| Angel Health Care Services Sc | |
|
7906 S Crandon Ave 2 Chicago IL 60617-1146 | |
| (312) 730-4223 | |
| Not Available |
| Full Name | Angel Health Care Services Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7906 S Crandon Ave, Chicago, Illinois |
| Authorized Official Name and Position | Kishore Khankari (PRESIDENT) |
| Authorized Official Contact | 3127304223 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Health Care Services Sc 7906 S Crandon Ave 2 Chicago IL 60617-1146 Ph: (312) 730-4223 | Angel Health Care Services Sc 7906 S Crandon Ave 2 Chicago IL 60617-1146 Ph: (312) 730-4223 |
| NPI Number | 1033352067 |
|---|---|
| Provider Enumeration Date | 04/07/2009 |
| Last Update Date | 06/15/2022 |
| Medicare PECOS PAC ID | 9739238445 |
|---|---|
| Medicare Enrollment ID | O20090528000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033352067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036104389 (Illinois) | Primary |
| Provider Name | Kishore Khankari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235210097 PECOS PAC ID: 3072503010 Enrollment ID: I20040513000330 |
| Provider Name | Shweta Khankari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992970800 PECOS PAC ID: 8325223753 Enrollment ID: I20110429000282 |
| Provider Name | Kimberly Caceres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376189415 PECOS PAC ID: 0547699605 Enrollment ID: I20200411000422 |
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