| Genesis Integrative Medicine Llc | |
|
1881 S Randall Rd Ste C Geneva IL 60134-2532 | |
| (331) 442-4132 | |
| Not Available |
| Full Name | Genesis Integrative Medicine Llc |
|---|---|
| Speciality | General Practice |
| Location | 1881 S Randall Rd Ste C, Geneva, Illinois |
| Authorized Official Name and Position | Nathan Conroy (OWNER) |
| Authorized Official Contact | 3314424132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Integrative Medicine Llc 1881 S Randall Rd Ste C Geneva IL 60134-2532 Ph: () - | Genesis Integrative Medicine Llc 1881 S Randall Rd Ste C Geneva IL 60134-2532 Ph: (331) 442-4132 |
| NPI Number | 1306311725 |
|---|---|
| Provider Enumeration Date | 10/11/2018 |
| Last Update Date | 10/11/2018 |
| Medicare PECOS PAC ID | 0143659433 |
|---|---|
| Medicare Enrollment ID | O20200408000958 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306311725 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Anthony S Leazzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912056995 PECOS PAC ID: 5698722767 Enrollment ID: I20050401000046 |
| Provider Name | Nathan Adam Conroy |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1023116456 PECOS PAC ID: 8820198740 Enrollment ID: I20070706000464 |
| Provider Name | Heather M Creed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457712929 PECOS PAC ID: 5698073286 Enrollment ID: I20160414002113 |
| Provider Name | Therese G Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881239549 PECOS PAC ID: 9436589371 Enrollment ID: I20200417000257 |
| Provider Name | Stephanie M Schuster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164021168 PECOS PAC ID: 6204244379 Enrollment ID: I20210412000032 |
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