| Fort Care, Llc | |
|
18241 West St Ste 209 Lansing IL 60438-3200 | |
| (800) 897-4575 | |
| (800) 306-9509 |
| Full Name | Fort Care, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 18241 West St Ste 209, Lansing, Illinois |
| Authorized Official Name and Position | Lateisha Nicole Fort (CEO/PROVIDER) |
| Authorized Official Contact | 7086686971 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Care, Llc 18241 West St Ste 209 Lansing IL 60438-3200 Ph: (800) 897-4575 | Fort Care, Llc 18241 West St Ste 209 Lansing IL 60438-3200 Ph: (800) 897-4575 |
| NPI Number | 1841906047 |
|---|---|
| Provider Enumeration Date | 01/31/2023 |
| Last Update Date | 11/03/2024 |
| Medicare PECOS PAC ID | 8224493176 |
|---|---|
| Medicare Enrollment ID | O20230427001131 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841906047 | NPI | - | NPPES |
| 248004959 | Other | IL | DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION |
| 14D2284487 | Other | IL | CMS CLIA CERTIFICATE OF WAIVER |
| Provider Name | Lateisha Nicole Fort |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275024523 PECOS PAC ID: 2466708102 Enrollment ID: I20180710003116 |
Fabi & Associates Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18127 William St, Lansing, IL 60438 Phone: 708-474-8844 Fax: 708-474-6135 | |
Groups Recover Together - Illinois Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2457 Ridge Rd, Lansing, IL 60438 Phone: 800-683-8313 | |
C F Eye Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18707 Burnham Ave, Lansing, IL 60438 Phone: 708-474-0404 | |
Christian Community Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2320 Thornton Lansing Rd, Lansing, IL 60438 Phone: 773-233-4100 Fax: 773-233-4055 | |
Desired Medical Services Incorporated Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3224 Ridge Rd Ste 201, Lansing, IL 60438 Phone: 708-394-3296 | |
Fort Care, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18241 West St Ste 209, Lansing, IL 60438 Phone: 800-897-4575 Fax: 800-306-9509 |