| Thorek Memorial Hospital Dba Methodist Hospital Of Chicago | |
|
5025 N Paulina St Chicago IL 60640-2772 | |
| (773) 271-9040 | |
| (773) 271-2010 |
| Full Name | Thorek Memorial Hospital Dba Methodist Hospital Of Chicago |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 5025 N Paulina St, Chicago, Illinois |
| Authorized Official Name and Position | Edward Budd (CEO) |
| Authorized Official Contact | 7739756705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thorek Memorial Hospital Dba Methodist Hospital Of Chicago 5025 N Paulina St Chicago IL 60640-2772 Ph: (773) 271-9040 | Thorek Memorial Hospital Dba Methodist Hospital Of Chicago 5025 N Paulina St Chicago IL 60640-2772 Ph: (773) 271-9040 |
| NPI Number | 1891755351 |
|---|---|
| Provider Enumeration Date | 03/27/2006 |
| Last Update Date | 03/05/2020 |
| Certification Date | 03/05/2020 |
| Medicare PECOS PAC ID | 5890770655 |
|---|---|
| Medicare Enrollment ID | O20040624000228 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891755351 | NPI | - | NPPES |
| 362012788001 | Medicaid | IL | |
| 362012788002 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0000125 (Illinois) | Secondary |
| 282N00000X | General Acute Care Hospital | 0000125 (Illinois) | Primary |
| Provider Name | Paramjit S Chopra |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1316948565 PECOS PAC ID: 3577477967 Enrollment ID: I20031119000151 |
| Provider Name | Rajiv Kandala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376608059 PECOS PAC ID: 2062302094 Enrollment ID: I20040316000195 |
| Provider Name | Pedro F Delostrinos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922099183 PECOS PAC ID: 2961474036 Enrollment ID: I20040810000011 |
| Provider Name | Victor E Nutenko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346325404 PECOS PAC ID: 9739158775 Enrollment ID: I20040928000075 |
| Provider Name | Maxim Chasanov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124028584 PECOS PAC ID: 9234199233 Enrollment ID: I20041014000194 |
| Provider Name | Thomas Michael Albert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457465098 PECOS PAC ID: 2860453156 Enrollment ID: I20041020000854 |
| Provider Name | Wilfredo G Dacuycuy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407818545 PECOS PAC ID: 6709844608 Enrollment ID: I20041223000093 |
| Provider Name | Mohammad J Khamis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881687390 PECOS PAC ID: 2163473042 Enrollment ID: I20050208000877 |
| Provider Name | James C Danziger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427032838 PECOS PAC ID: 0143267542 Enrollment ID: I20050415000669 |
| Provider Name | Agustin D Dormitorio |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1326120999 PECOS PAC ID: 5294756094 Enrollment ID: I20051208000265 |
| Provider Name | Americo M Ramos |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912959305 PECOS PAC ID: 7618999327 Enrollment ID: I20051222000069 |
| Provider Name | Rene C Velazco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245257955 PECOS PAC ID: 3072663327 Enrollment ID: I20090609000217 |
| Provider Name | Mahdi A Alsaden |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538231089 PECOS PAC ID: 8325231160 Enrollment ID: I20101025000781 |
| Provider Name | Sanjoy Majumdar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467495648 PECOS PAC ID: 0042408080 Enrollment ID: I20101217000357 |
| Provider Name | Camilla Larsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336151752 PECOS PAC ID: 0840471264 Enrollment ID: I20110217000875 |
| Provider Name | Zarina Z Bandukwala |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790805778 PECOS PAC ID: 3173707874 Enrollment ID: I20110404000807 |
| Provider Name | Carol L Childers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700086220 PECOS PAC ID: 2365337532 Enrollment ID: I20130528000327 |
| Provider Name | Jessica Wunder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013306240 PECOS PAC ID: 2264758036 Enrollment ID: I20150313001875 |
| Provider Name | Valerie M Brostrom |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285894782 PECOS PAC ID: 4284872151 Enrollment ID: I20151208001288 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |