D/b/a Genoa Medical Clinic | |
109 S Genoa St Genoa IL 60135-1120 | |
(815) 784-5188 | |
(815) 784-5189 |
Full Name | D/b/a Genoa Medical Clinic |
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Speciality | General Practice |
Location | 109 S Genoa St, Genoa, Illinois |
Authorized Official Name and Position | Steven J Disanti (PRESIDENT) |
Authorized Official Contact | 8157845188 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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D/b/a Genoa Medical Clinic 109 S Genoa St Genoa IL 60135-1120 Ph: (815) 784-5188 | D/b/a Genoa Medical Clinic 109 S Genoa St Genoa IL 60135-1120 Ph: (815) 784-5188 |
NPI Number | 1013939602 |
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Provider Enumeration Date | 07/24/2006 |
Last Update Date | 12/10/2007 |
Medicare PECOS PAC ID | 1052312576 |
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Medicare Enrollment ID | O20070126000225 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013939602 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Secondary |
208D00000X | General Practice | (Illinois) | Primary |
Family First Physicians Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 599 Pearson Dr, Genoa, IL 60135 Phone: 815-784-6300 Fax: 815-784-6363 |