| Mpac Smh Of California Pc | |
|
200 N La Salle St Ste 1550 Chicago IL 60601-1034 | |
| (888) 705-8722 | |
| (888) 705-8722 |
| Full Name | Mpac Smh Of California Pc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 200 N La Salle St Ste 1550, Chicago, Illinois |
| Authorized Official Name and Position | Sean C Cannone (OWNER) |
| Authorized Official Contact | 3303283167 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mpac Smh Of California Pc Po Box 80694 City Of Industry CA 91716-8415 Ph: (888) 705-8722 | Mpac Smh Of California Pc 200 N La Salle St Ste 1550 Chicago IL 60601-1034 Ph: (888) 705-8722 |
| NPI Number | 1821660960 |
|---|---|
| Provider Enumeration Date | 07/16/2021 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Medicare PECOS PAC ID | 6002206380 |
|---|---|
| Medicare Enrollment ID | O20211130001905 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821660960 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
| Provider Name | Diane H Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003022534 PECOS PAC ID: 1052408804 Enrollment ID: I20071026000188 |
| Provider Name | Michelle S Eslami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689627143 PECOS PAC ID: 7618016098 Enrollment ID: I20091124000217 |
| Provider Name | Shelli Nunes-briones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528465408 PECOS PAC ID: 3274833942 Enrollment ID: I20151202000692 |
| Provider Name | Karen J Caruso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679816680 PECOS PAC ID: 0648572297 Enrollment ID: I20160113002149 |
| Provider Name | Corey H Everett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922511187 PECOS PAC ID: 1850651241 Enrollment ID: I20180202001447 |
| Provider Name | Marilyn Rivas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043715949 PECOS PAC ID: 1254675507 Enrollment ID: I20181128000479 |
| Provider Name | Joshua B Espano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275983991 PECOS PAC ID: 6103251699 Enrollment ID: I20200109002651 |
| Provider Name | Jessica Cintron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376151795 PECOS PAC ID: 8820416175 Enrollment ID: I20200915002696 |
| Provider Name | Rahal Ehsan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710553268 PECOS PAC ID: 8729481320 Enrollment ID: I20210720001888 |
| Provider Name | Stephanie Hill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043589351 PECOS PAC ID: 6305238098 Enrollment ID: I20220107001663 |
| Provider Name | Catherine Susie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629734496 PECOS PAC ID: 7416340377 Enrollment ID: I20220217001138 |
| Provider Name | Rachel Jimenez Doronio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780299289 PECOS PAC ID: 5395139687 Enrollment ID: I20220302002450 |
| Provider Name | Rachel Pasternak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770012189 PECOS PAC ID: 6204221526 Enrollment ID: I20220322003326 |
| Provider Name | Candy Grace Jacome De Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548924012 PECOS PAC ID: 1951796143 Enrollment ID: I20220325001080 |
| Provider Name | Lynette Woo-sam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427716612 PECOS PAC ID: 9335536242 Enrollment ID: I20220425000280 |
| Provider Name | Georgina Laus Villacorta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174192512 PECOS PAC ID: 8820485451 Enrollment ID: I20220428001115 |
| Provider Name | Jehrel Andre Bruno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366893935 PECOS PAC ID: 1951780972 Enrollment ID: I20220622002369 |
| Provider Name | Nancy Anda Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437885837 PECOS PAC ID: 0345623617 Enrollment ID: I20220818002954 |
| Provider Name | Kaycee Ann Forinash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689382327 PECOS PAC ID: 7810367844 Enrollment ID: I20230106002328 |
| Provider Name | Tiffany Rosalind Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750632451 PECOS PAC ID: 3678947686 Enrollment ID: I20230314002500 |
| Provider Name | Lynnette Julie Cromwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013158773 PECOS PAC ID: 5799150959 Enrollment ID: I20230331002443 |
| Provider Name | Hanna Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447911284 PECOS PAC ID: 7214302272 Enrollment ID: I20230405002554 |
| Provider Name | Jennifer Buggeln |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659877876 PECOS PAC ID: 6901296094 Enrollment ID: I20230406002493 |
| Provider Name | Denise Aguilar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104958818 PECOS PAC ID: 9335505296 Enrollment ID: I20230518001553 |
| Provider Name | Holly Vanderhyde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033773379 PECOS PAC ID: 8426415480 Enrollment ID: I20230606002880 |
| Provider Name | Mary Dorothy Martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982300901 PECOS PAC ID: 9739546326 Enrollment ID: I20230613003176 |
| Provider Name | David Keith Canete |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881382174 PECOS PAC ID: 2769840792 Enrollment ID: I20230622002308 |
| Provider Name | Lauren Ludlow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972119170 PECOS PAC ID: 2163881350 Enrollment ID: I20230706001962 |
| Provider Name | Rachel Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376234328 PECOS PAC ID: 5597125047 Enrollment ID: I20230717001106 |
| Provider Name | Abayomi Adetokunbo Taiwo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871126086 PECOS PAC ID: 1658731682 Enrollment ID: I20230721001422 |
| Provider Name | Leocarlo De Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396434874 PECOS PAC ID: 9931560182 Enrollment ID: I20230803002708 |
| Provider Name | Julee L Loces |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073149662 PECOS PAC ID: 6901281591 Enrollment ID: I20230809003647 |
| Provider Name | Terry Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235493479 PECOS PAC ID: 1759743230 Enrollment ID: I20230815003492 |
| Provider Name | Jamie Ann Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396081360 PECOS PAC ID: 4688811748 Enrollment ID: I20230821003187 |
| Provider Name | Christopher Blackwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699224980 PECOS PAC ID: 3678937083 Enrollment ID: I20230918002287 |
| Provider Name | Victoria Boyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922556695 PECOS PAC ID: 3173978640 Enrollment ID: I20231018003583 |
| Provider Name | Michael Sinfuego |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174235451 PECOS PAC ID: 9537515093 Enrollment ID: I20231019003709 |
| Provider Name | Ruth Topacio Orbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598546640 PECOS PAC ID: 7810345485 Enrollment ID: I20231121002535 |
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 |