| Flossmoor Family Care, S.c. | |
|
19150 Kedzie Ave Suite 207 Flossmoor IL 60422 | |
| (708) 799-9700 | |
| Not Available |
| Full Name | Flossmoor Family Care, S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 19150 Kedzie Ave, Flossmoor, Illinois |
| Authorized Official Name and Position | Shelanda Hayes (OWNER) |
| Authorized Official Contact | 7087999700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Flossmoor Family Care, S.c. 19150 Kedzie Ave Suite 207 Flossmoor IL 60422 Ph: (708) 799-9700 | Flossmoor Family Care, S.c. 19150 Kedzie Ave Suite 207 Flossmoor IL 60422 Ph: (708) 799-9700 |
| NPI Number | 1366836132 |
|---|---|
| Provider Enumeration Date | 03/19/2015 |
| Last Update Date | 10/15/2015 |
| Medicare PECOS PAC ID | 7315224607 |
|---|---|
| Medicare Enrollment ID | O20170516001315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366836132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036108398 (Illinois) | Primary |
| Provider Name | Shelanda Charise Hayes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528194131 PECOS PAC ID: 4587679014 Enrollment ID: I20060220000479 |
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