| Arlington Primary Care | |
|
121 S Wilke Rd Suite 110 Arlington Heights IL 60005-1533 | |
| (847) 398-4536 | |
| (847) 398-4712 |
| Full Name | Arlington Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 121 S Wilke Rd, Arlington Heights, Illinois |
| Authorized Official Name and Position | Mamdouh Latif Ishak (PRESIDENT) |
| Authorized Official Contact | 8473984536 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arlington Primary Care 121 S Wilke Rd Suite 110 Arlington Heights IL 60005-1533 Ph: (847) 398-4536 | Arlington Primary Care 121 S Wilke Rd Suite 110 Arlington Heights IL 60005-1533 Ph: (847) 398-4536 |
| NPI Number | 1205084571 |
|---|---|
| Provider Enumeration Date | 08/28/2008 |
| Last Update Date | 04/15/2015 |
| Medicare PECOS PAC ID | 7315005485 |
|---|---|
| Medicare Enrollment ID | O20081017000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205084571 | NPI | - | NPPES |
| 036041272 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036041272 (Illinois) | Primary |
| Provider Name | Mamdouh L Ishak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275612343 PECOS PAC ID: 2365500535 Enrollment ID: I20081017000256 |
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