Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles A. Lane, MD

Individual provider Surgery Physician · NPI 1164581468

Charles A. Lane, MD is a General Surgery in Maryville, Illinois. Qualified in 1984, 42 years ago. Practices with Anderson Medical Group LLC, a 139-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
42
Licensed in
IL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

6810 State Route 162 Ste 100
Maryville, IL 62062-8560
Phone: (618) 288-5711
Fax: (618) 288-3647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 036083769 (IL)

Record details

NPI number1164581468
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 6, 2006
Last updated in NPPESMarch 9, 2020
Certification dateMarch 9, 2020
Mailing address6810 State Route 162 Ste 100, Maryville, IL 62062-8560

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1984 (42 years in practice)
Group practice Anderson Medical Group Llc — 139 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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