| Elizalde Healthcare Sc | |
|
1508 Bloomingdale Rd Glendale Heights IL 60139-2757 | |
| (630) 915-2037 | |
| Not Available |
| Full Name | Elizalde Healthcare Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 1508 Bloomingdale Rd, Glendale Heights, Illinois |
| Authorized Official Name and Position | Marnella Elizalde (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6309152037 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizalde Healthcare Sc 1508 Bloomingdale Rd Glendale Heights IL 60139-2757 Ph: (630) 915-2037 | Elizalde Healthcare Sc 1508 Bloomingdale Rd Glendale Heights IL 60139-2757 Ph: (630) 915-2037 |
| NPI Number | 1710712070 |
|---|---|
| Provider Enumeration Date | 09/05/2024 |
| Last Update Date | 09/05/2024 |
| Medicare PECOS PAC ID | 8820522212 |
|---|---|
| Medicare Enrollment ID | O20241107001506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710712070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marnella Elizalde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184275448 PECOS PAC ID: 0244502755 Enrollment ID: I20241107001593 |
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