| Foundation For Outreach Services | |
|
326 W 64th St Chicago IL 60621-3114 | |
| (773) 962-4100 | |
| Not Available |
| Full Name | Foundation For Outreach Services |
|---|---|
| Speciality | Family Medicine |
| Location | 326 W 64th St, Chicago, Illinois |
| Authorized Official Name and Position | Charles Holland (CEO) |
| Authorized Official Contact | 7739624100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundation For Outreach Services 326 W 64th St Chicago IL 60621-3114 Ph: () - | Foundation For Outreach Services 326 W 64th St Chicago IL 60621-3114 Ph: (773) 962-4100 |
| NPI Number | 1316350242 |
|---|---|
| Provider Enumeration Date | 06/09/2014 |
| Last Update Date | 06/09/2014 |
| Medicare PECOS PAC ID | 3375507163 |
|---|---|
| Medicare Enrollment ID | O20041111001020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316350242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Krish G Venoo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487829834 PECOS PAC ID: 1153227194 Enrollment ID: I20031210000335 |
| Provider Name | Adel A Zayyad |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497722706 PECOS PAC ID: 8921909862 Enrollment ID: I20040115000170 |
| Provider Name | Ralph C Menezes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568417996 PECOS PAC ID: 2961398508 Enrollment ID: I20040223000430 |
| Provider Name | Eliyazar Gaddam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073561858 PECOS PAC ID: 0749274140 Enrollment ID: I20040409000013 |
| Provider Name | David N Butler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083821037 PECOS PAC ID: 8729050240 Enrollment ID: I20040809000194 |
| Provider Name | Bassam Osman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215937628 PECOS PAC ID: 1052372620 Enrollment ID: I20041027000492 |
| Provider Name | Daria B Terrell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477532364 PECOS PAC ID: 5991769002 Enrollment ID: I20041118000322 |
| Provider Name | Chung M Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710914999 PECOS PAC ID: 9830149855 Enrollment ID: I20050128000431 |
| Provider Name | Gary L Williams |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396711073 PECOS PAC ID: 4587692496 Enrollment ID: I20050802000259 |
| Provider Name | Bhavana P Vaidya |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437141108 PECOS PAC ID: 2264459767 Enrollment ID: I20051024000964 |
| Provider Name | Alan C Pollak |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790734069 PECOS PAC ID: 6507885944 Enrollment ID: I20051115000937 |
| Provider Name | Laura K Sanders |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1366591711 PECOS PAC ID: 3678676111 Enrollment ID: I20070321000377 |
| Provider Name | Soberekon M Koko |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992918866 PECOS PAC ID: 2860590528 Enrollment ID: I20070605000202 |
| Provider Name | Winston F Burke |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619068038 PECOS PAC ID: 1951488691 Enrollment ID: I20080404000844 |
| Provider Name | Phillip D Rosett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780692863 PECOS PAC ID: 9537248240 Enrollment ID: I20080507000122 |
| Provider Name | Dilipkumar K Parikh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376527044 PECOS PAC ID: 8628033677 Enrollment ID: I20080611000029 |
| Provider Name | Tahir A Abbasi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255495701 PECOS PAC ID: 0446215495 Enrollment ID: I20080701000569 |
| Provider Name | Ping Chan |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1649247586 PECOS PAC ID: 4587722285 Enrollment ID: I20081024000288 |
| Provider Name | Robert C Owens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598707481 PECOS PAC ID: 5991861841 Enrollment ID: I20090302000627 |
| Provider Name | Shanti Seker |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1437237476 PECOS PAC ID: 9436291333 Enrollment ID: I20100114000628 |
| Provider Name | Ryan J Malcom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992898217 PECOS PAC ID: 3274662689 Enrollment ID: I20100524000498 |
| Provider Name | Alemayehu Bekele |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184608879 PECOS PAC ID: 9931224920 Enrollment ID: I20100914001011 |
| Provider Name | Charles R Harris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508979758 PECOS PAC ID: 2860466497 Enrollment ID: I20101021001420 |
| Provider Name | Sheldon Lazar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275525172 PECOS PAC ID: 3870781685 Enrollment ID: I20101221000592 |
| Provider Name | Jocelyn A Rowe |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1902023864 PECOS PAC ID: 7315063351 Enrollment ID: I20111105000050 |
| Provider Name | John C Wu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033281506 PECOS PAC ID: 2860652567 Enrollment ID: I20120404000055 |
| Provider Name | Min Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386887701 PECOS PAC ID: 4880830546 Enrollment ID: I20130814000421 |
| Provider Name | Regina Mathews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477982270 PECOS PAC ID: 9739311242 Enrollment ID: I20140416001242 |
| Provider Name | Wyvon L Blackwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821398397 PECOS PAC ID: 8123340403 Enrollment ID: I20141124001757 |
| Provider Name | Vietta Louise Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285686899 PECOS PAC ID: 7911910971 Enrollment ID: I20150515001029 |
| Provider Name | Lanneka White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548662141 PECOS PAC ID: 0244551521 Enrollment ID: I20150611002746 |
| Provider Name | Teslim O Opakunle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922487370 PECOS PAC ID: 9537416961 Enrollment ID: I20180717001906 |
| Provider Name | Jessica L Frith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003463 PECOS PAC ID: 4880947902 Enrollment ID: I20181018003082 |
| Provider Name | Wanda S Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386207306 PECOS PAC ID: 2668707225 Enrollment ID: I20190718001746 |
| Provider Name | Shakira A Ayanlaja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003371717 PECOS PAC ID: 3577892736 Enrollment ID: I20190912002785 |
| Provider Name | Bimbola M Amoranbini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770145278 PECOS PAC ID: 8123450863 Enrollment ID: I20191118001914 |
| Provider Name | Biaisha Y Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437687464 PECOS PAC ID: 3476986985 Enrollment ID: I20191213000505 |
| Provider Name | Lashaun B Dumas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912255290 PECOS PAC ID: 7517396229 Enrollment ID: I20200401000815 |
| Provider Name | Sunil Sam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366934176 PECOS PAC ID: 5193146942 Enrollment ID: I20200602002902 |
| Provider Name | Erica D Dent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053980334 PECOS PAC ID: 1658464003 Enrollment ID: I20220623001882 |
| Provider Name | Shilpa Pulluru |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700452596 PECOS PAC ID: 0840647160 Enrollment ID: I20231108001886 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 | |
A Kavaliunas Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 | |
Doc Cam Medical Center Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 | |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 | |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 | |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 | |
Premier Primary Care And Alternative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1301 E 47th Street, Bldg 2 Suite B, Chicago, IL 60653 Phone: 773-891-2890 Fax: 773-891-4107 |