Gastroenterology Associates Sc | |
3004 N Ashland Ave Chicago IL 60657-3012 | |
(773) 871-4600 | |
(773) 871-2900 |
Full Name | Gastroenterology Associates Sc |
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Speciality | Internal Medicine |
Location | 3004 N Ashland Ave, Chicago, Illinois |
Authorized Official Name and Position | Frank J Konicek (PRESIDENT) |
Authorized Official Contact | 7738714600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Gastroenterology Associates Sc 222 E Dundee Rd Gastroenterology & Associates Sc Wheeling IL 60090-3009 Ph: (847) 520-0235 | Gastroenterology Associates Sc 3004 N Ashland Ave Chicago IL 60657-3012 Ph: (773) 871-4600 |
NPI Number | 1104815018 |
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Provider Enumeration Date | 10/14/2005 |
Last Update Date | 02/19/2008 |
Medicare PECOS PAC ID | 0840376554 |
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Medicare Enrollment ID | O20080320000470 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104815018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
Provider Name | Frank J Konicek |
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Provider Type | Practitioner - Gastroenterology |
Provider Identifiers | NPI Number: 1619966447 PECOS PAC ID: 3577649284 Enrollment ID: I20080320000463 |
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