| Abk Medical Center, Ltd. | |
|
2653 W Peterson Ave Chicago IL 60659-4017 | |
| (773) 728-9399 | |
| Not Available |
| Full Name | Abk Medical Center, Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 2653 W Peterson Ave, Chicago, Illinois |
| Authorized Official Name and Position | Audisho B Khoshaba (OWNER) |
| Authorized Official Contact | 7737289399 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abk Medical Center, Ltd. 2653 W Peterson Ave Chicago IL 60659-4017 Ph: (773) 728-9399 | Abk Medical Center, Ltd. 2653 W Peterson Ave Chicago IL 60659-4017 Ph: (773) 728-9399 |
| NPI Number | 1720263197 |
|---|---|
| Provider Enumeration Date | 01/04/2008 |
| Last Update Date | 01/04/2008 |
| Medicare PECOS PAC ID | 4183709280 |
|---|---|
| Medicare Enrollment ID | O20080313000542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720263197 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Audisho B Khoshaba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104933191 PECOS PAC ID: 9335224484 Enrollment ID: I20080313000139 |
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