Dr Gina L Detmer, MD | |
3860 W Ogden Ave, Chicago, IL 60623-2460 | |
(872) 588-3000 | |
(872) 588-3021 |
Full Name | Dr Gina L Detmer |
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Gender | Female |
Speciality | Pediatrics |
Location | 3860 W Ogden Ave, 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 |
---|---|---|---|
1295772473 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036-099469 (Illinois) | Primary |
Entity Name | Lawndale Christian Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245289214 PECOS PAC ID: 2264336346 Enrollment ID: O20031120000728 |
Mailing Address | Practice Location Address |
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Dr Gina L Detmer, MD 3860 W Ogden Ave, Chicago, IL 60623-2460 Ph: (872) 588-3000 | Dr Gina L Detmer, MD 3860 W Ogden Ave, Chicago, IL 60623-2460 Ph: (872) 588-3000 |
Nupur Mittal, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1725 W. Harrison St Suite 710, Rush University Medical Center,, Chicago, IL 60612 Phone: 312-942-5983 Fax: 312-563-2519 | |
Dr. Gustave Falciglia, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 45, Chicago, IL 60611 Phone: 312-227-4190 | |
Bessey Elizabeth Jose Geevarghese, DO Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 225 E Chicago Ave, Chicago, IL 60611 Phone: 630-933-6631 | |
Bernadeta Leegan Wibisono, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2951 S King Dr Apt 1004, Chicago, IL 60616 Phone: 312-351-1346 | |
Allie Dakroub, MD MS Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5841 S Maryland Ave, Chicago, IL 60637 Phone: 773-702-1000 | |
Ajay Bhasin, Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 251 E Huron St, Chicago, IL 60611 Phone: 312-926-5924 | |
Kyle L Macquarrie, MD PHD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 225 E Chicago Ave # 30, Chicago, IL 60611 Phone: 312-227-4000 |