| Vanguard Eldercare - Illinois, S.c. | |
|
1440 N Lake Shore Dr Apt 12d Chicago IL 60610-5909 | |
| (574) 546-1900 | |
| (574) 546-1999 |
| Full Name | Vanguard Eldercare - Illinois, S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1440 N Lake Shore Dr Apt 12d, Chicago, Illinois |
| Authorized Official Name and Position | Steven Posar (CEO) |
| Authorized Official Contact | 5745461900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanguard Eldercare - Illinois, S.c. Po Box 10633 Fort Wayne IN 46853-0633 Ph: (574) 546-1900 | Vanguard Eldercare - Illinois, S.c. 1440 N Lake Shore Dr Apt 12d Chicago IL 60610-5909 Ph: (574) 546-1900 |
| NPI Number | 1417591074 |
|---|---|
| Provider Enumeration Date | 11/06/2019 |
| Last Update Date | 11/16/2021 |
| Certification Date | 11/16/2021 |
| Medicare PECOS PAC ID | 6305230194 |
|---|---|
| Medicare Enrollment ID | O20220221001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417591074 | NPI | - | NPPES |
| Provider Name | Steven Posar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154308575 PECOS PAC ID: 8921020538 Enrollment ID: I20210618000646 |
| Provider Name | James Fenstermacher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295181154 PECOS PAC ID: 9436448222 Enrollment ID: I20240503000717 |
| Provider Name | Stephanie Paduch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033752266 PECOS PAC ID: 8527492719 Enrollment ID: I20240503001119 |
| Provider Name | Shawna Plunkett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245621432 PECOS PAC ID: 3476873829 Enrollment ID: I20240503001617 |
| Provider Name | Anita Arthur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023059573 PECOS PAC ID: 0143257691 Enrollment ID: I20240503002112 |
| Provider Name | Julie Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366641482 PECOS PAC ID: 4486953437 Enrollment ID: I20240503002226 |
| Provider Name | Daniel Heiser |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396914875 PECOS PAC ID: 3870667983 Enrollment ID: I20240506003700 |
| Provider Name | Darrin Clutteur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768322 PECOS PAC ID: 5294072567 Enrollment ID: I20240513002568 |
| Provider Name | Stephanie Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518419787 PECOS PAC ID: 4082996103 Enrollment ID: I20240610002820 |
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