| Atkinson Clinic Sc | |
|
100 N Atkinson Rd Ste 207 Grayslake IL 60030-7804 | |
| (847) 548-9777 | |
| (847) 548-9797 |
| Full Name | Atkinson Clinic Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 N Atkinson Rd Ste 207, Grayslake, Illinois |
| Authorized Official Name and Position | Sergei Shevlyagin (OWNER) |
| Authorized Official Contact | 8475489777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atkinson Clinic Sc 100 N Atkinson Rd Ste 207 Grayslake IL 60030-7804 Ph: (847) 548-9777 | Atkinson Clinic Sc 100 N Atkinson Rd Ste 207 Grayslake IL 60030-7804 Ph: (847) 548-9777 |
| NPI Number | 1437169646 |
|---|---|
| Provider Enumeration Date | 08/09/2006 |
| Last Update Date | 08/21/2012 |
| Medicare PECOS PAC ID | 7911092978 |
|---|---|
| Medicare Enrollment ID | O20071005000061 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437169646 | NPI | - | NPPES |
| 110224169 | Other | IL | RAIL ROAD MEDICARE |
| 4927894 | Other | IL | BLUE CROSS/SHIELD |
| 036978646 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036978646 (Illinois) | Primary |
| Provider Name | Sergei Shevlyagin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235123589 PECOS PAC ID: 3870406010 Enrollment ID: I20031112000515 |
| Provider Name | Inna Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568982742 PECOS PAC ID: 1759654403 Enrollment ID: I20170831002686 |
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