| Hospital Services Group Llc | |
|
326 W 64th St 3rd Floor Chicago IL 60621-3114 | |
| (630) 596-7654 | |
| Not Available |
| Full Name | Hospital Services Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 326 W 64th St, Chicago, Illinois |
| Authorized Official Name and Position | Dante Pimentel (ORGANIZER) |
| Authorized Official Contact | 6305967654 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Services Group Llc 326 W 64th St 3rd Floor Chicago IL 60621-3114 Ph: () - | Hospital Services Group Llc 326 W 64th St 3rd Floor Chicago IL 60621-3114 Ph: (630) 596-7654 |
| NPI Number | 1346586096 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 07/22/2022 |
| Medicare PECOS PAC ID | 2466693304 |
|---|---|
| Medicare Enrollment ID | O20130718000716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346586096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036111599 (Illinois) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Dante A Pimentel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972591527 PECOS PAC ID: 5597733014 Enrollment ID: I20040922000909 |
| Provider Name | Chung M Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710914999 PECOS PAC ID: 9830149855 Enrollment ID: I20050128000431 |
| Provider Name | Charles Edoigiawerie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073622957 PECOS PAC ID: 5991732091 Enrollment ID: I20050720000641 |
| Provider Name | Ayoade O Akere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538179379 PECOS PAC ID: 0244252328 Enrollment ID: I20060104000101 |
| Provider Name | Otuonye E Onyewuchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538354295 PECOS PAC ID: 0446312284 Enrollment ID: I20090102000410 |
| Provider Name | Raj Kumar Khurana |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1730166455 PECOS PAC ID: 8628264520 Enrollment ID: I20101117001424 |
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