Family Health Care Of Cissna Park | |
510 Prairie Ln Unit B Cissna Park IL 60924-9710 | |
(815) 457-2000 | |
(815) 457-2015 |
Full Name | Family Health Care Of Cissna Park |
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Speciality | Clinic/Center |
Location | 510 Prairie Ln Unit B, Cissna Park, Illinois |
Authorized Official Name and Position | Matthew Ertel (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2177842601 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Health Care Of Cissna Park 510 Prairie Ln Unit B Cissna Park IL 60924-9710 Ph: (815) 457-2000 | Family Health Care Of Cissna Park 510 Prairie Ln Unit B Cissna Park IL 60924-9710 Ph: (815) 457-2000 |
NPI Number | 1356884993 |
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Provider Enumeration Date | 11/30/2016 |
Last Update Date | 02/04/2022 |
Medicare PECOS PAC ID | 5092703124 |
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Medicare Enrollment ID | O20170111000757 |
Identifier | Type | State | Issuer |
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1356884993 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Cissna Park Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 141 W. Garfield Ave, Cissna Park, IL 60924 Phone: 217-283-5531 Fax: 217-283-7981 |