| Walmart Health Virtual Care | |
|
1715 N Kilpatrick Ave Chicago IL 60639-4611 | |
| (773) 276-7570 | |
| Not Available |
| Full Name | Walmart Health Virtual Care |
|---|---|
| Speciality | General Practice |
| Location | 1715 N Kilpatrick Ave, Chicago, Illinois |
| Authorized Official Name and Position | Mark Shen (OWNER) |
| Authorized Official Contact | 5127797276 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walmart Health Virtual Care 6910 E Chauncey Ln Ste 220 Phoenix AZ 85054-5162 Ph: (480) 247-3366 | Walmart Health Virtual Care 1715 N Kilpatrick Ave Chicago IL 60639-4611 Ph: (773) 276-7570 |
| NPI Number | 1518603695 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/18/2023 |
| Medicare PECOS PAC ID | 4486060167 |
|---|---|
| Medicare Enrollment ID | O20230707002619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518603695 | NPI | - | NPPES |
| Provider Name | Lane Clayton Thaut |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174984058 PECOS PAC ID: 2567792005 Enrollment ID: I20201019001798 |
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