| Firstmdvip | |
|
222 W Ontario St Ste 230 Chicago IL 60654-3653 | |
| (312) 772-5040 | |
| (248) 294-1235 |
| Full Name | Firstmdvip |
|---|---|
| Speciality | Internal Medicine |
| Location | 222 W Ontario St Ste 230, Chicago, Illinois |
| Authorized Official Name and Position | Ranjit K Dhelaria (PRESIDENT/OWNER) |
| Authorized Official Contact | 6822350825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Firstmdvip 222 W Ontario St Ste 230 Chicago IL 60654-3653 Ph: (312) 772-5040 | Firstmdvip 222 W Ontario St Ste 230 Chicago IL 60654-3653 Ph: (312) 772-5040 |
| NPI Number | 1467222919 |
|---|---|
| Provider Enumeration Date | 01/05/2024 |
| Last Update Date | 03/26/2024 |
| Medicare PECOS PAC ID | 4880032283 |
|---|---|
| Medicare Enrollment ID | O20240404001387 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467222919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ranjit Kumar Dhelaria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386891315 PECOS PAC ID: 1456539915 Enrollment ID: I20240404001534 |
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