| Downers Grove Immediate Care Inc. | |
|
425 Ogden Ave Downers Grove IL 60515-3066 | |
| (630) 212-5338 | |
| Not Available |
| Full Name | Downers Grove Immediate Care Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 425 Ogden Ave, Downers Grove, Illinois |
| Authorized Official Name and Position | Azharuddin Mohammed (MANAGER) |
| Authorized Official Contact | 6302125338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Downers Grove Immediate Care Inc. 425 Ogden Ave Downers Grove IL 60515-3066 Ph: (630) 212-5338 | Downers Grove Immediate Care Inc. 425 Ogden Ave Downers Grove IL 60515-3066 Ph: (630) 212-5338 |
| NPI Number | 1568073674 |
|---|---|
| Provider Enumeration Date | 08/12/2020 |
| Last Update Date | 08/12/2020 |
| Medicare PECOS PAC ID | 8123438553 |
|---|---|
| Medicare Enrollment ID | O20201113000528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568073674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mohammed R Shabbir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073551594 PECOS PAC ID: 3173619988 Enrollment ID: I20071009000878 |
| Provider Name | Wakas N Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447446521 PECOS PAC ID: 1456449925 Enrollment ID: I20071116000156 |
| Provider Name | Stephanie Fayne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609489525 PECOS PAC ID: 7810303393 Enrollment ID: I20210308001941 |
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