Cordial Medical Center, S.c. | |
333 E Il Route 83 Ste 105 Mundelein IL 60060-4278 | |
(847) 970-9922 | |
(847) 970-9955 |
Full Name | Cordial Medical Center, S.c. |
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Speciality | Family Medicine |
Location | 333 E Il Route 83 Ste 105, Mundelein, Illinois |
Authorized Official Name and Position | Mikhail Khodarkovskiy (PRESIDENT) |
Authorized Official Contact | 2243923643 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Cordial Medical Center, S.c. 333 E Il Route 83 Ste 105 Mundelein IL 60060-4278 Ph: (847) 970-9922 | Cordial Medical Center, S.c. 333 E Il Route 83 Ste 105 Mundelein IL 60060-4278 Ph: (847) 970-9922 |
NPI Number | 1093771263 |
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Provider Enumeration Date | 04/25/2006 |
Last Update Date | 08/13/2023 |
Medicare PECOS PAC ID | 6901898873 |
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Medicare Enrollment ID | O20040331001211 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093771263 | NPI | - | NPPES |
042-618285 | Other | IL | CORPORATION LICENSE NO. |
036-107538 | Other | IL | PHYSICIAN LICENSE NO. |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036-107538 (Illinois) | Primary |
Provider Name | Mikhail Khodarkovskiy |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215919196 PECOS PAC ID: 7113919937 Enrollment ID: I20040401000611 |
Provider Name | Bela Glantsman |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750347803 PECOS PAC ID: 8426023755 Enrollment ID: I20040831000602 |
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