| Hy-vee Health Pc | |
|
1 E Erie St Ste 640 Chicago IL 60611-4756 | |
| (515) 225-2930 | |
| Not Available |
| Full Name | Hy-vee Health Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1 E Erie St Ste 640, Chicago, Illinois |
| Authorized Official Name and Position | Daniel S Fick (CEO) |
| Authorized Official Contact | 5152252930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hy-vee Health Pc 5820 Westown Pkwy West Des Moines IA 50266-8223 Ph: () - | Hy-vee Health Pc 1 E Erie St Ste 640 Chicago IL 60611-4756 Ph: (515) 225-2930 |
| NPI Number | 1992491732 |
|---|---|
| Provider Enumeration Date | 04/14/2023 |
| Last Update Date | 11/03/2023 |
| Medicare PECOS PAC ID | 1254701618 |
|---|---|
| Medicare Enrollment ID | O20230428001806 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992491732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel Fick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457347049 PECOS PAC ID: 3779662168 Enrollment ID: I20230428001926 |
| Provider Name | Cornie Bautista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740063312 PECOS PAC ID: 5496109589 Enrollment ID: I20230922002228 |
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