Elizabeth A Ackerson, D.O.
Individual provider Active NPI Family Medicine Physician · Champaign, IL
NPI 1003223470 · NPPES record last updated May 1, 2018
Key facts
- NPI
- 1003223470
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036142010 (IL)
- Practice address
- 1701 Curtis Rd
Champaign, IL 61822-9678 - Phone
- (217) 365-6203
- NPI assigned
- Jul 17, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Midwestern University, Chicago College of Osteopathic Med, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carle Health Care Incorporated
Practice addresses (Care Compare)
1701 W Curtis Rd
Champaign, IL 61822-9678
Phone (217) 365-6200
1818 E Windsor Rd
Urbana, IL 61802-9566
Phone (217) 255-9500
611 W Park St
Urbana, IL 61801-2500
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
Hospital & facility affiliations
- Carle Foundation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171109000474 | IL | Practitioner - Family Practice |
5698072494 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036142010 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Family Medicine | Current |
Accepting new patients |
| Carle Health Care Incorporated | Past | Accepting new patients |
Locations
3310 Fields South Dr
Champaign, IL 61822
Phone (217) 417-2352
1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036142010 | IL | Yes |
Addresses
Primary practice location
1701 Curtis Rd
Champaign, IL 61822-9678
Mailing address
611 W Park St
Urbana, IL 61801-2529
Phone (217) 383-4846
Other names
- Elizabeth A Sutton
Other providers in Champaign, IL
- Nadia Abuamouneh
- Abusua Doula Services
- Accelerated Rehabilitation Centers
- Accent Counseling LLC
- Nathan Ackerman
- Dule Acuna
- Courtney Adair
- Alanna Adams
- Maria Adams
- Michele Adams
All providers in Champaign, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.