washington St
(608) 754-6000
Janesville, WI 53548
Orthopedic Surgery Practice Status:
Klean, Kevin, DO Open
Board Certified: Not Board Certified
Des Moines Univ-College of Osteopathic Medicine, Des Moines, IA
Midwestern Univ-Franciscan St. James Health, Olympia Fields, IL
Medical School:
Residency:
Pittenger, David, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
Blodgett Memorial Medical Center, Grand Rapids MI
Medical School:
Residency:
Physical Medicine & Rehabilitation Practice Status:
Garcia, Ronald Allan M, MD Open
Board Certified: American Board of Physical Medicine and Rehabilitation
Univ of the East-Ramon Magsaysay Memorial Med Cntr, Philippines
Rehabilitation Insititue of Chicago, Northwestern University Medical School, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Curtis, Stephanie, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Midwestern Univ, Downers Grove, IL
,
Medical School:
Residency:
Psychology Practice Status:
Gartland, Howard, PhD Open
Board Certified: Not Applicable
Texas Woman's University, Denton, TX
Not Applicable,
Medical School:
Residency:
Wakely, David, PhD Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Sports Medicine Practice Status:
Rutherford, Darin, MD Open
Board Certified: American Board of Family Medicine (Sports Medicine)
Univ of Iowa College of Medicine, Iowa City,IA
St. Mary's Hospital, Milwaukee, WI
Medical School:
Residency:
Mercyhealth Terrace - Surgery
510 North Terrace St
(608) 756-6869
Janesville, WI 53548
Surgery Practice Status:
Garner, Patricia, MD Open
Board Certified: American Board of Surgery
Univ of Arkansas for Medical Sciences, Little Rock, AR
Naval Medical Center, San Diego, cA
Medical School:
Residency:
Lynn, David, MD Open
Board Certified: American Board of Surgery
Univ of Illinois College of Medicine, Rockford, IL
Baystate Medical Center, Springfield, MA
Medical School:
Residency:
McGauley, Michael, DO Open
Board Certified: American Osteopathic Board of Surgery - General
Kansas City Univ of Medicine and Biosciences, Kansas City, MO
Garden City Osteopathic Hosp-MI State Univ, Garden City, MI
Medical School:
Residency:
Shaaban, Hadi, DO Open
Board Certified: Not Board Certified
Midwestern Univ, Downers Grove, IL
Garden City Hospital, Garden City, MI
Medical School:
Residency:
Mercyhealth Transitional Care Center
1000 Mineral Point Ave
(608) 756-6050
Janesville, WI 53548
Skilled Nursing Facility Practice Status:
Mercy Manor Transition Center Skilled Nursing Facility,
,
Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth Urology Center
1000 Mineral Point Ave
(608) 741-6990
Janesville, WI 53548
Urology Practice Status:
Gianitsos, A. Nicholas, MD Open
Board Certified: American Board of Urology
Boston Univ School of Medicine, Boston, MA
Univ of Wisconsin Hospitals & Clinics, Madison, WI
Medical School:
Residency:
Kaveggia, Francis, MD Open
Board Certified: American Board of Urology
Univ of Wisconsin Medical School, Madison, WI
Univ of Nebraska Medical Center, Omaha, NE
Medical School:
Residency:
Mercyhealth West
1000 Mineral Point Ave
(608) 756-6800
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Wimmer, Jennifer, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Infectious Disease Practice Status:
Konkol, Keith, MD Closed
Board Certified: American Board of Internal Medicine (Infectious Disease)(Hospice & Palliative Care)Univ of Wisconsin Medical School, Madison, WI
Walter Reed Army Medical School, Washington, DC
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 18 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Nephrology Practice Status:
Shaikh, Sumaira, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Aga Khem Univ, Karachi Pakistan
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Mercyhealth WINGS Program
903 Mineral Point Ave
(608) 756-6530
Janesville, WI 53548
Licensed Professional Counselor Practice Status:
Davis, Rebecca, LPC, SAC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, Whitewater, WI
,
Medical School:
Residency:
Substance Abuse Counselor Practice Status:
Davis, Rebecca, SAC, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, Whitewater, WI
,
Medical School:
Residency:
Mercyhealth Women's Center - Janesville
1000 Mineral Point Ave
(608) 756-6890
Janesville, WI 53548
Advanced Practice Nurse Prescriber Practice Status:
Harris, Margot, APNP Open
Board Certified: National Certification Corporation (Women's Health Care Nurse PractitionerVanderbilt Univ School of Nursing, Nashville, TN
Not Applicable,
Medical School:
Residency:
Gynecology Practice Status:
Neuman, Carol, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Emory Univ School of Medicine, Atlanta, GA
Emory Univ School of Medicine, Atlanta, GA
Medical School:
Residency:
Maternal-Fetal Medicine Practice Status:
Rogers, Dennie, MD Open
Board Certified: American Board of Obstetrics and Gynecology (Maternal-Fetal Medicine)
Univ of Illinois, Chicago, IL
Univ of Illinois @ Chicago, Chicago, IL
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Kaldor, Katheryn, DO Open
Board Certified: American Osteopathic Board of Obstetrics and Gynecology
Kansas City Univ of Medicine, Kansas City, MO
Philadelphia College of Osteopathic Medicine, Philadelphia, PA
Medical School:
Residency:
Munns, Meridyth, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Health Sciences, North Chicago, IL
Univ of WI Hospitals and Clinics, Madison, WI
Medical School:
Residency:
Nahn, Patricia, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Wisconsin Medical School, Madison, WI
Univ of Texas, Houston, TX
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Newmark, Dorothy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
State Univ of New York, Syracuse, NY
Univ of WI Hospital & Clinics, Madison, WI
Medical School:
Residency:
Okocha, Chukwunonyeluanyi, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Minnesota-Twin Cities, Minneapolis, MN
Univ of Texas Medical Branch, Galveston, TX
Medical School:
Residency:
Wistrom, Elana, DO Open
Board Certified: American Osteopathic Board of Obstetrics and Gynecology
A.T. Still Univ, Kirksvill, MO
Henry Ford Macomb Hospital, Clinton Twp, MI
Medical School:
Residency:
Premier Oral & Maxillofacial Surgery
1602 N Randall Ave
(608) 756-8744
Janesville, WI 53545
Oral & Maxillofacial Surgery Practice Status:
Kuerschner, Thomas, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Marquette Univ School of Dentistry, Milwaukee, WI
Univ of Louisville, Louisville, KY
Medical School:
Residency:
Meister, Richard, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Marquette Univ School of Dentistry, Milwaukee, WI
Hosp of St Raphael, New Haven, CT
Medical School:
Residency:
Swantek, Jason, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
UIC College of Dentistry, Chicago, IL
Woodhull Medical Center, Brooklyn, NY
Medical School:
Residency:
Rock Haven
3400 N County HWY F
(608) 757-5000
Janesville, WI 53547
Skilled Nursing Facility Practice Status:
Rock Haven, , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Jefferson, WI
Central Jefferson Chiropractic
202 N Main St
(920) 674-5025
Jefferson, WI 53549
Chiropractic Practice Status:
Lewis, Alan, DC Open
Board Certified: Not Applicable
National College of Chiropractic, Lombard, IL
Not Applicable,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 19 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Fort HealthCare Jefferson
840 W Racine St
(920) 674-6000
Jefferson, WI 53549
Advanced Practice Nurse Prescriber Practice Status:
Lyons, Noreen, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wisconsin, Milwaukee, WI
Not Applicable,
Medical School:
Residency:
Physician Assistant Practice Status:
DeThier, Miranda, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Fort HealthCare Orthopaedic Associates
840 W Racine St
(920) 563-7888
Jefferson, WI 53549
Orthopedic Surgery Practice Status:
Schuppner, Paul, DO Open
Board Certified: Not Board Certified
Midwestern Univ Chicago College of Osteopathic Medicine, Downers
Grove, ILMichigan State Univ College of Osteopathic Medicine, Lansing, MI
Medical School:
Residency:
Jefferson County Human Services
1541 Annex Rd
(920) 674-3105
Jefferson, WI 53549
Licensed Clinical Social Worker Practice Status:
Bykowski, Brandon, LCSW Open
Board Certified: Not Applicable
Univ of WI - Madison, Madison, WI
,
Medical School:
Residency:
Dunham, Lisa, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Milwaukeem WI
,
Medical School:
Residency:
Fischer, David, LCSW Open
Board Certified: Not Applicable
Aurora Univ at George Williams College, Aurora, IL
,
Medical School:
Residency:
Licensed Marriage & Family Therapist Practice Status:
Melvin, Katherin, LMFT Open
Board Certified: Not Applicable
Edgewood College, Madison, WI
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Doerr, Krista, LPC Open
Board Certified: Not Applicable
Univ of Wiscons - Whitewater, Whitewater, WI
,
Medical School:
Residency:
Lightner, Amanda, LPC Open
Board Certified: Not Applicable
Multmomah Dept of Juvinielle Justice, Portland, OR
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Wendt, Jennifer, LPC Open
Board Certified: Not Applicable
Chicago School of Professional Psychology, Chicago, IL
,
Medical School:
Residency:
Johnson Creek, WI
Fort HealthCare Center for Womens Health
400 Doctors Ct
(920) 699-3600
Johnson Creek, WI 53038
Obstetrics and Gynecology Practice Status:
Aguirre de Baker, Nancy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
University of WI Madison, Madison, WI
University of WI Madison, Madison, WI
Medical School:
Residency:
Chuppa, Christine, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of WI Medical School, Madison, WI
Univ of MO, Kansas City, MO
Medical School:
Residency:
Fort HealthCare Johnson Creek
400 Doctors Ct
(920) 699-4000
Johnson Creek, WI 53038
Advanced Practice Nurse Prescriber Practice Status:
Lyons, Noreen, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wisconsin, Milwaukee, WI
Not Applicable,
Medical School:
Residency:
Family Medicine Practice Status:
Misorski, David, MD Open
Board Certified: American Board of Family Medicine
Medical College of WI-Milwaukee, Milwaukee, WI
Medical College of WI-Milwaukee, Milwaukee, WI
Medical School:
Residency:
Misorski, David, MD Open
Board Certified: American Board of Family Medicine
Medical College of WI-Milwaukee, Milwaukee, WI
Medical College of WI-Milwaukee, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
DeThier, Miranda, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Urology Practice Status:
Manakas, Christopher, MD Open
Board Certified: American Board of Urology
Indiana Univ School of Medicine, Indianapolis, IN
Univ of WI Hospital & Clinics, Madison, WI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 20 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Fort HealthCare Wound & Edema Center
400 Doctors Ct
(920) 699-4245
Johnson Creek, WI 53038
Physical Medicine & Rehabilitation Practice Status:
Goldman, Robert, MD Open
Board Certified: American Board of Physicial Medicine and Rehabilitation AND American
Board of Preventive Medicine (Undersea & Hyperbaric Medicine)Univ of Texas Medical Branch at Galveston, Galveston, TX
MCP Hahnemann Univ School of Medicine, Philadephia, PA
Medical School:
Residency:
Podiatry Practice Status:
Yaeggi, Brent, DPM Open
Board Certified: American Board of Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, Chicago, IL
Covenant Medical Center, Waterloo, IA
Medical School:
Residency:
Surgery Practice Status:
McLaughlin, Jonathan, MD Open
Board Certified: American Board of Surgery
Univ of Minnesota, Minneapolis, MN
Butterworth Hospital Michigan State Univ, Grand Rapids, MI
Medical School:
Residency:
Three Oaks Health, SC
480 Village Walk Ln, Ste F
(920) 542-3010
Johnson Creek, WI 53038
Family Medicine including Obstetrics Practice Status:
Milford, James, MD Clinic Opening 1/3/17
Board Certified: American Board of Family Medicine
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
St. Michael's, Milwaukee, WI
Medical School:
Residency:
UWHP Center for Eye Care - Johnson Creek
540 Village Walk Ln, Ste G
(920) 699-4388
Johnson Creek, WI 53038
Ophthalmology Practice Status:
Van Hecke, Holly, MD Open
Board Certified: American Board of Ophthalmology
Univ of Illinois College of Medicine, Chicago, IL
Univ of Illinois Eye & Ear Infirmary, Chicago, IL
Medical School:
Residency:
Optometry Practice Status:
Anslinger, John, OD Open
Board Certified: Not Applicable
Indiana Univ, Indiana
Not Applicable,
Medical School:
Residency:
WRMC Center for Eye Care - Johnson Creek
540G Village Walk Ln
(920) 699-4388
Johnson Creek, WI 53038
Ophthalmology Practice Status:
Boush, George, MD Open
Board Certified: American Board of Ophthalmology
Univ of Wisconsin, Madison, WI
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Ophthalmology Practice Status:
Sullivan, Sheila, DO Open
Board Certified: Not Board Certified
DesMoines Univ, College of Osteopathic Medicine, Des Moines, IA
Philadeplphia College of Osteopathic Medicine, Philadelphia, PA
Medical School:
Residency:
Optometry Practice Status:
Roberson, Daniel, OD Open
Board Certified: Not Applicable
New England College of Optometry, Boston, MA
Captain James A. Lovell Federal Health Care Center, N. Chicago, IL
Medical School:
Residency:
WRMC Johnson Creek Clinic
540 Village Walk Ln, Ste J
(920) 699-6200
Johnson Creek, WI 53038
Orthopedic Surgery Practice Status:
Roman, Terry, DO Open
Board Certified: Not Board Certified
A.T. Still University, Kirksville, MO
Michigan State University, Grand Blanc, MI
Medical School:
Residency:
Physician Assistant Practice Status:
Hunter, Cathy, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Kolkovich, Cheryl, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Finch Univ of Health Sciences, The Chicago Medical School, North
Chicago, ILNot Applicable,
Medical School:
Residency:
Laurent, Allison, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado, Denver, CO
,
Medical School:
Residency:
Kenosha, WI
Rogers Memorial Hospital - Kenosha
9916 - 75th St
(800) 767-4411
Kenosha, WI 53140
Child & Adolescent Mental Health
ProgramPractice Status:
Rogers Memorial Hospital - Kenosha, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Lake Geneva, WI
Geneva Lakes Manor
211 S Curtis St
(262) 248-3145
Lake Geneva, WI 53147
Skilled Nursing Facility Practice Status:
Geneva Lakes Manor, , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 21 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth Hospital & Medical Center - Walworth
N2950 State Road 67
(877) 893-5503
Lake Geneva, WI 53147
Advanced Practice Nurse Prescriber Practice Status:
Disch, Nicole, APRN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse)Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Farrell, Amanda, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
UW- Milwaukee, Milwaukee, WI
,
Medical School:
Residency:
Junghen, Jennifer, APNP Open
Board Certified: American Academy of Nurse Practitioners (Adult Nurse Practitioner)
Univ of Wisconsin-Milwaukee, Milwaukee
,
Medical School:
Residency:
Martin, Jennifer, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
,
,
Medical School:
Residency:
Allergy & Immunology Practice Status:
Johnson, Tad, MD Open
Board Certified: American Board of Allergy and Immunology AND American Board of PediatricsMayo Clinic Collegeo f Medicine, Rochester, MN
Children's Hospital of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Cardiology Practice Status:
Bortin, Kenneth, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Hahnemann Univ, Philadelphia, PA
Medical College of Pennsylvania, Philadelphia, PA
Medical School:
Residency:
Cardiovascular Disease Practice Status:
Khemani, Anil, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Patna Med College, Patna, India
All India Inst of Med Sciences, New Delhi, India
Medical School:
Residency:
Dermatology Practice Status:
Compton, Marguerite, MD Open
Board Certified: American Board of Dermatology
Medical College of Wisconsin, Milwaukee, WI
Medical College of WI Clinics at Froedtert Hospital, Milwaukee, WI
Medical School:
Residency:
Gharia, Manish, MD Open
Board Certified: American Board of Dermatology
Medical College of Wisconsin, Milwaukee, WI
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Emergency Department Practice Status:
Mercyhealth Walworth Hospital and Medical Center -
Emergency, ,
Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Family Medicine Practice Status:
Allison, Daniel, MD Open
Board Certified: American Board of Family Medicine
Ross Univ School of Medicine, North Brunswick, NJ
Medical College of WI - St. Joseph Hospital, Milwaukee, WI
Medical School:
Residency:
Draper, Dominic, MD Open
Board Certified: American Board of Family Medicine
American Univ of Antigua, New York, NY
Medical College of Wisconsin St. Joseph's/All Saints, Milwaukee, WI
Medical School:
Residency:
McCoy, James, MD Open
Board Certified: American Board of Family Medicine (Geriatric Medicine)
Loyola Univ , Stritch School of Medicine, Maywood, IL
MacNeal Memorial Hospital, Berwyn, IL
Medical School:
Residency:
Gastroenterology Practice Status:
Khoury, Ramez, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Damascus Univ, Damascus, Syria
The Graduate Hospital, Philadelphia, PA
Medical School:
Residency:
Qazi, Baseer, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Declan College of Medical Sciences, Hyderabad, India
Advocate Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Hematology and/or Medical Oncology Practice Status:
Shekhani, Shahid, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)(Hospice & Palliative Care)Sind Medical College, Karachi, Pakistan
Prince Georges Hospital Center, Cheverly, MD
Medical School:
Residency:
Hospital Practice Status:
Mercyhealth Walworth Hospital and Medical Center, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Nephrology Practice Status:
Shaikh, Sumaira, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Aga Khem Univ, Karachi Pakistan
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Neurology Practice Status:
Gorelik, Maxim, MD Open
Board Certified: American Board of Psychiatry and Neurology (Pain Medicine)
Rush Medical College of Rush Univ, Chicago, IL
Univ of California, Davis Medical Center, Sacramento, CA
Medical School:
Residency:
Neurosurgery Practice Status:
Rust, Merle, MD Open
Board Certified: American Board of Neurological Surgery
Univ of Illinois College of Medicine, Peoria, IL
Univ of Illinois College of Medicine, Peoria, IL
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Osipova, Anastasia, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Russian State Medical Univ, Moscow, Russia
Russian State Medical Academy of Postgraduate Education, Moscow,
Russia
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 22 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Obstetrics and Gynecology Practice Status:
Villegas Van der Linde, Silvia, MD Open
Board Certified: American Board of Obstetrics and Gynecology
UNIBE - Universidad Iberoamericana, Santo Domingo, Dominican RepublicMount Sinai Hospital, Chicago, IL
Medical School:
Residency:
Ophthalmology Practice Status:
Luellwitz, David, DO Open
Board Certified: American Osteopathic Board of Ophthalmology
Western Univ of Health Sciences, Pomona, CA
Midwestern University, Olympia Fields, IL
Medical School:
Residency:
Whitehead, A. Jeffrey, MD Open
Board Certified: American Board of Ophthalmology
Univ of Wisconsin, Madison, WI
Washington Univ in St. Louis, St. Louis, MO
Medical School:
Residency:
Optometry Practice Status:
Rockwell, John, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Fideler, Bradley, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of Iowa College of Medicine, Iowa City, IA
Univ of Southern California, Los Angeles, CA
Medical School:
Residency:
Lyon, Craig, MD Open
Board Certified: American Board of Orthopaedic Surgery
Rush Medical College, Chicago, Il
Univ of Iowa Hospitals & Clinics, Iowa City, IA
Medical School:
Residency:
Otolaryngology Practice Status:
Riggs, Landon, MD Open
Board Certified: American Board of Otolaryngology
Loyola Univ of Chicago Stritch School of Medicine, Maywood, IL
Loyola Univ of Chicago, Maywood, IL
Medical School:
Residency:
Yang, Eric, MD Open
Board Certified: American Board of Otolaryngology
Univ of Southern California, Keck School of Medicine, Los Angeles, CA
Univ of Utah, Salt Lake City, UT
Medical School:
Residency:
Pediatrics Practice Status:
Lyon, Shaunna, MD Open
Board Certified: American Board of Pediatrics
Univ of Illinois College of Medicine, Chicago, IL
Univ of Iowa Hospitals & Clinics, Iowa City, IA
Medical School:
Residency:
Potsch, Shirley, MD Open
Board Certified: Not Board Certified
Southern Illinois Univ School of Medicine, Springfield, IL
Univ of Nebraska Medical Center, Omaha, NE
Medical School:
Residency:
Physical Medicine & Rehabilitation Practice Status:
Garcia, Ronald Allan M, MD Open
Board Certified: American Board of Physical Medicine and Rehabilitation
Univ of the East-Ramon Magsaysay Memorial Med Cntr, Philippines
