| Hcpan Llc | |
|
12450 Walker Rd Lemont IL 60439-9301 | |
| (708) 478-7201 | |
| (708) 221-6766 |
| Full Name | Hcpan Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 12450 Walker Rd, Lemont, Illinois |
| Authorized Official Name and Position | Adel Mouradi (PRESIDENT) |
| Authorized Official Contact | 7088292198 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hcpan Llc 1042 Maple Ave Ste 335 Lisle IL 60532-2329 Ph: (708) 336-0419 | Hcpan Llc 12450 Walker Rd Lemont IL 60439-9301 Ph: (708) 478-7201 |
| NPI Number | 1528679347 |
|---|---|
| Provider Enumeration Date | 08/14/2020 |
| Last Update Date | 08/14/2020 |
| Medicare PECOS PAC ID | 5395155097 |
|---|---|
| Medicare Enrollment ID | O20201109002356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528679347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Jennifer C Johansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992933188 PECOS PAC ID: 1557415213 Enrollment ID: I20090813000826 |
| Provider Name | Manamar Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770899221 PECOS PAC ID: 2769616598 Enrollment ID: I20131010001584 |
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