| Family Care Associates Of Chicago | |
|
6187 S Archer Ave Suite 103 Chicago IL 60638-2605 | |
| (773) 581-1500 | |
| (773) 581-2160 |
| Full Name | Family Care Associates Of Chicago |
|---|---|
| Speciality | Family Medicine |
| Location | 6187 S Archer Ave, Chicago, Illinois |
| Authorized Official Name and Position | Charles Shaw (MEMBER) |
| Authorized Official Contact | 7735811500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Associates Of Chicago 6187 S Archer Ave Suite 103 Chicago IL 60638-2605 Ph: (773) 581-1500 | Family Care Associates Of Chicago 6187 S Archer Ave Suite 103 Chicago IL 60638-2605 Ph: (773) 581-1500 |
| NPI Number | 1023065976 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 07/21/2016 |
| Medicare PECOS PAC ID | 6608169321 |
|---|---|
| Medicare Enrollment ID | O20160718002456 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023065976 | NPI | - | NPPES |
| 1618283 | Other | IL | BLUE CROSS BLUE SHIELD # |
| CL4550 | Other | IL | RAILROAD GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Charles T Shaw |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720086960 PECOS PAC ID: 1254222425 Enrollment ID: I20040329000310 |
| Provider Name | Alexander C Shaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609367119 PECOS PAC ID: 0749616563 Enrollment ID: I20210803001562 |
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