Rehabilitation Insititue of Chicago, Northwestern University Medical School, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Burns, Kevin, PA-C Open
Board Certified: The National Commission on Certification of Physician Assistants
Rosalind Franklin Univ of Medicine and Health Sciences, North Chicago, IL,
Medical School:
Residency:
Houtakker, Jeremy, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
,
,
Medical School:
Residency:
Palecek, Erin, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Toledo, Toledo, OH
,
Medical School:
Residency:
Schnell, Tina, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado Health Science Center, Denver, CO
Not Applicable,
Medical School:
Residency:
Plastic Surgery Practice Status:
Paulius Quinn, Karina, MD Open
Board Certified: American Board of Surgery
Univ of Illinois at Chicago, Chicago, IL
Univ of IL - Mt. Sinai Hospital Program, Chicago, IL
Medical School:
Residency:
Podiatry Practice Status:
Loch, Archibald, DPM Open
Board Certified: Not Board Certified
Rosalind Franklin Univ, North Chicago, IL
Massachusetts General Hospital, Boston, MA
Medical School:
Residency:
Psychology Practice Status:
Catuara, Katherine, PsyD Open
Board Certified: Not Applicable
Roosevelt Univ, Chicago, IL
,
Medical School:
Residency:
Gartland, Howard, PhD Open
Board Certified: Not Applicable
Texas Woman's University, Denton, TX
Not Applicable,
Medical School:
Residency:
Hanson, Christine, PhD Open
Board Certified: Not Applicable
Ohio State Univ, Columbus, OH
,
Medical School:
Residency:
Pulmonary Disease Practice Status:
Balagani, Rajesh, DO Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease)(Critical Care Medicine)Chicago College of Osteopathic Medicine, Midwestern Univ, Downers Grove, IL
Evanston Northwestern Hospital, Evanston, IL
Medical School:
Residency:
Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 23 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Surgery Practice Status:
Greenberg, James, MD Open
Board Certified: American Board of Surgery
Univ of Missouri, Kansas City, MO
Loyola Univ Medical Center, Maywood, IL
Medical School:
Residency:
Urology Practice Status:
Gianitsos, A. Nicholas, MD Open
Board Certified: American Board of Urology
Boston Univ School of Medicine, Boston, MA
Univ of Wisconsin Hospitals & Clinics, Madison, WI
Medical School:
Residency:
Kaveggia, Francis, MD Open
Board Certified: American Board of Urology
Univ of Wisconsin Medical School, Madison, WI
Univ of Nebraska Medical Center, Omaha, NE
Medical School:
Residency:
Vascular Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
Mercyhealth Lakeside Orthopaedics
352 Peller Rd
(262) 248-4467
Lake Geneva, WI 53147
Orthopedic Surgery Practice Status:
Knavel, James, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of Iowa College of Medicine, Iowa City, IA
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Mercyhealth Sports Medicine & Rehab Ctr - Walworth
N2950 State Road 67
(877) 893-5503
Lake Geneva, WI 53147
Physical Medicine & Rehabilitation Practice Status:
Garcia, Ronald Allan M, MD Open
Board Certified: American Board of Physical Medicine and Rehabilitation
Univ of the East-Ramon Magsaysay Memorial Med Cntr, Philippines
Rehabilitation Insititue of Chicago, Northwestern University Medical
School, Chicago, IL
Medical School:
Residency:
Mercyhealth Walworth Urgent Care
N2950 State Road 67
(262) 245-2230
Lake Geneva, WI 53147
Urgent Care Center Practice Status:
Mercyhealth Urgent Care - Walworth, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Lake Mills, WI
Fort HealthCare Lake Mills Clinic
200 E Tyranena Park Rd
(920) 648-8393
Lake Mills, WI 53551
Advanced Practice Nurse Prescriber Practice Status:
Runte, Laurel, APNP Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner)Not Applicable,
Not Applicable,
Medical School:
Residency:
Schultz, Kristin, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Flood, James, MD Open
Board Certified: American Board of Family Medicine
University of Michigan Medical School, AnnArbor, MI
Loma Linda University Family Practice Residency Program, Loma Linda, CA
Medical School:
Residency:
Philbin, Jennifer, MD Open
Board Certified: American Board of Family Medicine
Univ of Illinois College of Medicine, Chicago, IL
Univ of Illinois College of Medicine, Chicago, IL
Medical School:
Residency:
Internal Medicine Practice Status:
Wishau, James, MD Open
Board Certified: American Board of Internal Medicine
Univ of Wisconsin Medical School, Madison, WI
Kettering Med Cntr, Wright ST Univ., Dayton, OH
Medical School:
Residency:
Psychology Practice Status:
Mitchell, Colleen, PhD Open
Board Certified: Not Applicable
Adler Univ, Chicago, IL
,
Medical School:
Residency:
Fort HealthCare Lake Mills Urgent Care
200 E Tyranena Park Rd
(920) 648-3113
Lake Mills, WI 53551
Urgent Care Center Practice Status:
Fort HealthCare Lake Mills Urgent Care, , Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Fort HealthCare Orthopaedic Associates
200 E Tyranena Park Rd
(920) 563-7888
Lake Mills, WI 53551
Orthopedic Surgery Practice Status:
Zambrano, Isidoro, MD Open
Board Certified: American Board of Orthopaedic Surgery
Medical College of Wisconsin, Milwaukee, WI
State Univ of New York College of Medicine Stony Brook Univ Hospital,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 24 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Rock River Foot & Ankle Clinic
1025 Mulberry St
(920) 261-9591
Lake Mills, WI 53551
Podiatry Practice Status:
Yaeggi, Brent, DPM Open
Board Certified: American Board of Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, Chicago, IL
Covenant Medical Center, Waterloo, IA
Medical School:
Residency:
WRMC Lake Mills Clinic
1025 Mulberry St
(920) 648-4518
Lake Mills, WI 53551
Advanced Practice Nurse Prescriber Practice Status:
Howard, Karen, APNP Open
Board Certified: National Certification Corporation (Women's Health Care Nurse
Practitioner)Mt. Senario Collge, Ladysmith, WI
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Peters, Christopher, LCSW Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
DeJong, Julie, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Wisconsin, Madison, WI
Univ of Iowa Hospital and Clinics, Iowa City, IA
Medical School:
Residency:
Nguyen, VanLy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Arkansas for Medical Sciences, Little Rock, AR
Cooper Univ Hospital UMDNJ, Camden, NJ
Medical School:
Residency:
Siddiqui, Danish, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Aga Khan Medical College, Karachi, Pakistan
Bridgeport Hospital, Bridgeport, CT
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Rhodes, Steven, MD Open
Board Certified: American Board of Orthopaedic Surgery
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Hunter, Cathy, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Kolkovich, Cheryl, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Finch Univ of Health Sciences, The Chicago Medical School, North
Chicago, ILNot Applicable,
Medical School:
Residency:
Laurent, Allison, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado, Denver, CO
,
Medical School:
Residency:
Madison, WI
AIDS Resource Center
600 Williamson Stt, Ste H
(800) 486-6276
Madison, WI 53703
Patient Centered Medical Home Practice Status:
AIDS Resource Center, , Open
Board Certified: NCQA - Patient Centered Medical Home
,
,
Medical School:
Residency:
Madison East Comprehensive Treatment Center
5109 World Dairy Expo Dr
(608) 242-0220
Madison, WI 53718
Methadone Clinic Practice Status:
Madison East Comprehensive Treatment Center, , Open
Board Certified: CARF Accredited
,
,
Medical School:
Residency:
Madison West Comprehensive Treatment Center
151 E Badger Rd, Ste A
(608) 250-2512
Madison, WI 53713
Methadone Clinic Practice Status:
Madison West Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
Meriter Hospital
202 South Park St
(608) 267-6000
Madison, WI 53715
Child & Adolescent Addictions Program Practice Status:
Meriter Hospital Inc, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Child & Adolescent Mental Health
ProgramPractice Status:
Meriter Hospital Inc, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
MW Counseling, LLC
429 Gammon Place, Ste 200
(608) 843-7055
Madison, WI 53719
Behavioral Health Clinic Practice Status:
MW Counseling, LLC, , Open
Board Certified:
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 25 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Licensed Professional Counselor Practice Status:
Walden, Melissa, LPC Open
Board Certified: Not Applicable
Nova Univ, Fort Lauderdale, FL
,
Medical School:
Residency:
The Integral Psychology Center
1619 Monroe St
(608) 255-9330
Madison, WI 53711
Behavioral Health Clinic Practice Status:
The Integral Psychology Center, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Geer, Susan, LCSW Open
Board Certified: Not Applicable
New York University,
Not Applicable,
Medical School:
Residency:
Merritt, Dennis, LCSW Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Whelan, Meredith, LCSW Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Psychology Practice Status:
Cunningham, Lauren, PhD Open
Board Certified: Not Applicable
Univ of Kentucky, Lexington, KY
,
Medical School:
Residency:
Lund, Erika, PsyD Open
Board Certified: Not Applicable
Illinois School of Professional Psychology, Chicago, IL
,
Medical School:
Residency:
Mahlberg, Arden, PhD Open
Board Certified: Not Applicable
Not Applicable,
Klameth Mental Health Center, Klameth Falls, OR
Medical School:
Residency:
Rissman, Margaret, PsyD Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Milton, WI
Hammer Chiropractic, LLC
840 Arthur Dr
(608) 868-4343
Milton, WI 53563
Chiropractic Practice Status:
Hammer, Christopher, DC Open
Board Certified: Not Applicable
Northwestern College of Chiropractic, Bloomington, MN
Reeve Chiro Clinic, Austin, MN
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Milton
725 S Janesville St
(608) 756-5555
Milton, WI 53563
Licensed Clinical Social Worker Practice Status:
Benash, Jessica, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Mercyhealth Milton
725 South Janesville St
(608) 868-5800
Milton, WI 53563
Family Medicine Practice Status:
Kulas, Daniel, MD Open
Board Certified: American Board of Family Medicine
Medical College of Wisconsin,
Mercy Health System Family Medicine Residency Program, Janesville, WI
Medical School:
Residency:
Riethmiller, Daniel, MD Open
Board Certified: American Board of Family Medicine
Indiana Univ School of Medicine, Indianapolis, IN
North Colorado Family Medicine, Greeley, CO
Medical School:
Residency:
Van Beek, Rodney, MD Open
Board Certified: American Board of Family Medicine
Univ of Oklahoma College of Medicine, Oklahoma City, OK
Mercy Health System Family Practice Residency Program, Janesville, WI
Medical School:
Residency:
Nephrology Practice Status:
Shaikh, Sumaira, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Aga Khem Univ, Karachi Pakistan
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Wistrom, Elana, DO Open
Board Certified: American Osteopathic Board of Obstetrics and Gynecology
A.T. Still Univ, Kirksvill, MO
Henry Ford Macomb Hospital, Clinton Twp, MI
Medical School:
Residency:
Physician Assistant Practice Status:
Dahl, Carrie, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Milwaukee, WI
10th Street Comprehensive Treatment Center
4800 S 10th St, Unit 1
(414) 744-5370
Milwaukee, WI 53221
Methadone Clinic Practice Status:
10th Street Comprehensive Treatment Center, , Open
Board Certified: CARF Accredited
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 26 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
River's Shore Comprehensive Treatment Center
3707 N Richards St
(414) 967-7012
Milwaukee, WI 53212
Methadone Clinic Practice Status:
River's Shore Comprehensive Treatment Center, , Open
Board Certified: CARF Accredited
,
,
Medical School:
Residency:
Monona, WI
Tellurian Outpatient Clinic
5900 Monona Dr, Ste 300
(608) 442-4333
Monona, WI 53716
Adult Addictions Program Practice Status:
Tellurian Outpatient Clinic, , Open
Board Certified:
,
,
Medical School:
Residency:
Monroe, WI
Monroe Manor
516 26th Ave
(608) 325-9141
Monroe, WI 53566
Skilled Nursing Facility Practice Status:
Monroe Manor Nursing & Rehabilitation Center, , Open
Board Certified: Not Accredited
Not Applicable,
Not Applicable,
Medical School:
Residency:
Premier Oral & Maxillofacial Surgery
1005 16th Ave
(608) 325-7177
Monroe, WI 53566
Oral & Maxillofacial Surgery Practice Status:
Kuerschner, Thomas, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Marquette Univ School of Dentistry, Milwaukee, WI
Univ of Louisville, Louisville, KY
Medical School:
Residency:
Meister, Richard, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Marquette Univ School of Dentistry, Milwaukee, WI
Hosp of St Raphael, New Haven, CT
Medical School:
Residency:
Swantek, Jason, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
UIC College of Dentistry, Chicago, IL
Woodhull Medical Center, Brooklyn, NY
Medical School:
Residency:
Oconomowoc, WI
Rogers Memorial Hospital - Oconomowoc
34700 Valley Rd
(800) 767-4411
Oconomowoc, WI 53066
Adult Addictions Program Practice Status:
Rogers Memorial Hospital - Oconomowoc, , Adult
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Child & Adolescent Mental Health
ProgramPractice Status:
Rogers Memorial Hospital - Oconomowoc, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Racine, WI
Racine Comprehensive Treatment Center
5735 Durand Ave, Ste A
(262) 598-1392
Racine, WI 53406
Methadone Clinic Practice Status:
Racine Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
Sheboygan, WI
Sheboygan Comprehensive Treatment Center
2842 S Business Dr
(920) 458-6527
Sheboygan, WI 53081
Methadone Clinic Practice Status:
Sheboygan Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
Waterloo, WI
WRMC Waterloo Clinic
111 Anna St
(920) 478-3776
Waterloo, WI 53594
Advanced Practice Nurse Prescriber Practice Status:
Howard, Karen, APNP Open
Board Certified: National Certification Corporation (Women's Health Care Nurse Practitioner)Mt. Senario Collge, Ladysmith, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Siragusa, Jenifer, DO Open
Board Certified: American Board of Family Medicine
Arizona College of Osteopathic Medicine - Midwestern Univ, Glendale, AZ
St. Luke's Family Practice, Milwaukee, WI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 27 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Obstetrics and Gynecology Practice Status:
Nguyen, VanLy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Arkansas for Medical Sciences, Little Rock, AR
Cooper Univ Hospital UMDNJ, Camden, NJ
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Rhodes, Steven, MD Open
Board Certified: American Board of Orthopaedic Surgery
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Laurent, Allison, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado, Denver, CO
,
Medical School:
Residency:
Marsden, (Gordon) Roy, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin, Madison, WI
,
Medical School:
Residency:
Watertown, WI
Central Otologic, LTD
123 Hospital Dr, Ste 106A
(920) 261-0226
Watertown, WI 53098
Otolaryngology Practice Status:
Janowak, Michael, MD Open
Board Certified: American Board of Otolaryngology
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
Med College of Wisconsin, Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Martinelli, Dean, MD Open
Board Certified: American Board of Otolaryngology
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
Milwaukee County General Hosp,
Medical School:
Residency:
Directions Counseling Center
129 Hospital Dr
(920) 262-4800
Watertown, WI 53098
Behavioral Health Clinic Practice Status:
Directions Counseling Center, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Clinical Substance Abuse Counselor Practice Status:
Johnson, LeEllen, CSAC Open
Board Certified: Not Applicable
Walden Univ, Minneapolis, MN
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Loescher, Janell, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin Milwaukee, Milwaukee, WI
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
O'Neill, Kathleen, LCSW Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Peters, Christopher, LCSW Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Psychology Practice Status:
Beaver, Erik, PhD Open
Board Certified: Not Applicable
Northern IL Univ, Dekalb, IL
Not Applicable,
Medical School:
Residency:
Fort HealthCare Ear, Nose and Throat Specialists
125 Hospital Dr
(920) 563-6667
Watertown, WI 53098
Otolaryngology Practice Status:
Anderson, Michael, MD Open
Board Certified: American Board of Otolaryngology
Univ of Wisconsin, Madison, WI
Indiana University, Indianapolis, IN
Medical School:
Residency:
Hofmann, William, MD Open
Board Certified: American Board of Otolaryngology
Univ of Cincinnati College of Medicine, Cincinnati, OH
Indiana Univ Medical Center, Indianapolis, IN
Medical School:
Residency:
Luedtke-Storm-Mackey Chiropractic Clinic
808 E Main St
(920) 206-7959
Watertown, WI 53094
Chiropractic Practice Status:
Horkan, Jeffrey, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Tesch, Todd, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Meade Medical Clinic
134 Hospital Dr
(920) 261-6500
Watertown, WI 53098
Advanced Practice Nurse Prescriber Practice Status:
Beyer, Jan, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wisconsin Oshkosh, Oshkosh, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Meade, James, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin Medical School, Madison, WI
Harrisburg Hospital, Harrisburg, PA
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 28 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Pediatrics Practice Status:
Hayes, Kevin, DO Open
Board Certified: American Board of Pediatrics
Des Moines Univ, Des Moines, IA
Univ of Wisconsin, Madison, WI
Medical School:
Residency:
Martin, Scott, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin School of Medicine, Madison, WI
Marshfield Clinic/St. Joseph's Hospital, Marshfield, WI
Medical School:
Residency:
Meade, Jeffrey, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin Medical School, Madison, WI
Mercy Hospital of Pittsburgh, Pittsburgh, PA
Medical School:
Residency:
Physician Assistant Practice Status:
Fields, Dana, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette University, Milwaukee, WI
,
Medical School:
Residency:
Philip M. Marden, MD, SC
123 Hospital Dr, Ste 212-East
(920) 261-3898
Watertown, WI 53098
Pediatrics Practice Status:
Marden, Philip, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin, Madison, WI
University of Minnesota, Minneapolis, MN
Medical School:
Residency:
PMRis, SC - Watertown
123 Hospital Dr, Ste 2004
(877) 337-6747
Watertown, WI 53098
Physical Medicine & Rehabilitation Practice Status:
Fowler, William, MD Open
Board Certified: American Board of Physicial Medicine and Rehabilitation
Univ of North Dakota School of Medicine, Grand Forks, ND
Univ of Minnesota Hospital & Clinics, Minneapolis, MN
Medical School:
Residency:
Regional Gen & Vascular Surgeons
123 Hospital Dr
(920) 261-5101
Watertown, WI 53098
Surgery Practice Status:
Markus, Stanley, MD Open
Board Certified: American Board of Surgery
Wright State Univ, Dayton, OH
Mt. Carmel Hospital,
Medical School:
Residency:
Pangallo, Cynthia, MD Open
Board Certified: American Board of Surgery
Univ of Wisconsin, Madison, WI
Hospital of St. Raphael, New Haven, CT
Medical School:
Residency:
Stoddard, Emily, MD Open
Board Certified: American Board of Surgery
Univ of Wisconsin Medical School, Madison, WI
Univ of Wisconsin Hospital and Clinics, Madison, WI
Medical School:
Residency:
Richard Neils, MD Office
123 Hospital Dr, Ste 106
(920) 261-4143
Watertown, WI 53098
Dermatology Practice Status:
Neils, Richard, MD Open
Board Certified: American Board of Dermatology AND American Board of Internal
MedicineUniv of Minnesota, Minneapolis, MN
Roger Williams General Hosp, Providence, RI
Medical School:
Residency:
Rock River Foot & Ankle Clinic
101 Oakridge Court, Ste A
(920) 261-9610
Watertown, WI 53094
Podiatry Practice Status:
Eckerman, Christopher, DPM Open
Board Certified: American Board of Foot and Ankle Surgery
Dr. William Scholl College of Podiatric Medicine, North Chicago, IL
Thoreck Hospital, Chicago, IL
Medical School:
Residency:
Graglia, Greg, DPM Open
Board Certified: American Board Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, North Chicago, IL
VA Salt Lake City Health Care Systems, Salt Lake City, UT
Medical School:
Residency:
Soderstrom, Victor, DPM Open
Board Certified: American Board of Podiatric Surgery (Foot and Ankle Surgery)
Illinois College of Podiatric Medicine, Chicago, IL
Northwest General Hospital, Milwaukee, WI
Medical School:
Residency:
Yaeggi, Brent, DPM Open
Board Certified: American Board of Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, Chicago, IL
Covenant Medical Center, Waterloo, IA
Medical School:
Residency:
Turke Family Medicine, S.C.
