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Lyle D Pahnke JR., MD
Vascular Surgery Physician in Centralia, Illinois
NPI 1770538225

Lyle D Pahnke JR. is a Vascular Surgery Physician based in Centralia, IL and is specialized in Vascular Surgery. Lyle D Pahnke JR. practices in Centralia, IL and has the professional credentials of MD. The NPI Number for Lyle D Pahnke JR. is 1770538225 and holds a License No. 036089773 (Illinois).

The current practice location address for Lyle D Pahnke JR. is 400 N Pleasant Ave, Centralia, IL and can be reached out via phone at 618-436-6318 and via fax at 618-436-6386.

Location: 400 N Pleasant Ave, Centralia, IL, 62801-3056
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770538225
Provider Name
Lyle D Pahnke JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
400 N Pleasant Ave, Centralia, IL, 62801-3056
Phone Number
618-436-6318
Fax Number
618-436-6386
Provider Enumeration Date
05/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CG2264 01 IL RR GROUP NUMBER
207988 01 IL GROUP
036089773 05 IL
P00169541 01 IL RR MEDICARE NUMBER
institution
Provider Business Practice Location Address Details
Address
400 N Pleasant Ave
City
Centralia
State
Illinois
Zip
62801-3056
Phone Number
618-436-6318
Fax Number
618-436-6386
person
Provider Business Mailing Address Details
Address
400 N Pleasant Ave
City
Centralia
State
Illinois
Zip
62801-3056
Phone Number
618-436-6318
Fax Number
618-436-6386
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
036089773 (Illinois)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
-
Taxonomy
208600000X
License No.
036089773 (Illinois)
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
036089773 (Illinois)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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