| For Your Health & Wellness | |
|
401 W Ontario St Suite 220 Chicago IL 60654 | |
| (312) 255-1580 | |
| (312) 255-0783 |
| Full Name | For Your Health & Wellness |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 W Ontario St, Chicago, Illinois |
| Authorized Official Name and Position | Jeffrey A Dugas (PRESIDENT) |
| Authorized Official Contact | 3122551580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| For Your Health & Wellness 401 W Ontario St Suite 220 Chicago IL 60654-6957 Ph: (312) 255-1580 | For Your Health & Wellness 401 W Ontario St Suite 220 Chicago IL 60654 Ph: (312) 255-1580 |
| NPI Number | 1528123973 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 07/17/2015 |
| Medicare PECOS PAC ID | 6608883541 |
|---|---|
| Medicare Enrollment ID | O20060316000580 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528123973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036071610 (Illinois) | Primary |
| Provider Name | Jeffrey A Dugas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760566954 PECOS PAC ID: 8729006663 Enrollment ID: I20051114000156 |
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