132 Hospital Dr
(920) 261-2020
Watertown, WI 53098
Family Medicine Practice Status:
Turke, Terry, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin Medical School, Madison, WI
Univ of Wisconsin Affiliated Hospitals, Madison, Wi
Medical School:
Residency:
Physician Assistant Practice Status:
Erickson, Kristin, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of St. Francis, Fort Wayne, IN
,
Medical School:
Residency:
Watertown Family Practice Associates, SC
127 Hospital Dr
(920) 261-8500
Watertown, WI 53098
Advanced Practice Nurse Prescriber Practice Status:
Angove, Jessica, APNP Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse Practitioner)Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 29 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Advanced Practice Nurse Prescriber Practice Status:
Cantwell-Durand, Andrea, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wisconsin College of Nursing, Milwaukee, WI
,
Medical School:
Residency:
Family Medicine Practice Status:
Basarich, John, MD Open
Board Certified: American Board of Family Medicine (Hospice & Palliative Medicine)
Medical College of Wisconsin, Milwaukee, WI
Univ of Wisconsin Dept of Family Medicine, Madison, WI
Medical School:
Residency:
Cochrane, Bruce, MD Open
Board Certified: American Board of Family Medicine
Chicago Medical School, Chicago, IL
Southern Illiniois Univ School of Medicine, Springfield, IL
Medical School:
Residency:
Golden, Leslie, MD Open
Board Certified: American Board of Family Medicine
Ross Univ School of Medicine, Dominica West Indies
Greenville Memorial Hospital, Greenville, SC
Medical School:
Residency:
LeGrow, Robert, MD Open
Board Certified: American Board of Family Medicine
Univ of Texas Medical School, Houston, TX
Memorial Family Medicine Residency Program, South Bend, IN
Medical School:
Residency:
Sullivan, Michael, MD Open
Board Certified: American Board of Family Medicine
Univ of Illinois College of Medicine at Rockford,
Memorial Family Practice Residency, South Bend, IN
Medical School:
Residency:
Tonelli, Danielle, DO Open
Board Certified: American Board of Family Medicine
Chicago College of Osteopathic Medicine, Chicago, IL
Aurora St. Luke's Family Practice Residency, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Busalacchi, Rachel, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Howard, Alysia, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin - Madison, Madison, WI
,
Medical School:
Residency:
Ventura, Margaret, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Watertown Regional Medical Center, LLC
125 Hospital Dr
(920) 261-4210
Watertown, WI 53098
Hospital Practice Status:
Watertown Regional Medical Center, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
WRMC Center for Eye Care
123 Hospital Dr, Ste 1002
(920) 261-8225
Watertown, WI 53098
Ophthalmology Practice Status:
Boush, George, MD Open
Board Certified: American Board of Ophthalmology
Univ of Wisconsin, Madison, WI
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Met, Jay, MD Open
Board Certified: American Board of ophthalmology
Albert Einstein College of Medicine, Bronx, NY
New York Eye & Ear Infirmary, New York, NY
Medical School:
Residency:
Sullivan, Sheila, DO Open
Board Certified: Not Board Certified
DesMoines Univ, College of Osteopathic Medicine, Des Moines, IA
Philadeplphia College of Osteopathic Medicine, Philadelphia, PA
Medical School:
Residency:
Van Hecke, Holly, MD Open
Board Certified: American Board of Ophthalmology
Univ of Illinois College of Medicine, Chicago, IL
Univ of Illinois Eye & Ear Infirmary, Chicago, IL
Medical School:
Residency:
Optometry Practice Status:
Anslinger, John, OD Open
Board Certified: Not Applicable
Indiana Univ, Indiana
Not Applicable,
Medical School:
Residency:
Roberson, Daniel, OD Open
Board Certified: Not Applicable
New England College of Optometry, Boston, MA
Captain James A. Lovell Federal Health Care Center, N. Chicago, IL
Medical School:
Residency:
WRMC Center for Women's Health
128 Hospital Dr
(920) 262-4825
Watertown, WI 53098
Advanced Practice Nurse Prescriber Practice Status:
Howard, Karen, APNP Open
Board Certified: National Certification Corporation (Women's Health Care Nurse
Practitioner)Mt. Senario Collge, Ladysmith, WI
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
DeJong, Julie, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Wisconsin, Madison, WI
Univ of Iowa Hospital and Clinics, Iowa City, IA
Medical School:
Residency:
Nguyen, VanLy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Arkansas for Medical Sciences, Little Rock, AR
Cooper Univ Hospital UMDNJ, Camden, NJ
Medical School:
Residency:
Siddiqui, Danish, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Aga Khan Medical College, Karachi, Pakistan
Bridgeport Hospital, Bridgeport, CT
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 30 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Urology Practice Status:
Sokovich, Ronald, MD Open
Board Certified: American Board of Urology
Southern Illinois Univ School of Medicine, Springfield, IL
URO Rush Medical Center, Chicago, IL
Medical School:
Residency:
WRMC Doctors Court Clinic
1507 Doctors Ct
(920) 261-4111
Watertown, WI 53094
Advanced Practice Nurse Prescriber Practice Status:
Brown, Casey, APNP Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care Nurse)Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Family Medicine including Obstetrics Practice Status:
Grajewski, Michael, MD Open
Board Certified: American Board of Family Medicine
Univ of Wisconsin Medical School, Madison, WI
Univ of Missouri, Kansas City, MO
Medical School:
Residency:
Internal Medicine Practice Status:
Samdani, Moazam Jah, MD Open
Board Certified: American Board of Internal Medicine
Liaquat Medical College, Pakistan,
Louis A. Weiss Mem Hosp,, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Barnett, Sarah, PA-C Open
Board Certified: National Commission on Certification of Physican Assistants
Marquette University, Milwaukee, WI
Not Applicable,
Medical School:
Residency:
Kolkovich, Cheryl, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Finch Univ of Health Sciences, The Chicago Medical School, North Chicago, ILNot Applicable,
Medical School:
Residency:
Suwanabol, Promporn (June), PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Wisconsin-Madison Physician Assistant Program, Madison, WI
,
Medical School:
Residency:
WRMC Heart & Vascular Center
125 Hospital Dr
(920) 262-4434
Watertown, WI 53098
Advanced Practice Nurse Prescriber Practice Status:
Lambrecht, Shauna, APNP Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Concordia Univ, Mequon, WI
,
Medical School:
Residency:
Price, Teresa, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Alverno College, Milwaukee, WI
,
Medical School:
Residency:
Raatz, Healther, APNP Open
Board Certified: Not Board Certified
Univ of Cincinnati, Cincinnatio, OH
,
Medical School:
Residency:
Cardiology Practice Status:
Cullinane, David, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
UW Medical School, Madison, WI
Medical College of Wisconsin Hospital & Clinics, Milwaukee, WI
Medical School:
Residency:
WRMC Hospital Drive Clinic
123 Hospital Dr, Ste 2009
(920) 262-9833
Watertown, WI 53098
Physician Assistant Practice Status:
Laurent, Allison, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Univ of Colorado, Denver, CO
,
Medical School:
Residency:
WRMC Orthopedics and Sports Medicine
123 Hospital Dr, Ste 1008
(920) 206-6500
Watertown, WI 53098
Advanced Practice Nurse Prescriber Practice Status:
Damon, Rachel, APNP Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Wiscons - Oshkosh, Oshkosh, WI
,
Medical School:
Residency:
Weiss, Emily, APNP Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Acute Care Nurse Practitioner)Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Orthopedic Surgery Practice Status:
O'Halloran, Kevin, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of Illinois College of Medicine, Chicago, IL
Rush-Presbyterian-St. Lukes,, Chicago, Il
Medical School:
Residency:
Rhodes, Steven, MD Open
Board Certified: American Board of Orthopaedic Surgery
Loyola Univ of Chicago Stritch School of Medicine, Chicago, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Roman, Terry, DO Open
Board Certified: Not Board Certified
A.T. Still University, Kirksville, MO
Michigan State University, Grand Blanc, MI
Medical School:
Residency:
Physician Assistant Practice Status:
Lentscher, Luke, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Midwestern Univ, Downers Grove, IL
,
Medical School:
Residency:
WRMC Pulmonology Center
123 Hospital Dr, Ste 2009
(920) 262-4560
Watertown, WI 53098
Pulmonary Disease Practice Status:
Bawaadam, Hasnain, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care Medicine)Grant Medical College, Bombay, India
West Suburban Medical Center, Oak Park, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 31 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Pulmonary Disease Practice Status:
Eyzaguirre, Arturo, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)Alberto Hurtado Medical School, Lima, Peru
Henry Ford Hospital, Detroit, MI
Medical School:
Residency:
Lisi, Paul, DO Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)Des Moines Univ - College of Osteopathic Medicine, Des Moines, IA
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Mathai, Mathew, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care Medicine)American Univ of the Caribbean, Plymouth Montserrat British West Indies
,
Medical School:
Residency:
Stuleanu, Florin, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Sleep
Medicine)(Critical Care Medicine)Carol Davile Univ of Medicine & Pharmacy, Bucharest, Romania
The New York Flushing Hospital Medical Center/Cornell Univ, Flushing, NY
Medical School:
Residency:
Weber, Joseph, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)The Ohio State Univ College of Medicine & Public Health, Columbus, OH
McGaw Medical Center of Northwestern Univ, Chicago, Il
Medical School:
Residency:
WRMC Urgent Care
125 Hospital De
(920) 262-4210
Watertown, WI 53098
Urgent Care Center Practice Status:
Watertown Regional Medical Center, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
WRMC Urology Clinic
123 Hospital Dr, Ste 2006
(920) 261-1334
Watertown, WI 53098
Urology Practice Status:
Sokovich, Ronald, MD Open
Board Certified: American Board of Urology
Southern Illinois Univ School of Medicine, Springfield, IL
URO Rush Medical Center, Chicago, IL
Medical School:
Residency:
Waukesha, WI
Waukesha Comprehensive Treatment Center
2422 N Grandview Blvd
(262) 549-6600
Waukesha, WI 53188
Methadone Clinic Practice Status:
Waukesha Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
West Allis, WI
Rogers Memorial Hospital - West Allis
11101 West Lincoln Ave
(800) 767-4411
West Allis, WI 53227
Child & Adolescent Mental Health
ProgramPractice Status:
Rogers Memorial Hospital - West Allis, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Rogers Memorial Hospital - West Allis, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
West Milwaukee, WI
West Milwaukee Comprehensive Treatment Center
1610 Miller Pkwy
(414) 672-3801
West Milwaukee, WI 53214
Methadone Clinic Practice Status:
West Milwaukee Comprehensive Treatment Center, , Open
Board Certified: Council on Accreditation
,
,
Medical School:
Residency:
Whitewater, WI
Fort HealthCare Center for Womens Health
1461 W Main St
(262) 473-8920
Whitewater, WI 53190
Advanced Practice Nurse Prescriber Practice Status:
Dedrick, Joyce, APNP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Univ of Wisconsin, Madison, WI
Not Applicable,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Aguirre de Baker, Nancy, MD Open
Board Certified: American Board of Obstetrics and Gynecology
University of WI Madison, Madison, WI
University of WI Madison, Madison, WI
Medical School:
Residency:
Mokhtar, Julie, DO Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Osteopathic Medicine & Health Sciences, Des Moines, IA
Brooklyn Hospital Center, New York
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 32 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Fort HealthCare Ear, Nose and Throat Specialists
1461 West Main St
(262) 473-4081
Whitewater, WI 53190
Otolaryngology Practice Status:
Hofmann, William, MD Open
Board Certified: American Board of Otolaryngology
Univ of Cincinnati College of Medicine, Cincinnati, OH
Indiana Univ Medical Center, Indianapolis, IN
Medical School:
Residency:
Fort HealthCare Internal Medicine & Pediatrics
1461 West Main St, Ste A
(262) 473-5888
Whitewater, WI 53190
Internal Medicine Practice Status:
Koenig, Laura, MD Open
Board Certified: American Board of Internal Medicine
Univ of Wisconsin, Madison, WI
Univ of Wisconsin Hospital & Clinics, Madison, WI
Medical School:
Residency:
Pediatrics Practice Status:
Lemon, Katherine, MD Open
Board Certified: American Board of Pediatrics
Univ of Wisconsin Medical School, Madison, WI
Univ of Wisconsin Medicl School, Madison, WI
Medical School:
Residency:
Fort HealthCare Urology Associates
1461 West Main St
(262) 473-7774
Whitewater, WI 53190
Urology Practice Status:
Kozler, Craig, MD Open
Board Certified: American Board of Urology
Michigan State University, East Lansing, MI
University of Michigan, Ann Arbor, MI
Medical School:
Residency:
Luedtke-Storm-Mackey Chiropractic Clinic
1173 West Main St, Ste B
(262) 753-0017
Whitewater, WI 53190
Chiropractic Practice Status:
Tesch, Todd, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
Not Applicable,
Medical School:
Residency:
Weyenberg, Ryan, DC Open
Board Certified: Not Applicable
Northwestern College of Chiropractic, Minneapolis, MN
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Whitewater
507 W Main St
(608) 756-5555
Whitewater, WI 53190
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Whitewater, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Clinical Substance Abuse Counselor Practice Status:
Winiecki, Adrienne, CSAC Open
Board Certified: Not Applicable
Indiana Univ Northwest, Gary, IN
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Kollmansberger, Benno, LPC, LCSW Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Oczus, Alicia, LPC Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Mercyhealth Whitewater
507 W Main St
(262) 473-0400
Whitewater, WI 53190
Family Medicine Practice Status:
Harris, Nancy, MD Open
Board Certified: American Board of Family Medicine
Univ of Texas Southwestern Medical Center, Dallas, TX
Commun Hospital, Indianapolis, IN
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Lyon, Craig, MD Open
Board Certified: American Board of Orthopaedic Surgery
Rush Medical College, Chicago, Il
Univ of Iowa Hospitals & Clinics, Iowa City, IA
Medical School:
Residency:
Podiatry Practice Status:
Loch, Archibald, DPM Open
Board Certified: Not Board Certified
Rosalind Franklin Univ, North Chicago, IL
Massachusetts General Hospital, Boston, MA
Medical School:
Residency:
Mercyhealth Whitewater Urgent Care
507 W Main St
(262) 473-0401
Whitewater, WI 53190
Urgent Care Center Practice Status:
Mercyhealth Whitewater Urgent Care, ,
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Rock River Foot & Ankle Clinic
1461 West Main St
(920) 563-2136
Whitewater, WI 53190
Podiatry Practice Status:
Graglia, Greg, DPM Open
Board Certified: American Board Foot and Ankle Surgery (Foot Surgery)
Scholl College of Podiatric Medicine, North Chicago, IL
VA Salt Lake City Health Care Systems, Salt Lake City, UT
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 33 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Williams Bay, WI
Atrium Post Acute Care of Williams Bay
146 Clover St
(262) 245-6400
Williams Bay, WI 53191
Skilled Nursing Facility Practice Status:
Atrium Post Acute Care of Williams Bay , , Open
Board Certified: Not Accredited
,
,
Medical School:
Residency:
Mercyhealth Behavioral Health Clinic - Walworth
N2846 State Road 67
(262) 245-5608
Williams Bay, WI 53191
Advanced Practice Nurse Prescriber Practice Status:
Bunnell, Ann, APNP Open
Board Certified: American Nurses Credentialing Center (Child and Adolescent Mental Health),
,
Medical School:
Residency:
Behavioral Health Clinic Practice Status:
Mercyhealth Behavioral Health Clinic - Walworth, ,
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
DeGarmo, Karla, LCSW Open
Board Certified: Not Applicable
Univ of Wisconsin, Whitewater, WI
,
Medical School:
Residency:
Deller, Julia, LCSW Open
Board Certified: Not Applicable
Univ of Chicago, Chicago, IL
Not Applicable,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Jedrzejczak, Darolyn, LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Littig, Karen, LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Rice, Julie, LPC Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Psychiatry Practice Status:
Callison, (Sue) Ann, MD Open
Board Certified: American Board of Psychiatry and Neurology (Child & Adolescent Psychiatry)University of Arizona, Tucson, AZ
Univ. of Arizona, Tucson, AZ
Medical School:
Residency:
Algonquin, IL
Mercyhealth Algonquin
2401 Harnish Dr
(847) 458-5440
Algonquin, IL 60102
Otolaryngology Practice Status:
Cundiff, Jason, MD Open
Board Certified: American Board of Otolaryngology
Univ of Illinois at Chicago, Chicago, IL
Univ of Illinois at Chicago-Eye and Ear Infirmary, Chicago, IL
Medical School:
Residency:
Goodman, David, MD Open
Board Certified: American Board of Otolaryngology
State Univ of New York, Syracuse, NY
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Livingston, Gary, MD Open
Board Certified: American Board of Otolaryngology
Loyola Stritch School of Med., Maywood, IL
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Podiatry Practice Status:
Thorud, Jakob, DPM Open
Board Certified: American Board of Podiatric Medicine
Des Moines Univ, Des Moines, IA
Scott & White Memorial Hospital, Temple, TX
Medical School:
Residency:
Barrington, IL
Mercyhealth Barrington
500 W Hwy 22
(847) 381-3000
Barrington, IL 60010
Allergy & Immunology Practice Status:
Vemuri, Preeti, MD Open
Board Certified: American Board of Allergy and Immunology AND American Board of
Internal MedicineBoston Univ School of Medicine, Boston, MA
McGaw Medical Center of Northwestern Univ, Chicago, IL
Medical School:
Residency:
Neurology Practice Status:
Dave, Amarish, DO Open
Board Certified: American Board of Psychiatry and Neurology
Chicago College of Osteopathic Medicine, Downers Grove, IL
University of Illinois at Chicago, Chicago, IL
Medical School:
Residency:
Otolaryngology Practice Status:
Cundiff, Jason, MD Open
Board Certified: American Board of Otolaryngology
Univ of Illinois at Chicago, Chicago, IL
Univ of Illinois at Chicago-Eye and Ear Infirmary, Chicago, IL
Medical School:
Residency:
Goodman, David, MD Open
Board Certified: American Board of Otolaryngology
State Univ of New York, Syracuse, NY
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Livingston, Gary, MD Open
Board Certified: American Board of Otolaryngology
Loyola Stritch School of Med., Maywood, IL
Univ of Illinois, Chicago, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 34 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Rheumatology Practice Status:
Frank, Benjamin, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Univ of Chicago Pritzker School of Medicine, Chicago, IL
Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Belvidere, IL
Crusader Community Health - Belvidere
1050 Logan Ave
(815) 547-0282
Belvidere, IL 61108
Advanced Practice Nurse Practice Status:
Benters, Jennifer, APN Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Okeson, Edwin, MD Open
Board Certified: American Board of Family Medicine
Northwestern Univ Medical School, Chicago, IL
Rockford Medical Education Foundation UIC, Rockford, IL
