| Boycin Medical Clinic Ltd. | |
|
5219 W Madison St 1st Floor Chicago IL 60644-4152 | |
| (773) 378-4823 | |
| (773) 378-9401 |
| Full Name | Boycin Medical Clinic Ltd. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5219 W Madison St, Chicago, Illinois |
| Authorized Official Name and Position | Ndudi C Aniemeka (PROPERITOR) |
| Authorized Official Contact | 7733784823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boycin Medical Clinic Ltd. 5219 W Madison St Chicago IL 60644-4152 Ph: (773) 378-4823 | Boycin Medical Clinic Ltd. 5219 W Madison St 1st Floor Chicago IL 60644-4152 Ph: (773) 378-4823 |
| NPI Number | 1386976959 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 05/04/2011 |
| Medicare PECOS PAC ID | 5092859256 |
|---|---|
| Medicare Enrollment ID | O20100225000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386976959 | NPI | - | NPPES |
| 036085291 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036126142 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | 036085291 (Illinois) | Primary |
| Provider Name | Ndudi C Aniemeka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255447421 PECOS PAC ID: 6507941036 Enrollment ID: I20080307000626 |
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