| Greenbax Health Solutions, Llc | |
|
4922 W Chicago Ave Chicago IL 60651-3142 | |
| (312) 285-7678 | |
| Not Available |
| Full Name | Greenbax Health Solutions, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4922 W Chicago Ave, Chicago, Illinois |
| Authorized Official Name and Position | Gregory C Vachon (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 3122857678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenbax Health Solutions, Llc 4922 W Chicago Ave Chicago IL 60651-3142 Ph: (773) 417-3784 | Greenbax Health Solutions, Llc 4922 W Chicago Ave Chicago IL 60651-3142 Ph: (312) 285-7678 |
| NPI Number | 1538792221 |
|---|---|
| Provider Enumeration Date | 02/20/2020 |
| Last Update Date | 09/23/2020 |
| Medicare PECOS PAC ID | 3375973316 |
|---|---|
| Medicare Enrollment ID | O20200415001978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538792221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tamara L Norsworthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972704658 PECOS PAC ID: 6002904885 Enrollment ID: I20071112000492 |
| Provider Name | Mary Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508127051 PECOS PAC ID: 3678713484 Enrollment ID: I20130627000785 |
| Provider Name | Victor C Okamgba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629434741 PECOS PAC ID: 8628372711 Enrollment ID: I20160210001753 |
| Provider Name | Patricia Grayson-canty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768660 PECOS PAC ID: 9830434497 Enrollment ID: I20181231000732 |
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