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Pottinger, Sara, LCPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Geiselhart, Christina, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Nurse-Midwife Practice Status:
Dobson, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Hestrup, Amanda, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Keeney, Renee, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Oerkfitz, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Osborne, Victoria, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois - Chicago, Chicago, IL
,
Medical School:
Residency:
Nurse-Midwife Practice Status:
Rehberg, Stephanie, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Al Khabbaz, Antoun, MD Open
Board Certified: American Board of Obstetrics and Gynecology
American Univ of Beirut, New York, NY
Union Memorial Hospital, Baltimore, MD
Medical School:
Residency:
Arynova, Bakytbubu, MD Open
Board Certified: Not Board Certified
Ege Univ, Izmir, Turkey
Mount Sinai Hospital Medical Center, Chicago, IL
Medical School:
Residency:
Edwards, Vernee, MD Open
Board Certified: Not Board Certified
St. Georges Univ, School of Medicine, Great River, NY
Maimonides Medical Center, Brooklyn, NY
Medical School:
Residency:
Nanabawa, Zakera, MD Open
Board Certified: American Board of Obstetrics and Gynecology
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Mercyhealth Belvidere
1747 Henry Luckow Ln
(815) 971-3030
Belvidere, IL 61008
Family Medicine Practice Status:
Phoenix, James, MD Open
Board Certified: American Board of Family Medicine
Springfield Illinois Univ, Springfield, IL
UIC-Rockford, Rockford, IL
Medical School:
Residency:
Sandoval, William, MD Open
Board Certified: American Board of Family Medicine
San Carlos de Guatamala Univ, Guatemala City, Guatemala
Chicago Medical School, North Chicago, IL
Medical School:
Residency:
Ulmer, Meredith, DO Open
Board Certified: American Osteopathic Board of Family Medicine/OMT
Michigan State Univ, East Lansing, MI
Resurrection Hospital, Chicago, IL
Medical School:
Residency:
Remedies Renewing Lives - Belividere
2028 N State St
(815) 547-4502
Belvidere, IL 61108
Adult Addictions Program Practice Status:
Remedies Renewing Lives - Belvidere, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 35 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Byron, IL
Mercyhealth Byron
130 Kysor Dr
(815) 971-3000
Byron, IL 61010
Family Medicine Practice Status:
Ansari, Mohammed Sajid, MD Open
Board Certified: American Board of Family Medicine
Deccan College of Medical Sciences, Hyderabad, India
SIU Family Practice Residency, Decatur, IL
Medical School:
Residency:
Gellada, Karen Imma, MD Open
Board Certified: American Board of Family Medicine
Univ of the Philippines - Manila, Ermita, Manila
Univ of Illinois College of Medicine at Peoria, Peoria, IL
Medical School:
Residency:
McFadden, Jeffrey, DO Open
Board Certified: American Board of Family Medicine
Kansas City Univ of Medicine and Biosciences, Kansas City, KS
Univ of Kansas Medical Center, Kansas City, KS
Medical School:
Residency:
Cherry Valley, IL
Drake Healthcare, SC
1860 S Bell School Rd
(815) 580-8270
Cherry Valley, IL 61016
Chiropractic Practice Status:
Drake, James, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Jones Family Chiropractic, PC
706 E State St
(815) 332-5555
Cherry Valley, IL 61016
Chiropractic Practice Status:
Jones, Jason, DC Open
Board Certified: Not Applicable
National College of Chiropractic, Lombard, IL
,
Medical School:
Residency:
Crystal Lake, IL
Mercyhealth Crystal Lake Chiropractic
330 West Terra Cotta, Ste D
(815) 455-1751
Crystal Lake, IL 60014
Chiropractic Practice Status:
Gabbert, Rodney, DC Open
Board Certified: Not Applicable
Palmerc College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Mercyhealth Crystal Lake East
390 E Congress Pkwy, Ste M
(815) 455-0850
Crystal Lake, IL 60014
Advanced Practice Nurse Practice Status:
Ward, Ashley, APN Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
St. Joseph's College of Maine, Standish, ME
,
Medical School:
Residency:
Allergy & Immunology Practice Status:
Vemuri, Preeti, MD Open
Board Certified: American Board of Allergy and Immunology AND American Board of
Internal MedicineBoston Univ School of Medicine, Boston, MA
McGaw Medical Center of Northwestern Univ, Chicago, IL
Medical School:
Residency:
Otolaryngology Practice Status:
Cundiff, Jason, MD Open
Board Certified: American Board of Otolaryngology
Univ of Illinois at Chicago, Chicago, IL
Univ of Illinois at Chicago-Eye and Ear Infirmary, Chicago, IL
Medical School:
Residency:
Goodman, David, MD Open
Board Certified: American Board of Otolaryngology
State Univ of New York, Syracuse, NY
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Livingston, Gary, MD Open
Board Certified: American Board of Otolaryngology
Loyola Stritch School of Med., Maywood, IL
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Pulmonary Disease Practice Status:
Mehta, Daksha, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)NHL Municipal Medical College, Guyarat, India
St. Francis Hospital, Evanston, IL
Medical School:
Residency:
Mercyhealth Crystal Lake OB/GYN
750 E Terra Cotta Ave, Ste B
(815) 459-1212
Crystal Lake, IL 60014
Certified Nurse Practitioner Practice Status:
Hepperlen, Christine, CNP Open
Board Certified: The National Certification Corporation (Women's Health Care Nurse Practitioner)The Catholic Univ of America, Washington, DC
Not Applicable,
Medical School:
Residency:
Mercyhealth Crystal Lake South
415 A Congress Pkwy, Ste E
(815) 356-7494
Crystal Lake, IL 60014
Family Medicine Practice Status:
Seneviratne, Krishanthi, MD Open
Board Certified: American Board of Family Medicine
Faculty of Medicine Univ of Kelaniya, Ragama, WP
Mount Sinai Hospital, Chicago, IL
Medical School:
Residency:
Shen, Emily, MD Open
Board Certified: American Board of Family Medicine
Beijing Medical University, Beijing, China
West Suburban Medical Center, Oak Park, IL 60302
Medical School:
Residency:
Gastroenterology Practice Status:
Hussain, Yasmin, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Punjab Fatima Jinnah Medical College, Lahore, Pakistan
Loyola Univ Medical Center/Hines VA Hospital, Maywood, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 36 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Orthopedic Surgery Practice Status:
DeHaan, Paul, MD Open
Board Certified: American Board of Orthopaedic Surgery
Abraham Lincoln School of Medicine Univ of IL, Chicago, IL
Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Physician Assistant Practice Status:
Larson, Don, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rosalind Franklin Univ of Medicine & Science, North Chicago, IL
,
Medical School:
Residency:
Podiatry Practice Status:
Lisowsky, Mykola, DPM Open
Board Certified: American Board of Podiatric Medicine
Ohio College of Podiatric Medicine, Cleveland, OH
Loyola University Medical Center, Maywood, IL
Medical School:
Residency:
Rusthoven, Timothy, DPM Open
Board Certified: American Board of Lower Extremity Surgery
Dr. William M. Scholl College, Chicago, IL
Colmery-O'Neal Veterans Affairs Med Cntr, Topeka, KS
Medical School:
Residency:
PRA - Crystal Lake Office
350 Congress Pkwy, Ste C
(815) 356-5050
Crystal Lake, IL 60014
Licensed Clinical Professional
CounselorPractice Status:
Westerberg, Shane, LCPC Open
Board Certified: Not Applicable
Argosy Univ, Schaumburg, Il
,
Medical School:
Residency:
Harvard, IL
Mercyhealth at Home - Medical Equipment - Harvard
1819 N Division St
(815) 943-2071
Harvard, IL 60033
Durable Medical Equipment Supplier Practice Status:
Mercyhealth at Home - Medical Equipment - Harvard, , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Mercyhealth Harvard Hospital and Medical Center
901 Grant St
(815) 943-5431
Harvard, IL 60033
Emergency Department Practice Status:
Mercyhealth Harvard Hospital - Emergency, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Gastroenterology Practice Status:
Qazi, Baseer, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Declan College of Medical Sciences, Hyderabad, India
Advocate Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Hospital Practice Status:
Mercyhealth and Medical Center - Harvard, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
Mercyhealth Harvard Hospital Clinic
1001 Grant St
(815) 943-8090
Harvard, IL 60033
Cardiovascular Disease Practice Status:
Khemani, Anil, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Patna Med College, Patna, India
All India Inst of Med Sciences, New Delhi, India
Medical School:
Residency:
Ophthalmology Practice Status:
Rhee, Jung, MD Open
Board Certified: American Board of Ophthalmology
Univ of Chicago Pritzker School of Medicine, Chicago, IL
Texas Tech University Health Science Center, Lubbock, TX
Medical School:
Residency:
Orthopedic Surgery Practice Status:
DeHaan, Paul, MD Open
Board Certified: American Board of Orthopaedic Surgery
Abraham Lincoln School of Medicine Univ of IL, Chicago, IL
Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Podiatry Practice Status:
Lisowsky, Mykola, DPM Open
Board Certified: American Board of Podiatric Medicine
Ohio College of Podiatric Medicine, Cleveland, OH
Loyola University Medical Center, Maywood, IL
Medical School:
Residency:
Pulmonary Disease Practice Status:
Balagani, Rajesh, DO Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease)(Critical Care Medicine)Chicago College of Osteopathic Medicine, Midwestern Univ, Downers Grove, IL
Evanston Northwestern Hospital, Evanston, IL
Medical School:
Residency:
Mehta, Daksha, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)NHL Municipal Medical College, Guyarat, India
St. Francis Hospital, Evanston, IL
Medical School:
Residency:
Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
Greenberg, James, MD Open
Board Certified: American Board of Surgery
Univ of Missouri, Kansas City, MO
Loyola Univ Medical Center, Maywood, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 37 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Vascular Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
Mercyhealth Harvard South
348 S Division St
(815) 943-1122
Harvard, IL 60033
Family Medicine Practice Status:
Khan-Mundozie, Viquar, MD Open
Board Certified: American Board of Family Medicine
Deccan College of Medical Sciences, Hyderabad, AP, India
St. Louis Univ School of Medicine, St. Louis, MO
Medical School:
Residency:
Virani, Shailesh, MD Open
Board Certified: American Board of Family Medicine
Mahatma Gandhi Mission's Medical College, India
Rush Copley Family Practice Residency, Aurora, IL
Medical School:
Residency:
Pediatrics Practice Status:
Castillo, Allen, MD Open
Board Certified: Not Board Certified
Univ of Santo Tomas, Manila, Philippines
Medical City Hospital, Manila, Philippines
Medical School:
Residency:
Mercyhealth Hospital and Medical Center - Harvard
901 Grant St
(815) 943-2961
Harvard, IL 60033
Skilled Nursing Facility Practice Status:
Mercyhealth Harvard Care Center, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Loves Park, IL
Budzynski Counseling Services, Inc
7124 Windsor Lake Parkway, #10
(815) 633-8688
Loves Park, IL 61111
Behavioral Health Clinic Practice Status:
Budzynski Counseling Services, Inc., , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Budzynski, John, LCPC Open
Board Certified: Not Applicable
Trinity Evangelical Divinity School, Deerfield, IL
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Platzbecker, Karen, LPC Open
Board Certified: Not applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Crusader Community Health - Loves Park
6115 N 2nd St
(815) 490-1600
Loves Park, IL 61111
Advanced Practice Nurse Practice Status:
Benters, Jennifer, APN Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Miller, Kimberly, MD Open
Board Certified: American Board of Family Medicine
Univ of Minnesota Medical School - Twin Cities, Minneapolis, MN
Ball Memorial Family Medicine Residency, Muncie, IN
Medical School:
Residency:
Okeson, Edwin, MD Open
Board Certified: American Board of Family Medicine
Northwestern Univ Medical School, Chicago, IL
Rockford Medical Education Foundation UIC, Rockford, IL
Medical School:
Residency:
Oloriegbe, Fatimah, MD Open
Board Certified: American Board of Family Medicine
Univ of Ilorin, Kwara State, Nigeria
SIU Family Medicine Residency Program, Springfield, IL
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Jarvi, Therese, LCPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Pottinger, Sara, LCPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Geiselhart, Christina, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Nurse-Midwife Practice Status:
Dobson, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Hestrup, Amanda, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Keeney, Renee, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Oerkfitz, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 38 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Nurse-Midwife Practice Status:
Osborne, Victoria, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois - Chicago, Chicago, IL
,
Medical School:
Residency:
Rehberg, Stephanie, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Al Khabbaz, Antoun, MD Open
Board Certified: American Board of Obstetrics and Gynecology
American Univ of Beirut, New York, NY
Union Memorial Hospital, Baltimore, MD
Medical School:
Residency:
Arynova, Bakytbubu, MD Open
Board Certified: Not Board Certified
Ege Univ, Izmir, Turkey
Mount Sinai Hospital Medical Center, Chicago, IL
Medical School:
Residency:
Edwards, Vernee, MD Open
Board Certified: Not Board Certified
St. Georges Univ, School of Medicine, Great River, NY
Maimonides Medical Center, Brooklyn, NY
Medical School:
Residency:
Nanabawa, Zakera, MD Open
Board Certified: American Board of Obstetrics and Gynecology
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Geiger Psychiatric Care LLC
1752 Windsor Rd, Ste 203
(815) 986-1113
Loves Park, IL 61111
Advanced Practice Nurse Practice Status:
Zahrndt, Eve, APN Open
Board Certified: American Nurses Credentialing Center (Psychiatric - Mental Health Nurse Practitioner)Univ of Illinois - Chicago, Chicago, IL
Glenwood Associates, Rockford, IL
Medical School:
Residency:
Behavioral Health Clinic Practice Status:
Geiger Psychiatric Care LLC, , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Benedict, Janice, LCSW Open
Board Certified: Not Applicable
Aurora Univ, Aurora, IL
,
Medical School:
Residency:
Person, Bruce, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Razbadouski, Susan, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Licensed Marriage & Family Therapist Practice Status:
Finnan, Kristi, LMFT Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Nelson, Leila, LPC Open
Board Certified: Not Applicable
Argosy Univ, Schaumburg, IL
,
Medical School:
Residency:
Psychiatry Practice Status:
Geiger, Marianne, MD Open
Board Certified: American Board of Psychiatry and Neurology
Univ of North Dakota School of Medicine, Grand Forks, ND
Univ of Iowa Hospitals & Clinics, Iowa City, IA
Medical School:
Residency:
Mercyhealth Alpine
7702 N Alpine Rd
(815) 971-2000
Loves Park, IL 61111
Internal Medicine Practice Status:
Glovsky, Robert, MD Open
Board Certified: American Board of Internal Medicine
Boston Univ School of Medicine, Boston, MA
Univ of Massachusetts Medical Center, Worcester, MA
Medical School:
Residency:
Petersen, Kenneth, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine, Rockford, IL
St. Joseph's Hospital & Medical Center, Phoenix, AZ
Medical School:
Residency:
Pediatrics Practice Status:
Kaskavage, Jillian, MD Open
Board Certified: American Board of Pediatrics
Univ of Illinois College of Medicine-Rockford, Rockford, IL
Johns Hopkins Hospital, Baltimore, MD
Medical School:
Residency:
Ortega, Romulo, MD Open
Board Certified: American Board of Pediatrics
Univ of Costa Rica, San Jose, Costa Rico
Univ of Illinois Chicago Medical Center, Chicago, IL
Medical School:
Residency:
Machesney Park, IL
Cornerstone Clinic Ltd
9721 N Alpine Rd
(815) 484-6300
Machesney Park, IL 61115
Advanced Practice Nurse Practice Status:
Carey, Rebekah, APN Open
Board Certified: National Certification Corporation (Women's Health Care Nurse Practitioner)Univ of Alabama, Tuscaloosa, AL
,
Medical School:
Residency:
Frisella, Brittany, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Loyola Univ Chicago, Stritch School of Medicine, Maywood, IL
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 39 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Obstetrics and Gynecology Practice Status:
Holbrook, Jodi, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Iowa College of Medicine, Iowa City, IA
Univ of South Florida, Tampa, FL
Medical School:
Residency:
McHenry, IL
Mercyhealth Eye Center - McHenry
406 N Front St, Ste C
(815) 363-2021
McHenry, IL 60050
Ophthalmology Practice Status:
Rhee, Jung, MD Open
Board Certified: American Board of Ophthalmology
Univ of Chicago Pritzker School of Medicine, Chicago, IL
Texas Tech University Health Science Center, Lubbock, TX
Medical School:
Residency:
Mercyhealth Immediate Care - McHenry
3922 Mercy Dr
(815) 578-2020
McHenry, IL 60050
Immediate Care Center Practice Status:
Mercyhealth Immediate Care Center - McHenry, , Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Mercyhealth McHenry
3922 Mercy Dr
(815) 344-4499
McHenry, IL 60050
Cardiovascular Disease Practice Status:
Khemani, Anil, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Patna Med College, Patna, India
All India Inst of Med Sciences, New Delhi, India
Medical School:
Residency:
Family Medicine Practice Status:
Ahmed, Muhammad, MD Open
Board Certified: American Board of Family Medicine
Dow Medical College, Karachi, Pakistan
SIU Decatur Family Medical Residency, Decatur, IL
Medical School:
Residency:
Hassan, Syed, MD Open
Board Certified: American Board of Family Medicine
Baqai Medical College, Karachi, Pakistan
MetroHealth Hospital Case Western Reserve Univ, Cleveland, OH
Medical School:
Residency:
Gastroenterology Practice Status:
Qazi, Baseer, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Declan College of Medical Sciences, Hyderabad, India
Advocate Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Internal Medicine Practice Status:
Fojtik, Joseph, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois, Chicago, IL
Northwestern Memorial Hospital, Chicago, IL
Medical School:
Residency:
Orthopedic Surgery Practice Status:
DeHaan, Paul, MD Open
Board Certified: American Board of Orthopaedic Surgery
Abraham Lincoln School of Medicine Univ of IL, Chicago, IL
Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI
Medical School:
Residency:
Otolaryngology Practice Status:
Cundiff, Jason, MD Open
Board Certified: American Board of Otolaryngology
Univ of Illinois at Chicago, Chicago, IL
Univ of Illinois at Chicago-Eye and Ear Infirmary, Chicago, IL
Medical School:
Residency:
Livingston, Gary, MD Open
Board Certified: American Board of Otolaryngology
Loyola Stritch School of Med., Maywood, IL
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Larson, Don, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rosalind Franklin Univ of Medicine & Science, North Chicago, IL
,
Medical School:
Residency:
Podiatry Practice Status:
Thorud, Jakob, DPM Open
Board Certified: American Board of Podiatric Medicine
Des Moines Univ, Des Moines, IA
Scott & White Memorial Hospital, Temple, TX
Medical School:
Residency:
Pulmonary Disease Practice Status:
Balagani, Rajesh, DO Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease)(Critical Care
Medicine)Chicago College of Osteopathic Medicine, Midwestern Univ, Downers
Grove, IL
Evanston Northwestern Hospital, Evanston, IL
Medical School:
Residency:
Northbrook, IL
Autism Home Support Services, Inc.
