| Correa Medical Group S.c. | |
|
1045 W Belmont Ave Chicago IL 60657-3327 | |
| (773) 248-8644 | |
| Not Available |
| Full Name | Correa Medical Group S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1045 W Belmont Ave, Chicago, Illinois |
| Authorized Official Name and Position | Eduardo Correa (PRESIDENT) |
| Authorized Official Contact | 7732488644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Correa Medical Group S.c. 1045 W Belmont Ave Chicago IL 60657-3327 Ph: (773) 248-8644 | Correa Medical Group S.c. 1045 W Belmont Ave Chicago IL 60657-3327 Ph: (773) 248-8644 |
| NPI Number | 1275670192 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8426150699 |
|---|---|
| Medicare Enrollment ID | O20070220000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275670192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Eduardo Correa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487668653 PECOS PAC ID: 1254433428 Enrollment ID: I20070220000104 |
| Provider Name | Sandra Marie Pena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932563996 PECOS PAC ID: 3476836099 Enrollment ID: I20191003001333 |
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