| J C Medical Group Ltd | |
|
10551 S Ewing Ave Chicago IL 60617-6220 | |
| (312) 565-2251 | |
| (630) 590-5132 |
| Full Name | J C Medical Group Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10551 S Ewing Ave, Chicago, Illinois |
| Authorized Official Name and Position | Jolly C Anand (PRESIDENT) |
| Authorized Official Contact | 3125652251 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J C Medical Group Ltd 8900 S County Line Rd Burr Ridge IL 60527-6321 Ph: (312) 565-2251 | J C Medical Group Ltd 10551 S Ewing Ave Chicago IL 60617-6220 Ph: (312) 565-2251 |
| NPI Number | 1407961592 |
|---|---|
| Provider Enumeration Date | 08/20/2006 |
| Last Update Date | 07/02/2009 |
| Medicare PECOS PAC ID | 4082668405 |
|---|---|
| Medicare Enrollment ID | O20050309000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407961592 | NPI | - | NPPES |
| 1621630 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mohammad R Butt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881722833 PECOS PAC ID: 8820081870 Enrollment ID: I20040406000269 |
| Provider Name | Chandra S Anand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962439646 PECOS PAC ID: 2163419938 Enrollment ID: I20040426001450 |
| Provider Name | Jolly C Anand |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962515056 PECOS PAC ID: 3870547102 Enrollment ID: I20050309000455 |
| Provider Name | Madhu Shree Gundavaram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699796920 PECOS PAC ID: 7315972940 Enrollment ID: I20051003000021 |
| Provider Name | Crystal Marie Smith-coleman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972516664 PECOS PAC ID: 2860498995 Enrollment ID: I20061013000134 |
| Provider Name | Lisa C Yeh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740372788 PECOS PAC ID: 6204935810 Enrollment ID: I20070622000231 |
| Provider Name | Charles L Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003859554 PECOS PAC ID: 0749346070 Enrollment ID: I20090311000413 |
| Provider Name | Franz R Hinojosa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043521412 PECOS PAC ID: 3577750553 Enrollment ID: I20101203000672 |
| Provider Name | Ronald D Gordineer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700018785 PECOS PAC ID: 9537212253 Enrollment ID: I20120111000065 |
| Provider Name | Felix Ngeh Fonge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386994812 PECOS PAC ID: 1153574462 Enrollment ID: I20130118000145 |
| Provider Name | Patricia A Vowal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063832541 PECOS PAC ID: 1850516444 Enrollment ID: I20140716000972 |
| Provider Name | Chiriss Mcgraw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851700637 PECOS PAC ID: 1355667809 Enrollment ID: I20150228000148 |
| Provider Name | Hyunchai Park |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326448523 PECOS PAC ID: 0244558922 Enrollment ID: I20150408002109 |
| Provider Name | Oladimeji M Kassim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861885675 PECOS PAC ID: 8224341938 Enrollment ID: I20150723007351 |
| Provider Name | Oluseun Osinowo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548614431 PECOS PAC ID: 6507164803 Enrollment ID: I20160420001307 |
| Provider Name | Miciah B Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023479417 PECOS PAC ID: 4789973348 Enrollment ID: I20160520001066 |
| Provider Name | Idayat A Adekunle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427415207 PECOS PAC ID: 5294025565 Enrollment ID: I20160531000360 |
| Provider Name | Rozina A Virani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538572664 PECOS PAC ID: 0648561340 Enrollment ID: I20160628001921 |
| Provider Name | Candice Michelle Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528471059 PECOS PAC ID: 6204104888 Enrollment ID: I20170623000090 |
| Provider Name | Ngozi V Ubaghara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821583899 PECOS PAC ID: 1557592748 Enrollment ID: I20181115001497 |
| Provider Name | Comfort O Lacy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497221162 PECOS PAC ID: 6507107364 Enrollment ID: I20190404002810 |
| Provider Name | Foluke I Omoyeni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366985798 PECOS PAC ID: 4486938404 Enrollment ID: I20190408001734 |
| Provider Name | Bashiru Babawale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982163085 PECOS PAC ID: 5890028534 Enrollment ID: I20190912001690 |
| Provider Name | Bukola Odusote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124670948 PECOS PAC ID: 0840622577 Enrollment ID: I20191118001455 |
| Provider Name | Bimbola M Amoranbini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770145278 PECOS PAC ID: 8123450863 Enrollment ID: I20191118001914 |
| Provider Name | Julius A Njeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023669538 PECOS PAC ID: 7911328836 Enrollment ID: I20200602000935 |
| Provider Name | Sunil Sam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366934176 PECOS PAC ID: 5193146942 Enrollment ID: I20200602002902 |
| Provider Name | Ugonwa Gloria Izuegbu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750903159 PECOS PAC ID: 9032529565 Enrollment ID: I20201111002406 |
| Provider Name | Mojisola Akinfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497369672 PECOS PAC ID: 9436565074 Enrollment ID: I20210308000432 |
| Provider Name | Jawanda N Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003583675 PECOS PAC ID: 6103224811 Enrollment ID: I20211011002762 |
| Provider Name | Kristlin Weathersby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912646159 PECOS PAC ID: 8820478498 Enrollment ID: I20220629002740 |
| Provider Name | Joseph Olusola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649907536 PECOS PAC ID: 4587940853 Enrollment ID: I20230105001126 |
| Provider Name | Modupe O Adefeso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134832512 PECOS PAC ID: 0446611347 Enrollment ID: I20230725001062 |
| Provider Name | Ayuk-nje S Akat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750076485 PECOS PAC ID: 3678937653 Enrollment ID: I20230908002158 |
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