| Family Medical Center | |
|
52 N Wolf Rd Wheeling IL 60090-2901 | |
| (847) 465-0401 | |
| Not Available |
| Full Name | Family Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 52 N Wolf Rd, Wheeling, Illinois |
| Authorized Official Name and Position | Jorge E. Brunelle (PRESIDENT) |
| Authorized Official Contact | 8474650401 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center 52 N Wolf Rd Wheeling IL 60090-2901 Ph: (847) 465-0401 | Family Medical Center 52 N Wolf Rd Wheeling IL 60090-2901 Ph: (847) 465-0401 |
| NPI Number | 1922300086 |
|---|---|
| Provider Enumeration Date | 11/23/2010 |
| Last Update Date | 01/05/2011 |
| Medicare PECOS PAC ID | 1759560816 |
|---|---|
| Medicare Enrollment ID | O20110121000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922300086 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 36-097428 (Illinois) | Primary |
| Provider Name | Jorge E Brunelle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164443438 PECOS PAC ID: 6901804020 Enrollment ID: I20061207000030 |
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