| Health Care One Sc | |
|
4921 N Western Ave Chicago IL 60625-1921 | |
| (773) 478-5600 | |
| (773) 478-5602 |
| Full Name | Health Care One Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4921 N Western Ave, Chicago, Illinois |
| Authorized Official Name and Position | George Sianis (PRESIDENT) |
| Authorized Official Contact | 7734785600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Care One Sc 4921 N Western Ave Chicago IL 60625-1921 Ph: (773) 478-5600 | Health Care One Sc 4921 N Western Ave Chicago IL 60625-1921 Ph: (773) 478-5600 |
| NPI Number | 1902836687 |
|---|---|
| Provider Enumeration Date | 07/05/2006 |
| Last Update Date | 12/04/2023 |
| Medicare PECOS PAC ID | 6608823810 |
|---|---|
| Medicare Enrollment ID | O20050331000120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902836687 | NPI | - | NPPES |
| DF7575 | Other | IL | RAILROAD MEDICARE |
| 01635073 | Other | IL | BCBS |
| 14D0907680 | Other | IL | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | George J Sianis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255366191 PECOS PAC ID: 1153378369 Enrollment ID: I20050401000013 |
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