| Cermak Medical Group Llc | |
|
5741 W Cermak Rd Cicero IL 60804-2129 | |
| (708) 222-0100 | |
| (708) 222-0102 |
| Full Name | Cermak Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5741 W Cermak Rd, Cicero, Illinois |
| Authorized Official Name and Position | Ruchir Thakkar (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7082220100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cermak Medical Group Llc 5741 W Cermak Rd Cicero IL 60804-2129 Ph: (708) 222-0100 | Cermak Medical Group Llc 5741 W Cermak Rd Cicero IL 60804-2129 Ph: (708) 222-0100 |
| NPI Number | 1518498393 |
|---|---|
| Provider Enumeration Date | 03/23/2017 |
| Last Update Date | 01/25/2019 |
| Medicare PECOS PAC ID | 7113269242 |
|---|---|
| Medicare Enrollment ID | O20190422000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518498393 | NPI | - | NPPES |
| 036133879 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036133879 (Illinois) | Primary |
| Provider Name | Angelina D Ledonne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407977838 PECOS PAC ID: 6305024365 Enrollment ID: I20110623000024 |
| Provider Name | Tracie Clisby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942574769 PECOS PAC ID: 3173779303 Enrollment ID: I20120803000415 |
| Provider Name | Ruchir L Thakkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174812853 PECOS PAC ID: 2264654888 Enrollment ID: I20141117000023 |
| Provider Name | Wyvon L Blackwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821398397 PECOS PAC ID: 8123340403 Enrollment ID: I20141124001757 |
| Provider Name | Mohanjit K Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619371267 PECOS PAC ID: 7719209774 Enrollment ID: I20141201002123 |
| Provider Name | Amy Ruth Sheffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598156705 PECOS PAC ID: 2668522517 Enrollment ID: I20150602001538 |
| Provider Name | Nichelle M Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447647110 PECOS PAC ID: 2365762291 Enrollment ID: I20150911001296 |
| Provider Name | Victor C Okamgba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629434741 PECOS PAC ID: 8628372711 Enrollment ID: I20160210001753 |
| Provider Name | Sonja Enge-gilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659823458 PECOS PAC ID: 3375818065 Enrollment ID: I20171005001800 |
| Provider Name | Jeanette T Varquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649789876 PECOS PAC ID: 5092071498 Enrollment ID: I20171116002761 |
| Provider Name | Jessica L Frith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003463 PECOS PAC ID: 4880947902 Enrollment ID: I20181018003082 |
| Provider Name | Nancy Quezada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649752023 PECOS PAC ID: 3779822242 Enrollment ID: I20190227001673 |
| Provider Name | Tia J Hanke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568014843 PECOS PAC ID: 6709117740 Enrollment ID: I20191007000836 |
| Provider Name | Yekaterina S Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891404521 PECOS PAC ID: 3173993581 Enrollment ID: I20221229001770 |
| Provider Name | Crystal Elena Estrada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720782154 PECOS PAC ID: 5698137818 Enrollment ID: I20230818002168 |
| Provider Name | Lauren S King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336923382 PECOS PAC ID: 9436506870 Enrollment ID: I20231107002865 |
Roselia Herrera Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6039 W Cermak Rd, Cicero, IL 60804 Phone: 708-652-0056 | |
Mk Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5729 W Cermak Rd, Cicero, IL 60804 Phone: 708-477-6525 | |
Home Doctors, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1204 S 57th Ave, Cicero, IL 60804 Phone: 312-375-7145 Fax: 708-652-5424 | |
Morton East Adolescent Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2423 S Austin Blvd, Cicero, IL 60804 Phone: 708-656-1130 | |
Hernan Reyes Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5610 W Cermak Rd, Unit #2, Cicero, IL 60804 Phone: 708-656-9247 Fax: 708-656-9358 | |
Alivio Medical Center Cicero Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4842 W Cermak Rd, Cicero, IL 60804 Phone: 312-829-6304 Fax: 708-660-0349 | |
Luis F. Santiago, M.d., S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5533 W Cermak Rd, Cicero, IL 60804 Phone: 708-780-7612 Fax: 708-780-9122 |