| Family Medicine Of Illinois Sc | |
|
1507 S Falcon Dr Libertyville IL 60048-4897 | |
| (847) 494-0265 | |
| Not Available |
| Full Name | Family Medicine Of Illinois Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1507 S Falcon Dr, Libertyville, Illinois |
| Authorized Official Name and Position | Syeda Aisha Iftikhar (PHYSICIAN) |
| Authorized Official Contact | 2245678371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Of Illinois Sc 1507 S Falcon Dr Libertyville IL 60048-4897 Ph: (847) 494-0265 | Family Medicine Of Illinois Sc 1507 S Falcon Dr Libertyville IL 60048-4897 Ph: (847) 494-0265 |
| NPI Number | 1447426879 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 02/03/2021 |
| Medicare PECOS PAC ID | 8527138494 |
|---|---|
| Medicare Enrollment ID | O20080604000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447426879 | NPI | - | NPPES |
| 036102332 | Medicaid | IL | |
| 207R00000X | Other | TAXONOMY SPECIALITY CODE | |
| 1770599938 | Other | NE | NPI INDIVIDUAL NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036102332 (Illinois) | Primary |
| Provider Name | Syeda A Iftikhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770599938 PECOS PAC ID: 4385652387 Enrollment ID: I20080111000724 |
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