| Illinois Adult Healthcare Llc | |
|
800 Biesterfield Rd Suite 3007 Elk Grove Village IL 60007-3361 | |
| (847) 290-6513 | |
| (847) 290-8505 |
| Full Name | Illinois Adult Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Biesterfield Rd, Elk Grove Village, Illinois |
| Authorized Official Name and Position | Ilya I Fishman (OWNER/PHYSICIAN) |
| Authorized Official Contact | 7186446778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Adult Healthcare Llc 800 Biesterfield Rd Suite 3007 Elk Grove Village IL 60007-3361 Ph: (847) 290-6513 | Illinois Adult Healthcare Llc 800 Biesterfield Rd Suite 3007 Elk Grove Village IL 60007-3361 Ph: (847) 290-6513 |
| NPI Number | 1407219504 |
|---|---|
| Provider Enumeration Date | 04/05/2016 |
| Last Update Date | 04/05/2016 |
| Medicare PECOS PAC ID | 8921307620 |
|---|---|
| Medicare Enrollment ID | O20160502001498 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407219504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036118688 (Illinois) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 036118688 (Illinois) | Primary |
| Provider Name | Ilya I Fishman |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1346434578 PECOS PAC ID: 8729171632 Enrollment ID: I20070910000299 |
| Provider Name | Shiji Benny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770096489 PECOS PAC ID: 8820358971 Enrollment ID: I20180209000332 |
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