| Golf Mill Medical Center Ltd | |
|
7124 W Touhy Ave Niles IL 60714-4526 | |
| (847) 983-8695 | |
| (847) 972-1926 |
| Full Name | Golf Mill Medical Center Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 7124 W Touhy Ave, Niles, Illinois |
| Authorized Official Name and Position | Edward E Hernaez (MD) |
| Authorized Official Contact | 8479838695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golf Mill Medical Center Ltd 7124 W Touhy Ave Niles IL 60714-4526 Ph: (847) 983-8695 | Golf Mill Medical Center Ltd 7124 W Touhy Ave Niles IL 60714-4526 Ph: (847) 983-8695 |
| NPI Number | 1447356696 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 02/22/2013 |
| Medicare PECOS PAC ID | 2860416963 |
|---|---|
| Medicare Enrollment ID | O20060117000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447356696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036093705 (Illinois) | Primary |
| 208000000X | Pediatrics | 036083674 (Illinois) | Secondary |
| Provider Name | Edward E Hernaez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417001108 PECOS PAC ID: 2668496761 Enrollment ID: I20121012000834 |
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