5 Revere Dr, Ste 120
(844) 247-7222
Northbrook, IL 60062
Autism Treatment Practice Status:
Autism Home Support Services, Inc., , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Richmond, IL
Mercyhealth Richmond
9715 Prairie Ridge
(815) 678-4528
Richmond, IL 60071
Family Medicine Practice Status:
Hassan, Syed, MD Open
Board Certified: American Board of Family Medicine
Baqai Medical College, Karachi, Pakistan
MetroHealth Hospital Case Western Reserve Univ, Cleveland, OH
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 40 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Rockford, IL
Ann James Counseling, LLC
1639 N Alpine Rd, Ste 204
(779) 423-0275
Rockford, IL 61107
Licensed Clinical Social Worker Practice Status:
DeRango, Peggy, LCSW Open
Board Certified: Not Applicable
Univ of Chicago, Chicago, IL
,
Medical School:
Residency:
James, Ann, LCSW Open
Board Certified: Not Applicable
Univ of St. Thomas, St. Paul, MN
,
Medical School:
Residency:
Turek, Marcy, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Anthony B. D'Souza, MD
6072 Brynwood Dr, Ste 205
(815) 282-9606
Rockford, IL 61101
Psychiatry Practice Status:
D'Souza, Anthony, MD Open
Board Certified: American Board of Psychiatry and Neurology
R.G. Kar Medical College, Calcutta, India
Univ Hospitals & Clinics, Columbia, MO
Medical School:
Residency:
Caraotta Chiropractic Orthopedics
4921 E State St
(815) 398-4004
Rockford, IL 61108
Chiropractic Practice Status:
Caraotta, Jacob, DC Open
Board Certified: Not Applicable
National College of Chiropractic, Lombard, IL
,
Medical School:
Residency:
Cluchey, Agnieszka, DC Open
Board Certified: Not Applicable
National College of Chiropractic, Lombard, IL
,
Medical School:
Residency:
Micka, Nicholas, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Myers, Lance, DC Open
Board Certified: Not Applicable
National College of Chiropractic, Lombard, IL
,
Medical School:
Residency:
Crusader Community Health - Broadway
1100 Broadway
(815) 490-1601
Rockford, IL 61104
Family Medicine Practice Status:
Miller, Kimberly, MD Open
Board Certified: American Board of Family Medicine
Univ of Minnesota Medical School - Twin Cities, Minneapolis, MN
Ball Memorial Family Medicine Residency, Muncie, IN
Medical School:
Residency:
Family Medicine Practice Status:
Okeson, Edwin, MD Open
Board Certified: American Board of Family Medicine
Northwestern Univ Medical School, Chicago, IL
Rockford Medical Education Foundation UIC, Rockford, IL
Medical School:
Residency:
Oloriegbe, Fatimah, MD Open
Board Certified: American Board of Family Medicine
Univ of Ilorin, Kwara State, Nigeria
SIU Family Medicine Residency Program, Springfield, IL
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Pottinger, Sara, LCPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Geiselhart, Christina, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Nurse-Midwife Practice Status:
Dobson, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Hestrup, Amanda, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Keeney, Renee, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Oerkfitz, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Osborne, Victoria, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois - Chicago, Chicago, IL
,
Medical School:
Residency:
Rehberg, Stephanie, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Al Khabbaz, Antoun, MD Open
Board Certified: American Board of Obstetrics and Gynecology
American Univ of Beirut, New York, NY
Union Memorial Hospital, Baltimore, MD
Medical School:
Residency:
Arynova, Bakytbubu, MD Open
Board Certified: Not Board Certified
Ege Univ, Izmir, Turkey
Mount Sinai Hospital Medical Center, Chicago, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 41 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Obstetrics and Gynecology Practice Status:
Edwards, Vernee, MD Open
Board Certified: Not Board Certified
St. Georges Univ, School of Medicine, Great River, NY
Maimonides Medical Center, Brooklyn, NY
Medical School:
Residency:
Nanabawa, Zakera, MD Open
Board Certified: American Board of Obstetrics and Gynecology
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Crusader Community Health - Pierpont
1002 N Pierpont Ave
(815) 490-1600
Rockford, IL 61101
Advanced Practice Nurse Practice Status:
Benters, Jennifer, APN Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Miller, Kimberly, MD Open
Board Certified: American Board of Family Medicine
Univ of Minnesota Medical School - Twin Cities, Minneapolis, MN
Ball Memorial Family Medicine Residency, Muncie, IN
Medical School:
Residency:
Oloriegbe, Fatimah, MD Open
Board Certified: American Board of Family Medicine
Univ of Ilorin, Kwara State, Nigeria
SIU Family Medicine Residency Program, Springfield, IL
Medical School:
Residency:
Crusader Community Health - State Street
1200 W State St
(815) 490-1601
Rockford, IL 61102
Advanced Practice Nurse Practice Status:
Benters, Jennifer, APN Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Miller, Kimberly, MD Open
Board Certified: American Board of Family Medicine
Univ of Minnesota Medical School - Twin Cities, Minneapolis, MN
Ball Memorial Family Medicine Residency, Muncie, IN
Medical School:
Residency:
Okeson, Edwin, MD Open
Board Certified: American Board of Family Medicine
Northwestern Univ Medical School, Chicago, IL
Rockford Medical Education Foundation UIC, Rockford, IL
Medical School:
Residency:
Oloriegbe, Fatimah, MD Open
Board Certified: American Board of Family Medicine
Univ of Ilorin, Kwara State, Nigeria
SIU Family Medicine Residency Program, Springfield, IL
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Pottinger, Sara, LCPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Ryall, Andrew, LCPC Open
Board Certified: Not Applicable
Southern New Hampshire Univ, New Hampshire, NH
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Geiselhart, Christina, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Nurse-Midwife Practice Status:
Dobson, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Hestrup, Amanda, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Keeney, Renee, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Oerkfitz, Jennifer, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Osborne, Victoria, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois - Chicago, Chicago, IL
,
Medical School:
Residency:
Rehberg, Stephanie, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Al Khabbaz, Antoun, MD Open
Board Certified: American Board of Obstetrics and Gynecology
American Univ of Beirut, New York, NY
Union Memorial Hospital, Baltimore, MD
Medical School:
Residency:
Arynova, Bakytbubu, MD Open
Board Certified: Not Board Certified
Ege Univ, Izmir, Turkey
Mount Sinai Hospital Medical Center, Chicago, IL
Medical School:
Residency:
Edwards, Vernee, MD Open
Board Certified: Not Board Certified
St. Georges Univ, School of Medicine, Great River, NY
Maimonides Medical Center, Brooklyn, NY
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 42 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Obstetrics and Gynecology Practice Status:
Nanabawa, Zakera, MD Open
Board Certified: American Board of Obstetrics and Gynecology
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Dale Gray, MD SC
2829 Glenwood Ave
(815) 962-0633
Rockford, IL 61101
Internal Medicine Practice Status:
Gray, Dale, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois, Rockford, IL
Rochester General Hospital, Rochester, NY
Medical School:
Residency:
Errol C. Baptist, MD
461 N Mulford Rd, Ste 4
(815) 397-2400
Rockford, IL 61107
Pediatrics Practice Status:
Baptist, Errol, MD Open
Board Certified: American Board of Pediatrics
Faculty of Medicine, Colombo, Sri Lanka
Univ of Medicine and Dentistry of NJ, Newark, NJ
Medical School:
Residency:
Hulsebus Rockford Chiropractic, LLC
1877 Daimler Rd
(815) 398-3434
Rockford, IL 61112
Chiropractic Practice Status:
Callahan, Christopher, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Field, Brock, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Hays, Nathaniel, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Hulsebus, Brant, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Mueller, Brett, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Stear, Jr, Craig, DC Open
Board Certified: Not Applicable
Palmer College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Ignacio U. Omengan, MD
461 N Mulford Rd, Ste 10
(815) 394-1930
Rockford, IL 61107
Pediatrics Practice Status:
Omengan, Ignacio, MD Open
Board Certified: American Board of Pediatrics
St Louis Univ College of Medicine, Baguio City, Philippines
The Brookdale Univ Hospital and Medical Center, Brooklyn, NY
Medical School:
Residency:
James D. Koepsell, MD SC
2829 Glenwood Ave
(815) 962-0633
Rockford, IL 61101
Internal Medicine Practice Status:
Koepsell, James, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine,
Medical College of Wisconsin Affiliated Hospital, Milwaukee, WI
Medical School:
Residency:
Jody Striker, LCPC
2829 Glenwood Ave
(815) 962-0633
Rockford, IL 61101
Licensed Clinical Professional
CounselorPractice Status:
Striker, Jody, LCPC Open
Board Certified: Not Applicable
Trinity Evangelical Divinity School, Deerfield, IL
,
Medical School:
Residency:
KP Counseling
6392 Linden Rd
(779) 368-0060
Rockford, IL 61109
Advanced Practice Nurse Practice Status:
Wheeler, Lynn, APN Open
Board Certified: American Nurses Credentialing Center (Psychiatric-Mental Health Nurse Practitioner)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Behavioral Health Clinic Practice Status:
KP Counseling Center, , Open
Board Certified:
,
,
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Higgins, Sheila, LCPC Open
Board Certified: Not Applicable
National Lewis Univ, Chicago, IL
,
Medical School:
Residency:
Parker, Gregory, LCPC Open
Board Certified: Not Applicable
Northern IL Univ, DeKalb, IL
,
Medical School:
Residency:
Spangler, (George) Pat, LCPC Open
Board Certified: Not Applicable
Northern IL Univ, DeKalb, IL
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 43 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Licensed Clinical Social Worker Practice Status:
Anderson, Kevin, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Fricke, Jennifer, LCSW Open
Board Certified: Not Applicable
Aurora Univ, Aurora, IL
,
Medical School:
Residency:
Grindle, Delinda, LCSW Open
Board Certified: Not Applicable
Univ of Illinois,
,
Medical School:
Residency:
Polky, Kevin, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Warden, Christina, LCSW Open
Board Certified: Not Applicable
Univ of IL at Urbana-Chapaign, Urbana, IL
,
Medical School:
Residency:
Licensed Marriage & Family Therapist Practice Status:
Lauer, Karen, LMFT Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Logemann, Gail, LMFT Open
Board Certified: Not Applicable
Northern IL Univ, DeKalb, IL
,
Medical School:
Residency:
M. Asim Mustafa, MD
461 N Mulford Rd, #12
(815) 398-1009
Rockford, IL 61107
Pediatrics Practice Status:
Mustafa, Mohammad, MD Open
Board Certified: American Board of Pediatrics
Sind Medical College, Karachi, Pakistan
Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL
Medical School:
Residency:
Mercyhealth - Convenient Care
2300 N Rockton Ave
(815) 971-2000
Rockford, IL 61103
Convenient Care Practice Status:
Rockford Health Physicians Convenient Care, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth at Home - Medical Equipment - Rockford
5970 Churchview Dr
(815) 971-3330
Rockford, IL 61107
Durable Medical Equipment Supplier Practice Status:
Mercyhealth at Home - Medical Equipment - Rockford, , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Mercyhealth Brain and Spine Center
2350 N Rockton Ave Ste 502
(815) 971-7600
Rockford, IL 61103
Advanced Practice Nurse Practice Status:
Cain, Maureen, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Castronovo, Lynette, APN Open
Board Certified: American Nurses Credentialing Center (Gerontological Nurse Practitioner)
Univ of Michigan School of Medicine, Ann Arbor, MI
,
Medical School:
Residency:
Neurology Practice Status:
Kaufman, Mitchell, MD Open
Board Certified: American Board of Psychiatry and Neurology
Univ of California, Los Angeles, CA
West Los Angeles VA Medical Center, Los Angeles, CA
Medical School:
Residency:
Khan, Moshin, MD Open
Board Certified: American Board of Psychiatry and Neurology (Sleep Medicine)
AYUB Medical College, Abbottabad, Pakistan
Univ of Chicago Hospital, Chicago, IL
Medical School:
Residency:
Orozco, Daniel, MD Open
Board Certified: American Board of Psychiatry and Neurology
Tuft's Medical School, Boston, MA
Univ of Chicago Hospital, Chicago, IL
Medical School:
Residency:
Raja, Faisal, MD Open
Board Certified: American Board of Psychiatry and Neurology
Rawalpindi Medical Center, Rawalpindi, Pakistan
Univ of Missouri, Columbia, MO
Medical School:
Residency:
Sergeant, Michael, MD Open
Board Certified: American Board of Psychiatry and Neurology
Northwestern Univ, Chicago, IL
Northwestern Univ Hospital, Chicago, IL
Medical School:
Residency:
Wallery, Shawn, MD Open
Board Certified: American Board of Psychiatry and Neurology (Neruomuscular Medicine)
Ross Univ School of Medicine, Ediston, NJ
Loyola Medical Center, Maywood, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 44 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth Cancer Center - Rockford
2400 N Rockton Rd
(815) 971-5000
Rockford, IL 61103
Advanced Practice Nurse Practice Status:
Celner, Anne, APN Open
Board Certified: American Academy of Nurse Practitioners (Adult Nurse Practitioner)
Northern Illinois Graduate School,
,
Medical School:
Residency:
Hematology and/or Medical Oncology Practice Status:
Shekhani, Shahid, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)(Hospice & Palliative Care)Sind Medical College, Karachi, Pakistan
Prince Georges Hospital Center, Cheverly, MD
Medical School:
Residency:
Medical Oncology Practice Status:
Begum, Hosne, MD Open
Board Certified: American Board of Internal Medicine (Medical Oncology)
Mymensingh Medical College, Mymensingh, Bangladesh
Brookdale Hospital Medical Center, Brooklyn, NY
Medical School:
Residency:
Radiation Oncology Practice Status:
Hamidi, Maryam, MD Open
Board Certified: Not Board Certified
Univ of Wisconsin School of Medicine, Madison, WI
Columbia New York Presbyterian, New York, NY
Medical School:
Residency:
Mercyhealth Cardiac Rehabilitation Center - Rockford
2350 N Rockton Ave
(815) 971-2200
Rockford, IL 61103
Advanced Practice Nurse Practice Status:
Hess, Meghan, APN Open
Board Certified: American Nurses Credentialing Center (Acute Care Nurse Practitioner)
Univ of Illinois, Oak Lawn, IL
,
Medical School:
Residency:
Van Daele, Sallie, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Univ of Illinois College of Nursing, Rockford, IL
,
Medical School:
Residency:
Cardiology Practice Status:
Anna, Manjusha, MD Closed
Board Certified: American Board of Internal Medicine
Gandhi Medical College, Secunderbad, India
Newark Beth Isreal Medical Center, Newark, NJ
Medical School:
Residency:
Hayes, Richard, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Northwestern Univ Medical Sciences, Chicago, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Nowak, Gregory, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Academic Medical School, Gdansk Poland
Louis A Weiss Memorial Hospital, Chicago, IL
Medical School:
Residency:
Cardiology-Electrophysiology Practice Status:
Narra, Leela, MD Open
Board Certified: American Board of Internal Medicine (Clinical Cardiac
Elecrtophysiology)(Cardiovascular Disease)Guntur Medical College, Andhra Pradesh India
Cook County Hospital, Chicago, IL
Medical School:
Residency:
Smith, Jeffrey, MD Open
Board Certified: American Board of Internal Medicine (Clinical Cardiac
Electrophysiology)(Cardiovascular Disease)Univ of Illinois College of Medicine, Chicago, IL
Northwestern Memorial Hospital, Chicago, IL
Medical School:
Residency:
Cardiovascular Disease Practice Status:
Deveshwar, Sangita, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Government Medical College/Punjab Univ, Punjab, India
Univ of Oklahoma, Oklahoma City, OK
Medical School:
Residency:
Interventional Cardiology Practice Status:
Caceres, Erbert, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)(Interventional Cardiology)Universidad Nacional mayor de San Marcos, Lima, Peru
Engelwood Hospital and Medical Center, Englewood, NY
Medical School:
Residency:
Mercyhealth Cherry Valley
6998 Redansa Dr
(815) 971-3110
Rockford, IL 61108
Family Medicine Practice Status:
Guenev, Perka, MD Open
Board Certified: American Board of Family Medicine
Univ of Pleven, Bulgaria
Sparks Regional Medical Center, Fort Smith, AR
Medical School:
Residency:
Michalsen, Brian, DO Open
Board Certified: American Board of Family Medicine (Sports Medicine)
Midwestern Univ, Downers Grove, IL
Advocate Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Immediate Care Center Practice Status:
