| Wholehealth Chicago 3 Sc | |
|
2522 N Lincoln Ave Chicago IL 60614-2352 | |
| (773) 296-6700 | |
| (773) 296-1131 |
| Full Name | Wholehealth Chicago 3 Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2522 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | David Keith Edelberg (SECRETARY) |
| Authorized Official Contact | 7732966700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wholehealth Chicago 3 Sc 2565 N Clybourn Ave Chicago IL 60614-3052 Ph: (773) 296-6700 | Wholehealth Chicago 3 Sc 2522 N Lincoln Ave Chicago IL 60614-2352 Ph: (773) 296-6700 |
| NPI Number | 1487722666 |
|---|---|
| Provider Enumeration Date | 12/04/2006 |
| Last Update Date | 07/15/2021 |
| Certification Date | 07/12/2021 |
| Medicare PECOS PAC ID | 9335223247 |
|---|---|
| Medicare Enrollment ID | O20080229000390 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487722666 | NPI | - | NPPES |
| 1623831 | Other | IL | BLUE CROSS BLUE SHIELD |
| Provider Name | Janet M Chandler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033313218 PECOS PAC ID: 7315092350 Enrollment ID: I20090827000301 |
| Provider Name | Clifford P Maurer |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558694463 PECOS PAC ID: 3779629746 Enrollment ID: I20091005000490 |
| Provider Name | Jerry P Gore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972695633 PECOS PAC ID: 0840220307 Enrollment ID: I20120518000055 |
| Provider Name | Jean R Alexis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1346636594 PECOS PAC ID: 1557682143 Enrollment ID: I20150608002403 |
| Provider Name | Carol H Gore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154413987 PECOS PAC ID: 2961781315 Enrollment ID: I20161108001412 |
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