| Glen Flora Medical Clinic | |
|
935 Glen Flora Ave Ste 201 Waukegan IL 60085 | |
| (847) 249-3322 | |
| (847) 249-3381 |
| Full Name | Glen Flora Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 935 Glen Flora Ave, Waukegan, Illinois |
| Authorized Official Name and Position | Campo E Suescun (OWNER) |
| Authorized Official Contact | 8472493322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Flora Medical Clinic 935 Glen Flora Ave Ste 201 Waukegan IL 60085 Ph: (847) 249-3322 | Glen Flora Medical Clinic 935 Glen Flora Ave Ste 201 Waukegan IL 60085 Ph: (847) 249-3322 |
| NPI Number | 1003893017 |
|---|---|
| Provider Enumeration Date | 12/30/2005 |
| Last Update Date | 03/07/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003893017 | NPI | - | NPPES |
| 036099235 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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