Mercyhealth Cherry Valley Urgent Care, , Open
Board Certified:
,
,
Medical School:
Residency:
Mercyhealth Glenwood
2819 Glenwood Ave
(815) 971-4060
Rockford, IL 61101
Psychiatry Practice Status:
Irfan, Syed, MD Open
Board Certified: American Board of Psychiatry and Neurology (Child & Adolescent Psychiatry)Dow Medical Collge, Karachi, Pakistan
WV Univ Charleston Area Medical Center, Charleston, WV
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 45 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
MercyHealth Hospital - Rockton Avenue
2400 N Rockton Ave
(815) 971-5000
Rockford, IL 61103
Hospice and Palliative Care Practice Status:
Valaitis, Joseph, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Loyola Univ Chicago-Stritch Medical School, Maywood, IL
Loyola Univ Medical Center, Maywood, IL
Medical School:
Residency:
Hospital Practice Status:
Mercyhealth Hospital - Rockton Avenue, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth Hospital - Rockton Avenue - Emergency Department
2400 N Rockton Ave
(815) 971-3333
Rockford, IL 61103
Emergency Department Practice Status:
Rockford Health Physicians Emergency Department, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth McFarland
2780 McFarland Rd
(815) 971-2000
Rockford, IL 61107
Obstetrics and Gynecology Practice Status:
Taylor, Bryan, MD Open
Board Certified: Not Board Certified
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Pediatrics Practice Status:
Moody, Patricia, MD Open
Board Certified: American Board of Pediatrics
St. Georges Univ, Great River, NY
Brooklyn Hospital Center, Brooklyn, NY
Medical School:
Residency:
Phelan, Karen, MD Open
Board Certified: American Board of Pediatrics
Pennsylvania State Univ, Hershey, PA
Hershey Medical Center, Hershey, PA
Medical School:
Residency:
Potts, Michael, MD Open
Board Certified: American Board of Pediatrics
Univ of Illinois College of Medicine, Chicago, IL
Children's Hospital of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Mercyhealth Mulford
5970 Churchview Dr
(815) 971-2000
Rockford, IL 61107
Certified Nurse Practitioner Practice Status:
Bustle, Lindsay, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Internal Medicine Practice Status:
Mitchell, David, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine, Chicago, IL
Blodgett Memorial Medical Center/St. Mary's Hospital, Grand Rapids, MI
Medical School:
Residency:
Monkemeyer, Jon, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine, Chicago, IL
Lutheran General Medical Center, Park Ridge, IL
Medical School:
Residency:
Norem, Dennis, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine, Chicago, IL
Illinois Masonic Medical Center, Chicago, IL
Medical School:
Residency:
Nurse-Midwife Practice Status:
Huntley, Alicia, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Southern California, Los Angeles, CA
,
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Macaulay, Nicole, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Northwestern Univ Medical School, Chicago, IL
Emory Univ Hospital, Atlanta, GA
Medical School:
Residency:
Wang, Jeannie, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Loyola Univ Chicago-Stritch Medical School, Maywood, IL
Columbus Hospital, Chicago, IL
Medical School:
Residency:
Pediatrics Practice Status:
Hutt, William, MD Open
Board Certified: American Board of Pediatrics
Medical College of Wisconsin, Milwuakee, WI
Tripler Army Medical Center, Honolulu, HI
Medical School:
Residency:
Martinez, Maria, MD Open
Board Certified: American Board of Pediatrics
Universyt of Santo Tomas, Manila, Philippines
Univ of Florida College of Medicine, Gainesvill, FL
Medical School:
Residency:
Rhodes, Sharon, MD Open
Board Certified: American Board of Pediatrics
Univ of Iowa College of Medicine, Iowa City, IA
Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Mercyhealth North Rockton Ave
2400 N Rockton Ave
(815) 971-6431
Rockford, IL 61103
Pain Management Practice Status:
Oteng-Bediako, Evelyn, MD Open
Board Certified: American Board of Anesthesiology (Pain Medicine)
Univ of Ghana Medical School, Ghana
Univ of Louisville, Dpt of Anesthesiology, Louisville, KY
Medical School:
Residency:
Singh, Ishmeet, MD Open
Board Certified: American Board of Anesthesiology (Pain Medicine)
Rush Medical College of Rush Univ, Chicago, IL
Rush-Presby-St Luke's Medical Center, Chicago, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 46 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Mercyhealth North Rockton Ave, Bldg 1
2300 N Rockton Ave
(815) 971-2000
Rockford, IL 61103
Advanced Practice Nurse Practice Status:
Barr, Jessica, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Bowmar, Andrea, APN Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Olivet Nazarene Univ, Bourbannais, IL
,
Medical School:
Residency:
Evans, Lisa, APN Open
Board Certified: Pediatric Nursing Certification Board (Primary Care)
SUNY at Tony Brook, Stony Brook, NY
,
Medical School:
Residency:
Jack, Cynthia, APN Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Lewis, Sarah, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Rush Univ, Chicago, IL
,
Medical School:
Residency:
Schier, Andrea, APN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse Practitioner)Univ of Illinois Chicago Medical Center, Chicago, IL
,
Medical School:
Residency:
White, Roxanne, APN Open
Board Certified: American Academy of Nurse Practitioners (Adult-Gerontology Primary Care Nurse)Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Advanced Practice Nurse Prescriber Practice Status:
Hadie, Angela, APRN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse Practitioner)Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Allergy & Immunology Practice Status:
Cook, Marisha, MD Open
Board Certified: Not Board Certified in Allergy & Immunology
Rush Medical College, Chicago, IL
Johns Hopkins Hospital, Baltimore, MD
Medical School:
Residency:
Certified Nurse Practitioner Practice Status:
Bustle, Lindsay, CNM Open
Board Certified: American Midwifery Certification Board
Univ of Illinois at Chicago, Chicago, IL
,
Medical School:
Residency:
Endocrinology Practice Status:
Hovis, John, MD Open
Board Certified: American Board of Internal Medicine (Endocrinology, Diabetes and
Metabolism)Duke Univ School of Medicine, Durham NC
Univ of Iowa Hospital, Iowa City, IA
Medical School:
Residency:
Naseer, Aliya, MD Open
Board Certified: American Board of Internal Medicine (Endocrinology, Diabetes and
Metabolism)Dow Medical College, Karachi, Pakistan
Richland Memorial Hospital, Columbia, SC
Medical School:
Residency:
Paturi, Shalini, MD Open
Board Certified: American Board of Internal Medicine (Endocrinology, Diabetes and Metabolism)Sindhartha Medical College, Vijayawada Andhra Pradesh
St. Joseph Hospital, Chicago, IL
Medical School:
Residency:
Family Medicine Practice Status:
Prathipati, Sushmita, MD Open
Board Certified: American Board of Family Medicine
Kamineni Institute of Medical Sciences, Narketpally, India
Jackson Park Hosp & Medical Center, Chicago, IL
Medical School:
Residency:
Rizzo, Anthony, DO Open
Board Certified: American Board of Family Medicine
Midwestern Univ Chicago College of Osteopathic Medicine, Downers
Grove, ILPresence Resurrection Medical Center, Chicago, IL
Medical School:
Residency:
Hospice and Palliative Care Practice Status:
Ahmed Khan, Mohammed Ilyas, MD Open
Board Certified: American Board of Internal Medicine (Hospice & Palliative Care)
Deccan College of Medical Sciences, Hyderabad, India
SUNY-Buffalo, Buffalo, NY
Medical School:
Residency:
Internal Medicine Practice Status:
Racanelli, Vincent, DO Open
Board Certified: American Board of Internal Medicine
New York College of Osteopathic Medicine, Old Westbury, NY
Winthrop-University Hospital, Mineola, NY
Medical School:
Residency:
Rogers, Craig, MD Open
Board Certified: American Board of Internal Medicine
Loyola Univ Chicago-Stritch Medical School, Maywood, IL
Baylor College of Medicine, Houston, TX
Medical School:
Residency:
Neurology Practice Status:
Gorelik, Maxim, MD Open
Board Certified: American Board of Psychiatry and Neurology (Pain Medicine)
Rush Medical College of Rush Univ, Chicago, IL
Univ of California, Davis Medical Center, Sacramento, CA
Medical School:
Residency:
Nurse-Midwife Practice Status:
Boettner, Karen, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Henriquez, Whitney, CNM Open
Board Certified: American Midwifery Certification Board
Frontier School of Midwifery, Hyden, KY
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 47 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Ophthalmology Practice Status:
Boone, Diane, MD Open
Board Certified: American Board of Ophthalmology
Univ of Texas Medical School, San Antonio, TX
Univ of Iowa Hospital & Clinics, Iowa City, IA
Medical School:
Residency:
Luellwitz, David, DO Open
Board Certified: American Osteopathic Board of Ophthalmology
Western Univ of Health Sciences, Pomona, CA
Midwestern University, Olympia Fields, IL
Medical School:
Residency:
Mathew, Benjamin, MD Open
Board Certified: American Board of Ophthalmology
Univ of Manitoba Faculty of Medicine, Winnipeg, Canada
Univ of Ottawa Eye Institute, Ottawa, Canada
Medical School:
Residency:
Optometry Practice Status:
Alexander, John, OD Open
Board Certified: Not Board Certified
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Alexander, Cathy, OD Open
Board Certified: Not Applicable
Pennsylvania College of Optometry, Philadelphia, PA
,
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Leu, David, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of California, San Francisco, CA
John Hopkins Univ School of Medicine, Baltimore, MD
Medical School:
Residency:
Pediatric Cardiology Practice Status:
Kazmouz, Suhaib, MD Open
Board Certified: American Board of Pediatrics (Pediatric Cardiology)
Aleppo Univ, Aleppo, Syria
Crozer Chester Medical Center, Chester, PA
Medical School:
Residency:
Masood, Syed, MD Open
Board Certified: American Board of Pediatrics
Dow Medical Univ - Pakistan, Karachi Sindh Pakistan
Louisiana State Univ Health Science Center, Shreveport, LA
Medical School:
Residency:
Pediatric Endocrinology Practice Status:
Carrion, Francisco, MD Open
Board Certified: American Board of Pediatrics (Pediatric Endocrinology)
Univ of Puerto Rico, San Juan, Puerto Rico
Caguas Regional Hospital, Caguas, Puerto Rico
Medical School:
Residency:
Pediatric Gastroenterology Practice Status:
Burress, Glendon, MD Open
Board Certified: American Board of Pediatrics (Pediatric Gastroenterology)
Univ of Illinois College of Medicine, Champaign, IL
Univ of Chicago Hospital, Chicago, IL
Medical School:
Residency:
Deutsch, David, MD Open
Board Certified: American Board of Pediatrics (Pediatric Gastroenterology)
Univ of Illinois College of Medicine - Rockford, Rockford, IL
Columbus Children's Hospital/The Ohio State Univ, Columbus, OH
Medical School:
Residency:
Pediatric Gastroenterology Practice Status:
Nguyen, Kim-Doan, MD Open
Board Certified: American Board of Internal Medicine AND American Board of Pediatrics
(Pediatric Gastroenterology)American Univ of the Caribbean School of Medicine, Coral Gables, FL
Univ of Missouri-Columbia, Columbia, MO
Medical School:
Residency:
Vortia, Eugene, MD Open
Board Certified: American Board of Pediatrics (Pediatric Gastroenterology) and American
Board of Internal MedicineUniv of Ghana Medical School, Korle Bu, ACCRA Ghanna
MI State Univ - Kalamazoo Ctr for Medical Studies, Kalamazoo, MI
Medical School:
Residency:
Pediatric Neurology Practice Status:
Domnitz-Gebet, Avi, DO Open
Board Certified: Not Board Certified
Chicago College of Osteopathic Medicine, Downers Grove, IL
Univ of Medicine & Dentistry, Newark, NJ
Medical School:
Residency:
Miner, Philip, MD Open
Board Certified: American Board of Pediatrics And American Board of Psychiatry & Neurology (Child Neruology)Jefferson Medical College, Philadelphia, PA
Valley Medical Center, Fresno, CA
Medical School:
Residency:
Schuman, Gail, DO Open
Board Certified: American Board of Psychiatry and Neurology (Neurology with Special
Qualification in Child Neurology)NY College of Osteopathic Medicine, Old Westbury, NY
Good Samaritan Hospital, West Islip, NY
Medical School:
Residency:
Pediatric Pulmonology Practice Status:
Shoberg, David, MD Open
Board Certified: American Board of Pediatrics (Pediatric Pulmonology)
Univ of Illinois College of Medicine, Chicago, IL
Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Pediatrics Practice Status:
Beaves, Sarah, MD Open
Board Certified: American Board of Pediatrics
Univ of Iowa College of Medicine, Iowa City, IA
Univ of Iowa Hospital, Iowa City, IA
Medical School:
Residency:
Davis, Raymond, MD Open
Board Certified: American Board of Pediatrics (Child Abuse Pediatrics)
Univ of Illinois College of Medicine, Peoria, IL
St. Francis Medica Center, Peoria, IL
Medical School:
Residency:
Hornbach, Mark, MD Open
Board Certified: American Board of Pediatrics
Rush Medical College, Chicago, IL
Wyler Children's Hospital, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Kucia, Tammy, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Malcom X College, Chicago, IL
,
Medical School:
Residency:
Plastic Surgery Practice Status:
Frye, Aaron, MD Open
Board Certified: American Board of Surgery
St Georges Univ, Great Rivers, NY
New York Medical College Sound Shore, New Rochelle, NY
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 48 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Podiatry Practice Status:
Chase, Kari, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine at Rosalind Franklin Univ of Medicine & Sciences, North Chicago, ILWeiss Memorial Hospital, Chicago, IL
Medical School:
Residency:
Holmbeck, Ryan, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine, North Chicago, IL
Sts Mary and Elizabeth Medical Center, Chicago, IL
Medical School:
Residency:
Norem, Nathan, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine at Rosalind Franklin Univ, North Chicago, ILHahnemann Univ Hospital/Drexel Univ College of Medicine, Philadelphia,
PA
Medical School:
Residency:
Psychiatry Practice Status:
Vaid, Khatija, MD Open
Board Certified: American Board of Psychiatry and Neurology
Sindh Medical College,
Jinnah Medical Center,
Medical School:
Residency:
Rheumatology Practice Status:
Dietz, Frederick, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Loyola Univ Chicago, Stritch School of Medicine, Maywood, IL
Evanston Northwestern HealthCare, Evanston, IL
Medical School:
Residency:
Hovis, Robin, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Univ of Iowa College of Medicine, Iowa City, OA
Univ of Iowa Hospital, Iowa City, IA
Medical School:
Residency:
Surgery Practice Status:
Appavu, Samuel, MD Open
Board Certified: American Board of Surgery (Surgical Citical Care)
Madras Medical College Univ of Madras, Madras, India
Cook County Hospital, Chicago, IL
Medical School:
Residency:
Breitman, Igal, MD Open
Board Certified: American Board of Surgery
Ben-Gurion Univ of the NegrevFaculty of Health Science, Beer Sheeva,
IsrealIchilov Sourasky Medical Center, Tel Aviv, Isreal
Medical School:
Residency:
Cowden, William, MD Open
Board Certified: American Board of Surgery
Univ of Illinois College of Medicine-Rockford, Rockford, IL
Synergy Medical Education Alliance, Saginaw, MI
Medical School:
Residency:
McCarthy, Michael, DO Open
Board Certified: American Osteopathic Board of Surgery
Des Moines Univ, College of Osteopathic Medicine, Des Moines, IA
St James Hospitals & Health Centers, Olympia Fields, IL
Medical School:
Residency:
Michelotti, Michael, MD Open
Board Certified: American Board of Surgery
Northwestern Univ Medical School, Chicago, IL
Northwestern Memorial Hospital, Chicago, IL
Medical School:
Residency:
Zappia, Anthony, MD Open
Board Certified: American Board of Surgery
Indiana Univ School of Medicine, Indianapolis, IN
Henry Ford Hospital, Detroit, MI
Medical School:
Residency:
Surgery Practice Status:
Zarnke, Mark, MD Open
Board Certified: American Board of Surgery
Univ of Wisconsin Medical School, Madison, WI
Medical College of Ohio, Toledo, OH
Medical School:
Residency:
Mercyhealth Orthopedic Specialists
2350 N Rockton Ave
(815) 971-7400
Rockford, IL 61108
Orthopedic Surgery Practice Status:
Fochios, Dean, MD Open
Board Certified: American Board of Orthopaedic Surgery
George Washington Univ School of Medicine, Washington, DC
Maimonides Medical Centr, Brooklyn, NY
Medical School:
Residency:
Krpan, Marko, DO Open
Board Certified: American Osteopathic Board of Orthopaedic Surgeons
Univ of Oseopathic Medicine & Health Services, Des Moines, IA
Michigan State U, Oakland General Hospital, Madison Heights, MI
Medical School:
Residency:
Pickvance, Elizabeth, MD Open
Board Certified: American Board of Orthopaedic Surgery
Univ of Texas Medical Branch, Galveston, TX
Univ of Minnesota, Minnapolis, MN
Medical School:
