LYLE D. PAHNKE, JR. MD – NPI #1770538225
Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
LYLE PAHNKE, JR. is a surgeon located in CENTRALIA, IL. NPPES has assigned the NPI number 1770538225 to LYLE PAHNKE, JR. on May 23, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery
The NPI profile was previously updated about 4 years ago on Apr 15, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LYLE PAHNKE, JR. below.
NPI Profile for
LYLE D. PAHNKE, JR.
(more than 20 years ago)
CENTRALIA, IL 62801-3056 Phone: (618) 436-6318 Fax: (618) 436-6386
1 Other location(s):
Mount Vernon, IL 62864-5116
Phone: (618) 242-4750
Fax: (618) 242-7674
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for LYLE PAHNKE, JR.
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| OTHER | GROUP | IL | 207988 |
| OTHER | RR GROUP NUMBER | IL | CG2264 |
| OTHER | RR MEDICARE NUMBER | IL | P00169541 |
| MEDICAID | IL | 036089773 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 2086S0129X - Surgery / Vascular Surgery (Primary) |
IL | 036089773 |
| 208600000X - Surgery |
IL | 036089773 |
| 207Q00000X - Family Medicine |
IL | 036089773 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.
Additional Information
- Refer to Part B
- Order Durable Medical Equipment
- Refer to Home Health Agency
- Order Power Mobility Devices
LYLE PAHNKE, JR. is affiliated with the following medical group(s):
- HOSPITAL
- SSM HEALTH - GOOD SAMARITAN HOSPITAL1 GOOD SAMARITAN WAY
MOUNT VERNON, IL 62864 - SSM HEALTH ST MARY'S HOSPITAL -CENTRALIA400 NORTH PLEASANT AVENUE
CENTRALIA, IL 62801
- SSM HEALTH - GOOD SAMARITAN HOSPITAL1 GOOD SAMARITAN WAY
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