| Colmed Clinic Ltd | |
|
3615 N Ashland Ave Apt 1n Chicago IL 60613-4742 | |
| (773) 770-6300 | |
| (773) 665-5007 |
| Full Name | Colmed Clinic Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 3615 N Ashland Ave Apt 1n, Chicago, Illinois |
| Authorized Official Name and Position | Wayne Meyers (OFFICE MANAGER) |
| Authorized Official Contact | 7737706300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colmed Clinic Ltd 3615 N Ashland Ave Apt 1n Chicago IL 60613-4742 Ph: (773) 770-6300 | Colmed Clinic Ltd 3615 N Ashland Ave Apt 1n Chicago IL 60613-4742 Ph: (773) 770-6300 |
| NPI Number | 1194380147 |
|---|---|
| Provider Enumeration Date | 05/06/2019 |
| Last Update Date | 05/06/2019 |
| Medicare PECOS PAC ID | 8426381286 |
|---|---|
| Medicare Enrollment ID | O20190610002305 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194380147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Harold R Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508886409 PECOS PAC ID: 3779639471 Enrollment ID: I20090922000441 |
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