| Caring Family S. C. | |
|
781 Mchenry Ave Crystal Lake IL 60014-7444 | |
| (815) 459-2200 | |
| (815) 788-9263 |
| Full Name | Caring Family S. C. |
|---|---|
| Speciality | Clinic/Center |
| Location | 781 Mchenry Ave, Crystal Lake, Illinois |
| Authorized Official Name and Position | Todd S Giese (PRESIDENT) |
| Authorized Official Contact | 8154592200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Caring Family S. C. 781 Mchenry Ave Crystal Lake IL 60014-7444 Ph: (815) 459-2200 | Caring Family S. C. 781 Mchenry Ave Crystal Lake IL 60014-7444 Ph: (815) 459-2200 |
| NPI Number | 1902025547 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 01/22/2008 |
| Medicare PECOS PAC ID | 0648379503 |
|---|---|
| Medicare Enrollment ID | O20070626000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902025547 | NPI | - | NPPES |
| 5600288 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jamie Tm Gancayco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669470431 PECOS PAC ID: 1254390891 Enrollment ID: I20041008000058 |
| Provider Name | Todd S Giese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558374017 PECOS PAC ID: 1355440215 Enrollment ID: I20070619000412 |
| Provider Name | Racquel Norada Ramirez Dolleton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265542260 PECOS PAC ID: 2264531128 Enrollment ID: I20070628000315 |
| Provider Name | George B Gancayco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477566834 PECOS PAC ID: 4981703840 Enrollment ID: I20070628000363 |
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