Residency:
Mercyhealth Perryville
3401 N Perryville Rd
(815) 971-2000
Rockford, IL 61114
Advanced Practice Nurse Practice Status:
Hedberg, Alina, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Olivet Nazarene Univ, Bourbonnais, IL
,
Medical School:
Residency:
Pinawin, Maxita, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Ansari, Mohammed Sajid, MD Open
Board Certified: American Board of Family Medicine
Deccan College of Medical Sciences, Hyderabad, India
SIU Family Practice Residency, Decatur, IL
Medical School:
Residency:
Nowak, Magdalena, MD Open
Board Certified: American Board of Family Medicine
Pmeraniam Medical Univ, Szczecnin, Poland
Univ of IL at Chicago, Chicago, IL
Medical School:
Residency:
Rohrbacher, Melissa, DO Open
Board Certified: American Board of Family Medicine
Midwestern Univ, Chicago College of Osteopathic Medicine, Downers Grove, ILChrist Hospital & Medical Center, Oak Lawn, IL
Medical School:
Residency:
Schermer, Ian, MD Open
Board Certified: American Board of Family Medicine
Univ of Iowa College of Medicine, Iowa City, IA
Univ of Illinois Chicago Medical Center, Chicago, IL
Medical School:
Residency:
Schroeder, Paul, MD Open
Board Certified: American Board of Family Medicine
Univ of Illinois College of Medicine at Rockford, Rockford, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 49 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Internal Medicine Practice Status:
Brito, Tracy, MD Open
Board Certified: American Board of Internal Medicine
Inov pf Cape Town, Faculty of Medicine, Cape Town, South Africa
North Shore Univ Hospital, Manhasset, NY
Medical School:
Residency:
Coates, Aaron, MD Open
Board Certified: American Board of Internal Medicine
MCP Hahnemann Univ College of Medicine, Philadelphia, PA
St. Joseph Mercy Health System, Ann Arbor, MI
Medical School:
Residency:
Muhammad, Tracy, MD Open
Board Certified: American Board of Internal Medicine
Rosalind Franklin Univ, North Chicago, IL
Rosalind Franklin Univ, North Chicago, IL
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Bhattacharya, Sumoulindra, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Tennessee College of Medicine, Memphis, TN
Cook County Hospital, Chicago, IL
Medical School:
Residency:
Higgins, Phillip, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Univ of Floriday College of Medicine, Gainesville, FL
Rush-Presby-St Luke's Medical Center, Chicago, IL
Medical School:
Residency:
Optometry Practice Status:
Koteles, Gary, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Otolaryngology Practice Status:
Severson, James, MD Open
Board Certified: American Board of Otolaryngology
Southern Illinois Univ School of Medicine, Springfield, IL
Medical College of Wisconsin, Milwaukee, WI
Medical School:
Residency:
Zahurullah, Fazlur, MD Open
Board Certified: American Board of Otolaryngology
Univ of Michigan Medical School, Ann Arbor, MI
Albert Einstein College of Medicine, Bronx, NY
Medical School:
Residency:
Mercyhealth Pulmonary Rehabilitation Center - Rockford
2350 N Rockton Ave
(815) 971-2000
Rockford, IL 61103
Pulmonary Disease Practice Status:
Qassem, Zaher, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine) (Geriatric Medicine)Damascus Univ of Medicine, Damascus, Syria
Morehouse School of Medicine, Atlanta, GA
Medical School:
Residency:
Roy, Bharati, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Sleep
Medicine)Baroda Medical Univ, Baroda, India
Georgetown Univ Hospital, Washington, DC
Medical School:
Residency:
Mercyhealth Strathmoor
5727 Strathmoor Dr, #1
(815) 971-3160
Rockford, IL 61107
Pediatrics Practice Status:
Hart, John, MD Open
Board Certified: American Board of Pediatrics
New York Medical College, Valhalla,
,
Medical School:
Residency:
Panzica, Patricia, MD Open
Board Certified: American Board of Pediatrics
Univ of Illinois - Chicago, Chicago, IL
Rainbow Babies & Child Hospital, Cleaveland, OH
Medical School:
Residency:
Mercyhealth Visiting Nurses Association, Inc.
4223 E State St
(815) 971-3550
Rockford, IL 61108
Home Health Provider Practice Status:
Mercyhealth Visiting Nurses Association, Inc., , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Hospice Care Practice Status:
Mercyhealth Visiting Nurses Association, Inc., , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Mercyhealth Women's Center - Rockford
7180 Spring Brook Rd
(815) 971-2299
Rockford, IL 61114
Advanced Practice Nurse Practice Status:
Bass, Joyce, APN Open
Board Certified: National Certification Corporation (Women's Health Care Nurse
Practitioner)Univ of Cincinnati, Cincinnati, OH
,
Medical School:
Residency:
Surgery Practice Status:
Mahatme, Arvind, MD Open
Board Certified: American Board of Surgery
Univ of South Florida College of Medicine, Tampa, FL
Univ of Nebraska Medical Center, Omaha, NE
Medical School:
Residency:
Mercyhealth Wound Center - Rockford
2300 N Rockton Ave
(815) 971-7454
Rockford, IL 61103
Family Medicine Practice Status:
Gellada, Karen Imma, MD Open
Board Certified: American Board of Family Medicine
Univ of the Philippines - Manila, Ermita, Manila
Univ of Illinois College of Medicine at Peoria, Peoria, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 50 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Plastic Surgery Practice Status:
Frye, Aaron, MD Open
Board Certified: American Board of Surgery
St Georges Univ, Great Rivers, NY
New York Medical College Sound Shore, New Rochelle, NY
Medical School:
Residency:
Podiatry Practice Status:
Chase, Kari, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine at Rosalind Franklin Univ of
Medicine & Sciences, North Chicago, ILWeiss Memorial Hospital, Chicago, IL
Medical School:
Residency:
Holmbeck, Ryan, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine, North Chicago, IL
Sts Mary and Elizabeth Medical Center, Chicago, IL
Medical School:
Residency:
Norem, Nathan, DPM Open
Board Certified: Not Board Certified
Scholl College of Podiatric Medicine at Rosalind Franklin Univ, North Chicago, ILHahnemann Univ Hospital/Drexel Univ College of Medicine, Philadelphia, PA
Medical School:
Residency:
New Vision of Illinois, LLC
2929 McFarland Rd
(815) 654-2020
Rockford, IL 61107
Ophthalmology Practice Status:
Ericson, Eric, MD Open
Board Certified: American Board of Ophthalmology
Univ of Illinois, Chicago, IL
Univ of Illinois Eye and Ear Infirmary, Chicago, IL
Medical School:
Residency:
Romaniv, Natalya, MD Open
Board Certified: American Board of Ophthalmology
Washington Univ, St. Louis, MO
Louisiana State Univ/Ochsner Clinic Foundation, New Orleans, LA
Medical School:
Residency:
Vakharia, Mitul, MD Open
Board Certified: American Board of Ophthalmology
Weill Medical College of Cornell Univ, New York, NY
Univ of Michigan, Ann Arbor, MI
Medical School:
Residency:
Optometry Practice Status:
Hahn, Paul, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Shumaker, Douglas, OD Open
Board Certified: Not Applicable
Illinois College of Optometry, Chicago, IL
,
Medical School:
Residency:
Northern Illinois Retina
1235 N Mulford Rd, Ste 100
(815) 226-4990
Rockford, IL 61107
Ophthalmology Practice Status:
Fowell, Susan, MD Open
Board Certified: American Board of Ophthalmology
Northwestern Univ Medical School, Chicago, IL
Northwestern Memorial Hospital, Chicago, IL
Medical School:
Residency:
Remedies Renewing Lives - Rockford
220 Easton Pkwy
(815) 962-0871
Rockford, IL 61108
Adult Addictions Program Practice Status:
Remedies Renewing Lives - Rockford, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Reproductive Health & Fertility Center
973 Fetherstone Rd
(877) 373-7552
Rockford, IL 61107
Infertility/Reproductive Endocrinology Practice Status:
Graczykowski, Jacek, MD Open
Board Certified: American Board of Obstetrics and Gynecology (Reproductive
Endocrinology/InfertilitySchool of Medicine in Gdansk, Poland, Gdansk, Poland
Univ of Southern California/Los Angeses County Women's Hospital, Los Angeles, CA
Medical School:
Residency:
Sawetawan, Chiravudh, MD Open
Board Certified: American Board of Obstetrics and Gynecology (Reproductive
Endocrinology/InfertilityRush Medical College of Chicago, Chicago, IL
Univ of Illinois College of Medicine at Chicago, Chicago, IL
Medical School:
Residency:
RNA of Rockford, LLC
612 Roxbury Rd
(815) 227-8300
Rockford, IL 61107
Advanced Practice Nurse Practice Status:
Capriola, Kathleen, APN Open
Board Certified: American Nurses Credentialing Center (Clinical Nurse Specialist in Adult
Health)Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
May, Jacqueline, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Northern Illinois Univ, DeKalb, IL
Northern Illinois Univ, DeKalb, IL
Medical School:
Residency:
Schoonover, Yvonne, APN Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Univ of Wisconsin - Madison School of Nursing, Madison, WI
,
Medical School:
Residency:
Nephrology Practice Status:
Ahmad, Mashood, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Dow Medical College, Karachi
Civil Hospital & Usman Memorial Hospital, Karachi
Medical School:
Residency:
Ahmed, Syed, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Deccan College of Medical Schiences, Hyderabad
Harbor Hospital Center, Baltimore, MD
Medical School:
Residency:
Maynard, John, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Univ of Illinois College of Medicine at Chicago, Chicago, IL
Henry Ford Hospital, Detroit, MI
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 51 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Nephrology Practice Status:
Murdakes, Charlene, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Rusch Univ College of Medicine, Chicago, IL
Rush Univ Medical Center, Chicago, IL
Medical School:
Residency:
Niemiec, Joanna, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Jagiellonian Univ Medical College, Krakow
St. Joseph Hospital/Northwestern Univ Feinberg School of Medicine,
Chicago, IL
Medical School:
Residency:
Pavithran, Bindu, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Medical College of Trivandrum, Kerala, India
Mercy Hospital of Pittsburgh, Pittsburgh, PA
Medical School:
Residency:
Robertson, Michael, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Univ of Illinois College of Medicine at Chicago, Chicago, IL
Univ of Chicago, Chicago, IL
Medical School:
Residency:
Sankaran, Krishna, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Univ of Illinois College of Medicine at Rockford, Rockford, IL
Illinois Masonic Medical Center, Chicago, IL
Medical School:
Residency:
Stim, James, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Univ of Illinois College of Medicine, Chicago, IL
Univ of Illinois at Chicago, Chicago, IL
Medical School:
Residency:
Sweeney, Charles, MD Open
Board Certified: American Board of Internal Medicine (Nephrology)
Univ of Illinois College of Medicine at Rockford, Rockford, IL
Univ of Illinois at Chicago, Chicago, IL
Medical School:
Residency:
Rockford Gastroenterology Associates, LTD
401 Roxbury Rd
(815) 397-7340
Rockford, IL 61107
Advanced Practice Nurse Practice Status:
Sackmaster, Stacia, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
St Anthony College of Nursing, Rockford, IL
,
Medical School:
Residency:
Vernon, Dawn, APN Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Gastroenterology Practice Status:
Bowyer, Brad, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Southern Illinois Univ, Springfield, IL
Mayo Graduate School of Medicine, Rochester, MN
Medical School:
Residency:
DeGuide, John, MD Open
Board Certified: American Board of Internal Medicine (Gastorenterology)
Loyola Univ, Stritch School of Medicine, Chicago, IL
Wilford Hall Medical Center, Lackland AFB, TX
Medical School:
Residency:
Gastroenterology Practice Status:
Gibbs, Christopher, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Creighton Univ School of Medicine, Omaha, NE
Mayo Clinic, Rochester, MN
Medical School:
Residency:
Ikenberry, Steven, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Loyola Univ Stritch School of Medicine, Chicago, IL
Indiana Univ, Bloomington, IN
Medical School:
Residency:
Manley, Michael, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Wisconsin, Madison, WI
Loyola Univ Medical Center, Maywood, Il
Medical School:
Residency:
Nonevski, Ilche, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Cincinnati, Cincinnati, OH
Univ Hospitals of Cleveland/Case Wester, Cleveland, OH
Medical School:
Residency:
Patel, Sunil, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
New Jersey Medical School, Newark, NJ
Beth Isreal Deaconess Medical Center, Boston, MA
Medical School:
Residency:
Peifer, Kevin, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Medical College of Ohio, Toledo, OH
Barnes-Jewish Hospital/Washington, Univ, St Louis, MO
Medical School:
Residency:
Rosen, Arnold, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Albany Medical College, Albany, NY
Virginia Mason Medical Center, Seattle, WA
Medical School:
Residency:
Shiels, Aaron, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Washington Univ School of Medicine, St. Louis, MO
Barnes-Jewish Hospital, St. Louis, MO
Medical School:
Residency:
Snedegar, Clinton, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Vanderbilt Univ School of Medicine, Nashville, TN
Barnes-Jewish Hospital/Washington Univ School of Medicine, St Louis,
MO
Medical School:
Residency:
Tannous, George, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Cincinnati College of Medicine, Cincinnati, OH
Univ Hospitals Case Medical Center, Shaker Heights, OH
Medical School:
Residency:
Tewani, Sumeet, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Boston Univ School of Medicine, Boston, MA
Beth Isreal Deaconess Medical Center, Boston, MA
Medical School:
Residency:
Thukral, Chandrashekhar, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Illinois at Chicago College of Medicine, Chicago, IL
Beth Isreal Deaconess Medical Center, Boston, MA
Medical School:
Residency:
Vicari, Joseph, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Creighton School of Medicine, Omaha, NE
Creighton Univ Medical Center, Omaha, NE
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 52 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Rockford Health Physicians Child Development and Behavior
2400 N Rockton Ave
(815) 971-4920
Rockford, IL 61103
Advanced Practice Nurse Practice Status:
Etten, Kristen, APN Open
Board Certified: Pediatric Nursing Certification Board (Certified Pediatric Nurse
Practitioner - Primary Care)Univ of Illinois College of Medicine, Chicago, IL
,
Medical School:
Residency:
Rockford Health Physicians Family Practice
2350 N Rockton Ave
(815) 971-2000
Rockford, IL 61103
Family Medicine Practice Status:
Soufan, Bassam, MD Open
Board Certified: Not Board Certified
Damascus Univ of Medicine, Damascus, Syria
St. Mary of Nazareth Hospital, Chicago, IL
Medical School:
Residency:
Washington, Charles, MD Open
Board Certified: American Board of Family Medicine
Univ of Illinois College of Medicine, Chicago, IL
Rockford Medical Education Foundation, Rockford, IL
Medical School:
Residency:
Rockford Health Physicians Internal Medicine
2350 N Rockton Ave
(815) 971-7210
Rockford, IL 61103
Internal Medicine Practice Status:
Rone, Jr., Arthur, MD Open
Board Certified: American Board of Internal Medicine
Univ of Illinois College of Medicine, Chicago, IL
Illinois Masonic Medical Center, Chicago, IL
Medical School:
Residency:
Rockford Health Physicians Maternal Fetal Medicine
2400 N Rockton Ave
(815) 971-6310
Rockford, IL 61103
Maternal-Fetal Medicine Practice Status:
Rogers, Dennie, MD Open
Board Certified: American Board of Obstetrics and Gynecology (Maternal-Fetal Medicine)
Univ of Illinois, Chicago, IL
Univ of Illinois @ Chicago, Chicago, IL
Medical School:
Residency:
Yang, Lee, DO Open
Board Certified: American Osteopathic Association
Chicago College of Osteopathic Medicine, Downers Grove, IL
McLaren Greater Lansing Hospital, Lansing, MI
Medical School:
Residency:
Nurse-Midwife Practice Status:
Cascio, Paula, CNM Open
Board Certified: American Midwifery Certification Board
Marquette Univ, Milwaukee, WI
,
Medical School:
Residency:
Rawajih, Sadie, CNM Open
Board Certified: American Midwifery Certification Board
Frontier Nursing University, Hyden, KY
,
Medical School:
Residency:
Rockford Health Physicians Medical Genetics
2400 N Rockton Ave
(815) 971-5069
Rockford, IL 61103
Clinical Genetics Practice Status:
Hoganson, George, MD Open
Board Certified: American Board of Medical Genetics and Genomics (Clinical Biochemical
Genetics & Clinical Molectular Genetics)and American Board of PediatricsUniv of Illinois College of Medicine, Chicago, IL
Univ of Wisconsin Hospital, Madison, WI
Medical School:
Residency:
Rockford Oral & Maxillofacial Surgery
425 Roxbury Rd
(815) 226-4700
Rockford, IL 61107
Oral & Maxillofacial Surgery Practice Status:
Bruksch, Matthew, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Univ of Illinois at Chicago College of Dentistry, Chicago, IL
