Chicagoland Wellmed Center Sc | |
11933 S Pulaski Rd Ste C1 Alsip IL 60803-1100 | |
(708) 396-2500 | |
Not Available |
Full Name | Chicagoland Wellmed Center Sc |
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Speciality | Internal Medicine |
Location | 11933 S Pulaski Rd Ste C1, Alsip, Illinois |
Authorized Official Name and Position | Frank Vaught (OWNER) |
Authorized Official Contact | 3147045959 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Chicagoland Wellmed Center Sc 4071 Teak Cir Naperville IL 60564-1104 Ph: (314) 704-5959 | Chicagoland Wellmed Center Sc 11933 S Pulaski Rd Ste C1 Alsip IL 60803-1100 Ph: (708) 396-2500 |
NPI Number | 1881334373 |
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Provider Enumeration Date | 03/31/2022 |
Last Update Date | 03/31/2022 |
Medicare PECOS PAC ID | 6507239431 |
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Medicare Enrollment ID | O20230223002985 |
Identifier | Type | State | Issuer |
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1881334373 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Frank A Vaught |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1174544316 PECOS PAC ID: 6507828738 Enrollment ID: I20041101000109 |
Provider Name | Teia L Atwood |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205165222 PECOS PAC ID: 0648305193 Enrollment ID: I20100323000194 |
Provider Name | Syed Ahmed Naseeruddin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760599575 PECOS PAC ID: 4981754017 Enrollment ID: I20110808000747 |
Provider Name | Monica Conway |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699425066 PECOS PAC ID: 6305217902 Enrollment ID: I20230118001909 |
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