| Family Medicine For Mchenry County | |
|
1095 Pingree Rd Suite 108 Crystal Lake IL 60014-1725 | |
| (847) 658-2400 | |
| (847) 658-7755 |
| Full Name | Family Medicine For Mchenry County |
|---|---|
| Speciality | Family Medicine |
| Location | 1095 Pingree Rd, Crystal Lake, Illinois |
| Authorized Official Name and Position | Michael Lesser (PRESIDENT) |
| Authorized Official Contact | 8476582400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine For Mchenry County Po Box 1588 Crystal Lake IL 60039-1588 Ph: (847) 658-2400 | Family Medicine For Mchenry County 1095 Pingree Rd Suite 108 Crystal Lake IL 60014-1725 Ph: (847) 658-2400 |
| NPI Number | 1174503510 |
|---|---|
| Provider Enumeration Date | 01/20/2006 |
| Last Update Date | 05/20/2021 |
| Medicare PECOS PAC ID | 0840296240 |
|---|---|
| Medicare Enrollment ID | O20061006000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174503510 | NPI | - | NPPES |
| 5615119 | Other | IL | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael S Lesser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760593032 PECOS PAC ID: 6204832611 Enrollment ID: I20100618000284 |
| Provider Name | Christy A Benton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245342807 PECOS PAC ID: 4082746946 Enrollment ID: I20100713000649 |
| Provider Name | Cynthia G Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609988187 PECOS PAC ID: 3476747726 Enrollment ID: I20101030000200 |
| Provider Name | Allison A. Teliszczak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679941819 PECOS PAC ID: 7214202480 Enrollment ID: I20171013003017 |
| Provider Name | Ashley Lynn Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487347159 PECOS PAC ID: 6406203504 Enrollment ID: I20231110002430 |
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