Physician Compare National (NPI:1356488241)

HEALTHCARE PROVIDER: EDVARD LC GEREGA DC

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1356488241
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911196365
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110114001083
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GEREGA
	Individual professional last name
Provider First Name	EDVARD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PALMER COLLEGE CHIROPRACTIC - DAVENPORT
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1013 4TH ST
	Group Practice or individual's line 1 address
City	FULTON
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	612521715
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8155893291
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	160080
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY MEDICAL CENTER-CLINTON
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y