| Carlos H Zambrano Md Llc | |
|
2434 W Division St Chicago IL 60622-2942 | |
| (773) 486-8820 | |
| (773) 486-8823 |
| Full Name | Carlos H Zambrano Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2434 W Division St, Chicago, Illinois |
| Authorized Official Name and Position | Carlos H Zambrano (MD/DIRECTOR) |
| Authorized Official Contact | 7734868820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlos H Zambrano Md Llc Po Box 8088 Wilmette IL 60091-8088 Ph: (773) 486-8820 | Carlos H Zambrano Md Llc 2434 W Division St Chicago IL 60622-2942 Ph: (773) 486-8820 |
| NPI Number | 1467477257 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 08/28/2015 |
| Medicare PECOS PAC ID | 3779591003 |
|---|---|
| Medicare Enrollment ID | O20060329000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467477257 | NPI | - | NPPES |
| 0001636111 | Other | IL | BLUE CROSS/BLUE SHIELD |
| 615318701 | Other | IL | US DEPARTMENT OF LABOR |
| 615318700 | Other | IL | US DEPARTMENT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 036098517 (Illinois) | Primary |
| Provider Name | Carlos H Zambrano |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1639139272 PECOS PAC ID: 7416965751 Enrollment ID: I20060329000285 |
| Provider Name | Chris Odess Costas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992732630 PECOS PAC ID: 6800890328 Enrollment ID: I20060914000052 |
| Provider Name | Constance T Pachucki |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336185552 PECOS PAC ID: 1052582301 Enrollment ID: I20140418000148 |
| Provider Name | Liliya Panyshkevych |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750741864 PECOS PAC ID: 0840586731 Enrollment ID: I20160831002750 |
| Provider Name | Venus Liezl T Basnillo-san Diego |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265971204 PECOS PAC ID: 9931467016 Enrollment ID: I20171219000853 |
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