| Iws Family Health | |
|
3600 W Fullerton Ave Chicago IL 60647 | |
| (773) 782-2800 | |
| (773) 782-5042 |
| Full Name | Iws Family Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 3600 W Fullerton Ave, Chicago, Illinois |
| Authorized Official Name and Position | Cindy Herrera (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7737825024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iws Family Health 3600 W Fullerton Ave Chicago IL 60647 Ph: (773) 782-2800 | Iws Family Health 3600 W Fullerton Ave Chicago IL 60647 Ph: (773) 782-2800 |
| NPI Number | 1497872543 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 6800137407 |
|---|---|
| Medicare Enrollment ID | O20190409000984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497872543 | NPI | - | NPPES |
| Provider Name | Paola A Portela |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891917720 PECOS PAC ID: 7517153786 Enrollment ID: I20101130000806 |
| Provider Name | Jennifer M Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124131966 PECOS PAC ID: 9931345832 Enrollment ID: I20130419000372 |
| Provider Name | Luis L Rivera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619396371 PECOS PAC ID: 6901187996 Enrollment ID: I20170105002316 |
| Provider Name | Maria Isabel Angulo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659647865 PECOS PAC ID: 0840590196 Enrollment ID: I20170106001196 |
| Provider Name | Azalea Vicenteno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386187912 PECOS PAC ID: 3072897586 Enrollment ID: I20170301001119 |
| Provider Name | Jessica Espinosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063930907 PECOS PAC ID: 2769723931 Enrollment ID: I20190416002894 |
| Provider Name | Daniel Ceballos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659449767 PECOS PAC ID: 9436490612 Enrollment ID: I20190417000372 |
| Provider Name | Jennifer Julia Stagl Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649572934 PECOS PAC ID: 8426399619 Enrollment ID: I20190417000463 |
| Provider Name | Xiomara Nieto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619476116 PECOS PAC ID: 6507107794 Enrollment ID: I20190417000547 |
| Provider Name | Karen Callan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447681259 PECOS PAC ID: 1254672447 Enrollment ID: I20190417000865 |
| Provider Name | Sandra Frank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003942723 PECOS PAC ID: 9436491461 Enrollment ID: I20190423002319 |
| Provider Name | Elba-julie Quinones |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073615563 PECOS PAC ID: 0345582102 Enrollment ID: I20190425002519 |
| Provider Name | Laura Cabrales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366848400 PECOS PAC ID: 4284976002 Enrollment ID: I20190426002032 |
| Provider Name | Joann Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255970141 PECOS PAC ID: 9638507270 Enrollment ID: I20200316000066 |
| Provider Name | Susely Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962049452 PECOS PAC ID: 3779997556 Enrollment ID: I20210208001000 |
| Provider Name | Banesa Chavez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780297457 PECOS PAC ID: 0648661900 Enrollment ID: I20211221000086 |
| Provider Name | Emeline Ramos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184912891 PECOS PAC ID: 9537438486 Enrollment ID: I20230321001201 |
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