| Advocate Illinois Masonic Medical Center | |
|
3048 N Wilton Ave 2 Nd Floor Chicago IL 60657-6710 | |
| (773) 296-5424 | |
| (773) 296-5280 |
| Full Name | Advocate Illinois Masonic Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 3048 N Wilton Ave, Chicago, Illinois |
| Authorized Official Name and Position | Teresa Ramos (RESIDENCY PROGRAM DIRECTOR) |
| Authorized Official Contact | 7732967046 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advocate Illinois Masonic Medical Center 3048 N Wilton Ave 2 Nd Floor Chicago IL 60657-6710 Ph: (773) 296-5424 | Advocate Illinois Masonic Medical Center 3048 N Wilton Ave 2 Nd Floor Chicago IL 60657-6710 Ph: (773) 296-5424 |
| NPI Number | 1083880702 |
|---|---|
| Provider Enumeration Date | 05/02/2008 |
| Last Update Date | 05/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083880702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 125-049755 (Illinois) | Primary |
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