Gude Medical S C | |
2302 Twilight Dr Aurora IL 60503-6704 | |
(630) 636-1809 | |
Not Available |
Full Name | Gude Medical S C |
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Speciality | Family Medicine |
Location | 2302 Twilight Dr, Aurora, Illinois |
Authorized Official Name and Position | Charlie Gude (PRESIDENT) |
Authorized Official Contact | 6306361809 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gude Medical S C 2302 Twilight Dr Aurora IL 60503-6704 Ph: (630) 636-1809 | Gude Medical S C 2302 Twilight Dr Aurora IL 60503-6704 Ph: (630) 636-1809 |
NPI Number | 1710612486 |
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Provider Enumeration Date | 07/18/2022 |
Last Update Date | 08/29/2022 |
Medicare PECOS PAC ID | 6406238385 |
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Medicare Enrollment ID | O20220809003181 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710612486 | NPI | - | NPPES |
036101250 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
Provider Name | Charlie F Gude |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336202894 PECOS PAC ID: 8123928249 Enrollment ID: I20050426000161 |
Provider Name | Tracey M Davenport |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114033826 PECOS PAC ID: 5799703245 Enrollment ID: I20051103000670 |
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