| Aamg Reach Pllc | |
|
1357 W 103rd St Chicago IL 60643-2392 | |
| (773) 238-0800 | |
| Not Available |
| Full Name | Aamg Reach Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1357 W 103rd St, Chicago, Illinois |
| Authorized Official Name and Position | Nan Nelson (ASSISTANT TREASURER) |
| Authorized Official Contact | 4142191610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aamg Reach Pllc 1357 W 103rd St Chicago IL 60643-2392 Ph: (773) 238-0800 | Aamg Reach Pllc 1357 W 103rd St Chicago IL 60643-2392 Ph: (773) 238-0800 |
| NPI Number | 1609502707 |
|---|---|
| Provider Enumeration Date | 07/29/2022 |
| Last Update Date | 10/03/2023 |
| Medicare PECOS PAC ID | 5597133264 |
|---|---|
| Medicare Enrollment ID | O20221130002219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609502707 | NPI | - | NPPES |
| 100224369 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Mangala Yeturu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912010125 PECOS PAC ID: 9830084813 Enrollment ID: I20040407000896 |
| Provider Name | Necholas Ghannam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962480541 PECOS PAC ID: 4082679238 Enrollment ID: I20041130000065 |
| Provider Name | Sudha Kurien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407025133 PECOS PAC ID: 4880647684 Enrollment ID: I20050221000657 |
| Provider Name | Leonard Stallings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407944309 PECOS PAC ID: 6103913280 Enrollment ID: I20071106000744 |
| Provider Name | Evelyn M Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063526242 PECOS PAC ID: 6709965692 Enrollment ID: I20080502000647 |
| Provider Name | Jacqueline R Ivey-brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023299435 PECOS PAC ID: 1850466194 Enrollment ID: I20080820000596 |
| Provider Name | Edwin Earl Hollins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982721643 PECOS PAC ID: 3971650185 Enrollment ID: I20090403000478 |
| Provider Name | David M Mael |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134152739 PECOS PAC ID: 3173672748 Enrollment ID: I20090601000563 |
| Provider Name | John Gould Kelsey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386667939 PECOS PAC ID: 0446391692 Enrollment ID: I20100109000210 |
| Provider Name | Daniel Montalvo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437165594 PECOS PAC ID: 1254472400 Enrollment ID: I20100109000224 |
| Provider Name | Lolita M Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417968728 PECOS PAC ID: 9537204318 Enrollment ID: I20100304000269 |
| Provider Name | Sudhakar R Yeturu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093828212 PECOS PAC ID: 8820983802 Enrollment ID: I20100304000500 |
| Provider Name | Julie R Brandies |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467405472 PECOS PAC ID: 8022141332 Enrollment ID: I20100805001038 |
| Provider Name | Mirza Khalid M Baig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194776377 PECOS PAC ID: 9032021282 Enrollment ID: I20101118000853 |
| Provider Name | Navneet Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194783217 PECOS PAC ID: 2163691288 Enrollment ID: I20110808000091 |
| Provider Name | Lisa R Zull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376819730 PECOS PAC ID: 4284872300 Enrollment ID: I20130531000559 |
| Provider Name | Mariana K Krive |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063732931 PECOS PAC ID: 5294046553 Enrollment ID: I20150612002234 |
| Provider Name | Cynthia Kay Swanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629404298 PECOS PAC ID: 1355657446 Enrollment ID: I20150903002786 |
| Provider Name | Mehak Sethi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124386057 PECOS PAC ID: 3375844558 Enrollment ID: I20151211001572 |
| Provider Name | Sarwat Shaheen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710252465 PECOS PAC ID: 9032414511 Enrollment ID: I20170217000405 |
| Provider Name | Aashima Ghai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437544806 PECOS PAC ID: 5294030821 Enrollment ID: I20180606000212 |
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