| Hermosa Healthcare Of Chicago Inc. | |
|
2002 N Pulaski Rd Chicago IL 60639-3767 | |
| (773) 772-8876 | |
| Not Available |
| Full Name | Hermosa Healthcare Of Chicago Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2002 N Pulaski Rd, Chicago, Illinois |
| Authorized Official Name and Position | David Kang (PHYSICIAN) |
| Authorized Official Contact | 5804786347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hermosa Healthcare Of Chicago Inc. 2002 N Pulaski Rd Chicago IL 60639-3767 Ph: () - | Hermosa Healthcare Of Chicago Inc. 2002 N Pulaski Rd Chicago IL 60639-3767 Ph: (773) 772-8876 |
| NPI Number | 1013783075 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 11/30/2023 |
| Medicare PECOS PAC ID | 9234577396 |
|---|---|
| Medicare Enrollment ID | O20240409001724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013783075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | David Kang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205276136 PECOS PAC ID: 3678863842 Enrollment ID: I20160628001857 |
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