Keith Muccino, MD | |
2160 S 1st Ave, (luh - North Ent., Rm. 7604), Maywood, IL 60153-3328 | |
(708) 216-8757 | |
(708) 216-1259 |
Full Name | Keith Muccino |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 2160 S 1st Ave, Maywood, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861468357 | NPI | - | NPPES |
36112339 | Medicaid | IL | |
K12111 | Other | IL | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 36112339 (Illinois) | Primary |
Entity Name | Loyola University Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336159961 PECOS PAC ID: 3779488903 Enrollment ID: O20031202000027 |
Mailing Address | Practice Location Address |
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Keith Muccino, MD 2160 S 1st Ave, (luh - North Ent., Rm. 7604), Maywood, IL 60153-3328 Ph: (708) 216-8757 | Keith Muccino, MD 2160 S 1st Ave, (luh - North Ent., Rm. 7604), Maywood, IL 60153-3328 Ph: (708) 216-8757 |
Dr. Cathryn T Sawalski, DO, MBA Internal Medicine Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 888-584-7888 | |
Maryam Sabir, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 888-584-7888 | |
Holly Kramer, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2160 S First Ave, 101-1740 Loyola University Medical Center, Maywood, IL 60153 Phone: 708-216-9000 Fax: 708-216-9033 | |
Dr. Stephanie Bochen Tsai, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-9000 | |
Nicholas Poellinger, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 888-584-7888 | |
Marisa Luck, Internal Medicine Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 888-584-7888 | |
Sofia Ahmed, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 2160 S 1st Ave, Maywood, IL 60153 Phone: 708-216-8757 |