| Favia Primary Care, Sc | |
|
1340 Ryan Parkway Algonquin IL 60102 | |
| (815) 276-0150 | |
| Not Available |
| Full Name | Favia Primary Care, Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 1340 Ryan Parkway, Algonquin, Illinois |
| Authorized Official Name and Position | Philip Favia (OWNER) |
| Authorized Official Contact | 8152760150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Favia Primary Care, Sc Po Box 336 Algonquin IL 60102-0336 Ph: (815) 276-0150 | Favia Primary Care, Sc 1340 Ryan Parkway Algonquin IL 60102 Ph: (815) 276-0150 |
| NPI Number | 1669964300 |
|---|---|
| Provider Enumeration Date | 05/30/2018 |
| Last Update Date | 04/08/2024 |
| Medicare PECOS PAC ID | 4284983974 |
|---|---|
| Medicare Enrollment ID | O20180814000051 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669964300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-111767 (Illinois) | Primary |
| Provider Name | Philip Favia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295729564 PECOS PAC ID: 6305807249 Enrollment ID: I20041022001180 |
| Provider Name | Haydee Cantu-manley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043638042 PECOS PAC ID: 3678878204 Enrollment ID: I20170829004406 |
| Provider Name | Erin Huggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447907696 PECOS PAC ID: 8820473853 Enrollment ID: I20220912002932 |
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