| Crestwood Medical Associates Ltd | |
|
13117 Rivercrest Dr Crestwood IL 60418-4419 | |
| (708) 371-1190 | |
| (708) 448-8812 |
| Full Name | Crestwood Medical Associates Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 13117 Rivercrest Dr, Crestwood, Illinois |
| Authorized Official Name and Position | Antonio Noriega (PRESIDENT) |
| Authorized Official Contact | 7083711190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Medical Associates Ltd 13117 Rivercrest Dr Crestwood IL 60418-4419 Ph: (708) 371-1190 | Crestwood Medical Associates Ltd 13117 Rivercrest Dr Crestwood IL 60418-4419 Ph: (708) 371-1190 |
| NPI Number | 1992746309 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 01/09/2019 |
| Medicare PECOS PAC ID | 9537256854 |
|---|---|
| Medicare Enrollment ID | O20071103000032 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992746309 | NPI | - | NPPES |
| 036049076 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Antonio T Noriega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073701850 PECOS PAC ID: 1759317662 Enrollment ID: I20071103000023 |
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