Vanderbilt Univ Hospital, Nashville, TN
Medical School:
Residency:
Rentschler, Edward, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Univ of Louisville, Louisville, KY
Univ of Louisville School of Dentistry, Louisville, KY
Medical School:
Residency:
Rockford Orthopedic Appliance Co
422 E State Street
(815) 965-7759
Rockford, IL 61104
Durable Medical Equipment Supplier Practice Status:
Rockford Orthopedic Appliance, , Open
Board Certified: Not Applicable
,
,
Medical School:
Residency:
Rockford Psychiatric Medical Services, SC
1639 N Alpine Rd, Ste 260
(815) 395-1500
Rockford, IL 61107
Advanced Practice Nurse Practice Status:
Brechlin, Angeline, APN Open
Board Certified: American Nurses Credentialing Center (Adult Psychiatric & Mental Health Clinical Nurse Specialist)Univ of Illinois College of Medicine at Rockford, Rockford, IL
,
Medical School:
Residency:
Carter, Colette, APN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care
Nurse Practitioner)Univ of Cincinnati, Cincinnati, OH
,
Medical School:
Residency:
Behavioral Health Clinic Practice Status:
Rockford Psychiatric Medical Services, SC, , Open
Board Certified:
,
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 53 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Licensed Clinical Professional
CounselorPractice Status:
Thomas-Bua, Anita, LCPC Open
Board Certified: Not Applicable
UW-Whitewater, Whitewater, WI
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Beard, Brenda, LCSW Open
Board Certified: Not Applicable
Aurora Univ, Aurora, IL
,
Medical School:
Residency:
Seerup, Wendy, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Licensed Marriage & Family Therapist Practice Status:
Rothermel, Rachel, LMFT Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Psychiatry Practice Status:
Giakas, William, MD Open
Board Certified: American Board of Psychiatry and Neurology (Geriatric and Forensic
Psychiatry)UMDNJ, New Jersey Medical School, Newark, NJ
Yale New Haven Hospital, New Haven, CT
Medical School:
Residency:
Rockford Spine Center
2902 McFarland Rd, Ste 300
(815) 316-2100
Rockford, IL 61107
Advanced Practice Nurse Practice Status:
Johnson, Angela, APN Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
St. Anthony's College of Nursing, Rockford, IL
,
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Roh, Michael, MD Open
Board Certified: American Board of Orthopaedic Surgery
Brown Medical School, Providence, RI
New York Orthopaedic Hospital, New York, NY
Medical School:
Residency:
Sliva, Christopher, MD Open
Board Certified: American Board of Orthopaedic Surgery
Rush Medical College of Rush Univ, Chicago, IL
Univ of Iowa Hospitals & Clinics, Iowa City, IA
Medical School:
Residency:
Sweet, Fred, MD Open
Board Certified: American Board of Orthopaedic Surgery
Rush Medical College of Rush Univ, Chicago, IL
Barnes-Jewish Hospital, St. Louis, MO
Medical School:
Residency:
Physical Medicine & Rehabilitation Practice Status:
Walker, Marie, MD Open
Board Certified: American Board of Physicial Medicine and Rehabilitation
Univ of Wisconsin, Eau Claire
Mayo Medical Clinic, Rochester, MN
Medical School:
Residency:
Physician Assistant Practice Status:
Schwabero, Matthew, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Medical College of Ohio, Toledo, OH
,
Medical School:
Residency:
Soare, Sean, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rocky Mountain College, Billings, MT
,
Medical School:
Residency:
Wolf, Bradley, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Chapman College, Pittsburgh, PA
,
Medical School:
Residency:
Rockford Urological Associates
351 Executive Pkwy
(815) 398-4057
Rockford, IL 61107
Urology Practice Status:
Cormier, Mark, MD Open
Board Certified: American Board of Urology
Rush Medical College of Rush Univ, Chicago, IL
Univ Hospital, Cincinnati, OH
Medical School:
Residency:
Frederick, Luke, MD Open
Board Certified: Not Board Certified
Southern Illinois Univ School of Medicine, Springfield, IL
Southern Illinois Univ School of Medicine, Springfield, IL
Medical School:
Residency:
Fumo, Michael, MD Open
Board Certified: American Board of Urology
Univ of Chicago, The Pritzker School of Medicine, Chicago, IL
Henry Ford Hospital, Detroit, MI
Medical School:
Residency:
Houlihan, Daniel, DO Open
Board Certified: American Board of Urology
Chicago College of Osteopathic Medicine, Chicago, IL
Michael Reese Hospital & Medical Center, Chicago, IL
Medical School:
Residency:
Roegner, Douglas, MD Open
Board Certified: American Board of Urology
Rush Medical College of Rush Univ, Chicago, IL
Naval Medical Center, Portsmouth, VA
Medical School:
Residency:
Taylor, Eric, MD Open
Board Certified: American Board of Urology
Univ of Illinois College of Medicine, Chicago, IL
Southern Illinois Univ School of Medicine, Springfield, IL
Medical School:
Residency:
Valadez, Richard, MD Open
Board Certified: American Board of Urology
Loyola Univ Chicago, Stritch School of Medicine, Maywood, IL
Loyola Strich School of Medicine, Maywood, IL
Medical School:
Residency:
Whelan, Christopher, MD Open
Board Certified: American Board of Urology
Southern Illinois Univ School of Medicine, Springfield, IL
St. John's Hospital, Springfield, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 54 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Rosecrance Griffin Williamson Campus
1601 University Dr
(815) 391-1000
Rockford, IL 61107
Child & Adolescent Addictions Program Practice Status:
Rosecrance Griffin Williamson Campus, , Child & Adolescent
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Rosecrance Mulberry Center
605 Mulberry Street
(815) 391-1000
Rockford, IL 61103
Adult Addictions Program Practice Status:
Rosecrance Mulberry Center, , Open
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Rosecrance on Harrison-Adult Facility
3815 W Harrison St
(815) 391-1000
Rockford, IL 61104
Adult Addictions Program Practice Status:
Rosecrance on Harrison, , Adult
Board Certified: The Joint Commission
Not Applicable,
Not Applicable,
Medical School:
Residency:
Van Matre HealthSouth Rehabilitation Hospital
950 S Mulford Rd
(815) 381-8500
Rockford, IL 61108
Rehabilitation Center Practice Status:
Van Matre HealthSouth Rehabilitation Center, LLC, , Open
Board Certified: The Joint Commission
,
,
Medical School:
Residency:
Rockton, IL
Rockford Health Physicians Pediatric Surgery
2350 N Rockton Ave
(815) 971-7255
Rockton, IL 61103
Pediatric Surgery Practice Status:
Askew, Allyson, MD Open
Board Certified: American Board of Surgery (Pediatric Surgery)
Tulane Univ School of Medicine, New Orleans, LA
The New York Hospital - Cornell Medical Center, New York, NY
Medical School:
Residency:
Roscoe, IL
HOPE Child & Family Counseling, Inc
11447 2nd St, Ste 9b
(815) 601-4673
Roscoe, IL 61073
Behavioral Health Clinic Practice Status:
HOPE Child & Family Counseling, Inc, ,
Board Certified:
,
,
Medical School:
Residency:
Licensed Clinical Professional
CounselorPractice Status:
Petty, Michelle, LCPC Open
Board Certified: Not Applicable
National-Louis Univ, Wheeling, IL
,
Medical School:
Residency:
Schroepfer, Stacy, LCPC Open
Board Certified: Not Applicable
Univ of Wisconsin - Stout, Menomonie, WI
,
Medical School:
Residency:
Wagner, Jamie, LCPC Open
Board Certified: Not Applicable
Mildred Berry Center, Rockford, IL
,
Medical School:
Residency:
Licensed Clinical Social Worker Practice Status:
Marcum, Vicki, LCSW Open
Board Certified: Not Applicable
Univ of Illinois at Urbana-Champaign, Urbana, IL
,
Medical School:
Residency:
Matz, Hanah, LCSW Open
Board Certified: Not Applicable
Aurora Univ, Aurora, IL
,
Medical School:
Residency:
Licensed Professional Counselor Practice Status:
Ebert, Marissa, LPC Open
Board Certified: Not Applicable
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Varghese, Grace, LPC Open
Board Certified: Not Applicable
Rosalind Franklin Univ, North Chicago, IL
,
Medical School:
Residency:
Weymer, Jean, LPC Open
Board Certified: Not Applicable
National Louis Univ, Elgin, IL
,
Medical School:
Residency:
Mercyhealth Roscoe
5000 Prairie Rose Dr
(815) 971-2000
Roscoe, IL 61073
Advanced Practice Nurse Practice Status:
Lee, Sandra, APN Open
Board Certified: American Nurses Credentialing Center (Adult-Gerontology Primary Care Nurse Practitioner)Univ of Cincinnati, Cincinnati, OH
,
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 55 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Internal Medicine Practice Status:
Hansen, David, MD Open
Board Certified: American Board of Internal Medicine
Univ of Chicago-Pritzker School of Medicine, Chicago, IL
Milwaukee Medical Complex, Milwaukee, WI
Medical School:
Residency:
Sekulic, Dusica, MD Open
Board Certified: American Board of Internal Medicine
Univ of Pristina, Pristian Yugoslavia
Medical Clinic Center, Titograd Medical Center, Danilovgrad, Yugoslavia
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Granzeier, Gregory, DO Open
Board Certified: American Board of Obstetrics and Gynecology
New York College of Osteopathic Medicine, Old Westbury, NY
Lutheran Medical Center, Brooklyn, NY
Medical School:
Residency:
Taylor, Bryan, MD Open
Board Certified: Not Board Certified
St. Matthews Univ, Orlando, FL
Central Michigan Univ, Saginaw, MI
Medical School:
Residency:
Pediatrics Practice Status:
Perryman, John, MD Open
Board Certified: American Board of Pediatrics
Univ of Michigan Medical School, Ann Arbor, MI
Children's Memorial Hospital, Chicago, IL
Medical School:
Residency:
Taylor, Jane, MD Open
Board Certified: American Board of Pediatrics
Univ of IL College of Medicine, Chicago, IL
Southern IL Univ School of Medicine, Springfield, IL
Medical School:
Residency:
Premier Oral & Maxillofacial Surgery
5606 E Rockton Road
(815) 525-4700
Roscoe, IL 61073
Oral & Maxillofacial Surgery Practice Status:
Meister, Richard, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
Marquette Univ School of Dentistry, Milwaukee, WI
Hosp of St Raphael, New Haven, CT
Medical School:
Residency:
Swantek, Jason, DDS Open
Board Certified: American Board of Oral & Maxillofacial Surgery
UIC College of Dentistry, Chicago, IL
Woodhull Medical Center, Brooklyn, NY
Medical School:
Residency:
Schaumburg, IL
PRA - Schaumburg Office
1701 E Woodfield Rd, Ste 1000
(847) 240-2211
Schaumburg, IL 60173
Licensed Clinical Professional
CounselorPractice Status:
Westerberg, Shane, LCPC Open
Board Certified: Not Applicable
Argosy Univ, Schaumburg, Il
,
Medical School:
Residency:
Winnebago, IL
Mercyhealth Winnebago
102 Landmark Dr
(815) 971-3200
Winnebago, IL 61088
Advanced Practice Nurse Practice Status:
Dinges, Jennifer, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
,
,
Medical School:
Residency:
Thompson, Beth Ann, APN Open
Board Certified: American Nurses Credentialing Center (Family Nurse Practitioner)
Northern Illinois Univ, Dekalb, IL
,
Medical School:
Residency:
Family Medicine Practice Status:
Rudolph, Hahn, DO Open
Board Certified: American Board of Family Medicine
Univ of Osteopathic Medicine and Health Sciences, Des Moines, IA
St. Elizabeth Bassett Hospital, Utica, NY
Medical School:
Residency:
Strutzenberg, Jon, DO Open
Board Certified: American Osteopathic Association (Family Medicine and OMT)
Univ of Oseopathic Med and Health Sciences, Des Moines, IA
Davenport Medical Center, Davenport, IA
Medical School:
Residency:
Woodstock, IL
Mercyhealth Woodstock
2000 Lake Ave
(815) 337-7100
Woodstock, IL 60098
Advanced Practice Nurse Practice Status:
Tamparong, Naomi, APN Open
Board Certified: American Academy of Nurse Practitioners (Family Nurse Practitioner)
Indiana State Univ, Terre Haute, IN
,
Medical School:
Residency:
Winkelman, Kelly, ANP Open
Board Certified: American Nurses Credentialing Center (Adult Nurse Practitioner)
Northern Illinois Univ, DeKalb, IL
,
Medical School:
Residency:
Cardiovascular Disease Practice Status:
Khemani, Anil, MD Open
Board Certified: American Board of Internal Medicine (Cardiovascular Disease)
Patna Med College, Patna, India
All India Inst of Med Sciences, New Delhi, India
Medical School:
Residency:
Chiropractic Practice Status:
Gabbert, Rodney, DC Open
Board Certified: Not Applicable
Palmerc College of Chiropractic, Davenport, IA
,
Medical School:
Residency:
Dermatology Practice Status:
Altman, Jeffrey, MD Open
Board Certified: American Board of Dermatology
Rush Medical College, Chicago, IL
Rush Univ Medical Center, Chicago, IL
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 56 of 57W9
MercyCare Health Plans Provider Directory
State of Wisconsin - 2018
Endocrinology Practice Status:
Paturi, Shalini, MD Open
Board Certified: American Board of Internal Medicine (Endocrinology, Diabetes and
Metabolism)Sindhartha Medical College, Vijayawada Andhra Pradesh
St. Joseph Hospital, Chicago, IL
Medical School:
Residency:
Family Medicine Practice Status:
Saikh, Shahariar, MD Open
Board Certified: American Board of Family Medicine
International Univ of the Health Sciences, Basseterre, St. Kitts & Nevis
Mid Michigan Medical Center, Midland Family Med Residency Program,
Midland, MI
Medical School:
Residency:
Gastroenterology Practice Status:
Hussain, Yasmin, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Univ of Punjab Fatima Jinnah Medical College, Lahore, Pakistan
Loyola Univ Medical Center/Hines VA Hospital, Maywood, IL
Medical School:
Residency:
Qazi, Baseer, MD Open
Board Certified: American Board of Internal Medicine (Gastroenterology)
Declan College of Medical Sciences, Hyderabad, India
Advocate Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Gynecology Practice Status:
Osipova, Anastasia, MD Open
Board Certified: American Board of Obstetrics and Gynecology
Russian State Medical Univ, Moscow, Russia
Russian State Medical Academy of Postgraduate Education, Moscow, Russia
Medical School:
Residency:
Immediate Care Center Practice Status:
Mercyhealth Woodstock - Immediate Care, , Open
Board Certified: Not Applicable
Not Applicable,
Not Applicable,
Medical School:
Residency:
Neurology Practice Status:
Dave, Amarish, DO Open
Board Certified: American Board of Psychiatry and Neurology
Chicago College of Osteopathic Medicine, Downers Grove, IL
University of Illinois at Chicago, Chicago, IL
Medical School:
Residency:
Obstetrics and Gynecology Practice Status:
Cook, Richard, MD Open
Board Certified: American Board of Obstetrics and Gynecology AND American Board of
Family MedicineUniv of Iowa, Iowa City, IA
Univ of Iowa Hosp and Clinics, Iowa City, IA
Medical School:
Residency:
Ophthalmology Practice Status:
Kershaw, Jeffrey, MD Open
Board Certified: Not Board Certified
Northwestern Univ Medical School, Chicago, IL
Indiana Univ Medical Center, Indianapolis, IN
Medical School:
Residency:
Orthopedic Surgery Practice Status:
Tarandy, Dana, MD Open
Board Certified: American Board of Orthopaedic Surgery
Rush Medical College, Chicago, IL
Univ of Ilinois at Chicago Medical Center, Chicago, IL
Medical School:
Residency:
Otolaryngology Practice Status:
Goodman, David, MD Open
Board Certified: American Board of Otolaryngology
State Univ of New York, Syracuse, NY
Univ of Illinois, Chicago, IL
Medical School:
Residency:
Physician Assistant Practice Status:
Raju, Jenna, PA-C Open
Board Certified: National Commission on Certification of Physician Assistants
Rush Univ, Chicago, IL
,
Medical School:
Residency:
Podiatry Practice Status:
Lisowsky, Mykola, DPM Open
Board Certified: American Board of Podiatric Medicine
Ohio College of Podiatric Medicine, Cleveland, OH
Loyola University Medical Center, Maywood, IL
Medical School:
Residency:
Rusthoven, Timothy, DPM Open
Board Certified: American Board of Lower Extremity Surgery
Dr. William M. Scholl College, Chicago, IL
Colmery-O'Neal Veterans Affairs Med Cntr, Topeka, KS
Medical School:
Residency:
Pulmonary Disease Practice Status:
Mehta, Daksha, MD Open
Board Certified: American Board of Internal Medicine (Pulmonary Disease) (Critical Care
Medicine)NHL Municipal Medical College, Guyarat, India
St. Francis Hospital, Evanston, IL
Medical School:
Residency:
Rheumatology Practice Status:
Frank, Benjamin, MD Open
Board Certified: American Board of Internal Medicine (Rheumatology)
Univ of Chicago Pritzker School of Medicine, Chicago, IL
Lutheran General Hospital, Park Ridge, IL
Medical School:
Residency:
Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
Vascular Surgery Practice Status:
Bryan, Douglas, MD Open
Board Certified: American Board of Surgery (Vascular Surgery)
State Univ of New York HSC & Brooklyn, Brooklyn, NY
Harlem Hospital Medical Center, New York, NY
Medical School:
Residency:
8/18/2017 Practice Status: Open = Accepting New Patients; Closed = Not Accepting New Patients Page 57 of 57W9
Live well.We’ll insure you do.
Live well.We’ll insure you do.
MERCYCARE HMO INC.
MercyCare Health PlansPO Box 550 Janesville (800) 895-2421
MercyCareHealthPlans.com
Live well.We’ll insure you do.TM
5533656