Angelica Moran, | |
5841 S Maryland Ave # 3083, Chicago, IL 60637 | |
(773) 702-1000 | |
Not Available |
Full Name | Angelica Moran |
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Gender | Female |
Speciality | Pathology - Clinical Pathology |
Location | 5841 S Maryland Ave # 3083, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1164878195 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZC0006X | Pathology - Clinical Pathology | 125.073611 (Illinois) | Secondary |
207ZC0006X | Pathology - Clinical Pathology | 036158724 (Illinois) | Primary |
Entity Name | Northshore University Healthsystem Faculty Practice Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
Mailing Address | Practice Location Address |
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Angelica Moran, 180 Harvester Dr Ste 110, Burr Ridge, IL 60527-6686 Ph: (773) 702-1150 | Angelica Moran, 5841 S Maryland Ave # 3083, Chicago, IL 60637 Ph: (773) 702-1000 |
Mark Wang, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 251 E Huron St, Feinberg Pavilion, Chicago, IL 60611 Phone: 312-503-8144 Fax: 312-502-8249 | |
Sandeep Gurbuxani, Pathology Medicare: Accepting Medicare Assignments Practice Location: 5841 S Maryland Ave, Chicago, IL 60637 Phone: 888-824-0200 | |
Dr. Carmencita Garcia Senseng, MD Pathology Medicare: Medicare Enrolled Practice Location: 1900 W Polk St, Chicago, IL 60612 Phone: 312-864-7561 | |
Suman Setty, Pathology Medicare: Accepting Medicare Assignments Practice Location: 1740 W Taylor St, Chicago, IL 60612 Phone: 866-600-2273 | |
Jayme Brentan, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611 Phone: 312-695-9797 | |
Dr. Megan Elizabeth Sullivan, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 680 N Lake Shore Dr, Suite 1000, Chicago, IL 60611 Phone: 312-926-3211 | |
Dr. Brett Michael Mahon, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 1750 W Harrison St, Jelke, Suite 570, Chicago, IL 60612 Phone: 312-942-5260 |