| Family Care Associates Ltd | |
|
4438 N Miwaukee Ave Chicago IL 60630-6063 | |
| (773) 205-8200 | |
| (773) 205-1222 |
| Full Name | Family Care Associates Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 4438 N Miwaukee Ave, Chicago, Illinois |
| Authorized Official Name and Position | Carlos A Gomez (PRESIDENT) |
| Authorized Official Contact | 7732058200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Associates Ltd Po Box 14439 Chicago IL 60614-0439 Ph: (773) 205-8200 | Family Care Associates Ltd 4438 N Miwaukee Ave Chicago IL 60630-6063 Ph: (773) 205-8200 |
| NPI Number | 1992802664 |
|---|---|
| Provider Enumeration Date | 09/17/2006 |
| Last Update Date | 02/10/2020 |
| Medicare PECOS PAC ID | 6305971631 |
|---|---|
| Medicare Enrollment ID | O20100311000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992802664 | NPI | - | NPPES |
| 036086306 | Medicaid | IL | |
| 036103291 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Carlos A Gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144327818 PECOS PAC ID: 5294860532 Enrollment ID: I20100311001037 |
| Provider Name | Pedro A Reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508884602 PECOS PAC ID: 7012042351 Enrollment ID: I20101007001212 |
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